UK public services need more cash to stop further decline, damning report says

Britain’s crisis-hit public services will not recover before the next election and may require significant cash injections to prevent further decline, according to a bleak annual review by the Institute for Government, a non-partisan think tank. – tank.

After nearly 13 years of austerity and severe damage to public sector capacity as a result of the pandemic, the IfG report said “it is unclear whether the government will find existing funding levels to be politically sustainable ahead of the next election”, which it must to be called by the end of 2024.

He added: “The situation will be even more difficult for whoever forms the next government.”

The authors predict that, under current policy, “hospital waiting times and lists will remain above what they were in 2019, students will not make up for lost learning and the market for social care providers will not be sustainable long-term financial base. . . The situation in prisons and courts is arguably worse.”

While budget increases already announced in the Autumn Statement in November should allow hospitals, GP practices, schools and local government services to avoid real cuts for the rest of this Parliament, the cost of higher pay that can be given to end the recent strikes would require compensating cuts in non-payroll budgets.

The report also concludes that the current budget “does not provide the level of funding required for significant performance improvements”.

There is room for help: this week, Jeremy Hunt, the chancellor of the exchequer, learned that the public finances had more short-term slack than expected, with the level of borrowing so far this financial year around £30bn lower than predicted. .

The state of the NHS has been identified as a major issue for voters. In a recent poll by Redfield and Wilton, for example, more than half of respondents said it was one of their top three concerns – behind only the economy.

The IfG noted that the number of people on waiting lists for treatment is now around 7.2 million — more than one in eight people in England. At the beginning of the pandemic, the corresponding figure was 4.4 million. The number of people waiting at least a year for treatment, which was 3,300 in March 2020, is around 400,000.

A key problem in combating this backlog is that the health service is still not operating at the same speed as before the pandemic. For example, the number of diagnostic tests each month has not yet returned to pre-2020 levels. The number of patients now waiting long periods for tests, something extremely rare before the pandemic, is increasing.

Line graph of NHS tests and patients waiting for tests (mn) showing NHS test numbers still below pre-pandemic trends

Stuart Hoddinott, a researcher at the IfG, identified many of these problems in the 13 years of austerity since the financial crisis. “Our testing capacity is massively constrained by a lack of capital investment over the past decade,” he said.

“Yes, the pandemic has had a huge impact. But you can see big declines in NHS performance up until the 2010s. It didn’t have resilience when it started,” he added.

Some of the NHS’s problems stem from issues in the social care system, which is largely funded by cash-strapped local authorities that have had their own funding cut by central government.

The service itself is underwhelming. During the pandemic, requests for care dropped — but only temporarily. And the sector, which tends to pay less than the NHS, struggles to recruit and retain staff.

As a result, the care system has struggled, leaving people who should be treated stranded in hospitals. This week, NHS England said that at one point this winter, more than 14,000 hospital beds were occupied by patients medically fit for discharge.

Display line chart There is a growing staffing problem in the adult social care service

The IfG noted: “The workforce crisis that eased briefly during the first year of the pandemic is now worse than ever, with 50,000 fewer social care workforce posts filled in March 2022 than at the same point in previous year and the highest vacancy rate on record.”

The authors pointed to similar problems in other parts of the state. Staffing is a serious problem in schools: adjusted for subject mix, the number of teachers required to train in England in 2022-23 was 44 per cent below target. England recruited just 17 per cent of its target number of trainee physics teachers.

The IfG estimated that the government is also likely to fail in its bid to recruit 20,000 new police officers.

However, of much greater concern is the performance of the judicial system. The proportion of reported crimes in England and Wales that result in charges has fallen from 17.2 per cent in 2013-14 to 5.6 per cent in 2021-22.

Line graph Percentage of police recorded crime in England and Wales leading to a charge/summons (%) showing fewer crimes leading to charges

This has led to a sharp decline in cases brought to court — and yet the judiciary and prison system have been overwhelmed. The report notes: “Progress in dealing with the crown court backlog will be slow and the prison service will find it very difficult to safely house the expected increase in prisoner numbers.”

Angela Rayner, deputy leader of the Labor Party, described the report as “a damning verdict on 13 years of Tory mismanagement” of Britain’s public services.

“The failure of the Tories to conquer and resolve differences has added insult to injury after a decade of failing to tackle the cost of living crisis,” he said. “While the Tories are managing decline and wallowing in failure, only Labor has a concrete plan for national renewal underpinned by growth.”

A government spokesman said: “In the last Autumn Statement, we set out how we will protect our vital public services. We have prioritized further investment with up to £14.1 billion available for the NHS and social care, an extra £2.3 billion a year for schools and we are also giving policing an extra £1.1 billion to tackle crime in the areas which have been most affected. “

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