Was there a big cut to NHS frontline services buried in the budget?

Rishi Sunak barely mentioned the NHS in his budget. So what’s the issue?

Labour claims the chancellor has quietly cut the Department of Health and Social Care’s (DHSC) budget for 2021-22 by £30.1bn. Jonathan Ashworth, the shadow health secretary, said: “Rishi Sunak promised to be ‘open and honest’ with the British public. But buried in the small print of his budget is a cut to frontline NHS services that will increase pressure on staff and do nothing for patients stuck on growing waiting lists.”

Is Ashworth right?

No. The reduction in the DHSC’s budget only relates to the extra costs it and the NHS in England have incurred from tackling the Covid-19 pandemic over the last year. That has involved spending billions on personal protective equipment (PPE) for staff and £22bn on the government’s test-and-trace programme, which has performed poorly. Importantly, despite Ashworth’s claim, the budget cut does not relate to frontline NHS services such as A&E care, diagnostic tests, surgery and outpatient appointments.

What are the sums of money involved here?

The Treasury gave the DHSC an extra £58.9bn in emergency additional funding this year to cover the huge extra costs resulting from the pandemic, which took its total budget for this year up to £199.2bn. However, in the new year starting on 1 April, Matt Hancock’s department will receive just £22bn over and above its core budget for Covid expenses. That means its overall budget will fall to £169.1bn.

Ashworth depicts the difference between those two sums as a £30.1bn “cut to frontline NHS services”. It is not, though. The extra £58.9bn was exceptional, and by definition temporary, funding. It was never meant to be permanent. With the pandemic receding for now, and a huge stockpile of PPE stored in warehouses, the DHSC is receiving much less this year than last from the Treasury.

So what is happening to the money the DHSC receives to fund normal NHS services?

This involves what in Whitehall speak is called the DHSC’s “resource departmental expenditure level (DEL or RDEL)”. It is actually going up, from £140.3bn this year to £147.1bn – an increase of £6.8bn.

But many NHS organisations are unhappy about the budget. Why is that?

The NHS Confederation (hospital trust bosses), British Medical Association (doctors) and the Health Foundation thinktank say the NHS in England needs at least £10bn more in 2021-22 to meet the extra costs Covid has caused, notably a big backlog of surgery and extra demand for mental health care. Sunak gave the service £3bn more in 2021-22 for those things in his autumn statement last November. But the confederation says that is “not enough”. They point to the fact that 4.5 million people are waiting to have treatment in hospital such as an operation – the highest number on record – and that it is estimated up to 10 million people, or almost 20% of England’s population, will need either new or extra mental health support as a direct result of the pandemic.