The Chancellor has labelled this the ‘Budget for Growth’ and has a number of aims to level up the country, focusing on supporting people ‘in work’. There are several inclusions relevant for the NHS and for families, including:
- An increase in the pensions tax free allowance from £40,000 to £60,000 and the lifetime allowance to be abolished entirely from April 2024. The budget documents state that this will mean “an estimated 80% of NHS doctors will not receive a tax charge with respect to accruals under the 2015 NHS career average scheme”.
- Providing 30 hours a week of free childcare for 38 weeks a year, for eligible working parents of children aged 9 months to 3 years. This will be rolled out in phases from April 2024 and is in addition to the 30 hours a week already provided for eligible working parents of 3 to 4-year-olds.
- The energy price guarantee will continue for another three months “capping” bills at £2,500.
In response to the budget, RCPCH President Dr Camilla Kingdon said:
NHS pension rules have placed a burden on the NHS for some time; ultimately causing many of our most senior colleagues to scale back their work or be forced into taking early retirement.* We have been urgently calling for pension reform from government, and it is useful to see the steps outlined today by the Chancellor. Paediatric services rely heavily on senior clinicians and specialist expertise and the changes announced today are positive steps, which we hope helps retain staff. However, on its own these changes are not enough.
It is positive to hear from the Chancellor that the long-term NHS workforce plan is imminent. We are clear this must include detailed figures backed up by funding and make inclusions around the health and wellbeing of staff so they can truly thrive. Only when our NHS staff are fully invested in and supported can they deliver the best care for patients.
At the same time, the children’s health system is under unparalleled pressure, child health outcomes are worsening in the UK, chronic conditions associated with obesity, mental health and poverty are on the rise, and waiting lists are getting longer. Supporting our workforce to stay longer is useful, but it is not a quick fix and real investment is needed in all child health services and prevention.
Unfortunately, we cannot help but notice in this budget a clear disconnect between the Chancellor’s desire to help people back into work and recognising that investing in child health is essential to achieving this goal in the long term.
Today’s budget may have a short-term impact in the retention of staff through pension reform and in encouraging those who can back into the workforce, but it lacked much-needed investments in good health and prevention, especially in childhood. We are yet to see any action on extending free school meals or providing ring-fenced funding for the recovery of child health services whether in hospital or the community.
This budget has been a missed opportunity to transform child health for the benefit of our future generation of adults.
* In a survey last year of RCPCH members, 59% of respondents believe that pension-related tax bills led to a reduction in paediatric services and 79% are likely to retire earlier because of this issue.