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Government plays 'cheap tricks' with STP funds

Philip Hammond outside number 11
HAMMOND: Progress is being made by STPs

The Government has been accused of playing ‘cheap tricks’ with health service funding after it emerged that promised capital for STP (sustainability and transformation plan) projects would be spread over three years.

Chancellor Philip Hammond told Parliament, while delivering his budget earlier this month, that £325m of capital would be made available to those plans now ready for investment – seemingly implying the money was available upfront.

Mr Hammond said the funding would be given to the ‘strongest’ STP areas ready to proceed ahead of the Autumn budget – with a fuller funding package, including a ‘multi-year capital programme’, to be announced later in the year.

Despite the promise, however, the Government’s budget document reveals that the actual capital on offer is £130m for this year, with further tranches to follow in future years.

BMA deputy council chair David Wrigley described the figures as ‘paltry’ and said the Government had got away with an ‘accounting trick’.

He said: ‘While the Government’s U-turn on NI rates has dominated the headlines the chancellor appears to have got away with yet another cheap trick on health spending. Nearly two thirds of the capital announced for STPs has vanished in an accounting trick and will not be seen for months or years – if at all.

‘Speaking to Parliament Mr Hammond appeared to be clear that this money was for those STP projects ready to go ahead now and that the situation would be addressed again in the Autumn, but only a paltry amount remains and the £130 million available will make little or no impact.

‘There is nothing sustainable about asking the health service to design its own future and then ignoring its needs, and there is nothing transformative about providing around 100 times less than the capital funding that these plans require.

‘This is the same Government that regularly claims the NHS is fully funded and gave us a fictitious claim of having injected £10bn into the health service.

'It is time the Government is open and honest with the public and with those who work in our brilliant NHS – the health service cannot be forced to limp from one crisis to another with only sticking plasters to help. The NHS is in crisis and urgent action is required.’


Capital question

The issue of capital funding for STP projects was thrust into the spotlight earlier this year when BMA research found that at least £9.5bn of upfront cash would be needed to get the plans off the ground.

Despite each of the 44 STP footprint areas giving their realistic assessment of the cash needed it is unlikely anything like the capital required will be available – and local and national leaders are now picking individual projects to support.

Speaking in Parliament on 8 March Mr Hammond said the Government recognised the progress being made by STPs.

He said: ‘We recognise, too, that in addition to the funding already committed, some of those plans will require further capital investment.

‘So the Treasury will work closely with the Department of Health over the course of the summer as the STPs are progressed and prioritised.

‘And at Autumn budget I will announce a multi-year capital programme to support implementation of approved high quality STPs.’

Mr Hammond added: ‘In the meantime, [the health secretary] expects that a small number of the strongest STPs may be ready ahead of Autumn budget.

‘And so I am allocating an additional £325m of capital to allow the first selected plans to proceed.’


Project unravelling

The £325m promised would just cover the costs of implementing just one of the 44 STPs – the South West London STP, which needs £320m of capital.

But with the written budget revealing the amount available this year to be just £130m, the announced funding looks even less likely to make a major difference.

And last month the BMA reported that NHS leaders had raided capital coffers to pay for running costs again – leaving little upfront funding left.

BMA News asked the Treasury and the Department of Health for a comment.

The Treasury refused to give an on-the-record statement but told BMA News that the STP projects were ‘forward-looking’ and that the chancellor had made it clear that money was being made available to support the plans.

The spokesperson said the money being spread over three years had not been hidden.

In The Government’s mandate to NHS England for 2017-18 presented to Parliament yesterday health secretary Jeremy Hunt writes: '2017-18 should be the year in which we see concrete progress on local STPs, with NHS England supporting local leaders to work with their communities to drive real improvements in patient care and outcomes. As part of this effort, the Government has already made £325m of capital funding available for the best STPs over the next three years. In the Autumn a further round of local proposals will be considered.'

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