What should we expect from the Budget 2017?
Shona Cleland, Research, Policy and Campaigns Manager, looks ahead to this week’s Spring Budget, when the Chancellor of the Exchequer will set out his plans for the economy.
The Chancellor will outline his priorities for tax and spending this Wednesday. What can people with arthritis expect?
The government is under mounting pressure to do something about the spiralling care crisis in England. Arthritis Care has been working with other charities to campaign for urgent investment and a long-term, cross-party plan. Social care services have been underfunded by successive governments over many years, so an inclusive, cross-party approach is needed to put our social care system on a sustainable footing.
The money needed is substantial. Social care services in England have faced funding reductions of £4.6 billion in five years and the number of people in need of care and support is growing. Good care costs money; all political parties must face up to the costs and consequences of ensuring that disabled and older people have the support they need.
The Chancellor has recognised that there is a very good case for taking a strategic look at how we deal with social care funding over the longer term. This would be a positive step, but a new review must not delay action. Thousands of people with long-term conditions like arthritis do not get the support they need to lead full and active lives; they have been failed by our care system and this should not be allowed to continue while another review takes place.
Closely connected to social care funding are the difficulties facing the NHS in England. New research from the Care & Support Alliance, a coalition of charities including Arthritis Care, shows that almost nine in ten GPs think cuts to social care have increased pressure on their surgeries. The effects of care cuts on hospitals are also well documented, with nearly one in ten beds taken by someone medically well enough to be discharged.
However, the pressure on the NHS goes beyond social care funding. NHS Trusts in England reported a £2.5 billion net deficit in 2015/16, with spending on the health service falling far behind the investment needed to keep pace with new treatments and growing demand.
People with arthritis are paying the price. Restrictions to eligibility criteria for hip and knee replacements, common in people with osteoarthritis, are being used as a cost-cutting measure by CCGs. Last year, The Royal College of Surgeons found that nearly one third of CCGs (31 per cent) are imposing mandatory restrictions on overweight or obese patients referred for routine surgery and 12 per cent require patients to stop smoking. There is no clinical justification for these measures, which undermine clinical guidance and leave people with arthritis in pain and without the help they need.
People with inflammatory conditions also find their treatment affected by pressures on the system. For example, The British Society of Rheumatology found that only 37 per cent of patients were seen by a rheumatologist within three weeks of referral, in line with national standards. This matters, because there is strong evidence that early treatment is crucial to prevent irreversible joint and organ damage.
Will the Chancellor do something about NHS finances in his budget? It is unlikely. He has already indicated there will be no new funding, and the government has repeatedly insisted that it has given the NHS enough money. However, we know that all too often people with arthritis do not have access to the care they need when they need it, so Arthritis Care will continue to campaign for better support from the health service.
Another area of government spending to keep a close eye on is benefits. Damaging cuts of £30 a week for new claimants in the work-related activity group of Employment and Support Allowance (ESA) and the equivalent group in Universal Credit (UC) are due to come into force from April.
We have argued that this reduction is counterproductive and will make it harder for disabled people to move into work. Research by the Disability Benefits Consortium, a coalition of charities including Arthritis Care, found that more than two thirds of sick and disabled people surveyed thought the lower level of income would cause their health to suffer. 45 per cent said the reduction would probably mean they would return to work later, and a cross-party committee has questioned the evidence the government uses to justify the cut.
There are over 10 million people with arthritis in the UK, and this number is set to grow by 50 per cent by 2030. The impact of arthritis on individuals, families, and our economy has been overlooked for too long. This week’s Budget is another opportunity to change this; we hope the government takes it. If not, Arthritis Care will continue to work with other charities and people with arthritis to press for a better deal.
 ADASS budget survey 2016
 BBC One, 05/03/2017, The Andrew Marr Show
 Care & Support Alliance, 03/03/2017, Lack of social care is piling pressure on surgeries and A&Es
 Lord Carter of Coles, 2016, Operational productivity and performance in English NHS acute hospitals: Unwarranted variations
 Nuffield Trust, The Health Foundation and The King's Fund, 2016, The Autumn Statement: Joint statement on health and social care
 The Royal College of Surgeons, 2016, Smokers and overweight patients: Soft targets for NHS savings?
 The British Society for Rheumatology, 2016, National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis: 2nd Annual Report
 House of Commons Work & Pensions Committee, 2017, Disability employment gap
 House of Lords Committee on Public Service and Demographic Change, 2013, Ready for ageing?