Jeremy Hunt, the chancellor and former health secretary, has warned against complacency and said the government expects the NHS and the Department of Health and Social Care to find new efficiencies. In a cabinet debate on the NHS, Rishi Sunak said the health service was facing a “challenging winter”, although he praised progress on recruiting 30,000 new nurses and setting up community diagnostic centres. A No 10 source said he made no explicit commitment to spending in his comments to ministers. Steve Barclay, the health secretary, told cabinet ministers that people were seeing a significant variation in the quality of services across the NHS, which he said would be a “particular area of focus”. A No 10 spokesman said: “The Prime Minister has said that this Government will always support the NHS and that they will continue to be a priority as difficult spending decisions are made. He said that in return it was right to look further at ways of improving the services the public receive and he was confident that this could be achieved.’ Asked if the health budget would be protected, he added: “I’m not going to get into individual budgets. The prime minister said it would be and the chancellor talked about prioritizing while tough decisions are being made, but beyond that I won’t go into more detail about budgets.” Sunak also backed a cut in the number of civil servants, saying the target of 91,000 job losses had been scrapped, as first reported in the Guardian. But he warned in a letter to civil servants that he would tell every government department “to look for the most effective ways to deliver value and maximize efficiency within budgets” in November’s autumn statement, “so that we can use taxpayers’ money sustainably in the long term.” Amid warnings that the UK is likely to face years of tax rises to plug a £50bn budget hole, the Treasury is set to extend a four-year freeze on personal tax relief and caps, which will draw people into new tax zones and would raise around £5bn a year if extended into the late 2020s. A senior government source said such a “fiscal setback” would likely be the “guiding principle” behind raising taxes across the board. The chancellor appears to be planning a budget statement that balances spending cuts and tax rises 50/50, including a possible extension of the windfall tax on oil and gas companies. Under George Osborne, the Treasury operated on an 80/20 formula of cuts and tax measures. Other tax-raising measures being considered include a tougher windfall tax, either increasing the amount paid or extending the tax until 2028. Another option on the table is to target some more politically palatable personal tax increases, such as reducing the tax relief of pensions for higher rate payers. Archie Bland and Nimo Omer take you to the top stories and what they mean, free every weekday morning Privacy Notice: Newsletters may contain information about charities, online advertising and content sponsored by external parties. For more information, see our Privacy Policy. We use Google reCaptcha to protect our website and Google’s Privacy Policy and Terms of Service apply. Although Sunak had previously increased national insurance to pay for NHS and social care reforms, MPs voted to scrap the increase under the Truss at a cost of £12bn. Government sources said the rollback of the increase remains under consideration, along with all other tax measures, but it is understood it is difficult to ask MPs to vote to reverse a policy a second time. Despite plans not to cut health spending, NHS England is already weighing up the cuts it will have to make to cover an estimated £7bn hole in its budget next year due to inflation. Julian Kelly, the NHS’s chief financial officer, warned last month that he would have to “completely review investment in cancer, mental health, primary care [and] diagnostic capability’ unless the Treasury increased its budget. In a private briefing for senior colleagues recently, the usually unflappable Amanda Pritchard, chief executive of NHS England, was downright gloomy about the financial situation facing the service, telling them that “money is a fucking nightmare”. The additional financial commitments facing the health service are on top of the £12 billion in “efficiency savings” it has already agreed to make between this year and 2024-25.
