Week in Public Services: 22nd March 2024
This week: Spring budget breakdown; prisons and police problems; council cuts
General
Fiscal fiction? Fictitious future? Politicians’ pretence over public spending? If you still haven’t had enough of the spring budget, head here to read our team’s comprehensive coverage. If you have had enough of the frenzy of fiscal events, then allow me to direct you to this classic piece we published after the autumn statement arguing that we should only have one fiscal event per year. I would say that that sentiment holds more true than ever in IfG towers.
Wordplay over, there was little in store for long term improvements in public services, much like the autumn budget barely four months ago. The pre-budget speculation that there would be public service spending cuts to fund tax cuts didn’t come to pass, and there was a very welcome £3.4 billion in extra capital spending for the NHS, though this is a long way from even beginning to address the effects of more than a decade of underinvestment. This comment provides a full lowdown, but in sum, the government would need to spend £10.2 billion just to resolve the maintenance backlog in hospitals. It also seems likely that the service will continue to raid capital budgets to fund day-to-day spending shortfalls, as has already happened in this financial year.
Health and social care
The IFS released analysis of the most recent revised health budgets for the UK government and the devolved Scottish and Welsh administrations. Despite adding another £2.5 billion for England, the IFS notes that this is still a 2.4% fall in real terms for 2024/25, making it very likely, if not certain, that there will have to be more top ups if the government want to avoid making staffing cuts next year. Scotland and Wales too face real terms falls in spending, although these are smaller than England at 0.75% and 0.7% respectively.
A research briefing published by the House of Commons provides a stark overview of the scale of funding pressures affecting adult social care, a timely piece given the increasing number of councils pointing to demand and cost pressures in the sector as a reason for financial strain. It’s the largest area of council spending (excluding education, over which councils don’t really have any control) reaching £20.5 billion in 2022/23. Even that large amount still leaves substantial amount of unmet need. Budgetary pressures in coming years are set to be severe. Demand will continue to ratchet up as the population ages further, workforce-related costs will increase as the national living wage rises, and increasing prevalence of long-term health conditions means that people will need more complex care. The King’s Fund released their annual Social care 360, a really comprehensive overview of adult social care across twelve metrics. In their words, adult social care has not ‘turned a corner’ and the disparity between requests for support and the number of social care recipients remains greater than seven years ago.
The controversy over the role and status of physician associates (PAs) — who assist healthcare teams after two years of training — continues, with the BBC reporting that the Academy of Medical Royal Colleges (AMRC) has taken the opposite view to the BMA in the latest consultation. The AMRC has come out in support of new regulations proposed by parliament which would allow PAs to register with the General Medical Council. In the other corner, the BMA remains strongly opposed, arguing that the public might confuse the two separate medical professions and warning that physician associates would take on roles for which they aren’t qualified.
NHS England is attempting to improve A&E performance through a capital incentive scheme, doling out £2 million in capital funding to the 10 NHS trusts which record either the highest or most improved four-hour performance in March compared with January. I have serious doubts as to whether introducing a competition for extra cash will lead to any improvements in performance, or whether it just incentivises hospitals to game performance figures. It would frankly be better just to provide adequate capital resources to begin with, rather than resort to what might end up being a free-for-all that does little to actually help.
Children and young people
This thread from Jack Worth gives a good overview of the latest teacher recruitment figures, and there are some interesting findings. Total teacher recruitment is similar to last year, but there’s a big variation at subject level with an astonishing 141% rise in accepted applications for physics teachers. Most of this is driven by international recruits, with a bursary and £10,000 relocation payment available for overseas applicants. Physics isn’t the only subject where international recruitment has gone up, across the board there’s been a 57% rise in applications from outside the UK and Europe, whereas there’s actually been a fall for the latter. The DfE clearly saw DHSC’s increasing reliance on international recruitment and thought “it looks like fun juggling a political hand grenade to fill workforce vacancies, we’re going to get involved with that”.
Ofsted has responded to the education select committee’s recommendations for the schools inspection body, agreeing in principle to longer and more in depth inspections but calling for an extra £8.5 million in annual funding to carry them out. Ofsted also insists that the committee’s most notable demand — to replace the now infamous one word inspection judgments — is in DfE’s remit, something which the committee already acknowledges.
The controversy over Ofsted judgements continues, with Schools Week reporting that headteachers who were sacked following an ‘inadequate’ inspection are being forced to sign non-disclosure agreements (NDAs). The scale of NDA use is not clear, but it obviously does little to help resolve the very public breach in trust between the inspections body and a large number of headteachers.
Schools Week also carried out an in-depth investigation into SEND provision against the backdrop of a near-tripling in complaints to the local government and social care ombudsman in the last five years. Only 6% of the 1,435 complaints issued this year to date were not upheld, implying something is seriously going wrong with the process of issuing education, health and care plans (EHCPs), which set out how a local authority plans to support a child with SEND. The most common reason for upheld complaints is the delay in issuing an EHCP, with less than half being issued within the 20-week requirement, and in some cases taking up to 20 months.
While I’m certain that this will not reassure any parent waiting for their child to officially receive a plan, it’s important to remember that SEND provision has become a serious source of financial pressure to local authorities. So much so that the government has allowed 23 councils to top-slice a total of £67 million from local schools budgets to fund SEND services for 2024/25. This represents all councils which had applied for permission to do so, an almost complete turnaround from just four years ago when 90% of applications were turned down.
Law and order
In yet another indictment of overcrowding in England’s prisons, the justice secretary Alex Chalk announced that “certain low-level offenders” could now be released up to 60 days early to relieve pressure on prisons. Last year, Chalk announced a plan to release some inmates 18 days early, but it seems that the Ministry of Justice has realised there simply isn’t enough capacity to accommodate a prison population that could surpass 100,000 by March 2027. Naturally we’ve covered this before in Performance Tracker, and it’s an issue which will only get more pressing. With an election date still to be confirmed, it’ll be interesting to see how two parties which usually engage in one-upmanship about being tough on crime confront the undisputable fact that currently there simply isn’t enough prison space.
The latest in a line of scathing inspections by HM Inspectorate of Prisons finds truly appalling conditions in HMYOI Wetherby. An unannounced inspection of the young offender institution found high rates of self-harm by vulnerable young people and frequent use of strip-searching by staff in response, including a girl that had been restrained and had clothing removed by an all-male team on two occasions. Unsurprisingly, the Children’s Commissioner is “shocked and appalled” by the conditions in HMYOI Wetherby.
The Met Police’s internal culture, vetting and disciplinary processes have been thrust back into the spotlight. The Angiolini Inquiry has been investigating how the Met retained Wayne Couzens as a serving officer despite multiple allegations of sexual offences before the murder of Sarah Everard. The inquiry’s first report has found a need to improve vetting procedures — both at the recruitment stage and for serving police officers — and to combat an internal culture which failed to combat sexism and misogynistic behaviour within its ranks. The Met Commissioner, Sir Mark Rowley, accepted Angiolini’s recommendations and reiterated an aim to rebuild public trust in the Met Police. Words are cheap in this situation; the report lays bare the scale of the improvements needed to achieve this and the Met’s track record on cleaning up its culture doesn’t fill me with confidence that the necessary changes will be made. A first step in the Met’s mission to restore trust was the launch of a hotline in 2022 where people can anonymously report suspected corruption, abusive or violent behaviour by police officers, which has now been rolled out nationwide.
Local government
Before the budget the Local Government Information Unit (LGiU) released its annual survey on the state of local government finance. It makes for grim reading. 51% of councils expect to issue a section 114 notice in the next five years, and only 4% feel confident about the sustainability of their local government finance. The LGIU states that councils have only a limited number of options to try and balance their budgets: 9 in 10 have put up council tax or fees and two-thirds dipped into spending reserves or cut services.
Looking deeper into service cuts, it’s noticeable how councils feel forced to slash universal services to prop up acute spending. Arts and culture, parks and libraries are among the biggest areas for funding reductions. However, this doesn’t mean that councils protected acute services at all cost, often cutting them, but to lower extent than the aforementioned services: nearly 12% of survey respondents reduced spending on children’s social care.
The Guardian meanwhile picked up on another aspect of the broad-ranging council cuts to services, namely the dimming or turning off of street lights. It records Norfolk council’s claim to have saved £15 million since 2008 by measures including switching off some 20,000 street lights between midnight and 5am. It’s a fairly light-hearted piece, pointing out that one of the main beneficiaries of this was not the council but local wildlife, but it does make a serious point about the depth of the cuts that more and more councils are willing to take.
Additional analysis of the LGiU’s findings by Grant Thornton reveals a regional disparity in the geographical distribution of the most financially vulnerable councils, with 30% of councils in North England at risk of declaring effective bankruptcy within a year, in comparison with 17% in the South. The division only grows after five years, where 55% of northern councils anticipate financial failure whilst the figure is 35% for the south.
The biggest — and also quietest — recent development in local government is that DLUHC is providing ‘exceptional financial support’ to 19 English councils which have already or are at high risk of becoming unable to balance their budgets for the coming financial year. This support mainly comes in the form of capitalisation directions, which provides councils with greater powers to sell assets to cover day-to-day costs. Jennifer Williams of the FT has a comprehensive thread on the ramifications of this, noting that this essentially pushes financial problems into the future while services continue to suffer.
The outlook for residents for local authorities which have issued a section 114 notice is a grim combination of reduced public services and rising council tax. Nottingham City Council approved a council tax rise of 4.99% and a raft of sweeping cuts for the 2024/25 financial year. Planned measures include closing 12 of the city’s 15 public libraries, shutting two council-run care homes, and ending practically all council funding for community centres and local cultural services.
Meanwhile, Birmingham City Council passed a raft of ‘devastating’ cuts to local services: similarly to Nottingham it plans to slash funding for libraries and close down 11 community centres. The council also confirmed £100 million in cuts to children and families’ services between the 2024/25 and 2025/26 financial year: early help services alone will be cut by £8.4 million. It’s another sobering reminder of the people affected by cuts, who are among the most vulnerable residents.
