Britain’s civil service needs more money to stem another decline, says a damning report

Britain’s crisis-hit public services will not recover before the next election and could require significant cash injections to prevent a further decline, according to a sobering annual review from the Institute for Government, a non-partisan think tank.

After almost 13 years of austerity measures and severe public sector capacity damage as a result of the pandemic, the IfG report states: “It is unclear whether the government will consider existing funding levels politically viable in the run-up to the next elections”, which are called by the end of 2024 must.

It added: “The situation will be even more difficult for those who form the next government.”

The authors predict that based on current policies, “waiting times and lists in hospitals will remain above 2019 levels, students will not catch up on lost learning, and the market for welfare providers will become unsustainable over the long-term financial base. . . The situation in prisons and courts is probably even worse.”

While the budget increases already announced at the autumn declaration in November should allow hospitals, GP surgeries, schools and local government services to avoid real cuts for the rest of this Parliament, the cost of higher wages that might be awarded will end the recent strikes would one Requiring to offset cuts in non-payroll budgets.

Do you work for the NHS?

We examine the current state of the NHS – and its future – and want to hear from FT readers. Take a short survey and tell us about your experience of working in the National Health Service. We plan to post some of your responses on FT.com

The report also concludes that the current budget “does not provide the level of funding needed to make significant performance improvements.”

There is room for some help: Jeremy Hunt, Chancellor of the Exchequer, learned this week that public finances had more room to maneuver in the near term than expected, with borrowing about £30bn lower than forecast so far this financial year.

The state of the NHS was cited as a key issue for voters. For example, in a recent survey conducted by Redfield and Wilton, more than half of respondents said it was one of their top three concerns – behind only the economy.

The IfG found that the number of people on waiting lists for treatment is currently around 7.2 million – more than one in eight people in England. At the start of the pandemic, there were 4.4 million. The number of people waiting at least a year for their treatment was around 400,000 at 3,300 in March 2020.

A key problem in tackling this backlog is that healthcare is still not operating at the same pace as before the pandemic. For example, the number of diagnostic tests per month has still not returned to pre-2020 levels. The number of patients now waiting a long time for tests, an extreme rarity before the pandemic, is growing.

Stuart Hoddinott, researcher at the IfG, attributed many of these problems to the 13 years of austerity since the financial crisis. “Our testing capacity has been severely limited by the lack of capital investment over the past decade,” he said.

“Yes, the pandemic has had an outsized impact. But you can see big drops in NHS performance in the 2010s. When it started, there was a lack of resilience,” he added.

Some of the problems in the NHS stem from problems in the welfare system, which is largely funded by struggling local authorities whose own funding has been cut by central government.

The service itself is overwhelmed. During the pandemic, care requests have declined — but only temporarily. And the sector, which tends to pay less than the NHS, is struggling to recruit and retain staff.

As a result, the care system struggles, leaving people who should be cared for stuck in hospitals. This week NHS England announced that at some point this winter over 14,000 hospital beds were occupied by patients medically eligible for discharge.

The IfG noted: “The staffing crisis briefly relaxed in the first year of the pandemic is now worse than ever, with 50,000 fewer social care jobs filled in March 2022 than at the same time last year and the highest vacancy rate on record.”

The authors referred to analogous problems in other parts of the country. Staffing levels are a serious problem in schools: adjusted for subject mix, the number of teachers to be trained in England in 2022-23 was 44 per cent below target. England hired just 17 percent of its target number of prospective physics teachers.

According to IfG estimates, the government will also fall short when it comes to recruiting 20,000 new police officers.

Much more worrying, however, is the effectiveness of the judicial system. The proportion of reported crimes in England and Wales that result in a charge has fallen from 17.2 per cent in 2013-14 to 5.6 per cent in 2021-22.

This has led to a significant reduction in cases referred to courts – yet the court and the prison system are overwhelmed. The report states: “Progress in addressing the Crown Court backlog will be slow and the Prison Service will find it very difficult to safely accommodate the expected increase in prison numbers.”

Angela Rayner, Labor Deputy Leader, described the report as a “damning verdict on 13 years of Tory mismanagement” in the UK civil service.

“The Tories’ failure to manage and settle disputes has compounded the hurt after a decade of failure to address the cost of living crisis,” she said. “While the Tories navigate decline and bask in their failure, only Labor has a concrete plan for national renewal grounded in growth.”

A government spokesman said: “In last autumn’s statement we set out how we would protect our vital public services. We are prioritizing further investment with up to £14.1bn available for the NHS and social care, a further £2.3bn a year for schools and we are providing a further £1.1bn to the police available to fight crime in the hardest hit areas. ”