8 Months after he picked up the keys to No11 it is difficult to discern any clear pattern or purpose to Philip Hammond’s Chancellorship.
His most decisive action to date has been to cancel the annual ritual of a spring budget. The one he presents to the House in two weeks’ time will be the last. In future the budget is to be rolled into the autumn statement and delivered before Christmas. It’s a sensible reform but scarcely spectacular. On all matters economic the Chancellor has ceded visibility, if not control, not only to the PM but also to other ministers, particularly Boris Johnson, even to David Davies. March the 8th will be his moment in the sun and a chance to answer the question “what is Philip Hammond for?”
On taking office last July the new Chancellor spoke about a “new phase” for the economy. Contrary to some of the reporting at the time and some of the comment that has filled the void since then, he didn’t say that austerity was over but that it was “right to review the pace at which the government balanced the books.” Is that review now completed? And if so will he be challenging the conclusion of the IFS Green Budget which claimed last week that “The rate of reduction (in levels of day-to-day public service spending) is set to speed up after this year, with cuts of nearly 4% due between 2016–17 and 2019–20”?
This matters because it is these kinds of numbers that have led Lord Porter the chairman of the LGA, to warn this week that services supporting very vulnerable people are “at breaking point”. Lord Porter, the Conservative leader of South Holland in Lincolnshire, subsequently said he was “hugely disappointed” by the funding settlement for councils which was set out by the Communities Secretary in a written statement to parliament yesterday: “As we continue to bring the deficit down” wrote Sajid Javid “local government, must continue to play its part”.
Trolleys in corridors have become a familiar picture on the front pages this winter and such has been the level of disquiet on the government’s own benches that the Chancellor will surely have something in the budget for the NHS. Anything less will risk mutiny. But doctors and hospitals are part of an ecology of care that reaches out through domiciliary services, reduces need through strong public health programmes and builds resilience and wellbeing through a diverse range of community services. So the question is not about whether Mr Hammond responds to the crisis but about whether he sticks a bandage on the creaking fabric of an acute sector that faces irreconcilable trajectories of demand and resource or becomes the first chancellor to really grip the necessity for prevention and for a cross government “need reduction strategy” stretching beyond the NHS, into other arms of government, particularly local government, and on to the community sector where some of the most effective (and cost effective) work is already going on. Our own work on a community development approach to the early detection of cancer for instance has increased the take up of cancer screening appointments in east London by 15%.
Clinicians at the huge and ferociously overworked London Hospital just down the road from Community Links tell me that one in five beds are taken up by patients whose condition is caused by, or seriously exacerbated by, diabetes. We know that more than half of all Type 2 diabetes can be prevented or delayed by simple life style changes and the most basic early action. Ultimately it is only a sustained investment in this kind of preventative work that will enable our hospital, and the many others like it, to deliver the high quality acute services that they should be delivering.
The budget that the Chancellor is writing could buy enough new trolleys to placate his own side of the House for a few months more or it could set out the simple but ground breaking measures for the longer term transition to a preventative economy that I suggested in my address to the All Party Parliamentary Group last year and that we have detailed in the various publications of the Early Action Task Force. It’s time to decide Mr Hammond. What are you for?