Labour promised a 'healthier Britain' – the spending review will test that

10 June 2025, 14:47 | Updated: 10 June 2025, 14:48

A year ago this week, Keir Starmer launched Labour’s general election manifesto. He spoke of creating a ‘fairer, healthier, more secure Britain’ with growth in every community. This was to be delivered through five missions, spanning growth, energy, crime, education and health. On Wednesday, the chancellor will set budgets for government departments up to 2028/29. Hopes of delivering tangible improvements in public services will rest partly on Reeves’ choices. In health and care, the challenges are pressing: large care backlogs, falling public satisfaction, and the health of the population flatlining with stark inequalities between regions.  Where should the chancellor focus to address these pressures?

The NHS was a relative winner from the Autumn Budget last year securing funding growth of around 2.8%. Recent media reports suggest the spending review may hand the NHS similar increases of nearly 3% a year.  In health care, funding pressures grow year on year. Health Foundation analysis suggests increases of 3% a year (after inflation) are needed to keep up with an ageing and growing population, invest in new technologies and deliver improvements in services. Over the long term, the NHS has seen annual increases of 3.7% a year, so even if the spending review delivers close to 3% growth a year, that will leave tough choices to be made. And sensible reforms will be needed to help the NHS make best use of its resources.

Boosting NHS funding generally goes with the grain of what the public wants, but other services, like adult social care and public health, are vital to people’s health and ability to live well. So far, the government’s main decision on social care has been to establish an independent commission to explore long-term reform options. But this won’t help social care services struggling with pressures today. More people needing social care and rising costs, including from uplifts to the minimum wage, mean social care services will need roughly £3.4bn extra by 2028/29 to stand still. And that’s to prop up a system widely seen as broken; more fundamental reforms to social care would require further funding.

Health in England is fraying too. Life expectancy in England is roughly 81 years – and has plateaued for a decade. Recent research has found health has got worse for some, for example people aged 25-49 now have mortality rates higher than in other rich countries. The drivers of these problems are complex and lie beyond health services. It includes the building blocks of health like housing, education, communities and job opportunities.

A government agenda to boost health would see a renewed focus on preventative services – like smoking cessation and drug and alcohol services. National funding for these services has been cut by around a quarter since 2015/16; restoring that funding and distributing it equitably would cost just over £5bn by 2028/29. And the spending review could take steps to embed a focus on health across all government departments.

Labour’s inheritance was tough: weak economic growth, public services reeling from the pandemic, poor health in the population and international instability. Health and care services are struggling to meet the needs of older people, as more individuals are living with long-term health needs. COVID-19 has also had a lasting impact on staff morale and productivity.

In these circumstances, delivering the government’s twin goals of inclusive economic growth and improved public services will not be easy or quick. But the route to growth lies through better health. The spending review should take steps to build a healthier future – as Keir Starmer pledged a year ago.

The Health Foundation’s analysis setting out priorities for the spending review is available here.

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Leo Ewbank is Policy Fellow and Ruth Thorlby is Assistant Director of Policy, both at the Health Foundation.

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