“The new money has its price, and that price is institutional reform”

The Budget, as we all expected, confirmed the priority that this Government will give to health spending. However, as both the Chancellor and the Health Secretary have been signalling for weeks, that increase in funding does not come without strings. Yes, they may have taken the politically pragmatic steps in the immediate aftermath of the election to find millions of pounds to end the doctors’ disputes, but Wes Streeting is adamant that he is not merely content to spend the new millions he has been given in the same old way. The new money has its price, and that price is institutional reform.

The principles behind that reform are now clear, thanks to the Government’s immediate adoption of the Darzi report. The report’s three key aims – cure to prevention, hospital to community, and analogue to digital – are exactly in tune with our thinking. What better example of prevention is there than GOS sight tests? What better way of moving care from hospital to the community is there than cataract and glaucoma follow-ups within optometry? And as for analogue to digital: who has been making more noise on the issue of IT connectivity than the AOP?

While setting out principles is one thing, delivering to them is something else entirely. Ministers recognise that the proposed shift from secondary to primary care has been suggested before – indeed, Darzi himself proposed such a policy when he was a Minister in the Brown-led Labour Government. They also understand that the stranglehold of secondary care thinking on health policymaking needs to be broken.

Let us celebrate at least the fact that we have Ministers who understand the problem that they have inherited and who also recognise that optometry might be part of the solution

The Government’s first step towards doing this is the public consultation it has initiated on its proposed 10-year plan for healthcare – a consultation that launched last week and will close at the end of the year.

The responses will be analysed in the early months of 2025, with the plan itself being published in the Spring.

The consultation process should allow voices that are not usually heard to reach the ears of Whitehall decision-makers. Which is where you come in…

As you would expect, the AOP will be responding, both individually and, we hope, in partnership with like-minded colleagues from across primary care. Plus, as we usually do, we have already started canvassing our members for their views too. Once we have done that, we will come back to you with our key messages, both so that you are aware of what we are likely to be saying and, equally importantly, to make sure that any of you who do intend to respond individually – and we really encourage members to do so – have a framework to help shape what you might want to say.

As I say, none of this guarantees that we will get a plan which articulates everything we want, still less that the plan leads to the sort of rebalancing of the system away from secondary care and towards primary care as we would wish. But let us celebrate at least the fact that we have Ministers who understand the problem that they have inherited and who also recognise that optometry might be part of the solution. And while the Budget does not mean they have as much money to spend as they might like, the clear message from the Chancellor that future flows of money are contingent on meaningful reform should be one which helps concentrate some NHS minds.