The devil is in the detail – concerned and cautious Budget optimism

Our Executive Director, Will Haydock, responds to this week’s Budget.

There was lots in this week’s Budget to welcome.  Whether or not you agree with every element, I think it can be described as a realistic response to what has been a serious assessment of the situation facing the country.

But as ever, the devil is in the detail, and we’ll have to wait for much of that.  Some of it I feel hopeful about, and some makes me much more concerned.

Most of the funding in England for community treatment for issues with alcohol or other drugs comes through local authorities’ public health grant and the Supplementary Substance Misuse Treatment & Recovery grant – both of which are provided through the Department of Health and Social Care (DHSC).

The Budget announced a real terms increase in the funding for DHSC, along with some other key departments like the Ministry of Justice and the Ministry of Housing, Communities and Local Government.  So I’m hopeful that the overall increase will filter down to individual programmes, and mean that funding for local providers is at least maintained at current levels.

There were also some specific announcements of potentially interesting schemes.  £233 million of additional spending in 2025-26 on homelessness was revealed, as well as a scheme called ‘Get Britain Working Trailblazers’, which will bring together providers of health, employment and skills services to improve the support available to those who are inactive due to ill health and help them return to work.  This sounds like a programme that could benefit from the learning and expertise of our providers, given the success of the Individual Placement and Support (IPS) scheme.

But my concern is that charities could be overlooked in these discussions.  Will they be remembered as part of ‘health’, given this is often simply thought of ‘the NHS’?  I’d be keen to make sure charities are involved in those discussions – and the Government would be missing a trick if they didn’t involve charities.

But there’s a more fundamental challenge where I’m worried that charities might have been overlooked.

Much of the investment announced in the Budget is dependent on a rise in employer contributions to National Insurance.  Rachel Reeves was clear in her statement that the NHS will be protected from this, and there is a line of calculations about the cost of this to the ‘public sector’ in the appendices to the Budget.  But it’s not clear – I’d go as far as to say it’s unlikely – that charity providers have been included in these calculations and plans under the NHS or ‘public sector’ categories.

Private companies have been considered – at least to some extent.  There is an exemption from employer National Insurance for the smallest organisations.  And the logic is that bigger, well-run companies can either pass the cost onto customers or dip into their profits.

It’s not even clear that the media have fully picked up on this – when Sarah Montague pressed Wes Streeting on Radio 4’s World at One programme as to whether non-NHS providers of health and social care would be protected from these cost increases, she asked about private companies and even mentioned GP practices, but not charities.

In his answer, Wes Streeting started to talk about opportunities to shift care from hospitals to the community, and we would be keen to support that process – indeed Collective Voice charities already do  work  through initiatives such as hospital liaison and community detoxes to help with exactly this.

But this shift to community-based care doesn’t resolve the issue or help us in the short term.  Charity providers of treatment and recovery services don’t have the options open to private companies.  They’re funded by local authority contracts and grants to provide services free at the point of use, so we can’t increase prices, and as charities we don’t make profits.

This means that unless the value of charity contracts and grants is increased, the rise in costs will surely mean cuts to frontline services.

But as I said earlier, the devil is in the detail, and I’m still hopeful.  This can still be resolved as the Government works through those details, and there are lots of interesting possibilities and opportunities.  This Budget is just the start, and I look forward to seeing the Government work with charities across the drug and alcohol field and beyond to fix the NHS, repair the criminal justice system and deliver across all its Missions.