Even at the height of Osborne’s austerity, we were often told that schools and the NHS were safe.
Officially, these most sacred of our universal public services will be spared the knife, while other budgets are repeatedly slashed to bring down the deficit. But beneath the rhetoric, trouble has been brewing. The truth is that protecting one or two budgets while cutting others to the bone doesn’t yield quite the results the government intended.
The spat between NHS England chief Simon Stevens and Theresa May earlier this year over health funding illustrates how cuts to social care have forced the NHS to pick up the pieces. At the heart of the dispute was how much extra money was needed by the NHS to continue doing its job.
Theresa May told Parliament that not only were NHS budgets protected, the £10 billion in extra cash they had been allocated was more than they had asked for.
But it was pointed out that cuts to social care and public health budgets have a knock on effect on NHS costs – in effect that budgets may be protected, but spending isn’t. This seems to make sense: if a hospital can’t discharge a patient because there is no social care to look after them in the community, the NHS bears the cost.
It has become clear that schools are facing an equivalent challenge. Sure, in theory the budget is protected. But what about all the extra pressures they face? Take a child who helps care for their sick parent. What happens when they are taking on more caring responsibilities because social services are over-stretched. School councillors and nurses are increasingly rare, leaving over-worked teaching staff to take on a lion’s share of pastoral support.
Local authorities fund school nurses and similar services through public health budgets. But with councils facing ever-tougher economic choices, the money is running dry. Last year, the Kings Fund estimated local authority spending on programmes aimed at reducing alcohol and drug misuse among young people would drop by around 10 per cent.
Similar cuts are planned for sexual health services, health protection campaigns and a raft of other interventions that help the public to stay healthy. Extra spending by local authorities is expected in work relating to obesity and physical activity in children, but these small gains go against the grain. Young people will look to teachers to provide this information, advice and support, adding to the strain on school resources.
With fewer and fewer school nurses, who will step in to support students with long-term health conditions such as asthma, epilepsy, diabetes, anaphylaxis and eczema? A study by the National Children’s Bureau last year found that high caseloads, limited time and scarce resources were challenging school nurses’ ability to do the job well (Nursing in Schools, NCB, September 2016). If adequate numbers of school nurses are not recruited by the local authority, schools will have to plug the gap in support for children with these health conditions.
Perhaps where these pressures are found most acutely is in mental health. Increasingly, schools are seen as the front-line in promoting wellbeing and acting as a triage to specialist help for children in crisis. And it is right that schools have a key role to play. But they can’t be expected to do so without specialist training and staff to support teachers. And they can’t provide an alternative to specialist CAMHS. Yet official data show that some six in 10 children don’t get the support they need from CAMHS, and while they wait, school is often the only service available.
These hidden pressures on schools could be the straw that breaks the camel’s back. Reeling under a funding crisis, a recent National Association of Head Teachers’ survey of school leaders found that increasing numbers were unable to balance their school budgets without dipping into reserves or cutting back on the scope of teaching, pastoral care and other aspects of school life that pupils should enjoy.
An analysis from the public spending watchdog, the National Audit Office, says that despite their “protected” budget, state schools in England will have to find £3 billion in savings by 2019/20 to make ends meets, despite facing rising numbers of pupils.
As the funding crisis in the public sector deepens we must ask how long schools can bear the added pressure this puts on the work they do. All the things that schools do above and beyond the curriculum are especially vital because of the jeopardy of social care and public health funding, but they also eat up vulnerable education resources that are far from protected.
- Anna Feuchtwang is chief executive of the National Children’s Bureau. Visit www.ncb.org.uk