How safe is the NHS ring fence?

Seasoned political commentators will tell you that first impressions of a Budget speech are often wrong.

The most brilliant speech, which has government MPs cheering to the rafters, can quickly unravel. The budget that is poorly received can turn out to be just what was wanted.

George Osborne’s latest effort was a noisy affair and Ed Milliband’s response the sort of ‘Punch and Judy’ politics that so annoys the voters.

The National Association of Dental Accountants and Lawyers (NASDAL) tells us that it has given impetus to practice-owners wanting to appoint more staff.

A new Employment Allowance, which will result in a saving in Employers National Insurance of up to £2,000, will be especially beneficial to small scale employers such as practices. The rise in the tax free personal allowance to £10,000 from next year will staff working part-time.

Those practices concerned about their readiness to operate the new Real Time Information process for payroll taxes from next month, will be relieved to know that HMRC have agreed to postpone its implementation businesses with fewer than 50 employees until October of this year. Postponed that is not scrapped.

For dentists themselves, there are some concessions. For those yet to step on the housing ladder the ‘help to buy scheme’ may be useful. For those at the upper end of the salary scale reducing the top rate of tax from 50% to 45%, announced last year, will be helpful. Dentists who bought  Equitable Life annuities before 1992 will receive something.

Those who work in the NHS will be disturbed to know that there will be yet another year of pay rises limited to a maximum of 1%. With inflation running at 3 to 4 times this figure, it is another year of cuts.

The budget also revealed that the Department of Health is this year on course for its biggest annual underspend in the current parliament – with none of the unused budget due to be carried over for future use.

So much for a ring fence round health. For dentists, the NHS Commissioning Board, which takes over from PCTs in a few days’ time, will be making every effort to find whatever savings it can in its budget, including dentistry.

Any advantage from ‘business friendly’ changes in the Budget could well be cancelled out by more austerity from the NHS and in the private market patients with less disposable income.

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