Labour has accused the Conservatives of breaking a manifesto pledge to increase real-terms funding for the NHS in every year of this parliament by not promising sufficient extra funds in the budget.

An analysis carried out for Labour by the House of Commons library shows that despite the chancellor, Philip Hammond, announcing an extra £2.8bn in day-to-day funding, real-terms funding per head is set to fall in 2018-19, and remain flat for two years after that.

Commons library calculations show spending per head rising from £2,207 in the current financial year, to £2,223 in 2018-19; before falling back to £2,222 for 2019-20 and 2020-21.

But the Conservatives’ manifesto said: “We will increase NHS spending by a minimum of £8bn in real terms over the next five years, delivering an increase in real funding per head of the population for every year of the parliament.”



Jonathan Ashworth, the shadow health secretary, said: “This new analysis shows that the Tories are breaking their promise to increase in real terms NHS spending on a per-head basis. In fact, NHS spending will fall slightly and then level out.



“The truth is the Tories are refusing to give the NHS the funding it needs, which means patient care will deteriorate, waiting lists rising and more rationing of treatment.”

A Treasury spokesman stressed that the new funding announced on Wednesday was just a “significant first step” towards meeting the pledge of £8bn in extra resources promised before the general election.

NHS bosses took the rare step of expressing public disquiet after the budget, with Sir Malcolm Grant, the chairman of NHS England, saying: “We can no longer avoid the difficult debate about what it is possible to deliver for patients with the money available. The NHS England board will need to lead this discussion when we meet on 30 November.”

The board is understood to be holding a private, unscheduled meeting on Friday to plan what they will say about the consequences for patients of the funding shortfall.

Anita Charlesworth, director of research at thinktank the Health Foundation, said: “He [Hammond] has staved off a real problem over the next two years in terms of emergency [care]. Whether it is enough to start dealing with the waiting list problem is very unlikely.”

She added that the government’s failure to tackle the social care system was adding to the pressures on the health service.

“He gave some money last year for social care to try to get people home; but actually, the number of people stuck in hospital because they’re medically fit to go home but can’t, because they haven’t got social care, has gone up, not down.”

“Essentially over the next five years, the ageing of the population starts. You’ve got 900,000 more over-65s over this parliament. And with a social care system collapsing, that’s having knock-on consequences,” she said.

After ditching its controversial manifesto policy on social care, which would have resulted in patients contributing more from the value of their homes, May’s government has announced that it will commission a fresh independent review of the subject by a panel of experts including Sir Andrew Dilnot, who carried out a major review of the same topic for David Cameron.

As MPs debated the budget in the House of Commons, John McDonnell, the shadow chancellor, challenged the communities secretary, Sajid Javid, over the risk of increased rationing in the NHS.

“There will be more rationing. There will be more people suffering. There will be more people’s lives put at risk,” he said. “Under this government, 4 million people are now waiting for care – the highest level in a decade. More than 100,000 patients were left waiting more than two weeks to see a specialist after being diagnosed with cancer, and more than one in 10 did not start treatment within 62 days.”

Javid spoke for the government in the debate, in which a string of Labour MPs attacked the chancellor for failing to be ambitious enough on housing, social care and tackling weak productivity.

He repeatedly criticised McDonnell’s economic policies, insisting that “Labour’s answer to the housing crisis – in fact, Labour’s answer to everything – is simply to throw more of someone else’s money at the problem and hope that it goes away”.

Michael Fallon, in his first Commons address since resigning as defence secretary, warmly supported the budget, particularly extra funding for the NHS and infrastructure.

But having said that being a backbencher again would allow him to speak “more freely than the constraints of government allow”, Fallon called for increases to income tax allowances to be matched by higher national insurance allowances.

“Is it logical to keep raising the personal allowance but not the national insurance threshold?” he said. “A full-time worker on the national living wage pays almost as much in national insurance as in income tax.”

He also called for more action to bring higher tax revenues from global tech companies: “Their staff, too – Amazon staff, Google staff, Facebook staff – need well-funded schools and good local services and a proper NHS. It is right that they should pay their proper share of local and national taxes.”