Add GBP 20bn NHS capital: note

Central fiscal result

+GBP 4.0bn - Net fiscal impact in 2028-29

Low case: +GBP 3.0bn. High case: +GBP 9.0bn. Positive numbers are fiscal costs or borrowing pressure. Negative numbers are Exchequer savings or receipts.

Scenario and baseline

• Models add gbp 20bn nhs capital by 2028-29.
• Baseline is current policy or published departmental plans.
• Central case uses published party or official anchors where available.
• Wider manifesto interactions are excluded unless stated.

Affected population

• Affected units are people, firms, households or providers depending on policy.
• Direct exposure follows the manifesto or government target group.
• Indirect exposure includes suppliers, workers, consumers and taxpayers.
• Weakest counts are widened in the low and high cases.

Gross impact

• Published anchor or scenario central is +GBP 4.0bn in 2028-29.
• Gross costs or receipts are adjusted for behaviour and delivery risk.
• Tax, benefit or procurement offsets are separated in the fiscal build-up.
• The range is deliberately wider where implementation detail is thin.

Fiscal build-up, central case

• Gross programme or delivery cost: +GBP 4.6bn
• Tax and receipt offsets: -GBP 0.3bn
• Administration and evaluation: +GBP 0.1bn
• Behavioural and pass-through effects: -GBP 0.4bn

Central net impact: +GBP 4.0bn in 2028-29.

Behaviour and pass-through

• Low case assumes stronger delivery or receipts than central.
• Central case applies moderate behavioural leakage and pass-through.
• High case allows weaker delivery, larger take-up or higher costs.
• Output effects follow incidence, capacity and investment channels.
• Distributional gains do not automatically imply GDP gains.

Phasing

• 2026-27: +GBP 0.4bn. Phased implementation and take-up.
• 2027-28: +GBP 2.2bn. Phased implementation and take-up.
• 2028-29: +GBP 4.0bn. Phased implementation and take-up.
• 2029-30: +GBP 4.0bn. Phased implementation and take-up.

Main source groups

• S1: Green manifesto and current party material define the scenario, not an official costing.
• S2: Official statistics and departmental baselines anchor affected populations and public spending.
• S3: Academic evidence informs behavioural, price, labour-supply and investment assumptions.
• S4: IFS and OBR-style reasoning support wide ranges where delivery or tax yields are uncertain.