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further measures to support greater local decision making and freedom for healthcare professionals to do their job. This will include commissioning an independent review by Patricia Hewitt into how best the new Integrated Care Boards can work with appropriate autonomy and accountability The Autumn Statement recommits to the government’s transformative growth plans for our railways. These include East West Rail, core Northern Powerhouse Rail, and High Speed 2 to Manchester. These will provide fast, more reliable services and connect people to new job opportunities. As set out in Table 4.2, while borrowing is expected to fall by 2027-28, it remains higher in every year than the OBR’s March forecast. This is due in large part to higher debt interest spending and a weaker economy forecast. Table 4.2: Changes in borrowing since March 2022

International comparisons of GDP during the coronavirus (COVID-19) pandemic, Office for National Statistics, February 2021. ↩ To achieve this aim, the government has reversed nearly all the measures in the Growth Plan 2022. The Autumn Statement sets out further steps on taxation and spending, ensuring that each contributes in a broadly balanced way to repairing the public finances, while protecting the most vulnerable. The government’s approach to delivering fiscal sustainability is underpinned by fairness, with those on the highest incomes and making the highest profits paying a larger share. While increasing tax revenues, the government is taking a responsible and disciplined approach to public spending which prioritises vital public services and infrastructure to drive economic growth. The government’s commitment to responsible management of the public finances is codified in new fiscal rules published in the Autumn Statement. The rules ensure that policy puts the public finances on a sustainable path, requiring that debt falls as a share of the economy over the forecast, while providing space for the economy to recover. The government will keep the EPG under review and may revisit the parameters of the scheme, for example if the forecast cost increases significantly. The government will consult on amending the scheme as soon as is feasible after April 2023 so that those who use very large volumes of energy have their state support capped, whilst the vast majority of households can continue to benefit. This proposal is intended to ensure taxpayers do not subsidise all of the energy usage of those households with extremely high usage. This consultation will explore the best ways to ensure that vulnerable high energy users, such as those with medical requirements are not put at risk.The economy continued the strong recovery from the effects of the pandemic in the first half of the year. Despite the after-effects of the COVID-19 pandemic and an increase in global energy prices, the economy continued to grow in the first half of this year by 0.7% and 0.2%, in Q1 (January to March) [footnote 36] and Q2 (April to June) [footnote 37] respectively. This followed on from 7.5% growth in 2021, which was the strongest growth in the G7. [footnote 38] In light of the deterioration in the economic outlook since the Spring, the government must now take further action to return the public finances to a sustainable path. In his annual remit letters, the Chancellor reaffirmed the Monetary Policy Committee’s (MPC) primary objective of ensuring price stability defined at 2% year-on-year CPI inflation and has stated that this government will not change this definition. appropriate percentages for electric and ultra-low emission cars emitting less than 75g of CO2 per kilometre will increase by 1 percentage point in 2025-26; a further 1% in 2026-27 and a further 1% in 2027-28 up to a maximum appropriate percentage of 5% for electric cars and 21% for ultra-low emission cars

Public sector net worth (PSNW) as a % of GDP is expected to be on an improving path from 2023-24 onwards. The OBR forecasts PSNW to strengthen to -89.4% of GDP in 2027-28, from a trough of -97.2% of GDP in 2023-24, improving faster than underlying debt due to a build up of financial and non-financial assets. Table 4.3: Overview of the OBR’s fiscal forecast (% of GDP) improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023-24, with further improvement towards pre-pandemic levels in 2024-25 Day-to-day (RDEL) spending assumption: increase by 1% p.a. on average in real terms beyond Spending Review 2021 Fiscal policy decisions will be guided by updated fiscal rules, which require public sector net debt (excluding the Bank of England) to be falling as a percentage of GDP and public sector net borrowing to be below 3% of GDP by the fifth year of the rolling forecast.While delivering overall spending restraint, the government is prioritising further investment in the NHS and social care, and in schools. Supporting these two public services is the government’s priority for public spending.

Public Sector Net Debt ex BoE – ONS code CPOA, Current Budget Deficit – ONS code JW2V, Public sector net investment – ONS code MUB2, Public sector net borrowing– ONS code J5IJ, General Government Gross Debt – ONS code BKPX, General Government Net Borrowing - ONS code NNBK All figures in this table are rounded to the nearest decimal place. This is not intended to convey a degree of unwarranted accuracy. Components may not sum to total due to rounding and the statistical discrepancy. Benefit Up-rating – Estimated number and type of GB families and individuals in families benefitting from the up-rating of benefits in 2023-24, 17 November 2022. ↩ Includes reinstating plans to set the Bank Corporation Tax Surcharge rate at 3% from April 2023 and the Diverted Profits Tax rate at 31% from April 2023.This measure is expected to have an indirect effect on wages. The impact of this effect on tax receipts is captured as part of the wider OBR forecast. The tax system should continue to adapt to reflect consumer behaviour. Reflecting the success of the transition to electric vehicles, the government will therefore introduce Vehicle Excise Duty on electric cars, vans and motorcycles from April 2025. This will ensure that all motorists begin to pay a fairer tax contribution.