The 2017 Budget on 8 March confirmed that, while there was extra money for social care and a small amount of extra capital funding for the NHS, there would be no extra revenue funding for the NHS in 2017/18, with the new financial year starting on 1 April 2017. Analysis by NHS Providers predicts that, without realism, flexibility and support, it will be impossible for the NHS hospital, ambulance, community and mental health trusts who account for more than 63% of NHS spend to deliver all that they are being asked for in 2017/18.
The NHS performance is at a breaking point, though not yet collapsing due to the sheer determination and good will of its work-force. NHS finances are as bad as in eighties and nineties, overall productivity is falling. Deteriorating workforce relations due to the stubbornness and arrogance of the health secretary, Jeremy Hunt, have opened into an extraordinary rift with junior doctors, consultants and GPs. And public satisfaction with the NHS is showing decline. The greater reliance on agency staff and difficulty recruiting consultants is further evidence of an overstretched NHS and the result of poor workforce planning by the government. The “magnificent” NHS is under-funded and “in deep trouble”.
The scale of the challenge that the NHS is now facing is unprecedented – rising demand coupled with economic pressures are creating difficult-to-manage situations that are putting patient care at risk.
The funding gap of £30 billion in 2020-21 has dominated recent debate about the NHS, but has clouded discussion. We need to talk about funding requirements over the full parliamentary term not just in a single year. We also need a better way of projecting future requirements to ensure that the NHS receives the funding it actually requires.
My own 10 Point Plan for solving the NHS funding crisis would be something like this:
1.) A penny increase in income tax will raise £5.5bn a year, or £32.5bn over the lifetime of a parliament.
2.) Scrapping the internal market in the NHS would save £4bn a year in administration costs in CSUs and CCGs.
3.) Renegotiate PFI deals to cut 14% profits down t
o 5%, pay off early, order firms to reinvest profits, thus cutting the current £2bn annual spent on PFI contracts.
4.) Spend on Temporary Agency Staff has tripled to £4bn under this government, despite the new cap. Halting the privatization of NHS Staff Bank, increasing medical school intake and ending the £2bn redundancy programme would reduce this.
5.) Halting NHS privatisation would save taxpayers’ money. Since 2010, £48bn has been handed to private health who have a stated intention of making 8%-14% profits. This £3-5bn could be better spent reversing cuts to social care and GP services.
6.) Closing 53 NHS Walk In centres and earmarking 51 more for closure is cutting the NHS’s capacity by 4m. More patients will present at A&E which is £50 more expensive per patient.
7.) Reversing the £5bn of cuts to social care would greatly ease the growing pressures and costs on the acute hospital sector and ultimately save the taxpayer cash.
8.) Reversing the £1bn cut to GP services, and the business rate hike to GP premises would create more sustainability in the primary care sector.
9.) Clinical Negligence pay-outs are up 60%, or £600m a year since 2010. Unsafe staffing levels, and use of temporary locums is in part contributing to this. Ultimately, more permanent staff is safer and costs the taxpayer less in unforeseen costs.
10.) Withdrawing the nurses’ bursary, extending the pay freeze, and imposing a contract on junior doctors has the ultimate effect of increasing the vacancy rate. This, in turn, accelerates spend on locums. If the government reversed these short-sighted decisions, it would save the taxpayer money in the long run.
Government must listen to the professionals who have the solutions to repair the harm being caused on a daily basis, within our NHS and in the social care system.