The Conservative government is stone deaf to the cries, pain, stresses and strains being felt in the health and social care system in England….writes Dr Kailash Chand
Chancellor Philip Hammond’s Autumn Statement has committed no extra funding for health or social care. There is actually not one single mention in the 72-page Autumn Statement document of the words NHS, social care, mental health, and public health.
‘Chancellor and Theresa May’s claims that the NHS will receive £10bn in extra funding are misleading, as in reality the increase in health spending is £4.5 billion according to King’s fund, BMA and health select committee. Government is stone deaf to the cries, pain, stresses and strains being felt in the health and social care system in England.
The Department of Health’s budget will increase by just over £4 billion in real terms between 2015/16 and 2020/21. This is not enough to maintain standards of NHS care, meet rising demand from patients and deliver the transformation in services outlined in the NHS five year forward view.
The pressures on the NHS will peak in 2018/19 and 2019/20, when there is almost no planned growth in real-terms funding. While there is significant scope for productivity improvements in the NHS, the huge pressures now being felt right across the health and care system mean that the pace of change required to deliver £22 billion of savings by 2020/21 is unrealistic. New inflationary pressures are also emerging that will increase costs and make pay restraint harder to sustain..
The absence of new money for health or social care means that the already intense pressures on services will continue to grow. The financial performance of NHS bodies worsened considerably in 2015-16 and this trend is not sustainable, according to the National Audit Office.
In 2015-16, NHS commissioners, NHS trusts and NHS foundation trusts reported a combined deficit of £1.85 billion, a greater than three-fold increase in the deficit position of £574 million reported in 2014-15. Provider trusts’ overall deficit grew by 185% to £2.45 billion, up from £859 million in 2014-15, against total income of £75.97 billion. In addition, two-thirds of NHS trusts (65%) and NHS foundation trusts (66%) reported deficits in 2015-16, up from 44% of NHS trusts and 51% of NHS foundation trusts in the previous financial year. The number of clinical commissioning groups reporting cumulative deficits was 32 in 2015-16, up from 19 in both 2014-15 and 2013-14.
This massive funding shortfall means hospital authorities have no choice but cutting bed numbers and already a third of A&Es are set to close to cope with rising hospital deficits. A combined financial and staffing crisis could cause ongoing chaos for years and ultimately kill off the NHS for good. We have been squeezing the lemon for “efficiency savings” for years. But it is getting to the stage where there is nothing left to squeeze.