Look beneath the headlines and it turns out the sum is contingent on results in the health serviceby Siva Anandaciva / June 27, 2018 / Leave a comment
The baseball player Yogi Berra once said, “when you come to a fork in the road, take it.”
A similar sense of strategic confusion and indecision has pervaded NHS funding in recent years, as the Treasury first sets firm budgets for the NHS and then finds itself topping these up in drips and drabs as pressures on services mount. The prime minister’s announcement of a new long-term funding package for the NHS now provides an opportunity to reset this approach, and give some clarity over the resources the NHS will have to work with over the coming decade.
But why was a new approach needed in the first place? Our recent review of national data shows that although the NHS continues to make substantial efficiency improvements, it is buckling under the pressure of rising demand and austere funding. Hospitals are full, with 90 per cent of beds now regularly occupied, well above the 85 per cent threshold generally considered safe. Staffing vacancies are rife, with nearly 100,000 posts waiting to be filled. And all this against a backdrop of relentless increases in the need for care as the population grows, and lives longer with a range of conditions.
The inevitable consequence of this mismatch between demand and available resources has been lengthening queues for accessing care. There are 4.2m patients on hospital waiting lists—the highest level in 10 years. National targets for seeing patients quickly in major A&E departments in hospitals have not been met for four years. And frontline providers of NHS services reported a financial deficit of nearly £1bn last year. Little wonder then, that after another punishing winter in which the NHS dominated the headlines, a change of direction was needed.
So, what do we know about the funding package that was announced? We know it is a long-term offer that covers the next five years, from April next year to the end of 2023/24. There is also a substantial sum of money, with day to day NHS spending rising £20.5bn over this period, a rise of 3.4 per cent each year in real terms. The government has floated a number of ways of finding this, including the controversial “Brexit dividend.” The Chancellor’s recent Mansion House speech makes clear that taxes…