Recent pledges alone will not transform the nation’s health. There must also be a commitment to investing in NHS infrastructureby Anita Charlesworth and Ben Gershlick / February 7, 2020 / Leave a comment
The House of Commons has just passed a bill enshrining into law extra funding for the NHS, described by the government as the “biggest increase in modern memory.” But while the government is trumpeting extra funding, heavy-hitting independent organisations have been sounding serious concerns about NHS finances. The National Audit Office (NAO) published two reports on NHS financial sustainability and capital funding this week, warning that the NHS still faces serious financial challenges. These warnings are echoed by NHS Providers, the membership body for organisations that deliver NHS services, which argued for further major investment on top of the NHS Funding Bill commitment. So why is there such concern around NHS finances when the government has committed to an apparently historic increase?
The government is right to say the outlook for NHS finances is improving, with funding set to rise by an average of 3.3 per cent a year above inflation. This is a lot higher—in fact, around double the rate of increase over the last decade of austerity. But it’s below the historic average for the health service and significantly lower than the 6 per cent average under the Blair and Brown governments. It just about matches growing demand pressures and rising input costs but provides no headroom either to address the legacy of a decade of under-funding or support major improvements in access to—or quality of—care. It is this legacy of underfunding which is responsible for many of the issues identified by the NAO and NHS Providers.
The NHS Funding Bill covers spending on front-line patient care but excludes other crucial areas of health spending: funding for training new doctors and nurses, investment in buildings and equipment and the grant to local authorities for public health programmes. These areas have all been cut as the government has “robbed Peter to pay Paul” across the health budget, in an attempt to protect front-line care. As the NAO highlights, over five consecutive years a total of more than £5bn has been taken from vital investment in buildings and equipment and used to prop up struggling front-line services. The chickens have now come home to roost, with the NHS facing a backlog of maintenance of at least £6.6bn.
Before the election, the…