21 Mar 2013

800 fewer nurses as NHS refunds £2.2bn to Treasury

There is an unhappy juxtaposition of figures swirling around at the moment.

The first is that the Department of Health is expected to underspent against its 2012-13 expenditure limit by £2.2bn, and none of that is to be carried over for future use. It will instead go back to the Treasury.

The second figure is in the NHS workforce survey which shows that last month the NHS lost 800 more nurses.

When the head of the NHS, Sir David Nicholson, announced the need for £20bn savings over a four year period it was promised that these savings would be reinvested on issues such as integrating services and longer term efficiencies.

Labour claims that Ministers were so distracted by the reorgansation of the NHS that they failed to keep a firm grip on how the savings were being made.  So, they claim, it has happened in a haphazard fashion with little thought to long term planning.

There is also growing evidence that operations are being rationed once again.

A reliable source has told me about delays in heart procedures at two hospitals in the south.  Along with the usual: cataracts, varicose veins, IVF.

When the Health Service Journal called the Department of Health to ask why this money was going to the Treasury and not to patient care, a spokeswoman said that health spending would increase by one per cent in real terms this year compared to the year before and by 0.5 per cent compared to 2009-10.

She also said that NHS underspends would “still be available for NHS organisations to ensure high quality, sustainable health services are delivered to patients now and in the future”.

But there is another point – raised via twitter.  Presumably this is NHS England money going back to UK Treasury coffers?   Perhaps it is the Treasury insisting that – despite its ring-fencing – the NHS plays its part.

Or as one person put it, also feels the pain.

Labour Andy Burnham has now written to Jeremy Hunt asking for clarification:

1.    Were you aware of the £2.2bn underspend before yesterday and did you authorise the decision not make any use of the Budget Exchange programme?  Or were you overruled by the Treasury?
2.    If so, when did you make your decision?
3.    Can you confirm that this means the Department’s underspend for 2012-13 would be 2%, higher than the 1.5% figure that your Department says is consistent with “prudent financial management”?
4.    Do you accept the recent findings of the Care Quality Commission that one in ten hospitals are failing to meet the CQC standard on adequate staffing levels? Did you consider this when making your decision?
5.    Why did you not make use of this underspend to prevent job losses and ensure all hospitals have adequate staffing levels?
6.    Yesterday, a Department of Health spokeswoman told the Health Service Journal that the NHS underspend would “still be available for NHS organisations to ensure high quality, sustainable health services are delivered to patients now and in the future”. Can you confirm that this will not be the case, as none of the £2.2bn underspend has been carried forward for future use?

Follow @vsmacdonald on Twitter.

Tweets by @vsmacdonald

7 reader comments

  1. Philip Edwards says:


    Another salami slice off the NHS.

    Another step nearer to Yankification and profiteering.

    And Nicholson still there, kept in place by his paymasters.

  2. Littlevoice says:

    Presumably the spokeswoman who said that NHS underspends would … “still be available for NHS organisations to ensure high quality, sustainable health services are delivered to patients now and in the future”… can explain why they weren’t available for this poor woman!
    The Tories lied when they said, prior to the election, that there would be ‘no top-down reorganisation of the NHS’. They lied throughout the passage of the Health & Social Care Bill. They are lying still. That the BBC and majority of the Press have failed to report the truth means that most people are unaware that their NHS is being dismantled & sold off to the highest bidder. Shameful!

  3. Ellie says:

    The NHS will never work with cut finds – it’s not working as it is. Either they need to find a new system – focussing on communication between different sectors and educating their doctors and nurses, or they need to give it enough money to run efficiently.

    A start would be standardising care so the post-code lottery is scrapped and poor areas of the health sector can be focussed on nationwide. Having one town with poor heart care and another with poor diabetes care will never lead to any significant change.

  4. mark says:

    the toffs all have private healthcare, so why should they give a s*** about joe ordinary that pay their salaries.
    they probably need that 2.2 billion to go towards trident and all the bubbly they can guzzle from the profits of their armament companies

  5. Cassandra says:

    Andy Burnham would probably know a lot more about how these decisions are made. After all the famous or more accurately infamous ‘Nicholson Challenge’ was launched whilst his party was in power.

    Perhaps Andy Burnham could propose that the DH come clean and accept that the NHS funded through taxation cannot deliver what politician’s and bureaucrats continue to say unless it moves towards a tiered system, where a base line is guaranteed, a higher level aspired towards and the motherhood and apple pie paid for by the users themselves.

    Instead of bickering and silly political point scoring the debate needs to move on to what will the NHS provide to all of its users that is the bottom line guaranteed by the government.

  6. Nic says:

    The government fails to be honest regarding the nhs. Trusts up and down the country are being clobbered for either financial or clinical failings. Few seem to be able to balance the books and provide the standard of care one would expect at the same time. Various trusts have been marked as beacons of good practice only then to have the financial rug taken from beneath them. Given the changing demographic of the nation, the apalling cuts in social care, changes to family structures and a general decline in social welfare the nhs is struggling to pick up the pieces. In addition recruitment to extremely tough posts, eg consultants in Emergency Medicine and also less senior medics, a changing demographic for nursing which will make recruitment of top calibre staff very challenging, the nhs is having an increasingly tough time.

  7. Annoyed says:

    I worked at golf club that hosted Devon PCT groups. I could see NHS money wasted at every day they hired rooms. Arriving late morning, coffee & snack break, 1 hour work then 2 course meal drinks laid on & coffee, a bit more work, coffee & buns then all finished 3:30/4pm! We also hosted the Child Abuse team meetings, arriving early, very short breaks, 1 course lunch if they were lucky & no extras (drinks/snacks) minimum room hire & they workshopped scenarios cobs tangly from 8:30am-5:30/6/7pm! It’s amazing to see different Agency’s and how their budgets are spent. The golf club owner was livid as we could see how all our tax money was wasted on jollys out & long lunches with golf thrown in if you wanted after. Yet serving & hearing harrowing stories of children in dreadful circumstances by a team of people who did not have the money to waste! There is money in the NHS but in all the wrong areas!!!! Cut the pointless agencies & red tape, then give the money to those on the front line actually caring for patients!

Comments are closed.