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?

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