24 Nov 2015

NHS: extra money ‘not enough’ to meet government’s ambitions

There was a general sigh of relief across the NHS this morning with the announcement that there is to be an extra £3.8bn for 2016/17. It was, by all accounts, a battle hard fought, with the Treasury having to be persuaded that the £8bn extra by 2020, promised in the Conservative Party manifesto, needed to be front-loaded.


Simon Stevens, the chief executive of NHS England, had led the charge, both publicly and privately for the money – or at least some of it – upfront. That the Treasury was finally persuaded was broadly welcomed. But the welcome was probably more muted than he would have liked.

Because few believe that the extra money will do much more than pay off the ever increasing deficits (projected to be £2.2bn by the end of this financial year), and meet increased pension demands.

What most analysts are saying today is this goes nowhere towards getting some stability into the health service. It will not be enough to meet the government’s ambitions, for instance, of a seven day a week NHS and more GPs working seven days.

This rise is also specifically for frontline services and not for other parts of the NHS. So tomorrow there are concerns that there will be an announcement in the spending review of cuts to the public health budget and to staff training budgets.

There has been a suggestion that local authorities will be able to increase council tax by 2 per cent and that this would be ring-fenced for social care. But nobody is clear yet what will happen to local authority budgets overall. So it could end up with robbing Peter to pay Paul and the NHS will end up with extra work as a result.

The same goes for cuts to public health budgets. All of which can see extra patients coming through he doors of a hospital because their health has otherwise suffered.

The Department of Health is clear, too, that the money to cope with this winter’s pressure has already been allocated. It says the moves to cap agency spend will help with over spends.

But we have been in Queen’s Medical Centre in Nottingham for the past two days and they are already feeling the effects of winter. Even before midday today, there were 8-10 trollies with patients lined up in the emergency department.

Most of the hospital’s beds were full and all the cubicles were being used. The staff were coping admirably, although they never stopped. And the worst of winter is still to come.

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