Why the new funding for the NHS is a “giant sticking plaster”
In January 2019, Theresa May and Simon Stevens finally launched the new NHS long-term plan. The overall aims of the plan, many of which revolve around keeping people well and identifying illness at an earlier stage, are dependent on two things - more funding and sufficient staff.
In money terms, Theresa May announced last autumn £20bn of extra funding. This extra money appeared at first to be a welcome jump out of an 8-year rut of underfunding for the NHS. But as the analysts picked over the numbers it quickly emerged that prolonged austerity has left our health service with a giant hill to climb just to maintain standards, let alone to improve them. The emerging consensus is that the new annual rises of 3.4% a year are simply not enough.
Whilst the extra funding is still welcome, despite being inadequate, little has been done to address the other major obstacle to the plan the crisis in workforce; the NHS has around 100,000 vacancies for staff and brexit is only going to make this much, much worse. Without sufficient staff the plan can not be delivered.
The funding rises will not match rising demand. The new settlement is significantly lower than the 4.3% annual growth in the Office for Budget Responsibility’s projection of future cost pressures. This is an estimate that the IFS, think tanks and most economists agree is a fair measure of how much money the NHS needs just to keep up with demand, let alone improve standards.
Important services have been left out. The funding increase will not reach all NHS budgets. Public health is excluded even though it provides services that can prevent ill health and reduce future spending. The cost of new buildings and training staff are also left out. The NHS needs an extra 100,000 staff and £10bn worth of capital investment in community healthcare to help relieve the pressure on hospitals.
The NHS needs to invest in capacity. Seven years of underfunding has left the UK unprepared for rising demand with below average numbers of doctors, nurses, hospital beds, MRI machines, and CT scanners per head. There is a now large mismatch between the capacity of the service and the health needs of our society.
Debts have grown during austerity. The NHS has existing debts, which will hinder their ability to organise the care of future patients. Hospitals are being hit with interest payments of up to 6% on loans from the government
The funding won’t arrive until next year. 2018/19 will be the most difficult year for the NHS in this Parliament and one of the most challenging in NHS history. Funding for the Department of Health is set to grow by just 0.4 per cent equivalent to £508 million.
Pressure on social care needs to be solved too. Pressure on social care is leading more patients into the healthcare system and meaning that some get stuck in hospital. An announcement from the government and a Green Paper are expected, but many previous reviews have already taken place, meanwhile lack of funding and declining care options has led to 25% less people accessing adult social care.