It is not a long-term cure...

Following Theresa May’s announcement over the weekend of an extra £20 billion a year by 2023, as a “70th birthday present” for the NHS, we look at the reactions of medical associations, think tanks and financial experts to see how far this money goes in securing a long-term solution for the NHS funding crisis.

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The average annual real growth rate of health spending from various governments since the birth of the NHS is 3.7%. This means that even with this latest announcement of an extra £20 billion, the spending of this Conservative Government remains well below the average.

The overwhelming response across the board is that although the money is a welcome boost that the NHS has needed, it will not go far enough to meet either the growing demands or ensure sustainable development of quality services.

Here's the response from the experts...

Services and Providers

Chris Hopson, the chief executive of NHS Providers, appeared on the Andrew Marr show and welcomed the extra money for the over-stretched and underfunded NHS but commented: “We will want to see the details of the announcement, including the impact on the wider health budget, but the immediate task ahead is significant. After almost a decade of austerity, the NHS has a lot of catching up to do, just to deliver the standards of care the NHS constitution requires.”

CIPFA (Chartered Institute of Public Finance and Accountancy) chief executive, Rob Whitman, explains that the extra cash would fail to deliver long-term change and the NHS is likely to “remain relatively starved of capital”.

Glen Garrod, president of ADASS (Association of Directors of Adult Social Services) expressed disappointment at the failure to implement further investment into social care in this announcement, saying: “Putting money into the NHS without putting it into social care is like pouring water down a sink with no plug in. If we’re to truly put health and social care on a sustainable footing, we must tackle it as a whole.”

Unions and associations

The Royal College of Nursing (RCN) has welcomed the announcement of a 3.4% increase in NHS funding for England but has warned it won’t go far enough and further investment is needed for social care.

RCN Chief Executive, Janet Davies commented: “The Government’s social care cuts have piled pressure onto hospitals. Investing in home care and local community services helps stop hospitals becoming overwhelmed. Theresa May must be under no illusion that there can be a long-term solution for the NHS without a solution for social care too.”

Similarly, the Royal College of Midwives  (RCM) welcome the extra funding but also question whether it will be enough... Gill Walton, RCM chief executive said: “With most respected commentators and economists arguing for at least a 4% increase over a longer time period, we have major concerns that 3.4% will simply not be enough to meet the rising demands on the NHS or ensure further development of services."

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Chair of the British Medical Association (BMA), Dr Chaand Nagpaul, also claims the money is not enough and the BMA will be reviewing the details of this funding.

The Royal College of General Practicioners also call for a substantial share of the funding to go to general practice so safe and effective care can continue to be delivered within the community.

bma tweet

UNISON General Secretary, Dave Prentis, further echoed the welcome calls from staff for the extra funding, but he also reiterates that it is not "the long-term funding package health workers will have been hoping for" and he calls for commitments to future funding for above inflation wage rises for NHS staff. Going even further, he comments: “More importantly, the NHS needs a funding guarantee, not a pledge borne out of fantasy economics and the dubious prospect of a Brexit bonanza to see it out of the woods.”

Unite the Union's statement included reference to the failure to address the growing problems of staff shortages due to pay cuts, increased pressures on staff and recruitment issues. Not addressing social care also presents issues for the future of health and social care services. Gail Cartmail, the assistant general secretary, says: "The NHS is suffering from years of underfunding and while the promised additional money is welcome it is the absolute minimum needed to begin tackling the funding crisis.

TUC respond to the announcement with a statement concluding 5 key issues:

  • Funding increases are not enough.
  • What strings are attached?
  • Where is the money coming from?
  • There is no sensible workforce strategy.
  • It does not address social care.

Think tanks and commentators

Chief executive of the King's Fund, Chris Ham, said: “The Prime Minister has administered a welcome shot in the arm that will get the NHS back on its feet but not provided the long term cure that would restore it to full health.”

He further addressed the issue of social care, suggesting a lack of confidence in the funding plans: “While we welcome the Prime Minister’s assurance that future decisions about social care spending will not add to pressures on the NHS, this hardly suggests an ambitious statement of intent.”

The Health Foundation believe that the extra money will help to prevent further decline in the health service, but also agree that it fails to address the fundamental challenges faced by the NHS.

Anita Charlesworth, the director of research and economics for the charity, said: “Increases of at least 4% a year are the minimum needed to tackle the backlog of financial problems from eight years of austerity. Increases of just 3.4% a year mean longer waits for treatment, ongoing staff shortages, deterioration of NHS buildings and equipment, and little progress to address cancer care. Tackling the huge disparity in access to mental health care will have to be an aspiration, rather than reality for another five years.”

The Nuffield Trust also address that the funding does not take into account public health in terms of the need for extra training for staff and investment into social care.

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Essentially, the money is not enough...

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funding settlement graph

In summary...

The general consensus of responses to this "birthday present" extra funding for the NHS is that it simply is not enough.

The IFS reported in May 2018 that for the NHS continue to cope with the current demands, provide the same level of service as it does today and deal with the backlog of funding problems funding needs to grow by around 4% a year for the next 5 years. To make meaningful progress on staff shortages, mental health provisions and waiting times the NHS will need funding growth of around 5% a year over that same period.

However, this extra funding announced by Theresa May accounts for an annual real-terms increase of only 3.4% - well off the suggested growth rates put forwards by the IFS and leading think tanks.

This extra funding will be just enough to keep the NHS on its feet but does not provide a long-term solution for improving services and keeping up with increasing demands.