How will NHS survive after the election

Ahead of the General Election, politicians must “not duck crisis in NHS to focus on ‘Brexit election’,” British Medical Association council chair Dr Mark Porter warned.

Turning 69 next month, the NHS is heading towards a breaking point.

Last January, waiting times in A&E hit a record with around 85 per cent of patients waiting four hours to be seen, the lowest performance since 2004, according to NHS England. Nine hundred and eighty-nine patients waited for more than 12 hours, compared to 158 a year earlier.

“The NHS hospitals and other services have been running up significant deficit for the last four financial years. Some of that was covered up through clever accounting until 2015/16 when a very large deficit emerged. Hospitals and other services spent £2.5bn more than they have coming in. But we think the real underlying debt was a deficit in the region of £3.7bn, the equivalent of the NHS not having money two weeks in a year.

“£1.8bn extra was given to hospitals in March 2016 but it doesn’t take a mass genius to see that £1.8bn can’t cure a £3.7bn problem,” said Sally Gainsbury, senior policy analyst at Nuffield Trust.

The NHS Five Year Forward View, a document reviewing the progress made since its launch in 2014 and looking at the future of health care, estimates that health service will face a funding shortfall of £30bn by 2020.

“The proportion of GDP spent on the NHS is falling and reduced compared to other nations, such as France, Germany or Scandinavian countries,” said Dr French, a sexual health specialist at the Central and North West London NHS Foundation Trust.

In 2013, the UK spent 8.5 per cent of its GDP on public and private health care, ranking 13th out of the 15 original European countries, according to the latest Organisation for Economic Co-operation and Development data.

Currently, the NHS is mainly funded from general taxation and National Insurance contributions.

But as the UK population is increasing and living longer, with multiple long-term illnesses, the demand for health care and costs are rising.

“Hospitals over the last two years have had to do a lot to cut their costs. The problem in a hospital or any health service is that 70 per cent of your costs is actually your staff.

“It then builds up waiting lists because if hospitals don’t have enough staff, people can’t get their planned operations and now they [hospitals] are quite far below the standards that have been setting stone for the last decade,” said Gainsbury.

As much as the main political parties are divided on different issues, they all have committed to increasing the NHS funding.

However, an analysis of four different spending scenarios by the Nuffield Trust showed that all three main parties will fall short of the rising demand within the five-year mandate.

The NHS budget for 2017/18 is £124bn , set to reach £128bn in the next five years if we carry on with the existing spending plans.

But based on the scenarios, the required spending ranges from £137bn to £155bn.

The “extra £6bn” proposed by the Liberal Democrats and the £8 billion offered by the Conservatives would amount to £132bn, while the “extra £8bn” per year promised by the Labour would bring a total of £135bn.

“There isn’t a huge difference between the main parties. Labour has offered slightly more but still, none of the parties will give enough money to allow the NHS to continue on sustainable footing.

“One of the scenarios we looked at was how much money would the NHS need at the end of the next Parliament, if it kept doing the same work it’s doing now, if costs went up, if they removed the cap on staff pay and found additional cost savings. We estimate that it will need £141bn. The closest would be Labour, with its £135bn, but we would still be £6bn short,” said Gainsbury.

Whichever party forms the next government, the UK will need more funding to protect the NHS. But according to a 2017 Ipsos Mori survey, people are willing to pay more, with 64 per cent preferring to see increased taxes rather than reduced levels of care.

 

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