Raiding the NHS budget or scrapping plans to rebuild crumbling hospitals would plunge the health service into its deepest crisis in decades. This was the stark warning this weekend from Matthew Taylor, chief executive of the NHS Confederation, who said the government is “living in a fantasy land” if it believes it can cut funds to the NHS without endangering patients.
Jeremy Hunt promised spending cuts of “eye-watering difficulty” last week after becoming chancellor of the exchequer. Yet he also did not reverse his predecessor Kwasi Kwarteng’s decision to scrap the £7bn health and social levy that had been earmarked for the NHS.
Taylor, whose organisation represents hospitals, ambulance trusts, mental health care, community care and GP services, said his members were issuing the “starkest warning” about “the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available”.
“We’re already looking at making unprecedented efficiency savings,” he told the Observer. “If the NHS is asked to deliver even more savings, then patients and local communities will pay the price. There is now a real and present danger to the NHS and anyone who thinks that further public sector funding cuts won’t have a direct impact on patient care and safety is living in fantasy land.
“NHS staff continue to do all they can, where they can, to improve NHS efficiency and productivity and tackle the care backlogBut they are being held back by budgets which have been hit very hard by inflationary pressures.”
The NHS in England is dealing with a waiting list of 7 million people, 132,000 staff vacancies and hospitals that are struggling with massive pressures on emergency departments and a fresh wave of Covid and flu cases.
Meanwhile hospitals and equipment are crumbling. The NHS maintenance backlog will now cost £10.2bn to fix. Nearly one fifth of that money needs to be spent on “high risk” repairs required to prevent catastrophic failure, major disruption to care or safety issues that could cause serious injury or prosecution.
Thirty hospitals have roofs in danger of collapsing, and energy bills have gone up by 21% since last year to £790m. Although Boris Johnson pledged to build 40 new hospitals, the Infrastructure and Projects Authority has given the project an “amber/red” ranking.
“One of the biggest mistakes the government could make is to raid capital budgets to plug holes in the day-to-day spending budget,” Taylor added. “This happened in the 2010s and it’s one of the main reasons why we now have over 130,000 staff vacancies and a crumbling estate and infrastructure.”
“It’s a false economy to disinvest in capital as it will mean local services are less able to make the changes they need in order to improve efficiency. This is a mistake that the government must not repeat over the 2020s.”
An independent analysis by consultants Carnall Farrar commissioned by the NHS Confederation found that for every £1 invested in healthcare, the economy gained £4.
More than 400,000 people have left the jobs market due to long-term ill-health since the Covid pandemic began, and the analysis showed that a 1% decrease in long-term sickness led to 180,000 workers returning to work.
“As well as delivering for patients, the NHS must be seen as an essential building block for the economic growth that this government wants to drive over the medium and long term,” Taylor said.
“If, as we unfortunately expect, further cuts are still to come, we need the government to be transparent with the public about the service they will get from the NHS in the months and years ahead.”
Hunt is expected to give details about where cuts will fall in his fiscal statement on 31 October.
