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Spending review ‘another missed opportunity’ to turn round NHS

So-called extra funding just a drop in the ocean of what health and social care need, say doctors

Louise Prime

Thursday, 05 September 2019

The government missed another opportunity to turn around the NHS in its spending review, doctors and healthcare bosses have insisted. They warned that the “extra funding” is just a drop in the ocean of what is needed for health and social care, and not enough to deliver the government’s ambitions in the NHS Long-Term Plan.

Chancellor of the exchequer Sajid Javid told MPs yesterday that the government’s latest spending plans for an added £13.8bn investment in total public spending (a 4.1% increase) including healthcare, education and policing, represented “turning the page on austerity and beginning a new decade of renewal”. He reaffirmed its commitment to a £6.2bn increase in NHS funding next year, with investment in more training and professional development for doctors and nurses, and over £2bn of new capital funding; and also announced that councils will have ​access to new funding of £1.5bn for social care next year.


The NHS Confederation, which represents healthcare organisations, welcomed the much-needed extra funding for the NHS and social care, particularly to invest in new equipment and facilities and to help attract and retain staff through additional cash for training. But its chief executive Niall Dickson argued: “These are sticking plaster solutions and do not provide the long-term certainty the NHS needs. Funding still falls short in key areas, including capital investment, social care and public health. Public health in particular has suffered major cuts in recent years and we have an extremely long way to go before that is recovered.

“Some may believe the NHS funding debate is settled following last year’s announcement of £20.5bn of new funding. But other key areas of health spending were not included and they have only been partially addressed in this Spending Round.

“The extra £1.8bn in capital funding is welcome but substantially short of the £6bn needed to clear the massive maintenance backlog that has built up in recent years. The government must increase capital funding to ensure all NHS organisations can access capital investment to address crumbling buildings, failing equipment and outdated IT.”


He added: “The additional cash for training and retaining nurses is also welcome but it’s a drop in the ocean. It is not nearly enough to cover the lost funding for continuing professional development that we have seen in recent years and it will not, on its own, address the staffing crisis the NHS is facing.”

Dr Sarah Wollaston, elected in 2017 as Conservative MP for Totnes but now a Liberal Democrat, echoed Niall Dickson’s warnings in her response to the chancellor’s speech. She said: “This morning I met with NHS trust leaders from around the country; they painted an absolutely shocking picture of infrastructure that is crumbling, unsafe and broken. They welcome the unfreezing of £1bn so that they can get on and fix some of that, but it does not go far enough; there is a £6bn backlog, and they are asking for us to reach the levels of comparable countries in spending on NHS infrastructure.”

Mr Javid argued that yesterday’s announcement was about day-to-day resource spending, whereas he had already made changes: “a few weeks ago… to unlock or bring forward £1bn of new capital investment in our hospitals and an additional fresh £850m on top of that to upgrade 20 hospitals.”

The British Medical Association (BMA) pointed out that two-thirds of the ‘extra’ £6.2bn NHS funding lauded by the chancellor is not new funding at all, having previously been announced in 2018 – and, as the BMA said at that time, it is inadequate to deliver the Long Term Plan. BMA Council chair Dr Chaand Nagpaul, BMA council chair, said: “After years of underinvestment, the NHS has been left struggling to cope with year-round pressures, leaving patients suffering long waits and doctors and their colleagues with rock-bottom morale. Today represents another missed opportunity from the government to turn this around.”

He went on: “There was no reversal to the £1bn public health cuts since 2015, so that common illnesses can be prevented; no detail on exactly how the government plans to support doctors in training, stop them leaving through burnout, and future-proof our medical workforce; and no long-term capital spending plan to address the £6bn maintenance backlog or investment in GP practice premises, so desperately needed to ensure patients are being treated in safe, up-to-date buildings.

“Meanwhile, the success of our health service relies on a high-quality, safe and properly-funded social care system, and the £1.5bn announced today falls short of what experts say is urgently needed to stave off the crisis in social care. 

“These are all areas that need urgent attention and long-term investment, not desperate short-term measures.

“Amid the chaos unfolding in Parliament, the NHS needs certainty, and today’s one-year plan, rushed out ahead of the October 31 Brexit deadline, does nothing of the sort.”

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