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MPs question NHS budget claims

And they express ‘grave doubts’ about ability to deliver Five Year Forward View

Mark Gould

Tuesday, 19 July 2016

A new report by MPs concludes that government claims about health spending are unfounded and expresses "grave doubts" about the capacity of the NHS and social care to deliver on the goals of the NHS Five Year Forward View. The cross-party House of Commons Health Select Committee said that while the government has made much of stating that the NHS in England was receiving an extra £8.4bn on top of inflation, the true figure was about £4.5bn.

The report says that instead of focusing on the whole health budget, ministers highlighted the amount going to the frontline via NHS England. In 2015-16 that was about £101bn, but that ignored £15bn of money set aside for other aspects such as training and public health. This is being cut once inflation is taken into account and means the total health budget rises from £116bn in 2015-16 to just over £120bn by the end of the parliament.

MPs said this was important because the cuts to other areas of spending would have an impact on everything from staffing to health promotion schemes, such as obesity programmes, which have a direct impact on the frontline of the NHS.

The committee also said the scale of overspending last year - NHS trusts finished 2015-16 £2.45bn in the red - would mean large chunks of the extra money being used to cover deficits.

The report concludes: "There are grave doubts about the capability and capacity in both the NHS and the social care system to achieve the vision set out in the Five Year Forward View, especially given the acute and increasing financial pressures which are apparent in the hospital sector and in social care. With much of the upfront investment flowing from the Spending Review being used to address deficits, there is a real danger that greater integration and the move to the new models of care set out in the Five Year Forward View will stall."

The Department of Health rejected the conclusions saying that in spite of public finances being tight the government had found the money needed. But Nigel Edwards, the chief executive of the Nuffield Trust, agreed that there is a serious gap between government rhetoric and reality.

“As the Nuffield Trust warned at the time, the £8bn headline increase announced last year for the NHS is partly based on taking money away with one hand to give back with the other. There will be tough cuts to public health, training for nurses and doctors, and money to invest in buildings and equipment: budgets which provide crucial support to frontline services.

“This report puts into sharp relief the situation now facing the service. Heroic savings are required against a backdrop of struggling social care and rising patient numbers. I worry that this situation is creating a disconnect between what NHS managers and staff are told to do, and the reality they see in front of them. This contributes to a growing problem of disengagement from the NHS workforce, expressed in difficulty recruiting and keeping full-time staff in key areas – at the very time we are asking them to go the extra mile to transform the way they work," he said.

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