NHS will be tested to limit by savings finds MPs
The NHS will be ‘tested to the limit’ as unprecedented savings ordered by ministers take effect on the front line, a powerful group of MPs have warned.
The Coalition pledge to increase spending on health in real terms will not be met, the Commons Health Select Committee has warned.
It means the scale of the savings required to meet rising demand with a shrinking budget is even greater.
The report quoted NHS chief executive Sir David Nicholson saying: “It is huge. You don’t need me to tell you that it has never been done before in the NHS context and we don’t think, when you look at health systems across the world, that anyone has quite done it on this scale before.”
Sir David predicted last year that the NHS would need to save between £15bn and £20bn over the next four years to keep pace with an ageing population, rising costs and lower funding settlements from government.
The Health Select Committee warned that severe cuts in social care budgets will also hit the NHS as there is a real danger some local authorities will have to reduce the eligibility criteria they use for care services meaning the NHS will have to pick up the pieces.
A large part of the savings is expected to come from paying hospitals less for treatments and operations but the report warned this could result in trusts refusing to provide surgery that they make a loss on.
The Committee was also critical of the government’s reorganisation of the NHS saying that many experts had suggested that it was too complex to try and attempt this at the same time as making such huge savings.
The report said the government must urgently release details of how much they expect the changes, which include abolishing primary care trusts and setting up GP consortia, to cost.
Stephen Dorrell MP, chairman of the committee, said: “The government’s plans for health and social care are based on assumptions which will test these services to the limit.”
Nigel Edwards, NHS Confederation acting chief executive said: “The Committee has hit the nail on the head with the concerns it has highlighted in its report. It has shown a thorough understanding of the fierce pressure that the health and social care sectors are now under.
“All at the same time, NHS trusts are grappling with unprecedented efficiency savings, major management cuts and radical structural reforms. It’s a mixture that is causing real anxiety among NHS leaders.
“We need the government to show that it understands these issues when it announces the next stage of its programme later this week.”
Dr Peter Carter, general secretary of the Royal College of Nursing, said: “This report echoes our fear about the current efficiency challenges facing the NHS. We fully support the Committee’s view that efficiency savings should not be about cuts, but achieving more with the same amount of money.
“Sadly, with 27,000 posts already earmarked for cuts, this message is clearly not reaching NHS Trusts. Some Trusts are already cutting jobs and services at an alarming rate, making short-sighted decisions to plug the gaps in their budgets.”
Dr Hamish Meldrum, chairman of the British Medical Association, said: “Doctors have been working hard to help identify how services can be delivered more efficiently without affecting patient care, and are at the forefront of leading innovation and improving services that will benefit patient and reduce costs. However, doctors are also seeing widespread cuts to staffing and services. There is evidence of posts being frozen and services rationed.
“Despite the Government’s pledge to protect the NHS budget, it would appear that the sums are wrong and there is a now an additional shortfall of over £2 billion. NHS Employers has asked staff to plug this gap by hammering their pay even further.”
John Healey Shadow Health Secretary said: “The last thing the NHS needs is a high-cost, high-risk reorganisation at a time when, in the government’s own words, it is attempting to make ‘unprecedented’ efficiency savings.
“But of equal concern is that the plans follow promises made both before the election and in the Coalition Agreement that there would be no more top down reorganisations in the NHS.
“Promises since broken by a Health Secretary operating in isolation in Whitehall and running a rogue department.”
A Department of Health spokesman said: “The Government is committed to the NHS – to sustain and to improve services in the face of a tough economic climate. But even with this commitment, in order to meet demand and improve the quality of services, the NHS needs to make up to £20 billion of efficiency savings by 2015.
“Reform isn’t an option, it’s a necessity in order to sustain and improve our NHS. We have been clear that the NHS must cut back on bureaucracy, not on frontline care.
“Overall funding will increase by more than 10 per cent in cash terms over the Spending Review period. And the day-to-day funding for the NHS will grow in real terms for the next three years.”
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