A History of Neglect – The Underfunding of Our Health Services

The state of the NHS has become a major election issue; unions, patient groups, campaigning organisations and numerous other bodies have been joined in opposition to government health policies by NHS Providers, the body that represents hospital trusts.

The Kings Fund new report, “The NHS Under the Coalition”, says that historians will not look favourably on the coalition and how they dealt with the NHS. In the Health and Social Care Act competition has been extended and decision making supposedly devolved. The Kings Fund view is that the Act is damaging and distracting.

The government has been unable to keep up with even its own health care or financial targets. Those for A&E, cancer treatment and routine operations were reported to have been missed at the half year point in October. In 2013-14 there was a £100 million deficit causing massive problems. This year the deficit has already increased to over six times that amount.

Under the ConDem coalition NHS funding has gone up by a yearly average of 0.7% “in real terms”, a fact which has been often made by government apologists. They were, after all, carrying out the neoliberal and EU policies of reducing public spending which were pursued by the previous New Labour government. In the decade to 2013, although the health service operated at a surplus, there were too few staff and the quality of services deteriorated in many hospitals across the land. The insistence on keeping to budgets which were inadequate, led to hundreds of deaths and grave distress to so many patients, as exposed at the Mid Staffs Trust and numerous other hospitals.

The 2011 decision to make 20 billion of “efficiency savings” by 2015, has also led to the financial crisis in Health. The Nuffield Trust found in 2012 “that financial pressure on hospitals is associated with improvements in ‘crude’ productivity”; they also found that competition on price has led to a worsening of quality. This latter point was made strongly by many people and organisations before the 2010 election, when it became apparent that the Tories would allow price to be an element in determining who won contracts in the Health Service.

There was a great public and professional outcry over the deaths and poor quality reported by the Francis and Keogh Reports. The government did not see fit to increase budgets, despite saying there should be more staff, that they should be better educated and that safety and quality should be a priority. Inn his autumn statement the Chancellor said £2 billion will be added to the NHS budget, but £700 million of this ‘winter pressure’ money is to be taken from other parts of the NHS.

In November the Kings Fund called for a further £2 billion for NHS Budget for 2015-16. They referred to the financial crisis in the NHS as unprecedented and endemic. This has reached such proportions that hospital chief managers have rejected plans for funding the NHS. Chris Hopson of the NHS Providers stated that 80% of hospitals are in deficit and so safe care can no longer be guaranteed. NHS Providers have blocked agreement on the funding formula.

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