Hospital deficits could force NHS to divert money meant for improving care
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Version 0 of 1. The NHS expects hospitals to go on racking up such large deficits in the next few years that it will have to divert £5.4bn earmarked for improving patient care to prop them up, experts claim. NHS trusts in England, which recorded a collective deficit of £2.45bn last year, are meant to reduce their overspending this year to only £580m to help tackle the service’s acute financial problems. But the Nuffield Trust thinktank has discovered that the £1.8bn trusts will receive this year to help wipe out their deficits will be made available to them again in 2017-18 and 2018-19, despite NHS pledges that they will have got close to balancing their books by the end of March. However, using that £5.4bn for deficit reduction will threaten the chances of success of the NHS’s plan to ensure its own future, according to Sally Gainsbury, the thinktank’s senior policy analyst who unearthed the planned diversion of funds. That is because the money will be swallowed up by cash-strapped hospitals and will not be available to be ploughed into overhauling how care is delivered, which NHS England chief executive Simon Stevens has made clear is vital if the health service is to stem the rising demand for care and ensure it remains sustainable. The disclosure of a cash shortage in the NHS comes as Stevens and health secretary Jeremy Hunt prepare to face tough questioning from MPs on the Commons health select committee on Tuesday about the state of the service’s finances. MPs are likely to ask about Theresa May’s decision, revealed by the Guardian last weekend, that the NHS will not get any extra money in next month’s autumn statement, despite fears that it is coming under unsustainable pressures. If the NHS cannot stop demand for A&E and other care rising from the current 3% increase a year to the 2% increase it hopes to achieve by 2020 – which giving the extra £1.8bn a year bailouts to trusts makes more unlikely – then hospitals will fail to get their finances back on track, Gainsbury added. “The risk is the NHS starting the next decade with a recurrent overspend of more than £2bn a year, even after the painful cost cuts providers are currently being asked to make to reduce their deficits,” said Gainsbury. “The fact that there is now less money available for investing in service transformation than originally envisaged matters because the NHS desperately needs to slow the pace at which the demand on its hospitals is growing. If that doesn’t happen through careful investment in alternative services and public health improvement then the risk is it will happen instead through crude rationing and service closures.” The planning guidance which NHS England issued to the service last month made clear that the sustainability and transformation fund, which Hunt created last year, will “focus on supporting sustainability rather than transformation, aiming not to fund service enhancements but to sustain services”. NHS England confirmed that all the £1.8bn in the fund this year will help cover hospitals’ deficits; and that of the £2.9bn it has set aside for sustainability and transformation activities in both 2017-18 and 2018-19, of that £1.8bn each year will be used to help ease the financial situation of NHS providers of care and the other £1.1bn to transform how it cares for patients. Meanwhile, a survey has found that 70% of Britons are prepared to pay an extra one pence in income tax to help fund the NHS, and almost half (48%) would pay an additional two pence. An extra penny on the basic rate of income tax would raise around £4.5bn, and 70% of those questioned for ITV1’s programme The Agenda said they would be happy to see a tax hike on this scale if it was guaranteed that all the money would go to the NHS. The same poll found that almost half of Britons (46%) think that the NHS is performing badly, double the number (23%) who think it is performing well. There is little public support for charges being introduced for NHS services to help ease its financial problems. Just one in four (27%) of those questioned said they would be willing to pay £5 to see their GP, while 66% said they would not. If that cost £10 then only 15% would be happy to pay, while 79% said they would not. Chris Hopson, chief executive of NHS Providers, which represents hospitals, said: “We know the NHS is under the greatest pressure in a generation. Patients can see this pressure. They’re saying very clearly that they are happy to pay a bit more income tax to get the right quality of care and relieve the pressure on the NHS. We elect governments to make decisions on the NHS budget and we hope the new prime minister and chancellor are listening. “And an extra penny on income tax would only give the NHS a quarter of the extra £350m a week patients were promised in the Brexit referendum campaign.” |