Can the NHS survive debt?

Published: 05 December 2016 Ezine

Author: Warren Town, director of industrial strategy

There is not a day goes by when we do not hear about rising debt in the NHS. Just as we seem to be subject to an endless stream of solutions.

The Autumn Statement from the government did nothing to address any concerns about how we can afford health for the future and said nothing about funding care, which is also in crisis.

In the 2015 spending review, £3.8bn above inflation was allocated to health in England for 2016/17. The intention was that this allocation would then increase annually to £8.4bn by 2020. But the Health Select Committee contest this assumption and that once you take into account the timing of the announcement and cuts in other areas of health care, the actual increase is £4.5bn, half of the expected amount.

For England at least, the answer hinges on the Sustainability and Transformation Plans (STPs). But how long will these take to come to fruition and even if they seem to address the underspend, the clock is ticking and debts are increasing.

What was once ‘X’ amount will only increase to ‘Y’ as time moves on and logically once STP1 takes effect, will we then move onto STP Take 2?

With the winter approaching, which is often the time when the NHS is stretched most, the pressure on A&E and the care system will be acute.

But the worry is that in England there is already growing opposition to the STPs, which are seen as saving costs first, patients and services last.

The problem is that once the rot sets in, panic takes over. How long before we see some form of restrictions or rationing that is designed to save money but is couched as being in the patient’s interest.

How about today? (29/11/16):  NHS Vale of York Clinical Commissioning Group (CCG) have announced that overweight patients will have to lose 10% of their weight before surgery and smokers (who will we assume go to the bottom of the queue) will have to wait six months for treatment.

"Why?" you may ask. Is it because these groups are an easy target and do not have public sympathy?

The clinical lead has stated that these measures are the ‘best possible outcomes in the long term’ and will ‘protect finances’.

You have to wonder as to the thinking. How do we save money? Thinks Vale of York CCG, “Oh, I know, let’s pick on the two groups that rarely get public support and couch the decision in terms of better health with saving costs as an afterthought!”

You have to wonder who is next. We are all equal in the NHS but some are less equal than others!