Speaking at the NHS Confederation Expo in Liverpool this week, health secretary Sajid Javid has talked down the idea of increasing funding for the health service by four per cent per year in real terms, warning that record waiting times for A&E care will not be a “quick fix”.
Javid made the comments after Amanda Pritchard, chief executive of NHS England, had called A&E waiting times “unacceptable” and admitted that it was difficult to see the social care crisis improving ahead of the winter months.
Pritchard told attendees: “The unacceptable rise in 12 hour waits for admission from A&E underlines an issue, as you know, is flow.
“You can trace the line from delayed discharges to A&E crowding all the way through the slower ambulance response times.
“It is difficult to see social care capacity being significantly expanded ahead of winter. So, the NHS must do everything in its power to tackle this.”
The underequipping of the social care sector is having a knock-on effect on hospitals due to bed-blocking, which is leading to record waiting times for patients presenting at A&E and making it difficult for service users to access GP appointments.
However, the health secretary suggested that increasing funding will not come as a magic bullet to fix the issue.
Javid said: “Funding will only ever be part of the answer. Growing health spending at double the rate of economic growth over the next decade, as I’ve heard some propose, is neither sustainable, desirable or necessary.
“I don’t want my children any children, anyone’s children to grow up in a country where more than half of public spending is taken up by healthcare at the expense of everything else from education, to housing.
“That’s not a fair deal for the British people, particularly young people.”
The NHS’s historical average annual funding increase between its formation in 1948 to 2009, the year before the Conservatives came into power under David Cameron, stood at four per cent.
The latest funding increase stands at 4.3 per cent, but due to the impact of inflation the NHS Confederation says that it could amount to a meagre 2.6 per cent in real terms.
By 2024-25 the annual NHS funding rise will have fallen to 3.6 per cent on average since its foundation in 1948, following a decade of austerity measures under the Tories.
Javid highlighted findings from The Resolution Foundation, which suggest that the 2020s are likely to yield the quickest rate of ageing in any decade from the 1960s to 2040s.
The health secretary said: “As our population gets older, more and more people are living with increasingly complex long-term conditions. Treating an 80-year-old is four times more expensive than treating a 50-year-old.
“You know at the start of this century, in 2000 health spending represented around 27 per cent of day-to-day public spending by 2024. That figure is set to rise to 44 per cent.”
However, the NHS Confederation’s chief executive, Matthew Taylor, called for a real terms increase in funding of at least four per cent per year for the next 10 years.
Taylor said: “We must learn the lessons of austerity and the ‘feast or famine’ approach to funding. We welcomed last year’s settlement for health and care.
“We may argue with the secretary of state and Treasury over its adequacy given the impact of inflation, but we can surely agree that it was only the first step back to financial sustainability.
“We are accountable to the taxpayer and we all want to flatten the demand curve and get to a position of financial sustainability. But we won’t get there until we close the capacity gap. This is why the NHS Confederation will call from all parties for an explicit commitment to the kind of real term funding increases that was given to the NHS from inception till 2009.
“That means at least four per cent per year in real terms for the next decade. This is in line with pre-austerity averages and the amount that the Health Foundation estimates is needed to ensure quality of care in the face of rising expectations, rising costs and population ageing.”
Vic Rayner OBE, CEO of the National Care Forum – the leading association for non-profit social care providers – said that greater collaboration across the health and social care sector was needed to better out-of-hospital care and help tackle the record NHS waiting times.
Rayner talked-up the need for innovation in developing new community care models that can meet a changing society post-pandemic, to address the needs of groups of people who have been left out or excluded from the health and care agenda.
Rayner said: “The social care reform paper has huge ambitions to enable integrated care and health for people. Yet there must be robust social care voices at the top table and opportunities for social care providers to share their wealth of knowledge and expertise at the heart of the health and care system.
Rayner also called for greater levels of investment in the social care workforce and for the urgent need of a fully funded People Plan for social care that provides clear career progression, better recognition, terms and conditions and investment in training and development.
Meanwhile, Nigel Edwards, CEO of the Nuffield Trust, was concerned that new policies that are not backed up by increased spending will do little to address the issues currently plaguing health and social care.
Edwards said: “It is hard to argue against a renewed focus on the workforce, better use of digital technologies or efforts to drive down health inequalities. But it’s hard to see how this blizzard of policy initiatives, coupled with a determination not to spend more, will address the fundamental problems wrought by years of underinvestment, woeful failures in workforce planning, and increased healthcare need. The NHS needs more people, not more policies.
“In fact, there is a danger that meeting these problems with nationally driven policy hyperactivity unsupported by any additional spending will backfire, causing services to spend large amounts of time looking upwards to Whitehall when they need to be tackling the backlog and delivering the best tailored care for patients in their local areas.
“Meanwhile the national policy initiatives that are needed, such as the hospital building programme and reforms to social care, are failing to deliver the results expected. Getting the right staff in the right place, improving facilities and equipment across the NHS, fixing social care and stabilising general practice should be an absolute priority for this government.”
Image taken from Wikimedia Commons
