News / MPs issue autumn statement challenge
Dr Wollaston wrote to chancellor Philip Hammond with the questions on funding following the committee’s enquiry into NHS finances. She said she was writing in advance of the chancellor’s autumn statement because committee members did not believe the government adequately recognised the pressure being faced by the NHS.
She criticised the government claims that it had given the NHS an additional £10bn up to 2020/21, insisting it was incorrect. ‘The £10bn figure can only be reached by adding an extra year to the spending review period, changing the date from which the real terms increase is calculated and disregarding the whole health budget,’ she wrote.
She added that a substantial part of the increase in NHS England’s allocation was funded by cuts in other parts of the health budget, including public health and education and training. The cuts amounted to £3.5bn between 2014/15 and 2020/21.Taking this into account and disregarding the 2014/15 funding rise to focus on the spending review period (2015/16 to 2020/21) the Department of Health’s budget will increase by £4.5bn, Dr Wollaston said.
Responding to the suggestion that the funding increase
is £4.5bn over the spending review period, HFMA policy director Paul Briddock (pictured) said: ‘This message shines a light on the increasing financial challenge facing the NHS and we fully support the calls for more clarity and transparency on the assigned funding.
‘Our research at the end of 2015 revealed that 92% of finance directors across CCGs and providers were sceptical that they would have sufficient funding and resource to implement the Five-year forward view. It is clear the NHS is struggling financially, and we share the committee’s views that extra funding is needed to cope with the demand on services.’
Dr Wollaston recognised the increase may still seem generous compared with other departments, but NHS inflation was ‘far greater’. Cuts to public health spending risked failing to achieve the Five-year forward view.
Reductions in social care spending, highlighted in the recent Care Quality Commission State of care report, were of more immediate concern. According to evidence heard by the health committee, without urgent action to improve social care the NHS cannot be expected to deliver the forward view.
Capital funding was needed to achieve the forward view vision of transformed services, yet funding was declining and had been raided to cut revenue deficits.
The letter also highlighted the deficit in NHS providers and that the frontloaded or U-shaped trajectory in funding increases could mean short-term pressures in 2017/18 and 2018/19 could become overwhelming.
Mr Briddock said the HFMA’s next temperature check, to be published in early December, would show how finance directors are coping with the difficult financial environment.
‘With speculation already in place over the required funding for the health service, it will be revealing to see whether the financial targets and service requirements are achievable – or if other scenarios need to be considered to make the NHS sustainable.’
NHS Providers chief executive Chris Hopson said the letter, which was signed by four other committee members, was a ‘clear sighted analysis’. He added: ‘Put simply, the gap between what the NHS is being asked to deliver and the funding it has available is too big and is growing rapidly. The committee has identified what has long been troubling those who run our hospital, mental health, community and ambulance services – in the face of spiralling demand for care from an older population with more complex needs, there is a big risk that the NHS will not be able to maintain services at current levels, let alone improve them.’
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