The denial continues despite the Kings Fund and the United Nations warning us … Listen to the eminent, the great and the good on Radio 4 since the announcement of the deficit. Nobody suggests rationing overtly – yet.. it is the GPs who have made the Health services efficient for many years, but lack of numbers, over-management, demographic changes, stupid innovations and obscene perverse incentives have all but destroyed them. IT overspend as a result of strategic failure compounds the problems.
Thinking of this as a financial problem is incorrect. It is an ideological and philosophical problem manifest in the finance. THE different Regional Health Services (there is no NHS now) are insurance based. Should there be a co-payment? Is there benefit in hypothecated taxation? Should there be regional differences in delivery? Should there be overt rationing of health services so that patients know what is not available to them in their own post code? Should the value of all goods and services be made overt to patients? Should the system encourage autonomy as much as possible? Do we believe in “deserts based rationing” for some people/goods/services? Do we believe in Everything for everyone for ever? And that’s without mentioning choice…
NHS hospitals have run up a record overspend of £1 billion in three months, prompting regulators to warn that the health service cannot carry on as it is.
Experts say the deficit means that patients will wait longer and receive poorer care as bosses struggle to balance the books.
A ballooning agency staff bill and relentless demand from an ageing population have pushed more than three quarters of hospitals into the red as they struggle to achieve efficiencies at the rate demanded by ministers.
A string of targets on A&E waiting times, ambulance response times and cancer treatment were missed in the first quarter of 2015-16, according to delayed figures from regulators.
Ian Wilson, of the British Medical Association, said: “These figures are staggering. The NHS is facing a funding crisis the likes of which we have never seen.”
Overall, NHS trusts overspent by £930 million between April and June, more than the £822 million deficit in the whole of 2014-15, and are on course to reach £2 billion this year.
Analysts urged the government to produce a plan to help the NHS to make the £22 billion of efficiencies demanded by 2020, but officials insisted that savings would kick in soon.
David Bennett, chief executive of the regulator Monitor, told hospitals that “radical and long-lasting change” was needed immediately. “The sector is under massive pressure and must change. The NHS simply can no longer afford operationally and financially to operate in the way it has been and must act now to deliver the substantial efficiency gains required to ensure patients get the services they need,” he said.
NHS bosses protested that they had been hit by a “triple whammy” of rising demand, a funding squeeze and the need for extra staff after the Stafford Hospital scandal. Hospitals spent £648 million on agency staff in the three months as they struggled to find permanent doctors and nurses.
Richard Murray, director of policy at the King’s Fund think tank, said: “The government must now acknowledge it cannot continue to maintain standards of care and balance the books. Unless emergency funding is announced in the forthcoming spending review, a rapid and serious decline in patient care is inevitable.”
Heidi Alexander, the shadow health secretary, said ministers were in denial. “With a difficult winter approaching, hospitals are facing a stark choice between balancing the books and delivering safe care,” she said.
Publication of the figures was delayed for more than a week and Nigel Edwards, chief executive of the Nuffield Trust, accused ministers of an “overly leisurely” attitude. “Financial problems on this scale cannot be explained by individual pockets of mismanagement. We are looking at a systemic problem across the health service,” he said.
A spokesman for the Department of Health said: “The NHS must play its part in delivering efficiencies, so we’re taking action to help hospitals clamp down on rip-off staffing agencies and cut spending on management consultants. We expect the impact of these measures to be reflected in figures released later in the year.”
Nick Triggle reported 9th October for BBC News: NHS deficits hit ‘massive’ £930m (as usual the BBC reports first)