Talk about understatement. “…there is growing evidence of the rationing of care”.

A letter and a leader in The Sunday Times. The letter, from 2 college presidents, says “…there is growing evidence of the rationing of care”. Talk about understatement…. and this even from those who might have expected gongs. They can say goodbye to them now..

Spending review must give NHS a vital shot in the arm

THE comprehensive spending review comes at a critical juncture for the NHS. The settlement will determine whether our patients will receive less of the same, or if we will be able to transform the NHS and improve the way care is delivered.

The NHS treats more people than ever before. However, we know that the combination of an ageing population, an increasing number of patients with complex long-term care needs and the increased cost of new treatments is taking its toll. The service is being pushed to breaking point.

Patients are waiting longer for vital treatments and there is growing evidence of the rationing of care. This may all be further exacerbated by proposed significant cuts in public health spending.

NHS England’s Five Year Forward View gives a way to progress that supports the integration of primary, secondary and community care much more effectively than before and should ensure that patients have access to the right care for their needs.

We fully support the view of Simon Stevens, chief executive of NHS England, that the government must front-load the £8bn it has committed to the NHS this parliament, in the next two years.

With this review, the government has the opportunity to signal that the next five years are about transforming and improving the NHS, and not just continuing the struggle to maintain existing patterns and standards of care.
Clare Marx, president of the Royal College of Surgeons;
Professor Jane Dacre, president of the Royal College of Physicians

The Sunday Times leader 15th November 2015: Nobody will gain from this doctors’ strike

The National Health Service is under strain. Years of irresponsible feast under the last Labour government have been followed by what many see as unsustainable famine. The NHS budget is ringfenced against the cuts faced by other public services but, faced with a rising population, demographic changes and medical advances that are often expensive to implement, it usually does not feel like it to those working within it.

In a letter to this newspaper the presidents of the two main medical royal colleges say the NHS is “being pushed to breaking point” by the squeeze on resources. “Patients are waiting longer for vital treatments and there is growing evidence of the rationing of care,” write Clare Marx, president of the Royal College of Surgeons of England and Professor Jane Dacre, president of the Royal College of Physicians. “This may be further exacerbated by proposed significant cuts in public health funding.”

That the NHS is under pressure is not in doubt, although it would be wrong to conclude that it is in full-blown crisis. The waiting time target for 92% of patients to be treated within 18 weeks is being missed in surgical specialities, though not by much. Official figures for England show a range running from 89.6% for neurosurgery to 91.9% for ear, nose and throat. Similarly, 93.4% of accident and emergency patients are seen within four hours, only just shy of the 95% target, despite the fact that A&E departments are dealing with significantly larger numbers of visitors.

The letter from the royal college presidents is aiming to put pressure on George Osborne ahead of his spending review in 10 days. In this they are echoing Simon Stevens, head of NHS England, who has urged a front-loading of the extra £8bn that has been promised during this parliament. Such a demand deserves to be listened to sympathetically by the chancellor, although he will rightly want firmer evidence that the NHS is delivering on the efficiency savings that were part of the funding deal.

One other thing is clear. The threatened strike by junior doctors next month will undermine the NHS and harm patients. Sir Robert Francis QC, who led the public inquiry into the Mid Staffordshire NHS scandal, has written to junior doctors urging them not to put patients at risk and warning: “I find it difficult to believe such action will be in anyone’s interests.”

Jeremy Hunt, the health secretary, could have been more careful in his negotiations over the new contract for junior doctors, but he is up against the British Medical Association which always resists change. Mr Hunt is right to say the government has a manifesto commitment to deliver safe weekend care, following this newspaper’s campaign for a proper seven-day NHS; delivering it requires a new contract for junior doctors. They should call off their proposed strike and get back to talks.

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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