A recent article in the Economist questions the reality of the UK Government’s claims that the NHS needs to become ” more efficient” and that ” efficiency savings ” can lead to a sustainable health service. The report makes it clear that the UK is not spending enough on healthcare to retain a world class service and choices over the future rationing of care and deterioration in standards of care must follow if this path is to be continued down . The continuing claims of successive Health ministers that the NHS is ” inefficient ” or “… not showing the expected productivity gains” are a smokescreen for chronic underfunding and catastrophic reorganisation from the top down once again after the introduction of the Health and Social care Act by the former health minister Andrew Lansley (?set to become Britain’s European Commissioner).
This graphic highlights the UK’s health spending ” Deficit” compared to other nations
The UK needs to decide on how to finance its Healthcare needs whether through Co-payment , Insurance or by increased Taxpayer funding …… the status quo is simply not going to meet the needs of the UK population as it ages, expectations of care rise and technology advances .
“Filling the gap”a report by the Health Foundation offers some ideas to close the NHS funding gap
(Tax and fiscal options for a sustainable UK health and social care system Adam Roberts, Spencer Thompson, Anita Charlesworth, Ben Gershlick, Alfie Stirling ,The Health Foundation November 2015)
- Our analysis shows that despite government commitments to additional funding for the NHS in the UK, there is still likely to be a shortfall of £2bn in 2020/21, rising to £9bn (above inflation) by 2030/31.
- For adult social care the pressures are greater. We forecast a funding shortfall of £6bn by 2020/21, rising to £13bn in 2030/31, assuming there is no change in policy.
- The projected health funding gap of £9bn in 2030/31 is worth 5% of the projected budget that year; for adult social care the funding gap of £13bn is equivalent to 62% of the total expected budget for 2030/31.
- The combined pressures on health and social care funding will amount to an estimated shortfall of £8bn in 2020/21 and £22bn in 2030/31.
- The government has committed to eliminating the deficit in the national budget by 2019/20 and is planning to run a surplus of £10.5bn (0.5% of GDP) by 2020/21. If the planned fiscal surplus of 0.5% of GDP were spent on health and adult social care, it would close the combined funding gap in 2020/21, but leave an estimated shortfall of £8.4bn in 2030/31.
- One alternative to taxing income and employment is to tax consumption and in particular consumption that has a harmful effect on health – a so called ‘sin-tax’. The report looks at taxing sugar specifically.
- There are choices that need to be made about the medium to long term financing of health and adult social care. One option is to bridge some of the gap through a lower public finance surplus than currently planned; another is to increase taxes.
- While our analysis suggests that the NHS faces considerable pressures, it does not appear unsustainable. However, there must now be real doubts about the sustainability of the current financing system for adult social care.
New deal risks junior doctor ‘brain drain’ – Hannah Summers in The Sunday Times
Read the whole Economist article (with apologies): Carry on Working – The Economist Nov 2015