Financial Reality – The Health and Social Security budget will break us by 2020. We need to focus on duties rather than rights in healthcare..

NHSreality is taking this opportunity to display some graphics showing the Financial Reality – The Health and Social Security budget will break us by 2020… without reinventing the health service. (The secret will “Out”. NHS finances: Why we are being kept in the dark… The word “rationing” will continue to be banned from the political lexicon. )

Encouraging autonomy and self-sufficiency is the implication of the Nesta report (2013): People Powered Health could save the NHS £4.4bn a year

and in May 2015 the same organisation published Realising the Value focusses on efficiency gains rather than “constructive deconstruction”.

Nesta also has an optimistic punt at the future with “The NHS in 2030: a people-powered and knowledge-powered health system”

The Nuffield Trust gives the real cost adjusted for inflation

UK spending on public and private health care 1997-2013

and Nick Triggle for BBC points out the cuts to Social Care budgets:

Over 65mspend per capita

The Kings Fund talks about the “Projected potential growth in health care spending by 2040”:

Projected Health Spend 2040

Reading between the lines of another Kings Fund publication, the future is bleak. Devolution – What it means for health and social care in England, reads to me like a denial of the benefits of mutualisation. Larger mutual give greater benefits.. and Wales in particular, with the smallest mutual will suffer most from lack of choice.

The Yorkshire Post 7th Jan 2015 runs this article: Norman Lamb: Why we need a 21st century Beveridge plan for the NHS

The graphics below (apologies that dates are different and sources omitted) reinforce the parlous state of the finances, the demands of the demographic changes and technological advances…. but as the lowest graph shows, this is a G8 problem, and USA is in an even worse position with regard to health spend. We surely need to focus on duties rather than rights in healthcare provision.

Focus on older people
UK Welfare State spend

Total Spending 2017-20

Public private split 2013

The USA problem as seen 2007 - before Obamacare

NHS finances: A likely headache for the next government – Evidence of wriggling on the financial hook of rationing is everywhere.

Resilient NHS – gutless politicians – the problem that seems to prove the rule – politics is small and cannot discuss philosophical issues

NHS cash crisis: Patients to pay for hospital shortcomings – HOSPITAL patients could suffer this winter – The difference in bail out per capita will be interesting. Emergencies will always trump other demands..

Our NHS is in serious danger – we should be scandalised – GPs are being paid not to refer cancer patients to hospital and free hearing aids are being axed. All the politicians are cowards.. This is a healthcare system under strain, but where is the debate?

How much does NHS Wales spend? You can find out the basics, but not in comparison with England yet.


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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