It is becoming as familiar as Halloween or 5 November fireworks – a crescendo of demands for more money for the NHS ahead of the Autumn Statement. So is it any different this time and are the financial pressures more intense than before?
In 2014, ahead of the general election, George Osborne, then Chancellor of the Exchequer, conjured up an extra £1.9bn for the NHS in England for 2015-16, after warnings there had been an unbridgeable gap in the finances.
Under the usual funding formula, this became £2.2bn across the UK, on the assumption the devolved administrations spent their allocations on health.
This was unveiled with a hospital photo opportunity involving Mr Osborne, Simon Stevens, of NHS England, and the Health Secretary Jeremy Hunt and was widely welcomed by health commentators and think tanks.
The election came and went, and it was not long into the 2015-16 financial year before hospital trust bosses were warning of mounting deficits and the sums not adding up.
Fast forward to the autumn of 2015, and Mr Osborne was publishing his Spending Review for the years up to 2020….
…NHS England is committed to finding up to £22bn of annual efficiency savings by 2020.
Across 44 areas of England local health and social care, leaders have been told to come up with sustainability and transformation plans (STPs), to make better use of resources and redesign services.
A poll of local commissioning groups by Health Service Journal has shone some light on the process.
Of those that responded (just under 50%), nearly half had plans to reduce hospital beds and a third intended to close or downgrade accident and emergency departments as part of their STP.
The underlying problem is the same as it always has been.
The NHS has a finite level of resources allocated by governments but has to cope with unlimited demand.
What looks like a good settlement the year before can seem more like a sticking plaster solution as the cash gets swallowed up in the face of unpredictable increases in patient numbers.
The money will be tight across the board in this Autumn Statement.
The chancellor and the prime minister may decide to leave the NHS to make better use of the above inflation increases already awarded.
But in doing so they may have to face damaging headlines as the NHS struggles to cope through this winter.
If Labour policy allows local taxation for the locally based Health Services, then we have official Post-Code rationing.
The Conservatives are denying that any of them know more than Mr Hunt, who knows nothing.
The Liberals and the other parties seem afraid to stand out from the crowd with the “unfortunate truth”…
So it’s going to get worse. And just because staff want to reform the system, this does not mean they want Labour’s solution. Questionnaires are often deceptively biased… Ian Macwhirter in The Herald in Scotland wants local taxation – which will solve nothing.
Since the media seems unable to grasp the concept, and the politicians have been neutered, the citizen needs to speak out. Want a question for your MP or WG member? Try “In a cradle to grave, in-rationed health service, government persistently funds maternity and child care fully. Why does government fail to fund palliative and terminal care fully?”