A reminder from 2015. BMJ. All main political parties’ pledges for NHS will prove inadequate, says former chief executive

All main political parties’ pledges for NHS will prove inadequate, says former chief executive  (BMJ 2015;350:h2081 ) Gareth Iacobucci

The NHS faces a “substantial financial problem” this year that will require significant upfront investment to maintain current services, the former chief executive of the NHS in England has warned.

David Nicholson, who led the service from 2006 to 2014, said that it would be “helpful” for the NHS if Labour joined the Conservatives and Liberal Democrats in committing to his successor Simon Stevens’s call for an additional £8bn (€11.1bn; $11.8bn) of funding above inflation by 2020.

But he said that the current pledges from all main political parties would prove inadequate in the short term and said that £8bn should be made available this year to help shore up the service and in particular the financially stricken hospital sector.

Speaking in an interview with BBC Radio 4’s Today news programme, Nicholson said he was concerned that politicians were promising additional services in the run up to the general election when there was already a huge financial gap to fill.1 “What politicians will be talking about is all the great extra things they want to do with the £8bn they want to put in, but actually there is a serious short term financial problem to solve here,” he said.

“We need to institute proper financial discipline in the system . . . and make some short term decisions to enable us to be in a position where we’re not building on sand, that actually there is a stable financial base on which you then can take forward the big changes that are needed.”

Nicholson highlighted that the £8bn projection first outlined in NHS England’s Five Year Forward View was based on the NHS’s ability to meet a hugely ambitious efficiency target of £22bn by 2020,2 which he said would be “a big ask” to achieve.

“In the history of the NHS it’s never delivered savings of that scale over the time that’s been described. There is no healthcare system in the world that’s delivered this scale.

“You could get close [with additional funds to support service delivery changes] but it means actually a united political, clinical, and managerial leadership in the NHS, with a proper debate and discussion with the population about what this all means in practice,” he said.

He said that in his view taxes should be increased to fund the NHS. He said, “There are not simple solutions to this. We do need to pay more money for the NHS. There is support among the public to make that happen.

“If we spend more money on health we can boost economic growth.”



This entry was posted in A Personal View, Uncategorized 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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