Comment

13.06.18

NHS funding: Waiting on white smoke

Source: NHE May/June 2018

Niall Dickson, chief executive of the NHS Confederation, makes the case for an integrated health and social care funding settlement.

For too long the NHS has been funded by what amounts to annual bailouts. It has had to rely on short-term, inadequate injections with no strategic underpinning, which have left the service significantly underfunded to deliver what is required. That is why the prime minister’s recent pledge for a multi-year settlement has been a welcome, and overdue, game-changer.

After a hugely challenging winter, which illustrated all too clearly the workforce and funding shortfall, there is now at least the prospect that we will be able to agree  a plan that links money to performance and seriously considers the longer-term requirements for both health and care services.

The Public Accounts Committee concluded in March that the national bodies charged with running the NHS “are too focused on propping up the system and balancing the books in the short term and have not paid enough attention to transforming and improving patient services.” A new settlement would give us all the opportunity to look ahead.

Alongside this, there is growing evidence that the public are now more willing to pay higher taxes to support the NHS. In the British Social Attitudes survey, 61% of respondents said they would support tax rises to increase NHS funding – that is 21% higher than in 2014. Recent polls have also indicated that, for many, the NHS is the number one issue of the moment – seen as more important even than Brexit. To that extent, the conditions are right for the government to act.

But before we all hang out the bunting, a word of caution. We do not know whether ministers will have the courage to provide the level of settlement that will be needed; we do not know whether the settlement will tackle the existing shortfall as well as the major issues that will arise from future demand; and we do not know if or how they will address the knotty issue of social care funding.

The latter point must not be forgotten. In   a recent poll of our members, 85% said they supported a long-term funding settlement for both health and care. They were unequivocal that both systems needed to be included, not least because of the pressures that are put on the NHS wherever social care is unable to meet demand.

A set of principles set out by the Department of Health and Social Care (DHSC) ahead of the social care green paper – due out later this year – recognises the need to ensure a sustainable financial system for care and, importantly, the need to have a debate with the public on the challenges of sourcing additional funding. But we have yet to see white smoke emerging on any of this from the new DHSC headquarters in Westminster.

The NHS Confederation has commissioned the Institute for Fiscal Studies and the Health Foundation to conduct a comprehensive study into the funding needs of the UK’s health and care systems for the next 15 years. The work – due to be published next month – is designed to provide objective evidence of what will be needed going forward. We hope this report will provide valuable input to inform the ongoing discussions in government about the amounts required for a settlement.

But this is not just about the government or indeed the centre coming up with more resources; that is necessary, but not sufficient. We also need an agreement which sets out what we will provide in return for that investment with clear and realistic goals over the next 10 years. And it will be essential that such a plan is not just cooked up in Whitehall, but involves the service as a whole.

We will continue to make the case for an integrated settlement on health and social care. Such a settlement, linked to a radical, ambitious and forward-looking plan, would be the best present for the NHS in its 70th birthday year.

 

Enjoying NHE? Subscribe here to receive our weekly news updates or click here to receive a copy of the magazine!

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our he... more >
Government issues £16m funding to speed up life-saving diagnoses

03/07/2020Government issues £16m funding to speed up life-saving diagnoses

Patients may be set to receive earlier and more accurate diagnoses for potentially life-threatening diseases such as cancer and Crohn’s dis... more >
Telecoms deal benefits half a million NHS frontline workers

03/07/2020Telecoms deal benefits half a million NHS frontline workers

Almost 500,000 NHS frontline staff in England have benefited from mobile and fixed broadband offers to stay connected at work during the cor... more >

the scalpel's daily blog

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our health system over the past few months. But as we recognise the best of the NHS and its response to the Covid-19 crisis we must not forget that for mental health the peak has yet to come. Covid-19 has placed enormous pressure on the entire health and care system. Despite the very real hardships f... more >
read more blog posts from 'the scalpel' >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

health service focus

How NHS Property Services adapted to a new way of working

01/07/2020How NHS Property Services adapted to a new way of working

From May/June 2020 edition Trish Stephen... more >
Cleaner, greener, safer media: Increased ROI, decreased carbon

12/06/2020Cleaner, greener, safer media: Increased ROI, decreased carbon

Evolution is crucial in any business and Nati... more >