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13.12.16

Stevens: NHS bouncing ‘between feast and famine, sugar-highs and starvation’

The NHS will need additional funding this Parliament to help it become more efficient in the long term, Simon Stevens said this morning.

The chief executive of NHS England told the House of Lords NHS Sustainability Committee this morning that he thought there was no evidence that support for a taxpayer-funded health service was “in any way diminishing”.

Stephen Dalton, interim chief executive of the NHS Confederation, said recently that private companies should not be seen as “bogeymen” in the NHS as it struggles to cope with a growing financial crisis, with £22bn in efficiency savings needed by 2020.

However, Stevens argued in the inquiry that the NHS was currently bouncing “between feast and famine, sugar-highs and starvation” because its funding rates are dependent on the state of the wider economy, ultimately leading to poorer care and inefficient use of resources.

Before the EU Referendum, the NHS England boss warned that the economic damage caused by voting to leave could further harm NHS finance. He has also previously warned that the NHS is expecting negative growth at a per person rate in 2018-19.

“I think the main question will be whether at some point during this Parliament it is possible to liberate more capital expenditure for the NHS, which would help invest in some of the new service models that we can see are part of what the future needs to look like,” Stevens told Peers today.

The government has repeatedly said that it will provide an additional £10bn for the NHS by 2020, despite critics accusing it of overestimating the sum, and ignored resounding calls for additional health and care funding in last month’s Autumn Statement.

But despite his calls for more funding, Stevens denied that he meant NHS reforms would be impossible to achieve without extra cash, explaining: “I simply say that I think there is an opportunity to ensure that we both drive productivity through well-targeted capital investment and lever some of the changes.”

In particular, the health boss said more capital was needed to address the fragmentation between “general practice as a cottage industry and hospitals as factories”.

He insisted the NHS was already very efficient “in macro terms”, but agreed that it needed to undertake “a huge efficiency programme”, particularly in regards to the workforce. He supported measures such as the decision to abolish the cap on student nursing places and introduce nursing associate places, saying they would help create a wider and more flexible workforce.

During the inquiry, Stevens once again argued that social care should be “at the front of the queue” for any funding that was available immediately because of knock-on consequences on hospitals.

He warned that simply pooling health and social care budgets wouldn’t be enough to guarantee fair funding for either.

“I think I said on my first day in the job about three years ago that simply putting together two leaky buckets does not produce a watertight solution,” he added.

In the longer term, he said decisions about pooling health and social care funding should be made locally, and that the government should replace the existing “triple lock” with a “triple guarantee” around pensions, care and housing funding to preserve social care.

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