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FYFV in danger because of lack of funding, MPs warn chancellor

Health Select Committee members have urged the government to provide more funding for the NHS in the Autumn Statement in order to deliver the Five Year Forward View (FYFV).

In a letter to chancellor Philip Hammond, signed by committee chair Dr Sarah Wollaston and four other MPs, they said that the government should stop saying it has given the NHS £10bn because this “risks giving a false impression that the NHS is awash with cash”.

Instead, they argued the £10bn figure is calculated by adding an extra year to the Spending Review period and cuts from areas such as public health and staff training, which are needed to deliver the FYFV.

The MPs said the government should “seriously consider a means of increasing the capital funding available to the NHS” in the Autumn Statement, with social care spending to be prioritised.

The letter argued that the FYFV cannot be achieved without adequate capital, and that the capital budget is currently being “plundered to shore up revenue spending”.

It also cited evidence from Chris Hopson, the chief executive of NHS Providers, that STP footprints are developing over-ambitious and undeliverable plans, and said STPs “need to be supported”.

Stephen Dorrell, chair of the NHS Confederation, said: “The NHS Confederation has long argued that it is misleading to suggest the NHS budget is being protected when the same is not true of social care and public health.

“In the past few weeks a string of highly reputable health organisations have spoken of the enormous strains on the system. This is impacting on staff morale and most importantly on the care available to those who need it most.

“The government must be honest with the public about exactly how much it is spending on the NHS and social care. Only by providing this clarity can it ensure the system is sustainable for future generations.”

Commenting on the letter, John Appleby, chief economist at the Nuffield Trust, said: “The health secretary himself has admitted that the NHS is facing one of the most difficult periods in its history, and social care is widely acknowledged to be on its knees.

“The committee’s letter to the chancellor should therefore focus minds within the Treasury to step in to address this before it begins to seriously affect patient care.”

Richard Murray, director of policy at the King’s Fund, argued that the committee members are right to “highlight the huge financial pressures that the NHS is facing”, especially later in this Parliament “when funding will barely increase in real terms”.

“It is no longer credible to argue that the NHS can continue to meet demand for services and deliver current standards of care at the same time as staying within its budget,” Murray added.

He also agreed that social care should be “the most urgent priority in the Autumn Statement”.

Dr Mark Porter, chair of the BMA council, added: “Our calls are now being echoed by experts and interested parties from all sides of the political landscape now. The prime minister and chancellor need to explain how exactly the NHS will keep up with rising demand without the necessary investment.

“The NHS is already the most efficient healthcare system in the world. The notion that the funding crisis can be solved with further efficiency savings is a myth, and these are not savings, they are year-on-year cuts that have driven almost every acute trust in England into deficit, led to a crisis in general practice and a community and social care system on the brink of collapse.”

Paul Briddock, director of policy at the Healthcare Financial Management Association (HFMA), backed the letter’s signatories, citing evidence from a 2015 survey that found 92% of finance directors were sceptical that they would have enough money to implement the FYFV.

“It is clear the NHS is struggling financially, and we share the committee’s views that extra funding is needed to cope with the demand on services,” he said.

Briddock added that the committee’s Temperature Check survey, out in early December, would show whether NHS finance directors feel that the financial targets for trusts are achievable.

But a government spokesperson said: “The government has backed the NHS’ own plan for the future with a £10bn real-terms increase in its funding a year by 2020-21, helping to ease the pressures on hospitals, GPs, and mental health services. It is wrong to suggest otherwise.

“As the chief executive of NHS England said last year, the case for the NHS has been heard and actively supported.

“We have also allowed local government to increase social care spending by the end of Parliament, with access to up to £3.5bn of new support.”

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