...the health committee letter on NHS finances to the chancellor

Chris Hopson

1. The health committee is right to argue that social care should be the first priority for any extra money in the autumn statement. The key will be to ensure that any extra spending, if there is to be any, benefits the NHS as well, doesn't get diverted into other areas of local authority spending, and doesn't substitute for already planned spending.
   
   
2. The government's “we gave the NHS £10 billion” statement extends the period of calculation beyond the spending review period, and splits the Department of Health budget between NHS England spend and non-NHS England spend in a way that has not been done before when talking about NHS funding increases.
   
   
3. NHS Providers, along with many others, welcomed the extra money for the NHS and the ‘front loading’ announced in the spending review. But we also argued, from day one, that the 2017/18, 2018/19 and 2019/20 increases, with flat or declining per head increases in spending for the NHS, looked impossible. Now that we are starting to properly plan for the middle years of this parliament, those concerns are coming home to roost.
   
   
4. We now have an unhelpful pantomime dialogue between the NHS and the government – “we gave you the money you asked us for”; “oh no you didn't”; “oh yes we did”. This helps no-one and we have to find a way to get beyond this.
   
   
5. If there is to be no more money for the NHS in the autumn statement, as the government are currently saying, then we need an open, honest and realistic dialogue about how the NHS copes with the consequences of the much lower funding increases that follow for the next three years. Remember the NHS is already six years into the longest and deepest financial squeeze it has ever faced.
   
   
6. We have to stop pretending the NHS can maintain current levels of service, deliver improvements and transformation, and absorb rising demand on these funding levels. It can't. We either need more funding, as the health committee letter argues, or a new, more realistic plan for the rest of the parliament.
   
   
7. The letter was right to highlight the issues around capital funding, which too often take a back seat. We've cut the capital budget and have already pre-committed 25% of this year's reduced amount to support the revenue budget. This is not sustainable.
   
   
8. It was particularly pleasing to see the letter challenge comparisons between the NHS and other government departments when it comes to delivering efficiency savings. Crime has fallen by around 30% in recent years, but in the NHS demand is going up by at least 4% a year. Not only this, but prisons, armed forces and police workforces have all been cut by at least 20% over the last five years. The NHS can't do the same in the current policy framework.
   
   
9. This is what select committees are for – to hold governments to account and speak truth to power. Hats off to the committee chair – Sarah Wollaston, a Conservative MP – for telling it like it is.
   
   
10. We at NHS Providers are pleased and proud to have helped trigger the mini health committee inquiry that led to this letter to the chancellor.