NHS chiefs are calling for the funding settlement unveiled by Theresa May to be drastically renegotiated, as they warn the service is already at increased risk this winter thanks to a shortage of resources.
The settlement, announced in 2018, promised an average budget increase of 3.4% per year for the next five years, leading to an extra £20bn for the NHS in England in 2023. However, significant long-term costs created by the Covid-19 pandemic, combined with Tory manifesto pledges for new hospitals and higher staff numbers, mean that NHS figures will push for a major increase in funding at a spending review, scheduled for later this year.
Health figures are already accusing the chancellor Rishi Sunak of breaking a pledge to give the NHS “whatever it needs” this winter after the Treasury refused a request for thousands of acute hospital beds and an increase in crisis community care, designed to keep pressure off hospitals. In an interview with the Observer, Chris Hopson, head of NHS Providers, said there would have to be a re-examination of May’s 2018 settlement.
“We will need a big debate in the spending review about whether the NHS has sufficient money to cope with the problems thrown up by Covid and meet the manifesto commitments that have been made,” he said. “The extra hospitals that are in the manifesto can’t be built, alongside the other NHS capital requirements, unless there is a significant multi-year increase in the amount of NHS capital available. It will also be impossible to deliver the extra nurses and doctors that the manifesto commits to unless there is an increase in education and training budgets.
“We’ve also always argued that the extra money the government gave the NHS in 2018 was only enough to keep up with the demands generated by an ageing population. Thanks to Covid-19, we’ve got a massive backlog to clear and a rapidly growing demand for mental health care. And that’s before you consider what is probably the most pressing problem – sorting out social care. So there are going to be some very difficult discussions.”
He also said the Treasury’s decision to reject a request for more acute hospital beds and crisis community care “will increase the risk that the NHS faces going into winter”. He added: “Everybody’s working on the assumption publicly that we’re still operating to that famous promise from March that the NHS gets everything that it needs. Yes, the NHS has had, and is still having, its direct extra Covid costs covered. But the NHS hasn’t been given all that it asked for to manage the unprecedented level of risk the NHS may face this winter.”
Nick Ville, director of policy at the NHS Confederation, which represents organisations across the healthcare sector, said: “The chancellor promised to give the NHS whatever it needs but if funding for additional capacity in hospitals is to be held back, then he has let the service down already.”
Pressure also continues to build on local government. Ian Hudspeth, the chairman of the Local Government Association’s community wellbeing board, said: “Emergency funding already received from government has been a positive step, but the evidence provided by councils highlights a looming financial crisis. Every pound invested in council-run services helps to relieve pressure on the NHS.”
A government spokesperson said: “We’ve been clear since the very start of this pandemic that the NHS and other public services will get the resources they need to respond to Covid-19 – and we’ve fulfilled this promise, with over £30bn approved for health and care services so far.
“This funding, which has paid for essential PPE, establishing the Test and Trace programme and keeping crucial services available to the public, is in addition to the existing NHS settlement, which provided the largest cash increase in public services since the second world war. “We’ve also announced an additional £3 billion to support the NHS through the winter months and have hugely increased the number of hospital beds available already by retaining the Nightingale hospitals for the rest of the year and increasing access to beds in the independent sector.”
