Writing in the Guardian, Shirley Williams picks up the baton passed on by Nigel Crisp, the former chief executive of the NHS, who four years ago wrote about his experiences in his book 24 Hours to Save the NHS.
Shirley explains that many of the financial woes in the NHS have been inherited from past schemes:
For example, the number of funded places for young men and women training in this country as nurses was cut by 12% – 2,500 places – in 2012. The consequent shortage of newly qualified nurses has been filled by people recruited by employment agencies. The cost of agency staff is one of the main reasons for overspending by NHS trusts. In 2014/15, agency staff cost the NHS £1,770m, a year-on-year increase of 29%.
Many young doctors took advantage of the special concession extended to overseas students studying medicine to work in the NHS for two years after qualifying. They filled places for junior doctors in hospitals, not least in A&E clinics. In 2012, that tier one concession was revoked and an absurdly high minimum income requirement for skilled non-EU workers was introduced. Some of the vacancies in these emergency facilities have had to be filled by more expensive agency staff.
The third area of inherited expenditure arose from the private finance initiative, contracts entered into by NHS trusts with the private sector for the building of new hospitals and usually paid for over 25 years or more. One of the first, at Darent Valley, cost £80m to build but the total repayment costs amount to £800m. Last year, five trusts went into deficit because of PFI commitments. In the most troubling cases, such as Peterborough and Stamford NHS trust and Barts Health in London, the PFI-related debt goes into the tens of millions – in the case of Barts, £93m.
There is, however, some prospect for substantial savings from new approaches to medical practice. In 2012, Professor Timothy Briggs, then medical director of the Royal National Orthopaedic hospital, asked the Department of Health to arrange meetings with ministers to allow him to present a radical plan to improve surgical practices in orthopaedics, changes that would save the NHS large sums of money. He was brushed off and offered no access to ministers.
I have spoken to Professor Briggs, who estimates that substantial savings can be made within a few years. But they cannot be achieved in a matter of months.
Front-loading the extra money could avoid an irreversible collapse. If the NHS, Britain’s single greatest achievement in public services, is to be saved, reconsideration by the chancellor is essential. Surely the prime minister will not want to be seen as the man who presided over the death of the NHS he claims so deeply to care for.
You can read the full article here.
* Mary Reid is the Monday Editor on Lib Dem Voice.