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The NHS may yet sink the Tories

Disaster-looms-for-NHS_large-e1308062563878The NHS is deteriorating fast, faster and more seriously than many of the public yet realise. Nearly half a million patients waited more than 4 hours in A&E for treatment, referral or discharge in the last quarter of 2014, half as many again as in the previous quarter and the worst performance for over a decade. In December 2014 there were 113,000 patients waiting longer than 18 weeks for treatment, a 30% increase over the year before. The cancer care waiting time target – within 62 days of referral from a GP – has now been missed for 3 consecutive quarters. Delayed discharges from hospital rose sharply to more than 5,000 per day in November 2014, 20% more than the previous year. Cuts to local authority adult social care of £4.6bn are behind this bed-blocking as 400,000 fewer elderly people get home care than 5 years ago – a false economy if ever there was one.

What is causing this slow-motion crisis? Fundamentally it’s the £20bn massive financial squeeze at a time of rising demand. But there’s much more to it than that. The toxic mixture of restructuring, complexity, confusion and lack of system leadership highlighted by the King’s Fund report is steadily taking its toll. The government has scrapped the strategic health authorities whose job was to ensure the smooth running of services in a region, and then abolished too the Audit Commission that oversaw value for money in NHS trusts. The government pretended that the new clinical commissioning groups were in the driving seat, but mostly this was outsourced to multinational healthcare corporations despite the blatant conflict of interest with their provider role.

So far the Tories have responded by patch-up. Osborne was panicked before the election into promising £8bn without saying where the money would come from or when it might be provided (2020?). Cameron demands 7-day hospital working without saying how it would be paid for. The Stevens plan to achieve £22bn of savings to keep the NHS ticking over on current funds is pure chimera. He announced last week quite sensibly that the way forward was prevention and better public health, only to discover that Osborne was imposing a £200m cut in public health to local authorities.

Other obstacles are now barring the way. 60 of the 83 acute Foundation Trusts are currently in deficit, and over three-quarters of NHS Trust finance directors now believe they will not be able to achieve financial balance in this current year. Furthermore over a quarter of CCGs doubt they can stick to budget without compromising care quality or access olver the next 12 months. Hunt’s tactics of shifting the blame on to NHS staff, sending in the CQC for ever tougher inspections, and sacking chief executives while still continuing to spend 2-3% less of GDP on health than all our main EU counterparts are a counsel of despair, if not panic.

5 Comments

  1. Altrincham says:

    Lest we forget the government that cracked the foundations to begin with. The critical damage was evident long before the tories took over.

  2. Robert says:

    yes but does labour have the answers do they even care or know the question, in the first place. When I say labour I mean of course progress.

  3. Sue says:

    Labour need to adopt the NHS reinstatement bill as policy. Labour also need to adopt a policy of taxing the rich and clamping down big time on tax avoidance and evasion. Top that off with taking up nay of the ideas from Positive Money and we could create a decent country for all to live in ——- not just exist!

  4. mickhall says:

    Perhaps, but it seems like the old Tory game of first hold back investment, it then runs down, people get fed up with it and angry, Tories mates in media claim there is a better way, look at the nice private hospitals in USA. Then privatise.

  5. Sue says:

    Yes I’ve been recommending people watch Michael Moores movie Sicko. It isnt about people in USA that have no health insurance it’s about those who do and all the trials they have to go through still to get treatment. Then it is still often denied due to “pre-existing conditions” and so on.

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