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How long can the NHS go on like this?

NHS Olympics imageThe number of NHS trusts referred to the Department of Health because of financial irregularities has increased almost 4-fold in 2013-4 compared to the previous year. The Audit Commission has just reported that 19 trusts, about 1 in 5,were flagged as financially failing. Similarly 24 clinical commissioning groups, about 1 in 9, were also referred to the Secretary of State mainly because of ‘issues with their financial position’. The same trend of deepening financial problems was reported by auditors over a quarter of trusts in the previous financial year, but by 2013-14 this group had risen to a third.

The trusts are caught in a vice between having to make unprecedented cuts of £20bn within the current 5-year parliamentary period, whilst having at the same time to meet enormous extra financial pressures from rising demand for healthcare services, the health needs of an ageing population, the above-inflation pressures from the ever-rising costs of the most advanced new technology, and the ever-stronger focus on the quality of care. Research by the King’s Fund shows that this year 1 in 4 finance directors at NHS trusts expect to overspend their budget. The list includes some of the trusts that have been outsourced to corporate partners, notably the private Circle Health Care which for the last 2 years has operated Hinchingbroke Health Care in Cambridge. Other well-known trusts include University Hospital of North Staffordshire, Barnet and Chase Farm Hospitals, and Ipswich Hospital.

This is a totally unsustainable situation. The NHS is heading ineluctably towards collapse. One can only speculate what is the objective of this most ideologically-driven Conservative government. Do they intend to drive the NHS into such a financial collapse that large parts of it can swallowed up by private sector corporates for a song?

Is this slow but relentless drift to collapse politically feasible when A&E departments are becoming more and more overloaded, waiting periods are growing inexorably, GPs are becoming seriously overstretched, and public sector pay for nurses, porters and ancillary staff is being ruthlessly held down year after year?

Then there is underpinning all this the really big issue that healthcare costs always have, and continue to, exceed the rate of inflation by a significant margin each year for both demographic and technological reasons.

The Health Department’s own accounts reveal that health spending rose last year by 2.6% above inflation, which is actually a much faster rate than the two previous years. And the Health Foundation charity has pointed out that staff costs have increased significantly as hospitals responded to the Francis report on the Mid Staffordshire debacle by recruiting more doctors, nurses and other front-line staff.

They conclude that it’s difficult to see how the NHS can end 2014-5 without another significant increase in the pay bill. This process of collapse is heading for an explosion before long.

One Comment

  1. Rober says:

    It can go on until the Tories or Labour decide the American model of health is better.

    We all know what is going on but between the three political parties to day does any of them have the answer, nope they do not

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