President's view: 10-year funding plan



NHS funding has once again been in the spotlight, this time in more welcome terms with the Prime Minister at last signalling the end of uncertainty for our health service, writes HCSA President Ross Welch.

The proposed £20 billion funding boost for England to 2024, matched elsewhere in the UK, marks a refreshing change to a string of “one-off bungs and bailouts,” as the Nuffield Trust put it.

But, as with every announcement on health, from whichever political party, it pays dividends to scratch a little deeper.

Key questions remain. At an average of 3.4 per cent, front loaded, this plan falls some way short of the 4 per cent rises identified by leading health think tanks the King’s Fund, Health Foundation and Nuffield Trust. The 4 per cent figure is based on the belief the NHS needs to recover from years of extreme belt-tightening.

Which highlights another unanswered question: how the rest of the health budget will fare – training, public health, and infrastructure, and indeed social care.  

Against all of this is the economic and political uncertainty of Brexit.

More details will emerge over the autumn, when a new 10-year plan for health and Social Care green paper is scheduled for publication.

However, HCSA has already made clear our view that additional funds must be channelled into addressing workforce issues and front-line services, not squandered on more layers of bureaucracy and interminable restructuring.

We are also concerned that there may be a sting in the tail in terms of both the strings attached in return and the source of the increase, where tax changes could impact negatively on many doctors. 

All will be revealed, we are told, at the 2019 Spending Review.

Certainly any “plan” must include concerted measures to boost recruitment and retention – and that means real rises to pay as well as improved working conditions.

Over coming months, it will become clear whether health policy-makers grasp the scale of the problems being built up by the relentless squeeze on medical staff.

Until then, hospital doctors, who have suffered years of pay decline and are often papering over the cracks of unfilled vacancies, should be forgiven for greeting this announcement with a healthy dose of scepticism.