Crisis, what crisis?

Amongst all the noise about Trump’s travel bans, Labour falling apart over Brexit and David Davis attempting to kiss Diane Abbott it was easy to miss the plethora of ‘NHS in crisis’ stories that have emerged recently.

Starting last week it emerged that NHS Trusts in Kent have been delaying surgery in order to save costs. The Guardian reported that ‘Around 1,700 patients will be affected by West Kent clinical commissioning group’s (CCG) attempt to save £3.2m by delaying non-urgent operations from 20 December last year until the new financial year starts in April’.

This was followed by a Public Accounts Committee report on the Better Care Fund for England. The report was critical of the effectiveness of this fund and it’s ability to support the delivery of an integrated health and care system that saves money. According to the report the Department of Health was expecting to save £511bn in the first year of the fund ‘but this was not realised’.

The BBC was reporting this morning that January’s A&E figures will be the worst there has ever been. More people are waiting longer than four hours in A&E than ever before and record numbers are also waiting longer than 12 hours for a bed once they have been seen by emergency doctors.

By this morning #CrisisInTheNHS was trending on Twitter. The pressures on the system are well versed and understood by all – increased demands on care without matching increases in budgets have left Providers stretched.

So what is the answer? The Labour Government from 1997 to 2010 increased budgets dramatically, which eased the burden on a stretched system. The Conservatives have been highly critical of the lack of focus on efficiency during a period of increased revenue. So the issue becomes that whilst Governments can’t go on pouring more and more money into a system that fails to reform and work more efficiently, they also can’t let the NHS collapse under its own weight.

In amongst all the noise about Government not giving over enough money and waving around copies of the Daily Mail, Simon Stevens and Jim Mackey gave a good overview of how they are addressing this at the Public Accounts Committee back in January.

Covering issues such as managing demand, integration of health and social care, system redesign and efficiency, Stevens set out a clear and positive vision for what needs to be done to reform the NHS and deliver a system that can support the ever increasing needs of the population. At the same time as doing this he also made the call for increased funding and was openly critical of the Prime Minister’s assertion that the NHS had received the funding it was promised.

For Theresa May and Jeremy Hunt the question is how to keep the wheels turning in the short term, whilst fixing the structural issues and avoiding the kind of media crises that can topple even the strongest of Governments. This will require both reform and extra funding. So maybe the real question is how long the Chancellor can hold out before plugging the gap?

Dan Jones, Associate Director