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%.
She adds:
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 In 2012, that tier one concession was revoked and an absurdly high minimum income requirement for skilled non-EU workers was introduced.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.
Shirley concludes:
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 a contributing editor on Lib Dem Voice. She was a councillor in Kingston upon Thames, where she is still very active with the local party, and is the Hon President of Kingston Lib Dems.
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16 Comments
The NHS consumes money like there is no tomorrow, the staff are well protected and by no stretch of the imagination are badly paid. The Doctors have had magnificent pay increases over the past decade and should be rostered at weekend as part of their normal duties, like most public servant organisations who cover 24 hours a day, 7 days a week, They are in danger of appearing prima donas and losing support.
“One very, very important point – I think breaking up the NHS is exactly what you do need to do to make it a more responsive service. I don’t think anything should be ruled out. I do think they deserve to be looked at because frankly the faults of the British health service compared to others still leaves much to be desired.”
Nick Clegg.
And he is correct.
OK, they are all greedy so and so’s. HOWEVER, if money really is a problem I, for one, would accept at least an extra 1% on my income tax to be earmarked specifically as a ‘Health Tax’.
As far as doctors and nurses are concerned, all the newly qualified should commit themselves initially to working at least four years in this country before they can ply their trade elsewhere. If they do choose to go and work abroad before that time, they should pay back some of the public funds they received to enable them to train. It’s probably not a very liberal approach and I am sure some will cite tuition fees. However, I believe that most medical courses are subsidised and, in any case, the earning potential of the medical profession is quite considerable .
@theakes
I know several ex-NHS staff (doctors and nurses) who quit because they weren’t physically capable of doing it any more. Someone close to me used to come home in tears quite often after 12-hour shifts on an intensive care ward where it literally wasn’t possible to have so much as a five-minute tea break due to the insufficient staffing. I guess she wasn’t terribly paid, but she was paid less than I earn for sitting on my backside 7 hours a day. So forgive me if I point out that your post seems pretty ignorant.
@ John Marriott : “OK, they are all greedy so and so’s”……
I’ll tell you who the greedy so and so’s are John. Shirley Williams rightly points to the continuing scandal of PFI from the Blair era. Report in : ” The Scotsman”, 19 July 2010 :
“HEALTH chiefs were today facing demands for an inquiry after it emerged the NHS will have to pay a total of £1.26 billion for the privately built Edinburgh Royal Infirmary – and still not own it. An investigation has discovered that while other hospitals built under private finance initiatives (PFI) eventually transfer to NHS ownership, the Little France site (Edinburgh Royal) will not. It means that by 2028, NHS Lothian will have effectively paid for the hospital SEVEN TIMES OVER but it will remain the property of private operator Consort”.
Consort, recipients of this public funded largess, is owned 50/50 by the Royal Bank of Scotland and Balfour Beatty.
To add insult to injury they not only control every light bulb – they also have a contract to supply food for patients made in Hampshire – frozen and transported to Glasgow – then twelve weeks later sent to Edinburgh. (500 miles plus).
Jeremy Hunt has got in a complete mess. Now, I owe my life to the doctors and nurses at the Royal…. but no thanks to Consort. I hope Norman Lamb looks into this…. taking back PFIs would be a good start to Lib Dem health policy.
@ Stimpson….. When,… why… did Clegg say” breaking up the NHS is exactly what you do need to do”. ? If true – he’s even further off the Christmas card list .
http://www.independent.co.uk/news/uk/politics/frontbencher-calls-for-nhs-to-be-broken-up-313546.html
Here is Clegg calling for the NHS to be broken up.
Thank you, Stimpson. Yet another example of a soundbite politician making a grandstanding comments without a clue what to do about it. as was to be revealed in later years. ………………… as was revealed later (odd that the date of the article is 2012 – ?).
Sadly, Shirley also seems to have forgotten who was in power in that same year of 2012 when she complains…” 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″. Did she complain at the time ??
@ Stimpson. Do you know who Alpha Medical Consultancy made a donation to ?
David,
That remark about greed was ironic. I was merely reflecting the first post. I’m not really interested in the past. It’s the future I’m concerned about. As I have said before, we in this country expect Scandinavian levels of public services at North American levels of taxation.
I reckon that, provided you ring fenced it, most people would be prepared to pay a little extra for health care. As far as staffing is concerned, it’s not too much to ask of newly qualified doctors and nurses to expect them to hold back their ambitions for a while and to give a little something back before they are let loose on the world. As far as PFI is concerned, I’m inclined to call the financiers’ bluff and just write off those loans. It’s probably highly illegal; but, hey ho, so what? They’ve already got far more than their pound of flesh.
Point taken, John.
So far as funding is concerned I hold to the old principle of universal funding through taxation (including NI) to pay for those in need. Dear Shirley was floating a charge for going to visit the GP…. a sure vote winner not….
Cameron only “voted” for the NHS to get votes. He is a free market capitalist who would love for this cherished Institiution to be opened to privatisation. That is what Conservatives believe in. Money only, not people.
“As I have said before, we in this country expect Scandinavian levels of public services at North American levels of taxation.” Wow! I’ve never seen it so perfectly put before but this is very much it. Unfortunately, given the choice between a two a lot of people – including Liberal Democrats – would go for the cheaper taxes. It’s ironic that Shirley Williams should be writing this now, whilst voting through Health and Social Care a few years ago.
Thanks, Samuel, for the compliment; however, I can’t claim ownership, but it’s a good one.
Whether it’s the Council Tax, Income Tax or NICs, I’d back DIRECT taxation every time. The trouble is that governments over the years have relied on INDIRECT taxes such as VAT to take up the slack. This form of taxation takes no account of an individual’s ability to pay. A few years ago your average Brit was more interested in the three B’s (Beer, Bingo and Benidorm) than paying higher taxes for things like health care that he took for granted. I wonder whether the message might be getting through now that you actually get what you pay for!
Stuart. Guessed I would touch a nerve. I worked managerially/operationally in the public service on more than 12 hour shifts, was paid nothing like the Doctors at their age. There is a balance somewhere and just calling me ignorant is one view but not necessarily the actual overall picture. By the way, being retired but working part time, I am still on call overnight once or twice a week for 16 hours. What I was warning was that Doctors need to be careful otherwise they may blow some of the public support they purport to have.
The most recent financial storm to hit the NHS was foretold by Allyson Pollock , professor of health, research and policy. For decades from its starting date of 1948 the administrative costs ran at 3/4%. Now, following the restructuring of 2012 , they are at 30/40%. The first article of the founding bill said that it was the duty of the Secretary of State to see that everybody in the country should have access to the best affordable health care. This is not in the 2012 bill. “Handing the NHS to the market is a highly inefficient way of delivering health care, introducing costs that are not experienced in public systems……mounting evidence that the English NHS is paying for work regardless of whether it is done or not ….. on track to the US system, where commercialisation results in $750 billion each year wasted on overtreating, undertreating, billing, invoicing and marketing….” Allyson Pollock. It was because it was not previously run that way that our system was the cheapest ,as well as one of the best , in the world.
I’m sorry, but after “Shirley’s Bill’ on the NHS top down re organisation, I refuse to listen to anything she has to say on the subject…