Hiatus over NHS spending

THE response to the NHS financial settlement was predictable and depressing in equal measure. Predictable because it was inevitable the Conservatives and Labour would argue about whether spending had increased "in real terms"; depressing because another management shake-up will deflect attention away from the growing crisis in social care.

This trading of statistics also masked a far more fundamental question – will the NHS be in better financial shape at the end of this Parliament, and will patients receive improved health care as a consequence? Regrettably, the answer to both is likely to be in the negative.

Every health shake-up costs far more money than envisaged. And, because the changes are never as effective as advertised, the NHS finds itself in a perpetual state of flux. These reforms also see policy revert back to the 1990s when GPs were in charge of large chunks of spending.

Yet, while it can be argued that they are better qualified than bureaucrats to identify the needs of patients, it should be remembered that their expertise is medicine and not accounting. Many GP surgeries are still unable to offer a competent appointments service, despite countless utterances to the contrary from both Labour and Conservative health ministers. How, therefore, can they be expected to control budgets running into the tens of millions?

It is also remiss of the Government to dogmatically claim that health spending is increasing when this takes no account whatsoever of the cuts being implemented by local authorities, and their likely impact on the elderly and disabled. The extra money supposedly made available will not compensate for town hall reductions,

The consequence could be more patients being forced to stay in hospital – the very opposite of the coalition's intentions – because there has been insufficient investment in community care. This is further compounded by a survey, published today, which reveals hospitals are providing "unacceptable" levels of dementia aware-ness training for their staff.

This report should prompt Ministers to consider whether their reforms will improve care for the elderly. If they do not, the Government should think again before it is too late.