Niall Dickson: A long-term plan is vital for NHS future

FOR too long the NHS has been funded by what amounts to a sticking-plaster solution: a series of annual bailouts.
Can the Government deliver a long-term funding plan for the NHS?Can the Government deliver a long-term funding plan for the NHS?
Can the Government deliver a long-term funding plan for the NHS?

Seven decades on from its birth, the NHS has become reliant on short-term inadequate cash injections with no strategic underpinning. These have left the service significantly underfunded to deliver what is required.

Politicians have got to have their feet held to the fire and see that throwing out an extra billion here or an extra two billion there does not work. A solution can’t come soon enough.

Hide Ad
Hide Ad

That is why we are delighted by the Prime Minister’s recent pledge for a long-term settlement.

The NHS is facing a funding and workforce crisis which means the next decade must be very different from the last.

The reality is that over the next 10 to 15 years, we are going to see a doubling of the number of people aged over 85.

What’s more, the numbers of people with long-term conditions is set to continue to grow, pushing ever greater pressure on hospital services as well as primary care, community, mental health and social care services.

Hide Ad
Hide Ad

After a hugely challenging winter, which illustrated all too clearly the workforce and funding shortfall, there is now at least the prospect that we will be able to agree a plan that links money to performance, and seriously consider the longer-term requirements for both health and social care.

Recent polls have also indicated that a majority of people would support tax rises to increase NHS funding, and that to many, the NHS as an issue is seen as more important even than Brexit.

To that extent, the conditions are right for the Government to act.

But before we all hang out the bunting, a word of caution. We do not know whether Ministers will have the courage to provide the level of settlement that will be needed.

Hide Ad
Hide Ad

We also do not know whether the financial settlement will tackle the existing shortfall as well as the major issues that will arise from future demand; and we do not know if or how they will address the knotty issue of social care.

Totally inadequate social care funding is leaving demand unmet and thousands of older people without the care and support they desperately need.

Yet successive governments have ducked the question and it remains dangerous political territory, as we saw with the Conservatives rowing back on a social care funding policy in the middle of the 2017 general election campaign.

In recognition of the crippling effects of rising demand, underfunding and workforce shortages, the NHS Confederation back in January – near the peak of the winter crisis – teamed up with the Institute for Fiscal Studies (IFS) and the Health Foundation to conduct a comprehensive study into the funding needs of the UK’s health and care systems for the next 15 years.

Hide Ad
Hide Ad

We hope the report will serve as a solid evidence base to convince the Government to act – and act fast.

The work, due to be published in the coming weeks, is designed to identify the challenges faced by health and care services and to provide objective evidence of what will be needed going forward.

We hope this report will provide valuable input to inform the ongoing discussions in the Government about the amounts required for a settlement.

But this is not just about the Government or indeed the centre 
coming up with more resources – that is of course necessary but is not 
sufficient.

Hide Ad
Hide Ad

We also need a compact – an agreement which sets out what we are agreeing to provide in return for that investment with clear and realistic goals for the service over the next 10 years.

And it will be essential that such a plan is not just cooked up in Whitehall but involves the service as a whole.

This month, we have launched a petition calling on the Government to commit to a funding plan for health and social care to 2035.

The petition, which is available on Parliament’s website, aims to gather over 100,000 signatures, surpassing the threshold needed for the petition to be considered for debate in Parliament.

Hide Ad
Hide Ad

The NHS Confederation will continue to make the case for an integrated settlement on health and social care.

Such a settlement, linked to a radical, ambitious and forward-looking plan, would be the best present for the NHS in its 70th birthday year.

Niall Dickson is chief executive of the NHS Confederation.