Seven day NHS working 'will not happen without proper investment'
Labour Shadow Lords spokesperson for Health writes about his question in the House of Lords today on "The impact of the current deficit position of the NHS on its ability for seven-day working".
The NHS is going through one of the biggest financial crises in its history. Yet, the Government’s response is one of denial as it burdens the service with more and more responsibilities without willing the resources it needs.
Full seven day working was unveiled as a key Queens Speech announcement with patients having a 16% greater risk of dying at the weekend than those admitted on a weekday.
The main cause is a lack of senior consultants present combined with less access to diagnostic and scientific services on Saturday and Sunday. This can only be put right by employing more senior staff which the NHS will struggle to do. Already, because of the potential expense, NICE has just shelved long anticipated guidelines on nurse patient ratios.
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The finances of the NHS are in a dire state. The deficit run up by NHS trusts last year approached nearly £1bn and this year it is expected to double.
This is hardly surprising. We spend less of our GDP on health than many European countries at a time of huge growing demand. True, spending in the last 5 years rose by an average of 0.9% a year. But that compares to the average rate of increase of 3.7% a year in real terms since 1948.
The Health Foundation have pointed out that the biggest drive of rising operating costs is staff costs. Some of that may be contained by the agency cap being belatedly imposed by the Government but its still difficult to see how the sums add up for seven day working.
Already performance is deteriorating rapidly. The four hour wait in major A and E departments has been missed every week for nearly two years. Ambulance response times have worsened and cancer waiting time targets have been missed for five consecutive quarters. Lack of access to GPs is a growing source of public concern.
The picture is even worse in social care. According to new research by the Association of Directors of Social Services the most vulnerable people in the country are being placed in jeopardy by a further £1.1 bn cuts to adult social care. This comes on top of big cuts over the past 5 years. All this increases pressure on the NHS as people turn up at hospital instead.
The Government has promised an extra £8bn to the NHS, but not until 2020 on the back of the 5 year forward plan. But even that depends on the NHS driving up efficiency levels to an extent never achieved before. Lord Carter’s forthcoming report on efficiency may help but it won’t close the gap.
The Secretary of State thinks the NHS has enough cash, but he is in isolated company. Even the OECD thinks that the Chancellor should spread the pain of tough spending cuts beyond the next two years to lower the adverse impact they will have on UK growth.
There is no question that seven day working is the right goal to pursue. But it will not happen without proper investment. And it's far too important to end up as an ineffective broken promise.
Lord Hunt of King’s Heath is Labour’s Shadow Lords Spokesperson for Health and Shadow Deputy Leader of the House of Lords
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