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Long-term considerations

Philip Hunt on the continuing funding crisis in the NHS and a lack of forward planning

At 70 years old, the NHS deserves a special birthday present. Unfortunately, the government’s recent financial pronouncement simply doesn’t do the job.

The promised increase in funding averaging 3.4 % p.a. over 5 years is less than the 3.7% average the NHS has received since its early days. It I also much less than the 4% calculated by The Nuffield Trust as the minimum required to roll back the damage inflicted by eight years of austerity. Add in the absence of any help for our beleaguered social care services and it is no surprise that the announcement received a heavily caveated welcome.

While the NHS has evolved considerably since its inception, the drivers of change are intensifying at a relentless pace. Demographic factors and changing disease patterns, technological and medical advances, income effects and increasing relative health care costs – separately and together, these are fuelling rising public expectations

The Office for National Statistics forecasts that the proportion of people aged 65 and over will increase from 18% of the population in 2016 to 26.1% in 2066. Growth will be particularly strong among the oldest cohort, with the share of the population aged 85 and above set to increase from 2.4% to 7.1% over the same period.

Sir Amyas Morse, head of the National Audit Office has warned that the NHS will require far greater financial support to meet the needs of the changing population. No wonder the service is struggling so much.

The BBC recently commissioned analysis from the Health Foundation, Institute for Fiscal Studies, The King’s Fund and The Nuffield Trust. It found that the NHS leads the world in terms of equity of access and ensuring people don’t suffer financial hardship when ill. It also performs well in managing long term conditions, such as diabetes and kidney disease.

Its Achilles heel however is outcomes. Although gradually closing the gap in a number of areas, the NHS lags behind many countries in saving lives when treating many leading causes of death – including several types of cancer, heart attacks and stroke. And it is also comparatively poorly resourced and has markedly fewer doctors and nurses, and among the lowest number of hospital beds and CT and MRI scanners.

Faced with these formidable challenges, the service warrants considerably more support than that what the government has promised if we are to get anything like the care we need.

Lord Philip Hunt of Kings Heath is a Labour Peer and former Health Minister. He tweets @LordPhilofBrum

Published 4th July 2018


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