Friday, November 03, 2017

By how much is the NHS underfunded?


One of my patients told me Nye Bevan used to visit his house when he was a kid, and heard him say
“We have got the NHS now, but if we abuse it, we'll lose it”.

We are in the process of losing Weston A&E.
Since July, it has been closed at night, because of difficulties getting doctors.
This is a national problem, made worse by Weston's small size.

Weston always has been underfunded (and underbedded) in terms of its population relative to Bristol.

With A&E, there is always a balance to be struck between the shorter travel time of the smaller hospital,
and the more specialised treatment available in bigger units further away.
Ambulance personnel are able to make that decision - so long as they are not overworked.

Sadly, Weston's closure has done just that - put more pressure on the ambulance service.

It is all down to resources.

First, the NHS is underfunded.

In 2014 NHS spending was £3971 per capita per year

In Netherlands, Sweden and Germany the figure is five thousand odd
In France it was £4367
The EU average was £4166
and here we are, down at £3971 - £137 billion a year, seven and a half % of GDP

NHS resources have been falling since the Tories came in in 2010, and are projected to keep on falling until 2020.
This is a fall planned by Blairite and Tory politicians - so-called efficiency savings.

So far, so bad. BUT - from this level, we have further hidden cuts:

The Lansley reforms cost £3 billion - but that was just a one off. Trivial. Look at this:

Each year, the NHS loses 12% of its notional budget, because

Litigation is rising 1 billion a year
Bed Blocking (Social Care failings ) 1 billion a year
PFI 2 billion a year
Agency Staff 3 billion a year
Internal Market 4 billion a year
Health Inflation (population increase,
technology, aging) 5 billion a year

These losses add up to £16 billion a year

That is about 12% robbed from the target budget every year.
12% from a budget that is already below the EU average.

How the NHS manages to function on this level of underfunding is a huge tribute to all healthcare staff,
and a huge condemnation of the abuse that Tory politicians, especially Jeremy Hunt, have poured on the NHS.
Clearly it is not sustainable. Yet, without a milligram of irony, the current STP - Sustainability and Transformation Plans - intend to rob even more from the budget.

There is much more to be said, not least that a fifth of the NHS budget is spent trying to treat illness caused by problems like unemployment, inequality, bad housing and pollution.
Problems caused by stupid politicians doing stupid politics.

But we have enough here to know that Nye Bevan would see our leaders are abusing the NHS he created.

The question for us now is - have we got the guts to stand up and end this abuse?

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