The NHS is under severe pressure, as evidenced by the National Audit Office’s new report on NHS finances, which concludes that the situation of continually rising deficits is both endemic and unsustainable. A year ago, the Comprehensive Spending Review (CSR) gave £8 billion of extra funding to the NHS for the period up to 2020, but commentary at the time noted that this was in fact ‘a crisis deferred not averted’ for about half of the extra funding was not new and was in fact coming from other Department of Health budgets such as capital spending, public health and training. This discrepancy between what the Government claims it gave to the NHS and what senior NHS leaders argue they have actually (not) had, has been the subject of much debate in recent weeks.
It is not however a surprise that the treasury did not announce extra funds to the NHS in the Autumn Statement, for there appears to be a view within Government that the NHS asked for more in 2014 to achieve the NHS Five Year Forward View, was given it in the CSR, and now needs to live within its means.
It is striking that the three major London health think tanks joined forces to argue that social care was the most urgent priority for any funding increase this autumn. Given the swingeing cuts that local government suffered in recent years and the resulting crisis in social care provision, this makes complete sense. It is particularly unfortunate that social care did not get a look in this time, for it is here that the pressures are most acute and needs greatest.