‘Short-sighted’ Fines Only Add to NHS Deficit Woes

The chief executive of NHS England, Simon Stevens’, five-year NHS plan, which was unveiled back in October 2014, outlines a vision for overhauling the health service in England to make it more patient-focused and efficient. However, one of its main stipulations is that the NHS must realise gains of 2-3% each year if it’s to combat a projected £30bn funding deficit for 2020-2021.

In fact, Stevens has previously stressed that the NHS is facing “the most sustained budget crunch since the Second World War” and that private service providers will play a pivotal role in helping patients get the treatment they need going forward.

Talking to BBC Radio 4’s Today programme shortly after announcing his five-year plan for the NHS, Stevens said that “sometimes there will be a case”, for example, where patients need to use private providers for operations paid by the NHS, and that it should be up to the patients themselves to decide who should treat them.

But that isn’t to say that Stevens’ intention is to have more private healthcare providers delivering care. He’s firmly of the belief that the majority of services will continue to be delivered by NHS providers and that “Ninety-four pence out of every pound” spent in the NHS goes on said providers.

Nevertheless, Stevens is very aware of the important role that private healthcare providers can play in complementing and supplementing the sterling work the NHS does.

However, the key challenge for the NHS and Stevens will be how they balance the books over the next 12 months, while simultaneously transforming the way in which they do business.

£600m to be withheld this financial year

Indeed, the 2015/2016 financial year was described by even well-seasoned NHS finance managers as their toughest since joining the service.

The situation this financial year will be exacerbated further as around £600m will be withheld from NHS trusts as a result of fines imposed on them for failing to hit performance targets. This equals almost a quarter of the £2.8bn deficit that trusts are expected to post for the 2015/2016 financial year.

Therefore, it’s not surprising that the chief executive of NHS Providers, Chris Hopson, slammed the fines, saying: “NHS trust chief executives tell us they are intensely frustrated by these fines and see them as short-sighted, counter-productive and reflecting a sense of denial about how serious the problems facing hospital, community, mental health and ambulance services really are.”

Hopson continued by stressing how much pressure trust chief executives are already under, without more financial risk being loaded onto them at a time when the NHS is in the midst of its “longest and deepest financial squeeze in its history”.

It’s not Hopson’s view, though, that trust should get a free pass. He believes they absolutely should be accountable for their performance. Fining them, however, for circumstances which are largely out of their hands, leads to bigger financial problems and worse patient care.

NHS funding continues to be a problem. People are living longer therefore requiring more medical intervention. In addition to that, as we have an ageing population, the percentage of the population paying taxes is reducing so less money coming in, as a percentage of overall population, and more treatment required. More partnership between the private and public sectors will help but it would also help if, people choosing to opt out of the NHS for treatment of acute conditions were supported more by the government. Taking PMI out of the IPT regime would be a big step in the right direction.


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