A fully-funded NHS?
Looming junior doctors’ strike, higher treatment costs, demographic challenge, a target of £22bn in efficiency savings … AND debt levels expected to exceed £2bn by the end of the financial year, the NHS’ future is made up of a series of conundrums that will affect all stakeholders, leaving no stone unturned.
The Chancellor’s Speech today during the Comprehensive Spending Review – combining the usual Autumn Statement and the Spending Review – confirmed the Department of Health’s budget remains ring-fenced – a practice questioned by some, including the Treasury Select Committee –, protected by the Conservative manifesto pledge and the Treasury’s Summer Budget: NHS funding in England is to increase by £10bn in real terms by 2020-21, above 2014-15 levels, with the NHS expected to deliver on efficiency savings.
As announced yesterday, Mr. Osborne reiterated he would award NHS England, the provider of frontline services, with an upfront £6bn above inflation as soon as next year – a package that will allow it to spend an additional £2bn on drugs, carry out 800,000 more operations and conduct 2m more diagnostic tests. An extra £600m is also earmarked for mental health services.
And this comes on top of a series of commitments the Prime Minister and Chancellor have taken in the last few days with the creation of the Dementia research Institute and the NHS/NICE consultation on the potential overhaul of the Cancer Drug Fund in its current form – both of which are likely to be welcomed by industry, the science community and patient groups alike.
Besides, the impact of the announced integration of health and social care by 2020 “feel[ing] like a single service for patients” should not be underestimated.
And measures on health R&D through official development assistance and the science budget also significantly affect the UK’s national security (epidemics) and attractiveness for local and foreign investors (science base). In this respect, the Chancellor responded to the business, research and scientific communities’ concerns by investing £6.9 billion in capital and by protecting the current £4.7 billion resource funding in real terms. The government will also be investing £5 billion in health research and development, confirming among other initiatives, the creation of a new £1 billion global fund – known as the Ross Fund – to speed up the development of drugs to eliminate the world’s deadliest infectious diseases – was also confirmed as part of the UK’s new aid strategy “tackling global challenges in the national interest” – this will also be welcomed by both researchers and vaccines companies. An additional source of satisfaction for such actors as the Association of the British Pharmaceutical Industry (ABPI), Mr. Osborne announced the Government would implement Sir Paul Nurses’, President of the Royal Society, recommendations in his independent review of the UK Research Councils.
Transformation is still the buzz word and a necessity – increased operational productivity for NHS providers and a transition towards more out-of-hospital care is expected. Opportunities exist to find efficiencies but, as Lord Carter of Coles, Chair of the NHS Procurement and Efficiency Board and author of a recent review on the productivity of NHS hospitals, puts it: “there is no magic wand for delivering them”.
The frontloading conceded to Simon Stevens, NHS England Chief Executive, by the Chancellor does not mean a rosy future in the long term for NHS England – not just now. As emphasized by the Health Foundation “even with additional funding this will be the most austere decade for the NHS since its inception. Public funding for the NHS will fall as a share of GDP from the current 7.4%.”
Concessions will continue to be asked of all stakeholders, and industry is likely to take on a fair share of the effort – the Department of Health’s current consultation on changes to the statutory scheme to control the prices of branded health service drugs is just one example.
A further Spending Review before the end of the current Parliament is a possibility or should we say – to follow the Chancellor’s steps - an opportunity for all healthcare and life sciences players to renegotiate their funding. Still, in the meantime, structural, long-term reforms, involving all stakeholders – including patient representatives – remain the key for the new NHS to live up to UK values and for the country to build on its first-class Life Science base, driving economic growth and prosperity.