GP charges needed for NHS to achieve savings

GP charges needed for NHS to achieve savings

The Chartered Institute of Public Finance and Accountancy (CIPFA) has published a report which contains stark warnings that the NHS is not on track to achieve the efficiency savings that the government is seeking from it – £22billion to plug the £30billion gap in its finances by 2020.

The NHS was not able to “react fast enough” to achieve this unprecedented level of savings over the next five years, said the CIPFA, while also maintaining the same level of service and carrying on treating an ageing population.

The report says it is clear that the NHS faces “severe financial challenges” and the government’s plans to deal with them are inadequate.

“Current plans are based on the Five Year Forward View’s assessment that £30bn of pressures are faced over the five years to 2021, and that £8bn of that will be offset by additional funding,” it says. “CIPFA concludes that the key figures of £30bn pressures and £22bn savings are both optimistic.”

In its The Health of Health Finances report, the CIPFA said that as things stood, the government was left with three choices:

- new charges, such as a charge for patients to use some services such as a flat rate contributory fee to see the doctor (including GPs) or paying a proportion of treatment costs

- reduce services

- increase funding

In addition, matters could be made worse and even more savings would be needed because of Conservative manifesto pledges such as increasing seven-day working in the NHS.

These electoral pledges included providing access to a GP from 8am to 10pm, seven days a week, guaranteeing same-day appointments to over-75’s and training 5,000 more GPs by 2020.

A lot of the work needed to deliver major efficiencies to the NHS required radical transformation but this was not realistic by 2020, said the authors, who urged trust boards to exercise more direct grip on short-term efficiency measures.

Pay restraint was also likely to become harder to deliver, even with the recent Budget announcement of a 1% cap on annual pay increases.

The current situation meant that the £8billion of additional support already promised by the government would be insufficient, even if £22billion of savings were delivered. The Treasury, therefore, should set out how it intended to tackle the issue over the long term though the comprehensive spending review in November.

Rob Whiteman, chief executive of CIPFA, said: “Without radical transformation, we will struggle to offer a high quality public health service for future generations.

“The NHS is presently beset by a Five Year Forward View and resource assumptions that will not add up. System leadership is needed with less short-term promises and more medium-term financial planning.

“But it is not all about the need for more resources, because presently there is insufficient will to improve productivity, encouraged by the prevailing expectation and culture that more state funding will continue indefinitely. This is simply not sustainable and we urgently need to do away with this approach.”

By Adrian O'Dowd

On Medica, Friday 07 August 2015

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