Dr Kailash Chand: NHS needs rebuilding, not promises

The Conservatives, who promised an extra £8bn a year by 2020, have not detailed how they will raise the money or how much will arrive in each year to keep the NHS functioning.

And a further promise, of a 24/7 service, does matter. Seven-day working, guaranteed shorter access times, and more GPs and nurses have been described by BMA chairman Dr Mark Porter as outlandish and unachievable.

Staff morale in many parts of the service is at rock bottom because of real-terms pay cuts and the relentless workload. Many GPs are retiring early and new recruits are thin on the ground.

The government's proposed £12bn austerity savings suggest larger reductions in local authority social care and related budgets. This could have direct and indirect effects on the NHS, and be a huge worry to practices already coping with many problems that have very little to do with health.

The King's Fund's chief health economist, John Appleby, has warned that short-term financial pressures may knock the NHS off course, while NHS England chief executive Simon Stevens, in his Five Year Forward View, demands savings of £22bn over the next five years. The underfunding of general practice and social care over the past five years means the NHS faces tough times ahead as it embarks on its journey of integration.

The closure of GP-led walk-in centres, hospital beds, mental health services and community services is placing worrying pressure on elderly care and community services.

History will not forgive if this government, without the constraints of coalition, contributes to the decline of the NHS. Let this be the five years that secure the future of the NHS as the best and fairest health service in the world.

What is needed from this government is to fund the NHS to the EU average, based on share of GDP; to restore the health secretary's accountability to provide a universal health service and to stop the damaging drive towards a health market.

The BMA is calling for an open and honest debate about the NHS. We need to rebuild the NHS in the next five years, rather than being offered a shopping list of new policies.

  • Dr Chand is BMA deputy chairman.

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