Time for the government to ditch NHS austerity, warns Lord Darzi report

The health and care system in England is at a 'tipping point', with an extra £50bn a year by 2030 needed to keep the NHS going, according to an interim report by former health minister Lord Darzi.

Lord Darzi - who led a major NHS review a decade ago under Gordon Brown's Labour government - warns that over the past 10 years 'austerity has been one of the most significant determinants of performance in health and care'.

In an interim report carried out for the Institute of Public Policy Research (IPPR) think tank, he says: 'Spending on healthcare has risen but it has still been the most austere decade in the NHS's history; meanwhile funding has fallen in real and cash terms for social care.'

Despite improvements in NHS productivity 'the main sources of increased productivity are running out of road', he says. 'There is now a clear need for a long-term settlement for the NHS and social care - as well as public health - to ensure that we can deliver high quality care now and for future generations.'

GP pressure

The report highlights rising waits for GP appointments, growing numbers of vacant GP posts and crumbling morale in primary care among factors that demonstrate pressure on the health service.

By 2030, the report says, without changes to the way the NHS works overall costs will rise to £200bn in today's prices. This means a £50bn hike in NHS funding, alongside a £10bn rise for social care, will be needed by 2030, and even then productivity in the health service will have to grow at 1.1%.

The report acknowledges that performance on key measures such as one-year cancer survival and maternal and infant mortality rates have been largely maintained or even improved. But this will become more difficult as the baby boomer generation age, it says - pointing to signs of distress in the health service such as rising waiting times for hospital treatment, long A&E waits and the 're-emergence of rationing'.

Lord Darzi said: 'NHS staff should be congratulated for the improvements they have made to the quality of care they provide. But it is getting harder and harder to access that care and the system is in financial distress.

NHS funding

'While the prospect of a long-term funding settlement is welcome, it is vital that it delivers enough money to meet the demands of the decade ahead. Funding the NHS, while social care falls over is not an option.'

BMA chair Dr Chaand Nagpaul said: 'This report echoes the BMA’s long-standing concerns that the quality and timeliness of care on the NHS is seriously suffering due to lack of adequate resources and will heighten unless decisive action is taken. With hospital targets being routinely missed, social care on the brink of collapse, and patients unable to reliably access general practice, it is clear that the NHS cannot cope without significantly greater funding.

'This report also shows that social care funding has also fallen significantly short of what is needed. Some of the most vulnerable people are being failed because the system simply doesn’t have the resources or staff to meet their needs.

'In the face of these challenges we urgently need politicians to set out a future plan of sustained and increased levels of funding for the NHS that helps doctors and other healthcare staff to provide high quality care that patients need. The government’s approach of cash top-ups and short-term fixes will no longer do.

'The prime minister recently pledged to draw up a long-term funding plan for the NHS but, with funding lagging behind that of other comparable European countries, we need the government to provide concrete details and ensure that resources are made available urgently.'

IPPR director Tom Kibasi said: 'Our research shows that ‘taxpayer-funded – free at the point of delivery’ is the most efficient way to finance and organise the health service. Social and private insurance models in other countries are more-costly.

'That’s why those who say the NHS is unsustainable are wrong. It is a fundamental error of logic to say that something is unaffordable, so we should move to something more expensive. As the review shows, the NHS provides high quality care—it is a service that we should be proud to invest in.'

A DHSC spokesman said: 'The NHS was recently ranked as the best and safest health system in the world and, as this report makes clear, the quality and safety of care continues to improve. But it faces long-term challenges and the prime minister has made clear that the government will work with clinicians, NHS leaders, patient representatives and health experts to put together a long-term plan and multi-year funding settlement for the health service.'

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