Viewpoint: Dr Kailash Chand: Budget could be catastrophic for GP morale and patient safety

Yesterday's budget does nothing to address the crippling funding shortfall in the NHS, writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: ' NHS reforms have neither improved patient safety nor quality, but outsourced the NHS at turbo speed.' Pic: Michele Jones
Dr Chand: ' NHS reforms have neither improved patient safety nor quality, but outsourced the NHS at turbo speed.' Pic: Michele Jones

It is  'another blow' to general practice that could be catastrophic for the profession’s morale and patient safety.

Most NHS staff and GPs in particular have been carrying the NHS through austerity for the last three years. Last week’s decision by the governments in England not to award in full the already meagre independent recommendation of a 1% pay rise and now ignoring resourcing and funding of the NHS sends a clear message what this coalition thinks of the NHS and patients.

With growth forecasts rising, it is even more shameful that the government won't uplift the NHS budget.

While the government claims the NHS budget is protected, in reality it has suffered £20bn of cuts - billions of which have come from a sustained attack on staff pay. The cost of living crisis is hitting the NHS family the hardest.

The assertion that NHS spending will grow in real terms is baseless: a commitment to a 0.1% real-terms rise in annual spending — just about the lowest level that could still claim to honour the government’s pledge – is neither here nor there.

With inflation in healthcare currently running at more than 4%, the health service’s purchasing power for drugs and equipment is suffering significantly. Considerable money from the NHS budget is being siphoned off to help to pay off debts accrued from the private finance initiative (PFI).

The annual charge that the NHS pays for acute PFI facilities is about 11-18.5% of hospital turnover, compared with 5-8% for non-PFI facilities. This produces an affordability gap that is filled only by diverting money from patient care and creating new pressures for hospital, community and primary care service closures in the medium and the long term. There is also the wide-scale pay decrease that NHS staff in general and primary care in particular, have to contend with, at a time of rising family expenditure and a real threat to pensions.

The NHS reforms have neither improved patient safety nor quality, but basically outsourced the NHS at turbo speed. Public resources have been allocated to the private sector.

The morale of the profession has sunk to rock-bottom in the last three years. The NHS has not faced this level of challenge in its history. The universal healthcare provided by the NHS is in serious danger of becoming unsustainable. David Cameron, who pledged his loyalty to the NHS before the general election, now appears to have committed more of a betrayal.

We have an infinite demand for healthcare and a finite budget. A rapidly ageing population, escalating obesity and alcohol-related illnesses, and growing health inequalities will continue to put increasing pressures on the health service. The government should be considering additional investment in primary care which deals with 90% of NHS contacts, to meet rising patient demand and put the NHS on a sustainable financial footing. Without it, the reality is that patient care - and indeed the very future of the NHS - will be at risk.

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