We don’t have to worry any more about the promises of opposition parties.However,the Conservatives who promised £8bn 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 services, does matter. Seven day working, guaranteed shorter access times, and more GPs and nurses—have been described by Mark Porter, the BMA’s chairman, 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. Funding of the NHS has dropped to only 7% of our national GDP – a level not seen since 2008. The proposed £12n austerity savings, suggest larger reductions in local authority social care and related budgets. This could have both direct and indirect effects on the NHS.
NHS faces tough times ahead as it embarks on its journey of integration
And, this is a huge worry to GP 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 are in danger of knocking the NHS off course. In his Five Year Forward View, NHS England’s chief executive, Simon Stevens, demands savings of £22bn over the next five years.
The serious underfunding of general practice and social care over the last five years means that the NHS faces tough times ahead as it embarks on its journey of integration. Moreover the closures to GP-led walk -in centres, hospital beds, mental health services and community services are placing worrying pressure on elderly care and community services, and indeed proving counterproductive.
The NHS was born out of war and strife. It helped heal a nation. The NHS constitution states that the NHS belongs to the people and it is a democratic service offering universal health care. It is a fair and affordable service. History will not forgive if this government, without the constraints of coalition, contribute to its decline. Let this be the five years that secure the NHS’s future as the best and fairest health service in the world.
Healthcare needs extra funding for NHS and social care for 2015-/6 and the rest of the next parliament. What is needed from this government is to provide the NHS funding to the EU or OECD average, based on share of GDP; restore accountability through the health secretary to provide a universal health service; and to stop the damaging and relentless 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 next five years, rather than a shopping list of new policies.
* Dr Chand is BMA deputy chairman