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MPs have painted a pretty grim picture of the future for health and social care, saying the scale of the funding challenge in health is “colossal” and historical cuts to social care funding have now “exhausted the opportunities for significant further efficiencies”.
The Health Committee in its report on Impact of the Spending Review on health and social care has revealed that the NHS is under ‘unprecedented strain and struggling to keep pace with relentlessly rising demand’.
Last year's Spending Review announced that the NHS would receive an additional £8.4bn above inflation by 2020-21. In fact the real figure is about £4.5bn, according to the Health Committee which accused the Government of manipulating the figures.
However the Department of Health rejected these claims saying despite finances being tight, the Government will find the money needed.
Committee Chair Dr Sarah Wollaston MP said: “Whilst the NHS has been treated favourably compared to many other departments, the increase in health funding is less than was promised if assessed by the usual definitions.
“Funding cuts to public health will make it more difficult to address the challenge set out by the Prime Minister to reduce health inequality. “ She added: “Cutting public health is a false economy, creating avoidable additional costs in the future.”
Is a seven-day NHS really feasible?
The report also questions whether the Conservative plan for a seven-day NHS is really feasible. It said ‘Given the constraints on NHS resources we will be reviewing whether the focus on seven-day services is delivering value for patients given the concern that it may displace measures which would be more cost effective’.
Dr Woolaston also voiced concerns over the effect of cuts to training budgets and said: “Short-term measures are being used to deal with the worsening financial situation. Capital budgets have been raided to meet current spending and trusts encouraged to 'review their accounting estimates for savings'.”
Social care funding
It was equally depressing news for social care with Dr Wollaston warning: “Historical cuts to social care funding have now exhausted the opportunities for significant further efficiencies in this area.
“Increasing numbers of people with genuine social care needs are no longer receiving the care they need because of a lack of funding. This not only causes considerable distress to these individuals and their families but results in additional costs to the NHS. We are concerned about the effect of additional funding streams for social care not arriving until later in the Parliament.”
Plans for additional funding for mental health were welcomed but Dr Woolaston said: “There is a danger that this could get sucked into deficits in the acute sector particularly as there is a lack of accurate data on mental health spending. We expect to see clear, verifiable evidence that the additional funding promised for mental health is being delivered to the front line if we are to make progress towards parity of esteem."
'Damning indictment' of state of social care
Janet Morrison, chief executive of Independent Age, the older people’s charity, called the statement that cuts to social care funding have ‘exhausted the capacity’ for further efficiencies a “frankly damning indictment of the state of care and support for hundreds of thousands of elderly and disabled people, and the new Government must take urgent steps to arrest it rather than wait for promised new cash to arrive in 2018”.
Richard Murray, director of Policy at The King’s Fund, said: “‘The Health Select Committee have summed up the funding challenges facing health and social care with laser-like precision.
“It is clear that it is no longer credible to argue that the NHS can continue to meet increasing demand for services, deliver its commitments on standards of care and stay within its budget. The Government must review its priorities for the NHS and be honest with the public about what the service can deliver with the funding it has been allocated.”
He added: “As the Committee points out, addressing the growing crisis in social care needs to be a much higher priority for the Government. With publicly-funded services increasingly only available to the poorest and those with the highest needs, this will be a key test of the Prime Minister’s promise of a country that works for everyone. Reigniting the stalled debate on funding reform must be an urgent priority, as should reviewing short-sighted cuts to public health spending.”
Theresa May urged to be 'progressive and fair'
Dr Rhidian Hughes, chief executive of The Voluntary Organisations Disability Group (VODG) urged new Prime Minister Theresa May to use the “report to lead a progressive and fair approach to care and support in this country” saying: “Demand for provision is rising whilst Government’s policies are leaving fewer disabled people eligible for essential community support.”
Martin Green, chief executive of Care England, the largest representative body for independent care providers, echoed these sentiments saying: “The findings demonstrate very clearly that people are not getting the care that they need and this needs to be tackled with immediate action.
“One of the Committee’s key recommendations is that the Government urgently assesses and sets out publicly the additional costs to the NHS as a result of delayed transfers of care, and the wider costs to the NHS associated with pressures on adult social care budgets more generally.
“Care England is very supportive of this recommendation and hopes that the Committee will hold the Government to account by ensuring that the assessment is accompanied by a plan for adult social care which demonstrates that it is addressing the situation in social care and dealing with its effect on health services”.