Boris Johnson has been warned he must give the NHS more money and not pursue a “have our cake and eat it” policy of thinking it can deliver Covid care within existing budgets.
The plea came from Chris Hopson, the leader of England’s hospital bosses, who said the extra £20.5bn the NHS was promised in 2018 was no longer enough to let it do its job.
The extra demands caused by the pandemic, and the Conservative election manifesto commitments to improve the NHS meant that settlement had to be revisited in the forthcoming comprehensive spending review, Hopson said.
“I recognise the pressures on public expenditure. But we have to avoid what the prime minister calls his ‘have our cake and eat it’ approach and pretend the NHS can cope with all these pressures on its current budget. It can’t,” said Hopson, the chief executive of hospitals group NHS Providers.
In 2018, Johnson’s predecessor, Theresa May, marked the service’s 70th birthday by pledging to give it annual rises of 3.4% every year until 2023-24. But Hopson stressed that that came after “the NHS had been through a near-decade of the longest and deepest financial squeeze in its history” and that 3.4% was less than the 3.7% average budget increase it had received between 1948 and 2010.
Changed circumstances meant the NHS in England’s three main sources of income – revenue funding to cover day-to-day running costs, capital for building new facilities and buying equipment, and money for educating and training staff – all needed to rise, added Hopson.
He warned that the NHS could end up like social care – unable to cope with growing demand and with doubts over the quality of care provided – unless Rishi Sunak, the chancellor, gave it extra money in the comprehensive spending review. In March, as the Covid-19 crisis unfolded, Sunak said he would give the NHS “whatever it needs” to cope.
“Having driven social care into crisis by failing to fund it properly and sustainably, we must avoid driving the NHS into a similar fate. And we must rescue social care from its current state of crisis,” added Hopson, who was addressing a virtual gathering of hundreds of hospital chiefs.
Anita Charlesworth, the director of research at the Health Foundation, said the pandemic meant that service needed “many more billions” than planned.
“Covid-19 has a very big short-term price tag for the NHS; £25bn alone for PPE and test and trace. But even if there is a vaccine the costs don’t end there. The pandemic will leave a long legacy of additional need for mental health, a big backlog of people waiting for hospital care and extra need to support those living with the after-effects of Covid-19. None of that was factored into the government’s spending plans for the NHS.
“Covid also puts pressure on capacity, and the NHS will need more staff, more facilities and investment in public health. None of this will come cheap. For those reasons the NHS will need many billions more than currently planned in order to do everything that ministers and the public expect it to do.”
The Department of Health and Social Care said it was giving the NHS record sums before the pandemic struck and had invested further amounts since.
A spokesperson said: “We provided £31.9bn extra in July for health services to tackle coronavirus, with £3bn specifically to support the NHS during winter and to update A&E facilities. Alongside this we confirmed funding for 40 new hospitals, as part of the biggest hospital building programme in a generation and the capital budget is increasing by a further £2.5bn this year, to continue investing in existing NHS buildings.”
It accepts the need for a long-term solution to social care and is “looking at a range of proposals as part of our commitment to bringing forward a plan that puts the sector on a sustainable footing for the future”, they added.
