Eleanor Roy, Policy Manager Health and Social Care
It’s official, in the words of the new Secretary of State himself, the new policy position is that ‘the NHS is broken’. Perhaps not the most positive message as an opener, but one that’s difficult to disagree with given the declining levels of public satisfaction and the findings of last year’s CIPFA/Institute for Government performance tracker.
Mr Streeting is not rushing into anything, like any good clinician he recognises the importance of a detailed diagnosis and makes no bones about the fact that it will not be fixed overnight. While it’s encouraging that he’s not looking for a quick fix, it will be interesting to see how this fits with the (relatively) short-term pledges which were actually costed as part of the Labour manifesto.
These included around £1.8 billion to increase appointments, operations and scans, double the number of MRI and CT scanners, increase the mental health workforce and introduce a dentistry package - all to be funded from closing tax loopholes and reducing tax avoidance. But in the absence of a baseline, it’s still not clear what these funding pledges actually mean for the overall NHS budget.
The manifesto did make commitments on some of the crunchier (and costlier) long-term issues, such as delivering the NHS workforce plan and the new hospitals programme. Although, it did not clarify how these costs would be met, and remained strangely silent on the wider NHS estate, including the eye-watering £11.6 billion backlog maintenance bill. It also made some encouraging noises around shifting care into the community – although again the detail and associated price tag, remains unclear.
Away from the NHS, the manifesto held some promising pledges on addressing the wider issues around social care and tackling the wider determinants of health. This is critical to fixing our broken NHS, which does not operate in isolation. There is also an extremely welcome commitment to embed a greater focus on prevention, echoing their 1945 manifesto statement ‘much avoidable ill health can be prevented’.
In making his diagnosis and considering a treatment plan, we encourage Mr Streeting to scan a wide horizon; incorporating not only the long-term, but a broad view of our public services and government departments.
As CIPFA have highlighted in our work on integrating care and prevention, recognising the inter-dependence of our public services, and the role they play in our health and wellbeing, will be key to addressing the challenges in our healthcare system.
As a new government with a strong majority there is now a real opportunity to turn the tide, to put our health and care services on a financially resilient and sustainable path for the future. We hope that the next fiscal event provides some much needed clarity on the above commitments. But we also encourage the new government to reach for a greater ambition - to change the mindset and invest not only in the NHS, but in the nation’s health as an asset. The benefits of this could be much more wide ranging and long-lasting, not only ensuring public resources are used to best effect to improve outcomes for individuals, but also ensuring we have a healthy population as the foundation for resilient communities and sustainable economic growth.