NHS spending

Author
Discussion

Biggy Stardust

6,796 posts

43 months

Thursday 15th October 2020
quotequote all
Could anyone please confirm when was the last time the NHS wasn't in crisis & in need of more money? I've heard that it was 1974 but this is uncorroborated.

blade runner

1,029 posts

211 months

Thursday 15th October 2020
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BlackLabel said:
“ 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.”

https://www.theguardian.com/society/2020/oct/06/nh...
Well the government wrote off all NHS trusts historic debts at the start of the pandemic, so presumably that's a fair chunk of budget that was planned to be spent that can be accessed?

MellowshipSlinky

14,673 posts

188 months

Thursday 15th October 2020
quotequote all
Biggy Stardust said:
Could anyone please confirm when was the last time the NHS wasn't in crisis & in need of more money? I've heard that it was 1974 but this is uncorroborated.
6 July 1948?

rossub

4,400 posts

189 months

Thursday 15th October 2020
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The health body I work for has requested £58m extra funding this year due to Covid. Sounds a lot, but it’s only 5% of the budget.

A lot of services are not being provided, so most health bodies are actually underspent this year on core budgets.

leef44

4,359 posts

152 months

Thursday 15th October 2020
quotequote all
Biggy Stardust said:
Could anyone please confirm when was the last time the NHS wasn't in crisis & in need of more money? I've heard that it was 1974 but this is uncorroborated.
biggrinbiggrinbiggrin

hidetheelephants

23,763 posts

192 months

Friday 16th October 2020
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MellowshipSlinky said:
Biggy Stardust said:
Could anyone please confirm when was the last time the NHS wasn't in crisis & in need of more money? I've heard that it was 1974 but this is uncorroborated.
6 July 1948?
Shortly before the ink dried on the Beveridge Report.

Riley Blue

20,915 posts

225 months

Friday 16th October 2020
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hidetheelephants said:
MellowshipSlinky said:
Biggy Stardust said:
Could anyone please confirm when was the last time the NHS wasn't in crisis & in need of more money? I've heard that it was 1974 but this is uncorroborated.
6 July 1948?
Shortly before the ink dried on the Beveridge Report.
"It was true that initial spending had been far higher than forecast: in its first year, Bevan had to seek an extra £53m from the Treasury, nearly a third more than his original estimate. In March 1950, he would be forced to request a supplement of £100m, roughly half the entire education budget."

from the Wellcome Collection: https://wellcomecollection.org/articles/WyjLYycAAL...

BlackLabel

13,251 posts

122 months

Monday 26th October 2020
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“ NHS short of over £1bn for Covid second wave and onset of winter
Exclusive: Hospitals in England each have up to £20m less than they need to cope in coming months”

https://www.theguardian.com/society/2020/oct/26/nh...

pavarotti1980

4,837 posts

83 months

Tuesday 27th October 2020
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rossub said:
The health body I work for has requested £58m extra funding this year due to Covid. Sounds a lot, but it’s only 5% of the budget.

A lot of services are not being provided, so most health bodies are actually underspent this year on core budgets.
projected income is also down too due to less activity which in turn means tariff based income has dropped significantly.

Add in that commissioners have now ditched PbR payments and are working on the basis of block contracts using a small window of the 19/20 financial year.

My trust (Shelford teaching hospital) is estimating a £30 million gap in finances this year despite the debt being written off. The debt write was just getting rid of what they told trusts to do a couple of years ago with control totals for finances. The DoH and their funding are a shambles. Its all smoke and mirrors and there is seldom increases in real terms. They may give with one but certainly take with the other. QIPP, CQUIN, control totals etc etc

pquinn

7,167 posts

45 months

Tuesday 27th October 2020
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It's a mismanaged bottomless money pit, you could put 100% of GDP in and it'd still be short.

Layers and layers of process and management and no personal or financial incentive to run anything properly.

And it'll never improve.

rossub

4,400 posts

189 months

Tuesday 27th October 2020
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pavarotti1980 said:
projected income is also down too due to less activity which in turn means tariff based income has dropped significantly.

Add in that commissioners have now ditched PbR payments and are working on the basis of block contracts using a small window of the 19/20 financial year.

My trust (Shelford teaching hospital) is estimating a £30 million gap in finances this year despite the debt being written off. The debt write was just getting rid of what they told trusts to do a couple of years ago with control totals for finances. The DoH and their funding are a shambles. Its all smoke and mirrors and there is seldom increases in real terms. They may give with one but certainly take with the other. QIPP, CQUIN, control totals etc etc
Thankfully I’m in Scotland, so things are a lot more straight forward!

BlackLabel

13,251 posts

122 months

Sunday 6th December 2020
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Sunak recently gave the NHS an additional £3 billion to fight the surgery backlog caused by covid.

The BMA say it’s a fraction of what’s needed.

“ The BMA said the pandemic has placed “unprecedented pressure” on a health system that was already stretched and underfunded.

In addition to the £10 billion, the BMA is calling for:

-An annual real-terms increase in health spending of at least 4.1%, taking the total to £164.9 billion by 2023/24 compared to £140.4 billion in 2019/20 – a £9 billion rise on pre-Covid planned spending.

– £6.5 billion to modernise and expand NHS trust facilities and GP practices, and to and help make them Covid-secure.

– £4.2 billion to modernise IT infrastructure across the NHS.

– £3.5 billion to fund 7,500 extra medical school places by 2023/24

– An increase of £1 billion to the public health grant – funding to local authorities to improve community health – plus additional funding to bring the grant up to £4.5 billion by 2023/24.

– An extra £12.2bn for social care by 2023/24.”

https://www.eveningexpress.co.uk/news/uk/at-least-...

leef44

4,359 posts

152 months

Sunday 6th December 2020
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If we all paid 80% income tax and it all went to NHS and nothing else then that would just about cover the needed funding to run it properly.

Du1point8

21,604 posts

191 months

Monday 7th December 2020
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leef44 said:
If we all paid 80% income tax and it all went to NHS and nothing else then that would just about cover the needed funding to run it properly.
Or they could run it properly and then no more is needed as they don't waste the money the tax payers so graciously give them.

BlackLabel

13,251 posts

122 months

Tuesday 29th December 2020
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“ A survey by the British Medical Association (BMA) Scotland found 61% of doctors think the service is funded “well below” the amount required.

Meanwhile, 92% believe the NHS will not be able to continue to provide the current range of services it does into the future without additional financial resources.

More than a third (36%) of doctors said staffing levels in their workplace had deteriorated in the last five years.

And half (50%) said they had experienced a situation where “the pursuit of targets has resulted in pressure to overturn clinical judgement”.”

https://www.heraldscotland.com/news/18973469.nhs-f...

Slaav

4,240 posts

209 months

Wednesday 30th December 2020
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There will never be ‘enough’ spent on the NHS! It is the Holy Grail and Sacred Cow all rolled into one..... sacrilege though that may be.

I’ve an idea, let’s divide the whole budget by the population and work out that figure per capita?

One estimate is £134 Bn and 66.65m population. My maths have waned but isn’t that (2019 numbers) c. £2,010 per capita for every man, woman and child?

If pure insurance premiums, that should give basic emergency and critical care? If not also include general healthcare?

Having said that, I would be open to an extra (eg) 1p in the £ to pay more..... but may I also have tax relief on my health insurance? It means I hardly ever use the NHS?!?!

Murph7355

37,651 posts

255 months

Wednesday 30th December 2020
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Slaav said:
There will never be ‘enough’ spent on the NHS! It is the Holy Grail and Sacred Cow all rolled into one..... sacrilege though that may be.

I’ve an idea, let’s divide the whole budget by the population and work out that figure per capita?

One estimate is £134 Bn and 66.65m population. My maths have waned but isn’t that (2019 numbers) c. £2,010 per capita for every man, woman and child?

If pure insurance premiums, that should give basic emergency and critical care? If not also include general healthcare?

Having said that, I would be open to an extra (eg) 1p in the £ to pay more..... but may I also have tax relief on my health insurance? It means I hardly ever use the NHS?!?!
Your opening sentence is correct.

On the rest...health insurance premiums don't cover emergency care. The reason they don't is that it's very expensive to provide.

Would paying and extra 1% offset your health insurance rebate?

I think you're on the right lines though....it's scope needs to be fully reconsidered in light of the available funds. It should not be considered a bottomless pit.

Slaav

4,240 posts

209 months

Wednesday 30th December 2020
quotequote all
Murph7355 said:
Your opening sentence is correct.

On the rest...health insurance premiums don't cover emergency care. The reason they don't is that it's very expensive to provide.

Would paying and extra 1% offset your health insurance rebate?

I think you're on the right lines though....it's scope needs to be fully reconsidered in light of the available funds. It should not be considered a bottomless pit.
Thanks for realising my basic point. It will never be enough. I seem to remember at the second last election (may have been BoJo) where Labour had ‘demanded’ an extra £x bn be spent; Tories announced £x+ commitment and when challenged, Labour just said ‘well we will spend more’.

It needs to stop being a Political football and become an ‘emergency service’ supplying/providing basic free healthcare. It should arguably also address social care but that’s a whole can of worms.....

If we looked at ‘general healthcare’ as a benefit, I would not get any benefit if means tested. FFS all I use it for now is emergency care and as you rightly state, that is often horrendously expensive!! I remember an episode a few years ago in Marys, Paddington where I had to overnight on a small critical care/A&E ward due to needing a full monitor etc. The Consultant apologised as the Lindo across the road had no beds w monitors/full facilities vacant.

All follow up was Private but that A&E/point of need is vital but incredibly important and expensive.

I also have considerable experience/knowledge of the NHS and it fundamentally cannot provide the care it has morphed into trying to deliver.

I don’t have the answers but I do believe what we are trying to do now isn’t the solution.