NHS ‘no longer able to meet standards in its constitution’, health boss tells Jeremy Hunt

‘Rising numbers of flu cases and more respiratory illness have placed intolerable pressures on staff’

Samuel Osborne,Alex Matthews-King

Thursday 11 January 2018 08:46 GMT

Health and Social Care Secretary Jeremy Hunt has been told the NHS budget needs to increase to £153bn by 2022/23 (Getty)

The National Health Service is at a “watershed moment” and cannot deliver care to the standards required by its constitution with the funding it receives, Jeremy Hunt has been told.

Chris Hopson, chief executive of NHS Providers, which acts as as bridge between trusts and the Department of Health, has written to the Secretary of State for Health and Social Care to call for extra investment on a long-term basis to address the “fragility of the wider NHS”.

The three-page letter calls for the Government to commit to increasing the NHS budget to £153bn by 2022/23 – a sum the Office for Budget Responsibility said was needed, given projected increased demand for services.

But Mr Hopson has warned that, due to the current state of NHS finances, “substantial progress” must be made before the Autumn Budget this year.

Mr Hopson said: “Despite planning for winter more thoroughly and extensively than before, it hasn’t been sufficient. Rising numbers of flu cases and more respiratory illness have placed intolerable pressures on staff.

Everyone the Government blames for the NHS crisis – except themselves

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1/6Everyone the Government blames for the NHS crisis – except themselves

Everyone the Government blames for the NHS crisis – except themselves

The elderly

“We acknowledge that there are pressures on the health service, there are always extra pressures on the NHS in the winter, but we have the added pressures of the ageing population and the growing complex needs of the population,” Theresa May has said. Waits of over 12 hours in A&E among elderly people have more than doubled in two years, according to figures from NHS Digital.

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Everyone the Government blames for the NHS crisis – except themselves

Patients going to A&E instead of seeing their GPs

Jeremy Hunt has called for a “honest discussion with the public about the purpose of A&E departments”, saying that around a third of A&E patients were in hospital unnecessarily. Mr Hunt told Radio 4’s Today programme the NHS now had more doctors, nurses and funding than ever, but explained what he called “very serious problems at some hospitals” by suggesting pressures were increasing in part because people are going to A&Es when they should not. He urged patients to visit their GP for non-emergency illnesses, outlined plans to release time for family doctors to support urgent care work, and said the NHS will soon be able to deliver seven-day access to a GP from 8am to 8pm. But doctors struggling amid a GP recruitment crisis said Mr Hunt’s plans were unrealistic and demanded the Government commit to investing in all areas of the overstretched health service.

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Everyone the Government blames for the NHS crisis – except themselves

Simon Stevens, head of NHS England

Reports that “key members” of Ms May’s team used internal meetings to accuse Simon Stevens, head of NHS England, of being unenthusiastic and unresponsive have been rejected by Downing Street. Mr Stevens had allegedly rejected claims made by Ms May that the NHS had been given more funding than required.

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Everyone the Government blames for the NHS crisis – except themselves

Previous health policy, not funding

In an interview with Sky News’s Sophy Ridge, Ms May acknowledged the NHS faced pressures but said it was a problem that had been “ducked by government over the years”. She refuted the claim that hospitals were tackling a “humanitarian crisis” and said health funding was at record levels. “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need,” said the Prime Minister. “They did that, we gave them that funding, in fact we gave them more funding than they required… Funding is now at record levels for the NHS, more money has been going in.” But doctors accused Ms May of being “in denial” about how the lack of additional funding provided for health and social care were behind a spiralling crisis in NHS hospitals.

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Everyone the Government blames for the NHS crisis – except themselves

Target to treat all A&E patients within four hours

Mr Hunt was accused of watering down the flagship target to treat all A&E patients within four hours. The Health Secretary told MPs the promise – introduced by Tony Blair’s government in 2000 – should only be for “those who actually need it”. Amid jeers in the Commons, Mr Hunt said only four other countries pledged to treat all patients within a similar timeframe and all had “less stringent” rules. But Ms May has now said the Government will stand by the four-hour target for A&E, which says 95 per cent of patients must be dealt with within that time frame.

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Everyone the Government blames for the NHS crisis – except themselves

No one

Mr Hunt was accused of “hiding” from the public eye following news of the Red Cross’s comments and didn’t make an official statement for two days. He was also filmed refusing to answer questions from journalists who pursued him down the street yesterday to ask whether he planned to scrap the four-hour A&E waiting time target. Sky News reporter Beth Rigby pressed the Health Secretary on his position on the matter, saying “the public will want to know, Mr Hunt”. “Sorry Beth, I’ve answered questions about this already,” replied Mr Hunt. “But you didn’t answer questions on this. You said it was over-interpreted in the House of Commons and you didn’t want to water it down. Is that what you’re saying?” said Ms Rigby. “It’s very difficult, because how are we going to explain to the public what your intention is, when you change your position and then won’t answer the question, Mr Hunt”. But the Health Secretary maintained his silence until he reached his car and got in.

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“The NHS is no longer able to deliver the constitutional standards to which it is committed. We need to be realistic about what we can provide on the funding available.

“If we continue to run the NHS at close to 100 per cent capacity day in, day out, permanently in the red zone, it’s not surprising that the service can’t cope when we get a high, but entirely predictable, spike in demand.”

Warning that failure to act would lead to targets moving further out of reach, he said: “There is so much at stake. We can fix this, but there must be no more delay. The ball is now firmly in the Government’s court.”

The letter follows the Health Secretary’s admission on Wednesday that the NHS will need substantially increased funding in future, which should be delivered across a 10-year spending period.

The letter adds: “The Government now needs to set out how it will create the sustainable, long-term health and care funding settlement you have rightly called for.”

NHS Providers has said the Government must commit to review this year’s winter preparations, which Prime Minister Theresa May has repeatedly said are “the best ever”, despite hospitals relying on a last-minute allocation of £335m in the Budget.

The Government has also guaranteed hospitals will be protected against further funding squeezes if they fail to hit increasingly remote financial targets.

The cancellation of non-urgent care, as advised by the NHS last week, will mean trusts, which are paid on a fee-for-service basis, miss out on income from these operations.

Jeremy Hunt apologises to patients as thousands of operations delayed

This will also make it harder to hit strict savings and performance targets and unlock the associated funding for delivering them.

NHS Providers’s intervention comes on the day after a leaked memo revealed Oxford’s Churchill Hospital was having to consider cutting back chemotherapy services for cancer patients because of staff shortages.

A letter from the hospital’s head of chemotherapy, Dr Andrew Weaver, said nurse numbers were down 40 per cent, and chemotherapy start dates may have to be pushed back or the number of cycles reduced.

Norman Lamb, a former Liberal Democrat minister, said the country had been “honest” about how to give the NHS more funding.

His party has called for adding a penny in the pound on income tax.

“The clear message from NHS leaders is that the Government must drop its sticking-plaster approach to the health service,” he said.

“The gap between demand and resources in the NHS is growing each year, with tragic human consequences across the country.

“The stark reality is that the current winter crisis is just a taster of what is to come unless ministers get to grips with the long-term funding shortfall facing the health service.”

A Department of Health and Social Care spokesman said: “The NHS was given top priority in the recent Budget with an extra £2.8bn allocated over the next two years, and was recently ranked as the best and safest healthcare system in the world.

“We know there is a great deal of pressure in A&E departments and that flu rates are going up, and we are grateful to all NHS staff for their incredible work in challenging circumstances.

“That’s why we recently announced the largest single increase in doctor training places in the history of the NHS – a 25 per cent expansion.”

Additional reporting by Press Association

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