Training Blog

The NHS is facing an uncertain future because of the credit crunch. This is because lower spending as well as more stress related illnesses caused by worries such as unemployment and money related issues means the health service must plan ahead if it is to survive.

John Appleby states: “at best the NHS might expect no real growth in funding from 2011 when the current budget runs out. Although the prime minister pledged not to cut spending on health, with foundation trusts reporting cash balances of £2.5 billion and the rest of the NHS planning a surplus of £1.7 billion, the government may look to claw back end of year NHS surplus funds — taking back unspent money may not be viewed as a cut.” He also says that it is the long term issues that cause him the most concern.

The increase in inflation will have a huge impact when every 1% increase is costing the health service around £380 million. The higher living expenses means even more pressure on NHS staff’s disposable income meaning higher wage claims and calls for contract renegotiation.

It isn’t just long term that the credit crunch is affecting the NHS in the short term, the credit crisis has had an impact on private sector health providers and foundation trusts. Virgin Healthcare has already pulled back from plans to enter the health market and it is likely that future private finance initiative schemes will slow down.

It is said that: “NHS spending is guaranteed up to April 2011, what happens after then looks decidedly less rosy. The health service will almost certainly have to plan for lower growth in funding from 2011 onwards.”

Professor Appleby said the NHS is now better equipped to deal with the economic downturn than in previous years, with almost two thirds of trusts now showing solid financial management. He also adds that the Government’s financial system bailout using £387 billion of taxpayers’ and borrowed money will push national debt to over half the UK’s gross domestic product and this will inevitably affect public services.

Therefore it would seem that the NHS has its work cut out with the cut in the budget allocation imminent and the increased demand on its resources with staff demanding more money in order to maintain the standard of living and also with more people suffering stress related illnesses. It would seem that there is no area of society that hasn’t been affected by the credit crunch which orginated from the banks therefore it’s safe to assume that all areas of society are interconnected.

Personal budgets have been used in social care since the mid 1990s and ministers claim that they can encourage patients to get more from the NHS. Evidence shows that personal budgets have allowed people in social care to be more imaginative and use funds more “carefully” than the system did. It is said that the personal budget programme employed in social care includes direct cash payments to the individual as well as budgets that a patient can put in the hands of a social care professional.

Those who support the idea of patients having their own personal budget have said that there is no reason why this should not happen in health, although it will need to be carefully introduced.

There are those who claim that the system who say that the system can be misused if you are simply giving patients money however the information on this scheme states that where direct payments are handed over to individuals the way they are used is carefully monitored and people receive help from professionals about what services are available. The chief executive of the NHS Confederation, which represents managers, states: “There is a growing body of evidence to suggest health outcomes are improved when the patient is directly involved in making decisions about their treatment and the way in which care is delivered by NHS staff.” Despite this there are a number of obstacles to overcome before the scheme can be launched nationally.

There are lots of questions from those who have their doubts about this new system such as, should patients be allowed to spend their personal budgets on non cost-effective treatments? or should individuals be allowed to top-up their care? Should patients be allowed to invest personal budgets to be spent at a later date? Dr Hamish Meldrum, who is the chairman of the British Medical Association, said the policy appeared to “further establish the idea of healthcare as a commodity”, which would not be in patients’ “best interests”.

Those who support the idea of patients managing their own budget claim that “Personal health budgets could revolutionise the way in which care is delivered, but they are not without risks.”

Niall Dickson states: “Getting the initial payment level right will be important as will deciding what restrictions to place on the kind of treatment a patient is allowed to purchase with tax payers’ money, and from whom.”

Ministers imagine that it will be of particular interest to those with long-term conditions such as diabetes and people using mental health services, for example, a person with diabetes may choose to use their budget to get treatment from a community clinic rather than being referred to a hospital specialist. Launching the Bill, Health Secretary Alan Johnson said: “People rightly have high expectations of the care the NHS offers, and they want more control over their own health – which is why this Bill will give more power to patients and drive up the quality of care.” Andrew Lansley adds: “Personal budgets have been at pilot stage since 2005. If Labour had stuck to their promises to deliver them then patients would already be benefiting”.

It would seem that the majority of people are dubious of this new scheme as it seems that they are worried about several factors:

• It is essentially privatising the NHS
• Some people may get a higher budget than others
• Some people may use their budget to jump through the waiting lists for procedures

Without a detailed plan of how the scheme will actually work it is impossible to know whether the scheme will actually work basically I’m not sure if the scheme is good or bad. Although the evidence would suggest that there is the potential for the scheme to work I think it may cause some people to lose out or be unable to get the treatment they need.