30 October 1998
A survey by the NHS Confederation found that only 3% of trusts had no need for a cash injection, despite the traditional increase in demand over the winter. Emergency admissions, the bulk of which occur over the winter, are rising by between 2% and 4% a year.
The confederation, which represents health authorities and trusts, said the public would expect better care because of the £21bn the government had promised the NHS following its Comprehensive Spending Review. But the benefits of this money would not be felt until next winter.
Stephen Thornton, the confederation's chief executive, said: 'Everyone wants this to be the last winter we face these dilemmas. So we must challenge the huge expectations that all the new NHS money will be available for new services or to meet pay demands, while maintaining a basic quality service must come first.'
It is not surprising that hospitals are calling for more winter cash. Last year, they received an extra £300m to help see them through these difficult months. But this year, extra money has been earmarked for cutting waiting lists. Last winter health secretary Frank Dobson told trusts that emergency admissions were to be their top priority, even if this meant longer waiting lists. But this winter he has promised trusts will stay open for emergencies and cut their waiting lists.
To most trusts, this is impossible without extra cash. Two-thirds of the 67 trusts surveyed said it was unlikely or very unlikely that waiting lists targets would be achieved.
On top of the extra demands, trusts will have to pay doctors, nurses and midwives the full pay rise they were awarded last spring. This will cost hospitals up to an extra £50m between December and March. Pay rises in the NHS this year are equivalent to a quarter of the extra £1.2bn the government has given the service this year.
The health department argued that trusts will be better prepared this year for the winter because of greater co-operation with council social services departments and better planning. This is borne out by the survey, with 91% of the trusts saying their boards had discussed the matter.
But Mr Thornton said this must be the last year when the NHS was put under such 'enormous' pressure. 'The government has said we now have a quality threshold in the NHS where better outcomes for patients are expected.'
PFoct1998
