By Richard Johnstone | 22 March 2013
The NHS met its efficiency savings targets last year partly by freezing wages and rationing treatments, the Public Accounts Committee concluded today.
In 2011/12, the Department of Health reported £5.8bn savings, slightly below its £5.9bn target. The MPs’ report said the NHS appeared to have made a positive start’ by almost reaching the target.
However, it concluded that most of the savings had been generated through short-term measures mandated by Whitehall. These included the pay freeze for staff, which was worth £1.4bn of the reported £5.8bn. As a result, the NHS could struggle to meet future targets after a 1% pay rise for workers was agreed for 2013/14.
Progress in making NHS efficiency savings also warned that the savings data was not ‘fully reliable’, with only 60% of those reported by ministers able to be substantiated using national data.
The committee highlighted concerns from patients' groups that some of the savings had come from rationing of treatment deemed to be of ‘low clinical value’, such as cataract surgery.
Although this might cut costs in the short term, MPs said, delaying treatment could lead to greater spending in future years.
Committee chair Margaret Hodge said: ‘We are concerned that other savings are being achieved by rationing patients’ access to certain treatments. These include cataract surgery and hip and knee replacements. These procedures are described as being “of low clinical value”, but people waiting for these operations suffer pain and a poorer quality of life.
‘Furthermore, the finances of some trusts are fragile, and there is a risk they may resort to simple cost-cutting rather than finding genuine efficiency savings.’
She added the NHS must ‘fundamentally change’ the way health care is provided to secure the level of savings needed, including the £6.5bn target for 2012/13.
This will include moving services out of hospitals and into the community. ‘We are not satisfied that the department and the NHS Commissioning Board are doing enough to help the NHS transform services. In replying to us, they should set out a clear plan for delivering the level of savings required from service transformation, including how they intend to use financial incentives to encourage NHS bodies to work together.’
A spokeswoman for the Department of Health said ministers were ‘absolutely clear that access to NHS services should not be restricted on the basis of cost’.
She added: ‘Decisions on treatments should be made by clinical experts based on the needs of each patient.
‘It is only right that changes to services are locally led – local health professionals are in the best position to know what is best for patients. And of course, the NHS must closely engage, right from the start with local communities and patients. We will respond fully to the PAC in due course.’
