Lords blast government’s “shocking” lack of long-term NHS plan

5 Apr 17

The government’s “shocking” lack of long-term planning and underfunding is a danger to the NHS and adult social care, a House of Lords select committee has warned.

Today the select committee on the long-term sustainability of the NHS blasted successive governments for their inability to form a far-reaching strategy for the national health service.

The report states “a culture of short-termism seems to prevail in the NHS and adult social care. The short-sightedness of successive governments is reflected in a Department of Health that is unable or unwilling to think beyond the next few years”.

It continues “almost everyone involved in the health service and social care system seems to be absorbed by the day-to-day struggles, leaving the future to ‘take care of itself’.”

It called for a cross-party consensus to be reached on producing a plan for the NHS that looked as far ahead as 2025, supported by dedicated funds and implemented following a full public consultation.

Lord Patel, chairman of the committee, said: “There is a shocking lack of long-term strategic planning in the NHS. This short sightedness stems from the political importance of the NHS and the temptation for politicians to reach for short-term fixes not long-term solutions.”  

The committee reiterated its commitment to a tax-funded, free-at-the-point-of-use NHS, as the most efficient way of delivering health care, and its members outlined 34 recommendations required to protect this vision of health care in the UK.

Its main proposals include a call for an independent Office for Health and Care Sustainability to be established to monitor the health and care needs for the next 15-20 years and report to parliament on the major issues affecting these services.

In addition it urged further funding to be provided for these services that in the past have suffered from “volatile” and “poorly co-ordinated” resourcing.

Patel said that NHS spending would need to rise at least as fast as GDP for 10 years after 2020.

He added that a decade of pay constraint in the NHS has damaged morale and made it difficult to train and recruit the right people – a point discussed at a CIPFA-run debate yesterday on the topic of how Brexit will affect the public sector.

Today’s report highlights that the failure to implement a comprehensive long-term strategy to secure a skilled, well-trained and committed workforce was the “biggest internal threat to the sustainability of the NHS”.

According to the committee’s analysis the model of primary care will need to change, secondary care will need to be reshaped and specialised services consolidated further.

A Department of Health spokesperson said: “We are totally committed to an NHS, free at the point of use, providing world-class care – and we agree that means taking decisions to ensure the sustainability of the service in future.

“That's why we are already expanding the number of medical training places by 25% to ensure we have all the doctors we need, investing in social care and working on a long-term funding solution in a green paper, and putting £325 million into local transformation plans to improve services, with more to follow in the autumn."

Candace Imison, director of policy at the Nuffield Trust, welcomed the findings, but warned that “whereas the financial difficulties can largely be solved by increased funding, the loss of the experienced, highly trained staff who are currently leaving the health service in droves cannot be easily reversed.” 

Elsewhere, Unite’s national officer for health, Sarah Carpenter, hailed the report, which she described as “well-balanced and thought-out, with pragmatic action points”.

She called on health secretary Jeremy Hunt to consider the report’s warnings over low pay following last week’s “measly” 1% pay rise for NHS staff.

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