Speaking in Manchester today, Mackey said: “No service in the world is anywhere near NHS. The 2016-17 deficit is £791m against £2.5bn in 2015-16 and locum and agency savings of £700m have been achieved.
“What the NHS has done with levels of efficiency is technically borderline impossible, but it’s been done and we need to do it again.”
Mackey said sustainability and transformation plans (STPs) had been a success though “in some parts because people have sat down and spoken to each other; I know cases where the local provider did not know who the director of adult care was”.
Niall Dickson, chief executive of the NHS Confederation, told the session there was an urgent need for an assessment for health and social care needs “to expose the scale of challenge so the ensuing debate is based on evidence, not speculation”.
He said the country had to decide the level of service for which it was willing to pay and pointed out that standards were already declining.
“There are literally hundreds of thousands of elderly people who receive no support who would have done seven or eight years ago,” he said.
Population growth and the rapid increase in those aged over 85 had created pressures which, despite the resilience of the NHS, meant “the system is doing very well in many ways but every day we are letting down to many patients,” Dickson said.
“The NHS will become unsustainable and we need to agree a vision for future for health and care services.”
Questioned from the floor by CIPFA chief executive Rob Whiteman, who is also chair of the North East London STP, on the government need to encourage more preventative work, Mackey said this could be done but too often contracts were being used that simply passed risk to contractors without bringing about any real change in attitudes towards preventative work.
Phil Butler, from the London Borough of Sutton, asked whether it would be beneficial were the NHS to gain prudential borrowings powers similar to those of councils.
Mackey said: “It would be a fantastic step forward. We are boxed in on every front. Every day people come to me with projects that cannot go ahead just for some technical reason.”
