What the NHS 10 year plan means for Leeds – Dr John Puntis

Stephen Hammond MP (Minister of State for Health) writing recently from his Wimbledon constituency to the good people of Leeds

https://www.pressreader.com/uk/yorkshire-post/20190112/282041918287291)

claimed: ‘The NHS Long Term Plan’ “will preserve the nation’s most prized asset”.

The ‘plan’ aims to keep people well and identify illness earlier, and is an amazing uncosted wish list of wonderful things that could be done if only the government could be persuaded to give the NHS enough money and staff:

  • community health crisis response services to swing into action within two hours of referral? – no problem sir;
  • home-based and wearable monitoring equipment to predict and prevent events that would otherwise have led to a hospital admission? – of course madam;
  • assessment and treatment of frail elderly patients by multidisciplinary teams delivering comprehensive geriatric assessment in A&E and acute receiving units? – definitely, every hospital medical and surgical department will have them.
  • One in three women experience urinary incontinence after childbirth – fine, we will have multidisciplinary pelvic health clinics across England, etc., etc.

The current reality, however, is that/ two thirds of acute Trusts are in the red, compared with 5% in 2010. Cancer waiting times are the worst on record, huge problems exist in A&E, and the average wait for a GP appointment is up 30% to two weeks.

This is all because of chronic underfunding. Until eight years ago, the NHS budget annual increase was 4% to meet rising demand, before being savagely cut to 1%. The Office for Public Responsibility estimates a 4.3% increase in spending is needed. The amount of extra funding which is supposed to pay for implementation of the ‘plan’ is a meagre £20.5 bn. It does not make up for the accumulated financial deficit, and increases the overall budget by only 3.4% – and not until 2023/4!

The ‘plan’ also sets out intentions to implement a top down reorganisation, with 44 ‘Integrated Care Systems’, lacking in public accountability (i.e. everything about you decided without you) and unprotected from takeover by the private sector.

Forced mergers of GP practices will cover populations of 30-50,000, causing accessibility problems for many. Whereas most of the 60+ uncosted commitments in the ‘plan’ to improve services would be very welcome, they are completely unrealistic given the funding offered.

An obsession with non-evidence based digital solutions, lack of a workforce plan to tackle the current 100,000 vacancies, absence of information on how much capital will be available for new projects, and ignoring the crisis in social care (“when agreeing the NHS funding settlement the government therefore committed to ensure that adult social care funding is such that it does not impose an additional pressure on the NHS over the coming five years” – so that’s alright then!) all spell further misery for patients. £20.5 bn may help keep the lights on, but this ‘plan’ is in reality a recipe not for the preservation but for the destruction of our most prized asset.

The lack of detail on manpower despite many trumpeted innovations that clearly would need more staff is astonishing. Perhaps they see unpaid volunteers as the solution, since £2.3 million is being committed to the Helpforce programme?

Helpforce is a charity that aims to boost the 74 000 volunteers in the NHS to “millions”. It was set up by Sir Thomas Hughes-Hallett, educated at Eton and Oxford before becoming a barrister and investment banker (giving him his soubriquet – ‘Thomas Huge-Wallet ‘). Apparently Sir Tom can often be seen waiting for a GP appointment or queuing in A&E. Billed by the Daly Mail as “one of the UK’s top health experts” (surely some mishtake? – Ed.), his insightful pronouncements on the NHS include: “to keep it on the road it should – like a garage – charge for extras”.

‘Leeds Keep Our NHS Public’ invites the people of Yorkshire to join a demonstration demanding proper NHS funding at 11.30 on March 30th 2019, outside the art gallery in Leeds.

Find the NHS Plan at: http://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/, write to NHS England, PO Box 16738 | Redditch | B97 9PT, or email at
england.contactus@nhs.net to request a paper copy.

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