Following on from my blog earlier this week, I want to be really clear in what I am saying!
- The funding formula used in health and social care is weighted towards the wealthy and the well…therefore the north is worse off compared to the south…
- We are already at a major deficit in terms of health outcomes, in the north
- The cuts affecting northern county councils were deeper and harder – both in terms of public health and social services, with a profound knock on effect to the NHS – therefore the further ‘efficiency savings’ being requested of us have an even more detrimental effect
- The actual investment from the government as shown by the King’s fund is not 8-10billion as promised, but only 4.5billion
- If you take into account economic growth, inflation and population need, the ‘investment’ is actually a disinvestment…..
- On top of this is the fact, shown through HEE (Health Education England) that the NW in particular has a massively reduced investment in recruitment compared to other areas, which flies in the face of what the Nuffield Trust and King’s Fund have shown is needed in areas of higher deprivation and worse health outcomes
- Even if we save the £560m we’re being asked to as an STP, our deficit at 2021 is £804m
My argument is this: if the correct investment was made, the formula wasn’t weighted against us and we therefore received the correct allocation of resource according to the task ahead of us, we would actually probably be in surplus and could really make a difference – we are already doing loads of great stuff, but asking us to make bricks with no straw is beyond the pale.…..as it is, what we’re being asked to do may affect the health and wellbeing of our population negatively because we are already at such a deficit, before we start….
This is not a political issue – this IS a Social Justice issue.
There are two different narratives that are shaping the debate around the NHS at present. They are different stories, but they are becoming dangerously intertwined. I want to highlight the two stories and make a clear distinction between the two.
The first story is that there are some ways in which the NHS needs to be more efficient, work more smartly, integrate its services more effectively, cut some unnecessary waste, be more collaborative and ensure that the service it provides is as affordable as possible in a manner that is safe, learning, compassionate and continually improving. Some of this involves working with communities to help us live in a way (individually and corporately) that helps us to be more healthy and well, taking some strain from the system. It also involves some restructuring and rearranging of services to enable them to deliver care in a more streamlined way. This is a true story.
There is another story that is told that sounds like it has some similarities, but it is not the same story. This is the story that tells us the NHS is unaffordable, that it is failing and that we need parts of it to be privatized for it to survive. This is based on an idea that we have to balance our books, cut our cloth, tighten our belts and ‘live within our means’. This story is not true. It is not true because no country has ever lived within its means. Countries are nothing like households. Households are very simple. The economies of nation states are not. Households do not have banks in their back gardens that print money when things go wrong. Households do not give special privileges to rich friends, making life easier for them, whilst treating poorer friends like servants, taking away things they need and telling them are lazy and need to work harder, whilst blaming their problems on other friends who have moved into the area aka immigrants. Cutting public services and seeing the gap between the rich and poor grow ever wider whilst taking away the welfare that helps families in genuine need, cutting the services available to help them (pretending these are efficiency savings and not cuts) is a choice being made by our politicians. We are told there is no other choice, but this is not a true story. The NHS could be better funded (it is currently one of the most under funded health care systems in the entire developed world) and we could choose to manage the money of the country in an altogether different way! The NHS is affordable and the first story is helping to make this more true, but it needs greater investment, not the removal of vital services. Do not confuse the two stories.