The new £5.4 billion cash boost for NHS England is the easy bit of a very tricky situation for the health service and the politicians trying to work out how to deal with it. As Health Secretary Sajid Javid made clear on Monday, while the money will help deal with the backlog in treatment caused by the pandemic, it won’t do so immediately. He said that waiting lists would go up before they started to go down because people are still coming forward for treatment. Javid has been pitch-rolling for a dreadful winter ever since he took on the job, warning almost immediately that waiting lists could reach 13 million. Currently there are over five million people needing operations and other NHS services.
The Treasury is, true to form, anxious that the health service doesn’t just take the money without it appearing to touch the sides
This new money also only covers the period up to April 2022. What trusts are much more concerned about — and what’s been keeping the Treasury and Department of Health and Social Care locked in talks — is the year after that. NHS Providers has said the health service needs £10 billion next year to be able to tackle the backlog while still dealing with the effects of Covid — both in terms of cases and infection control measures which take beds and staff out of action while demand is still high.
The Treasury is, true to form, anxious that the health service doesn’t just take the money without it appearing to touch the sides. There is dark talk of the need for efficiencies that have been long promised. But it’s hard to see how trusts can realistically operate at their most efficient when staff are having to self-isolate and spend more time between patients as they don and doff PPE. What’s more, the NHS England has lost around 7,000 beds during the pandemic.
The NHS is already having a summer crisis of record-breaking demand which, as I explained here, is making it very hard for staff to get through the backlog, despite their best efforts. It seems to be widely accepted by Tory MPs who’ve got a decent grasp of health matters that the winter is therefore going to be unavoidably grim. The extra money isn’t going to make an enormous amount of difference to that. The workforce shortages that were already visible from space before Covid will take years to solve, not weeks. At least trusts now have the certainty of being able to spend money on hiring those who are available. But it is going to be an extremely difficult winter, with a lot of very upsetting stories about long waits outside A&E departments as well as on lists for treatment. People are going to be sicker when they have their operations, some to the extent that they will have to live with greater disability or indeed face a worse prognosis. There’s been a lot going on politically recently and the NHS summer crisis hasn’t made the headlines as much as a result. But even with this feel-good cash boost, the NHS is soon going to end up on the front pages for all the wrong reasons.
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