A £30bn funding gap will open up in the NHS over the next seven years without radical changes, including more centralisation of hospital services, the chief executive of NHS England has warned.
The feared gap equivalent to almost a third of todays NHS budget, and the annual running cost of about 75 hospitals is the product of NHS Englands assumption that while the NHS budget will increase only about 2 per cent each year, the demands on the health service and its costs will increase by nearer 6.5 per cent a year.
The figure is being used to focus minds on the need for what Sir David Nicholson described as some really big decisions over how NHS resources are distributed from next April onwards, including which services funding will be taken away from.
Despite a call for a wide public debate on the matter, Sir David admitted that NHS England the new body in charge of £96bn of the NHSs total non-Whitehall budget already had some specific ideas about how the £30bn gap might be filled.
These included a further centralisation and consolidation of specialist hospital services such as cardiac and paediatric care an area which has already been subject to heated public debate and suspicions that decisions are driven more by cost considerations than the quality of care at smaller units.
Those cost considerations were acknowledged by the NHSs national medical director Professor Sir
Bruce Keogh who said in support of more centralisation: There are some [medical services] that do well if they are put in a place where theres appropriate expertise and appropriate resources, and of course its the cost in many ways that defines that, as well as local expertise.
Sustainable Healthcare
Specialist hospital services are funded directly by NHS England at an annual cost of about £12bn.
Sir David also said another likely target would be GP and primary care services which currently cost £11bn a year. NHS England will soon begin fresh negotiations on how GPs are paid for those services, with Sir David suggesting that he will seek a contract that results in larger, more efficient GP practices.
Although the small print to the report setting out the funding gap explains that £8bn of the £30bn could be saved by another seven years of NHS pay restraint, Sir David effectively ruled out a blanket freeze on the £45bn NHS pay bill, saying the savings would not be achieved by draconically cutting the pay of our staff.
He also ruled out filling the gap by introducing user charges, saying such a change would be contrary to the NHS constitution introduced by the last Labour government and reaffirmed by the coalition.
Source The Financial Times
