Commenting on the Public Accounts Committee report into NHS financial sustainability, Nuffield Trust Senior Policy Analyst Sally Gainsbury said:
“This damning report from the Public Accounts Committee is right to highlight how dysfunctional budget setting in health and social care has become, especially in recent years.
“As we have shown over the past decade, the government has habitually underestimated how much funding the NHS needs, making heroic assumptions about the potential for demand for healthcare to be reduced or efficiencies to be made. Every year, these assumptions are proven wrong, leaving the health and social care sector in an even worse position as longer-term ambitions like boosting preventative services are repeatedly sidelined in order to balance the books.
“We welcome the committee’s recommendation that ‘meaningful indicative budgets’ should be set no later than Christmas each year, but for such budgets to be genuinely meaningful, they also need to be realistic. This is more than a matter for just NHS England or even the Department of Health and Social Care: politicians of all parties and the Treasury need to reckon with the reality that a combination of our aging population and ever-increasing expectations of the health service mean it will increasingly eat up a larger share of our collective resources. While that growth can be moderated through productivity gains and changes in how care is delivered, these should not be over-stated.
“One area where the potential for savings is at particular risk of optimism bias is in the imagined gains from shifting care from hospital to community settings. As politicians deliberate the forthcoming 10 Year Health Plan, they should be mindful that simply enforcing a target to spend more on care closer to home will not be enough without leadership and clarity over what such a shift will mean for patients.”
Notes to editors
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