End to ring-fencing of NHS spending

Topics covered: Ridouts professional advice

The former Defence Secretary and Shadow Health Secretary, Dr Liam Fox, has called for the end of ring-fencing that protects NHS finances. He said an obsession with targets and spending was “killing patients” and that there was a “huge amount of waste” in the health service.

Dr Fox said that, “I think we’ve tested to destruction the idea that simply throwing lots more money at the health service will make it better. The increase over the last decade has been phenomenal and yet a lot of our health indicators lag behind other countries, particular things like stroke outcome or a lot of cancer outcomes. We’ve become obsessed with throughput and not outcomes and that has been hugely to the detriment of the patients in our system. If you treat the National Health Service itself as being the important entity, and not the patients, then you’re on a hiding to nothing.”

NHS expenditure was about £57bn in 2002 and £105bn in 2012. By 2015-2016 it is due to be around £110.4bn. Dr Fox said that ring-fencing any individual spend within a decreasing total budget led to “bigger and bigger distortions. They become, by definition, bigger and bigger proportions of the spending total … It also has a restricting ability inside Government to move money around when there is a particular problem. Anybody who has worked with or around the NHS knows there is still a huge amount of waste associated with it. It is very easy to be generous with other people’s money. The trouble is, there’s a finite amount of it.”

Dr Fox said there was too much emphasis placed on meeting targets and this was partly the cause for incidences of poor care. He said, “when I look at things like Mid Staffs, I see a breakdown in an understanding of what health care is all about. As a doctor myself, I do feel that the medical and nursing professions have some responsibility for having gone along with the whole concept of targets. Patients ought to be treated on the basis of their medical need. The idea that you would put patients in a different order to achieve a political outcome by arithmetic means, I find difficult to reconcile with basic ethics.”

Luciana Berger MP, Labour’s Shadow Public Health Minister, said that “the NHS is starting 2014 with a crisis in England’s A&E departments. It’s a crisis of this Government’s making and yet today a senior Tory thinks the answer is to cut the NHS’s budget. David Cameron already broke his promise to protect NHS spending in his first year in Downing Street, wasted billions on a reorganisation that set back patient care, and has overseen a crisis in A&E. Today’s intervention just reminds people why you cannot trust the Tories with the NHS.”

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