A five-year plan to increase the budget by £8bn a year by 2020 was only set out last year, but now hospital bosses have warned that is not enough. Chris Hopson, of NHS Providers, said the settlement needed to be redrawn. It comes as the half-year accounts for 2016-17 showed hospitals and other NHS trusts were failing to keep in budget. From April to September trusts overspent by £648m - this is despite hospitals being given an extra £1.8bn this year to bail them out following last year's record deficit of £2.45bn.
Mr Hopson's comments plus the emerging deficit puts the pressure on ministers ahead of the Autumn Statement next Wednesday. This will be the first time the government under Theresa May's leadership has outlined its spending priorities. All the indications to date are that ministers are not prepared to give the NHS more money, although there have been rumours that council-run care services could see investment to help reduce demands on the health service.
Mr Hopson criticised the way the current spending plans had been structured. He pointed out the rise in spending was actually £4.5bn rather than £8bn when cuts to other budgets, including those for training staff and money for public health schemes such as stop smoking services, was taken into account. He also said the extra demands being placed on hospitals, GPs and council-run care services had been underestimated, while the target to save £22bn in efficiencies by 2020 was "too ambitious". "For all these reasons, there is now a clear and widening gap between what is being asked of the NHS and the funding available to deliver it," Mr Hopson said. "We are therefore asking for a new plan for the rest of the parliament to finalise or confirm the NHS budget and honestly and realistically set out what can be delivered. "If there are no changes to the money available we will need to set out what the NHS stops doing. Right now the service cannot deliver what is being asked of it on the current budget."
He said that could include longer waiting times, rationing of non-emergency care such as knee and hip replacements and fewer doctors and nurses. Targets are already being missed in A&E and cancer care, while the waiting list for routine operations, such as knee and hip replacements, has hit 3.7m up from 3m two years ago. But instead of prioritising hospitals, he said any extra money should be invested in GPs and council care services to try to stem the rising demands. He refused to say how much more the health service needed however.
Meanwhile, the campaign group Equality 4 Mental Health, headed by Tony Blair's former spin doctor Alastair Campbell, Liberal Democrat MP Norman Lamb and Conservative Andrew Mitchell, called for more to be done to make sure extra money got through to mental health.
The group - with the backing of nine former health secretaries - has said services are still being squeezed despite promises for care to be prioritised. Sally Gainsbury, of the Nuffield Trust think tank, agreed there need to be a rethink on finances, saying a "long-term solution" was needed rather than the "sticking plaster" of the current plans. But the Department of Health defended its record. "The government has taken tough economic decisions that have allowed us to invest in our NHS, which is meeting record patient demand while improving standards of care."