“Looking ahead, the NHS and social care are now set for a decade-long funding squeeze which will see the largest sustained falls in spending as a share of GDP on both services in modern times.”
John Appleby, King’s Fund, commenting on 2016-2020 Spending Review, Nov 2105
On Thursday you’ll be voting for the person you want to represent your area on Leeds City Council. ‘What does that have to do with the NHS?’, you may ask. Here are six reasons why it’s important.
Our local NHS services, provided by the government, are closely tied to social care services provided by Leeds City Council.
Local council budgets for social care have been cut to the bone by the Coalition and Tory governments. John Appleby of the King’s Fund, an independent health think tank, reckons government cuts have resulted across England in a 25% reduction in the number of people receiving social care.
Leeds, like other local councils, is struggling to maintain social care services such as home carers. With these services cut back, people in hospital beds have to wait longer to go home safely (known as ‘delayed transfers of care’), which in turn puts more pressure on NHS hospital beds and A&E services needed by other people.
Older people, and people with disabilities or with long term medical conditions, are more likely than others to need both NHS and social care services.
Our ward – Otley and Yeadon – has an ageing population. In other words, there are more older people than average living in our communities, and the numbers are likely to grow with new housing designed for older people. This means that in our ward, family members, friends or neighbours will be more likely to need NHS or social care services from time to time or on a long term basis.
Confusion about the NHS out-of-hours system
Another reason for pressures on A&E services is that people are confused about how to access out-of-hours GP care, urgent care, and other types of out of hours care, such as district nurses. These services are all important in keeping people out of hospital, but many people find the out of hours and urgent care system confusing, partly because it’s so fragmented.
Two of the things that contribute to fragmented and confusing NHS services are:
- falling government spending in real terms on health service
- and continuing privatisation.
Government spending on the NHS is falling in real terms
The graph below from the King’s Fund (an independent charity working to improve health and care) shows UK NHS spending as percentage of Gross Domestic Product since the NHS was set up in 1948.
While spending on the NHS as a share of GDP rose visibly under the last Labour government, the blue line shows how sharply it has fallen under the Coalition and Tory governments. With the Spending Review settlement last autumn, it will continue to fall up to 2020. Although the government allocated more cash to the NHS for the next 5 years in the November Spending Review, this will almost all be eaten up by inflation, rising costs and rising demand for health care, so the proportion of GDP spent on the NHS will in fact fall.
John Appleby, Chief Economist for Policy at the King’s Fund says this is “the largest sustained fall in spending on health care as a percentage of GDP that we’ve seen since the foundation of the NHS.”
The NHS is being fragmented and steadily privatised
A key reason why NHS services seem fragmented is that they are increasingly run for profit by a range of private companies such as Circle and Richard Branson’s Virgin.
Virgin Care was only set up in 2012 to take advantage of the Coalition government’s Health and Social Care Act, which brought in much wider competitive tendering for NHS services. Circle, the private company that took over Hitchingbrooke Hospital and its debt in 2012, handed back the contract in 2014. Circle made ambitious claims about being able to make the hospital profitable, but following a damning report by the CQC, backed out of the contract only two years later.
The Tory Government has slashed Leeds City Council’s public health budget by over 7% – the largest cut to public health in Yorkshire
These are not ‘NHS’ services as such, because the government moved public health from the NHS to local councils in April 2013, but Leeds City Council’s public health budget covers important health services such as:
- sexual health
- school nursing
- health visiting
- suicide prevention
- domestic violence prevention
- drug and alcohol treatment services
- weight loss support
- health protection services including immunisation and infection control.