£150billion-a-year NHS will get even MORE money

Steve Barclay today told NHS leaders at a conference in Liverpool that the health service ‘absolutely’ needs financial support to meet inflationary pressures

The ailing NHS will get more cash in the budget set to be announced tomorrow, the Health Secretary has confirmed.

Steve Barclay today told NHS leaders at a conference in Liverpool that the health service ‘absolutely’ needs financial support to meet inflationary pressures.

He hit back at reports he told Treasury officials the NHS didn’t need more cash — saying it would become clear tomorrow, when the Autumn Statement is unveiled, the claim was ‘incorrect’.

NHS leaders have warned the service faces a £7billion shortfall next year, which has been fuelled by soaring inflation. Without this cash, key cancer, GP and mental health care face cutbacks, health bosses say.

This is despite the NHS budget soaring to £152billion this year, £30billion more than pre-pandemic levels. At the same time, it is treating fewer patients than before Covid.

It comes as the NHS faces a ‘tripledemic’ of Covid, flu and the A&E crisis this winter, on top of strikes by hundreds of thousands of members of its workforce, who are seeking better pay and working conditions.

HM Treasury data shows the NHS received £100.4billion in 2010/11 and its core budget has grown steadily until 2019. In 2020, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service received £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery. The health service has been allocated £151.8billion for 2022/23

The graph shows the Royal College of Nursing’s demands for a pay rise of 5 per cent above RPI inflation, which hit 14.2 per cent in October (red bars). This is in comparison to the Government’s pay offer (light blue bars). Pay is broken down by band, which less experienced members of staff being paid less than those more senior

At the annual conference of NHS Providers, which represents NHS emergency, community and mental health services, Mr Barclay was asked about reports he had told the Treasury the NHS could cope without extra cash. 

The claim was reported in The Times on Saturday, with Treasury officials said to be ‘pleasantly amazed’ by Mr Barclay’s willingness for the NHS to operate with its current budget.

But he told NHS leaders that the claim was nonsense.

Mr Barclay, who this summer pledged to save cash by slimming down the layers of bureaucracy within the health service, said: ‘Firstly, that is completely incorrect and we told the journalists that it was incorrect but the story was run, nonetheless. 

‘The great thing about this, is colleagues in the room will be able to see tomorrow. 

‘I can assure you the Treasury would not allocate any money to the department if the department said that it didn’t need it, given the fiscal situation we face. 

‘So in short, of course we face significant financial pressures and inflation is there.’

He said his previous experience working in the Treasury and Cabinet Office means he has ‘a very good understanding of how best to make the case for the Department of Health’. 

Mr Barclay said: ‘Firstly, I can absolutely confirm that we do need support to meet those inflationary pressures. 

‘And secondly, coming back to, I said in the speech “show not tell” and I think it’s probably just useful for local leaders because sometimes I’m sure in my tenure as Secretary of State, things will be written which won’t reflect my view. 

‘That kind of goes with the train in politics. 

‘And perhaps it is useful when you see tomorrow whether it is true that we don’t get a penny and have not asked for a penny, when you see tomorrow whether that is true or not, I hope you bare that in mind when in the future you also see stories which may not completely align with what we’re doing in the department.’

However, in a keynote speech to the conference this morning, Mr Barclay suggested the Government didn’t plan to meet NHS workers’ demands for more pay.

Hundreds of thousands of staff across the health service are set to walk out this winter, with nursing strikes set to start before Christmas and cause disruption through to May.

The Royal College of Nursing is seeking a pay rise of five per cent above RPI inflation, which soared to 14.2 per cent in October, economists confirmed today. Junior doctors, midwives and ambulance staff are also contemplating walk-outs, with unions plotting together to strike simultaneously. 

Meeting the offer would cost £9billion — six per cent of the NHS’ total budget, it is estimated.

Industrial action is expected to begin before Christmas, with reports it will take place over two dates, potentially a Tuesday and a Thursday. Pictured, NHS staff march from St Thomas’ Hospital to Downing Street in July 2021, in protest over pay

The graph shows the current average salary of public sector workers (blue bars) and how much more their unions are asking their pay to be increased by (yellow bars). The nurses’ union is asking for a salary increase of five per cent on top of RPI inflection, which current sits at 12.6 per cent

The RCN is just one NHS union which has or is balloting its members over pay

Mr Barclay said the country’s financial challenges — fuelled by ‘two “once in a hundred year” events’, the pandemic and the war in Ukraine — ‘places constraints on pay and creates the backdrop of industrial action’.

He met RCN representatives last week and held a roundtable with other unions yesterday to discuss ‘pay itself’, along with patient safety.

Mr Barclay said: ‘I do not think it is realistic that increases should be three times the amount paid to those outside the public sector. 

‘And the £9billion cost this would entail would impact other important areas of spend, such as buildings and technology, which are also important to staff.’   

However, he told NHS leaders that he is ‘extremely keen’ to put practical measures in place ‘to support the NHS and care workforce’.

‘If I can make the point more explicitly, when people ask what my priorities are for the NHS, then supporting the workforce is first amongst those priorities,’ Mr Barclay said.

The Health Secretary confirmed that £500million will be provided to NHS integrated care boards and local authorities to tackle the bed blocking crisis.

A tenth of beds in hospitals are taken up by people who are ready to be discharged but are left in hospitals due to a lack of social care staff to look after them outside of hospital.

The fund, first announced in September, will be paid out in December and January to ‘help get people who don’t need to be on wards’ out of hospital and into social care, he said.

Three quarters of all NHS trusts are still performing below pre-pandemic levels, according to MailOnline’s analysis of local data. West Hertfordshire Teaching Hospitals completed 718 inpatient treatments on average through June, July and August. The figure was more than double that (1,763) in 2019

NHS England data show just over 275,000 inpatients were given an operation or were treated in hospitals in August this year. It was down 6 per cent on the 293,000 average treated in the three months up to August in 2019

It will be spent on investing in technology, increasing domiciliary care capacity and funding physiotherapists and occupational therapists to support recovery at home, Mr Barclay said. 

He noted that this winter will be ‘one of the toughest’ in the 74-year history of the NHS, with nine in 10 trust leaders more worried about this year than any previous winter. 

Mr Barclay said: ‘We face the twin threats of Covid and flu, huge external pressures around energy and cost of living.

‘We enter the colder months without the breathing space that we might usually have had over the summer and that I’m sure colleagues were used to in the earlier stages in their career.

‘And due to the Covid pressures which have remained high, that has continued that pressure.’

There will be more staff working on NHS 111 and 999 services and the Department of Health will focus on what other ‘practical measures’ can be brought in, he said. 

He also pledged to remove targets that put ‘blame’ on parts of the NHS for problems that occur because of issues ‘elsewhere’.

And local NHS organisations will be empowered to make decisions, such as choosing to stop ‘lower priority spending’ to prioritise care that ‘matters most to patients’, Mr Barclay said. 

He noted that 90 per cent of the public’s contact with the NHS is through primary care and said improving access to GP appointments and ‘addressing the 8am morning scramble’ is a ‘key area of that focus’. 

The Department of Health will work to boost the primary care workforce, expand skills in primary care, create more appointments for patients and roll out more phone lines, he said. 

New ways of working, such as delivering patient tests in their homes, will also be explored, Mr Barclay said. 

Addressing the crumbling NHS estate, he noted that nine in 10 new hospitals were over time and over budget. Mr Barclay called for bespoke designs by trusts to be scrapped and replaced with national designs, which can be built quicker.

Saffron Cordery, interim chief executive of NHS Providers, said trust leaders ‘will welcome reassurances’ that Mr Barclay ‘has been batting’ on the NHS’ behalf.

She said: ‘They will also be pleased that he has recognised the critical importance of capital investment in the NHS and confirmation that the £500million discharge fund previously trailed by Government will be released shortly.

‘Inflationary pressures have left a £7billion shortfall in the NHS’ budgets and tough efficiency targets mean more savings will be hard to find without impacting on frontline patient care.

‘Leaders across the NHS will scrutinise tomorrow’s fiscal statement to see if the chancellor has heeded warnings from trusts — and the health secretary — about the urgent need to tackle the financial and workforce challenges facing the health service.’