Not much solid info this morning on what the NHS “birthday present” boils down to, but here’s a run down of the immediate cost pressures the NHS faces next year. Any funding increase that doesn’t at least cover these wont touch the sides (tiresomely endless thread follows>>)
£2.6bn= the cash increase to Dept of Health’s total budget already planned for 19/20. This represented a paltry 0.4% real terms increase over 18/19. Just bringing it up to the (insubstantial) average real terms increase since 2015/16 of 1.3% would cost a further £1.2bn
Last 3 yrs, hospitals have needed bailing out of their deficits to the tune of £2bn a yr. The planned budget for 19/20 was so low balled that cash wasn’t included. A further £1bn of any new cash will need to go on that (other half can come from the £1.2bn incrs mentioned above)
we're now £4.8bn down
Then there’s the already-announced pay deal, which the gov said would be fully funded. That will raise costs for NHS orgs by around £1.3bn in 2019/20. We've now eaten up £6.1bn of any extra cash for next yr.
Next there’s the obscure change in the pension discount rate that kicks in next yr. That essentially increases NHS org costs by at least £700m – which will be sent back to HMT. That brings us to £6.8bn extra cash needed in 2019/18 above 2018/19 before ANYTHING else can be fixed
For context, looks like the actual extra cash above 2018/19 will be just short of £6bn (give or take the inevitable confusion in weekend press briefings). So, er Happy Birthday NHS!!
Wish list for stuff to be fixed: £1bn back log on high risk maintenance, staffing shortages and 4m elective waiting list. Just halting growth in waiting list would cost around £500m extra a year
Some firmer figs coming in now: The £20bn real terms extra by 2023/24 is actually less than 3% a year growth on the total Dept of Health's budget for England. Consensus was that 4% on that was needed. What's been announced today is £8bn short
The £20bn is on NHS England's budget only. There's another £14bn of spending on NHS capital investment, doctor and nurse training, R&D and public health that is equally important and is excluded from the announcement today
