Winter Plans and White Elephants – Sunak’s £200m NHS plan just a PR exercise

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Samantha Wathen, the Press and Media Officer for Keep Our NHS Public, examines Sunak’s latest announcement of a £200m boost for the NHS this winter

Last week (13 September 2023) Prime Minister Sunak, along with Health and Care Secretary, Steve Barclay, held a meeting at Downing Street with selected clinical leaders and NHS chiefs to ‘drive forward planning to ease pressures in urgent and emergency care while protecting waiting list targets this winter’. NHS winter crises are a peculiarly British phenomenon most recently and acutely due to UK Government underfunding. The now unrelenting pressures are exacerbated still further by Covid and flu, seasonal illnesses, trips and falls and other weather-related issues.

Criticised for failing to plan ahead for winter in previous years, the Government was eager to show that it was now on top and had a plan to make sure that the horrific scenes of the worst winter on record that were witnessed last year in emergency departments up and down the country, were not repeated.

Head in the sand

In a way it was surprising that Sunak and colleagues could even see each other across the board room table considering the enormous elephant in the room. Junior doctors and hospital consultants are on strike again this week, joining forces for the first time ever on one of the days of action. This is the most significant escalation of industrial action in NHS history.

Clearly there can be no success this winter and no major headway made on reducing the now catastrophic 7.7 million-strong waiting lists without a workforce both sufficient in number and able to draw on the mental reserves necessary to face yet another relentless and punishing onslaught. Hospital managers have been quite clear that the doctors’ strike action represents the single biggest threat facing NHS capacity – ‘an unprecedented challenge’ this winter. Yet, even after nearly 200 days, the Government stubbornly refuses to sit down with the doctors’ union and talk about pay.

Frontline NHS staff, the Royal College of Nursing and the British Medical Association (BMA) were notably absent from the Downing Street invitations for discussions. Presumably, sticking one’s fingers in one’s ears is a preferable course of action to having to admit that any plan devised is ultimately doomed to failure without first settling the ongoing pay dispute with doctors and their unions.

Indeed, the BMA Council’s Chair Professor Philip Banfield said: ‘How can Steve Barclay claim to be shoring up the NHS for winter while at the same time refusing to engage with the doctors he needs to deliver that care? The Government would do well to remember that our NHS treats patients all year round and winter funding is only one part of a much bigger picture.’

Smoke and Mirrors

After the conclusion of talks, the Government announced that they are investing £200 million to boost resilience in the NHS and help patients get the care they need as quickly as possible this winter’.

However, following an exclusive investigation by theHealth Service Journal it is clear that the £200m promised will not be used to alleviate winter pressures, but instead will be earmarked solely in trying to mitigate strike action. The Government has therefore offered precisely nothing new in the way of supporting the health service to get through potentially its busiest winter on record, but rather it is only seeking to maintain the status quo; the summit in Downing Street was little more than a PR exercise.

As if this news wasn’t enough, in the Autumn statement next month, the NHS is expected to be cut further as the pay rise offered to frontline staff will be coming out of existing budgets leaving the health service in even worse shape than when industrial action began. The Government is therefore giving with one hand and taking away with the other. To add insult to injury, the cost of the junior doctors’ strike to the NHS so far has been estimated as £1bn, or enough to settle their pay claim for a year.

Public Health

On hearing news of the Government’s £200m for the NHS, Lord Bethell, the Conservative parliamentary Under-Secretary of State for Health during the Covid pandemic, stated that it was an ‘economically illiterate plan’. He posted on X (formally Twitter) that there was ‘literally nothing on prevention, nothing on reducing disease or reducing demand’. Bethell seems to be of the view that instead of so-called extra funding, Sunak should be concentrating on addressing the social determinants of ill health. All well and good, but this is not a problem that can be solved overnight, and the NHS must deal with the situation we are currently witnessing first.

In addition to the failure to supply any additional funding this winter for the day to day running of the health service, over 30 NHS hospitals in England alone have now been found to contain crumbling concrete (RAAC). Unlike schools, they will not close to ensure the safety of those who reside and work in them, but instead the advice is to be ready to evacuate if buildings crumble. There is also no money to correct the historic negligence in running down hospital estates, and to have to suddenly evacuate major hospitals, especially during winter, would be an unprecedented crisis. The cost of addressing the current NHS estates backlog stands at £10.2bn, with £1.8bn of this needed for ‘high risk’ repairs needed to prevent catastrophic failure or major disruption of clinical services.

NHS staff are the solution not the problem

There is a lot to do and a lot of money that must be spent to try and avert more suffering, hardship and unnecessary deaths this winter, but first on the agenda has to be resolving the dispute with doctors to end walkouts once and for all. Doctors are not the enemy here, and if the Government has even a hope of turning the NHS around, they need to start by working with and not against them.

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