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NHS chief contradicts Government on spending claims

NHS chief executive Simon Stevens has told MPs that NHS England did not get the funding it asked for from the Government.

This comes despite the Government’s repeated claims that it is giving NHS England £10bn, when NHS England had asked for £8bn in the Five Year Forward View.

Pushed for his opinion by the Public Accounts Committee this afternoon, Mr Stevens said NHS England had not got ‘what we asked for’ in terms of NHS funding in the Spending Review, adding that: ’There are clearly very substantial pressures and I don’t think it helps anybody to try and pretend that there aren’t.’

The PAC also asked Mr Stevens’ opinion on the House of Commons health committee claims that the Government’s NHS spending claims are ‘misleading’.

Health committee chair Dr Sarah Wollaston said in October that the Government should stop giving the ‘misleading’ impression that NHS is being given a £10bn cash boost by 2020, when the overall health budget over five years is actually just increasing by £4.5bn.

But Mr Stevens said: ’To some extent I think this debate about 2020 this, 2020 that, kind of misses the point actually, which is that in the here and now there are very real pressures. Over the next three years, funding is going to be highly constrained, and in 2018/19… real terms NHS spending per person in England is going to go down…

‘We all understand why that is, but let’s not pretend that that is not placing huge pressures on the service.’

But, when put on the spot over NHS and social care funding at Prime Minister’s Questions earlier today, Theresa May argued that the situation on the NHS front line is not as bad as suggested.

In the session, the Prime Minister said that the British Red Cross’ warning issued last week saying that there was a ‘humanitarian crisis’ in the NHS had been ’irresponsible and overblown’.

BMA chair Dr Mark Porter said Mr Stevens ‘admitted what we already know: there is not enough money to fund our health service’.

He added: ‘The Government talks about injecting £10bn into the NHS, yet in reality the increase in health spending is less than half of that. Instead of outlining a plan to deal with the crisis, the Government has tried to play down the pressure that services are under.

‘The Government cannot continue to stick its head in the sand. Our hospitals are in the red, GPs are unable to keep up with the number of patients coming through the surgery door, patients are suffering and staff are working under impossible conditions.’

How did £4.5bn become £10bn?

In the NHS Five Year Forward View, spanning 2015-2020, NHS England said there would be a £30bn funding gap by 2020. It said that in the most optimistic of scenarios £22bn of that gap could be closed via national and local efficiency savings.

In response, the Government said the NHS budget would be £8bn higher by 2020 than in 2015. This figure later changed because the Government started including funding pledged prior to 2015 – so the £10bn actually refers to a six-year, rather than a five-year period.

So where does the £4.5bn figure come from? The House of Commons health committee is pointing out that the overall health budget is increasing only by £4.5bn, because it is only the NHS England budget which is ring-fenced under the Government’s spending settlement.

This means that other parts of the health and social care budget are taking cuts to boost the funds made available to NHS England, including for example spending on health education.

The health committee therefore argues it is ‘misleading’ to claim the health service is getting a massive cash boost, when – as Simon Stevens also points out – funding per head of population on healthcare is actually decreasing.

In today’s session, PAC chair Meg Hillier said this amounted to ‘robbing Peter to pay Paul’, but Mr Stevens suggested it was actually ‘robbing Paul to pay Paul’.