Spending review scraps free scripts for long-term conditions as Lansley warns savings so far ‘not enough’

By Ian Quinn

The Government has scrapped plans for free prescriptions for people with long-term conditions and also a proposed target of a one-week wait for cancer diagnosis, as it reveals more details of plans for £20bn cuts across the NHS.

The Comprehensive Spending Review, published today, confirmed the Government's commitment to ringfence overall NHS funding, with total spending earmarked to grow by 0.4% between now and 2015.

But several high-profile targets planned by the previous Government have been axed, as experts warned the ringfencing masked difficult times ahead for the health service and health secretary Andrew Lansley said savings to date had not gone far enough.

Mr Lansley said the review ‘reinforces our historic commitment to protect health spending and means that funding for the NHS will increase in real terms in every year of this parliament.'

But he said there were increasing demands on the NHS ‘to make every penny count', with GPs set to be plunged into the heart of the decision-making under the white paper plans.

‘NHS organisations have already started a wide-ranging efficiency drive to make savings that can be redirected into patient care,' said Mr Lansley.

‘But that is not enough. The NHS budget will have to stretch further than ever before in these difficult times – and so reform isn't an option, it's a necessity in order to sustain and improve our NHS. The proposals I set out this summer will cut waste and bureaucracy and put patients and doctors in control to build a high-quality health service.'

Shadow chancellor Alan Johnson warned the real-terms increase in NHS funding will be ‘more than swallowed' by the Government's plans for a ‘top-down reorganisation' of health services they had promised would not happen before the election.

Under the Department of Health's spending plans a 17% decrease in capital spending and a 33% reduction in the administration budget will be reinvested into other services.

The health settlement for the spending review also includes:

• Additional investment to support social care, rising to £2bn per year by 2014-15, through the NHS and local government

• Expanding access to talking therapies

• A new cancer drugs fund of up to £200m a year

• Funding for priority hospital schemes, including St. Helier, Royal Oldham and West Cumberland

• NHS health research spending growing in real terms

The Government will no longer require PCTs to deliver hard copies of 'Your guide to NHS services' to every household, which it claims will generate total savings of £1.5m to £2.5m over four years.

And it said it plans to increase the use of highly qualified clinical scientists in the NHS to free up doctors to focus on the work that only they can do, as part of the Modernising Scientific Careers programme, which it claims will save in excess of £250 million per year.

BMA chair Dr Hamish Meldrum welcomed the Government's decision to ringfence overall NHS funding, but said that plans to further ramp up productivity within the health service were 'worrying'.

'Doctors and nurses work extremely hard to care for their patients and will continue to do so despite the challenging times ahead,' he said.'

'In the last decade the ‘productivity' of healthcare staff has contributed to reduced waiting times and improvements in the quality of patient care. If the Government is truly committed to reducing waste and inefficiency, their proposals for NHS reform should focus less on competition and more on a cooperative approach on delivering healthcare.'

Nigel Edwards, acting chief executive of the NHS Confederation, described the settlement as 'as good as the NHS could have hoped for in the circumstances' - but also warned that further pain lay ahead.

'Even with this settlement, the NHS is going to have to really up its game on productivity because of high levels of increasing demand and new technology,' he said. 'We already have some of the most stretching productivity targets anywhere. Achieving more will be immensely difficult when we are going through such a major programme of structural reform.'

For further reaction to the Government's Comprehensive Spending Review and the implications for GPs and the wider NHS, please click here.