Spending on GP services has dropped over the past ten years, while investment in hospitals has risen sharply, showing the Department of Health’s plans to shift more care into the community and cut costs are in reverse.
The report from the Nuffield Trust reveals spending on GP services has dipped by 0.2% a year over the last five years, with no additional investment into general practice since 2005.
This compares with spending on secondary care jumping 40.1% over the same period – an equivalent of an average increase of over 5% a year.
The research, published today, estimates that all primary care services – including dental care, opticians and high-street pharmacies – now counts for just 24% of the NHS budget, having taken up 26% in 2003/04.
It also shows since the Government’s tight financial envelope for the NHS began in 2011/12, GP services have particularly suffered, with overall spending on all health services held static at £105.4 billion, but spending on general practice declining by 1.2% during the year.
This compares with a 1.2% increase to spending on hospital care, a 6% increase to community services and a 0.5% rise to mental health services spending.
The report concludes that general practice was the only area of the NHS seeing financing decline in recent years, and that – although commmunity services have seen funding increases – it exposes that efforts to move care closer to patients are heading the the wrong direction.
It says: ‘Since 2007/08, spending on GP services by PCTs has fallen in real terms by an average of 0.2% a year. Despite the overall increase in spending on health since 2003/04, spending on GP services has been static since 2005.
‘The more rapid growth in hospital spending relative to primary care raises questions about whether the NHS has the right balance of services for the future.’
Commenting on the report, co-author and Nuffield Trust Chief Economist Anita Charlesworth said: ‘We will overlook opportunities to meet the efficiency challenge unless we pay close attention to where and how the NHS spends money, and what we get for it.
‘This report shows clearly that, for all the rhetoric, money is still moving into hospitals, not out of them. At the same time, however, we should recognise the success of PCTs in moving some care into the community.’
BMA chair Dr Mark Porter said: ‘The real terms decline in spending on primary care is disappointing but not surprising. Investing in community care and GP services would be hugely beneficial to patients and do much to relieve pressure on the hospital sector.’
Dr Peter Swinyard, chair of the Family Doctors’ Association, commented: ‘That is absolutely the experience we have on the ground. We are being paid at 2005 levels and that is eight years ago. That is in cash terms – in real terms it is significantly less.’
Health minister Lord Howe said: ‘This report shows that the NHS needs to be more efficient than it has been to deliver sustainable, high quality services for patients in the future. The NHS has made a good start at delivering these efficiency improvements, and is forecasting to have made a total of £10.8bn of savings by the end of this year. All of these savings are available to reinvest in front line care. However we are not complacent. We know that improving the way the NHS treats patients is not going to be easy. If the NHS is to meet the needs of an ageing population, it needs to seriously look at how it can improve how care is being provided, particularly to older patients and those with long term conditions.’