Simon Stevens, appearing with the PM at his NHS speech, warns that other changes could take priority at a time of funding shortfalls
Simon Stevens, the chief executive of NHS England, warned that progress towards seven-day services may not be a priority because of cash shortages and the need to make other changes.
His comments came as a former Liberal Democrat health minister, Norman Lamb, claimed that David Cameron’s plan could not be delivered within the service’s existing budget and would need even more money than the £8bn extra by 2020 the Conservatives have already pledged. Health unions have threatened strike action if workers’ benefits for working anti-social hours are cut.
Cameron used his first major speech since his re-election to guarantee care to patients “wherever they are and whenever they need it”.
Speaking at a GP surgery in the West Midlands on Monday, he promised more GPs, faster access to new drugs and treatments and a greater focus on mental health and healthy living. A GP access fund, which will ensure that 18 million patients will have access to a GP in the evenings and at weekends, will be expanded to ensure that more seven-day access will be available.
Cameron said: “It’s a shocking fact, but mortality rates for patients admitted to hospital on a Sunday can be 16% higher than on a Wednesday, while the biggest numbers of seriously ill patients arrive at the weekend when hospitals are least well equipped to handle them. So seven-day care isn’t just about a better service – it’s about saving lives.”
But Stevens, speaking alongside the prime minister, sounded a note of caution about Cameron’s pledge by pointing out that expanding NHS services when it was facing a £30bn budget gap would take time.
“We’ll need careful and disciplined phasing of our ambition to expand services – be it improved cancer care, mental health, primary care, seven-day services – all of which we want to do,” he said.
Stevens’s public dampening-down of expectations follows concerns raised by health thinktanks that political parties’ promises made during the election to give patients easier access to key NHS services were not realistic.
Labour pledged to reinstate patients’ right to see a GP within 48 hours, despite a chronic and growing shortage of family doctors, for example. Dr Mark Porter, the leader of the British Medical Association, criticised the “outlandish and unrealistic election pledges” made by all the parties.
Speaking to the Guardian before Cameron’s speech, Lamb, a contender to succeed Nick Clegg as Liberal Democrat leader, said the plans could not be delivered in the current budget. “The idea that you can just achieve this without additional resources is just fanciful,” he said.
Lamb backed the ambition of a 24/7 NHS. “There’s a moral obligation to do this. The bottom line is that you can’t justify [having] different survival rates depending [on] whether you fall seriously ill on a weekday or at the weekend.”
But, he added, the extra capacity the NHS would need to become fully operational across all seven days – especially the extra staff involved – could not be achieved within the service’s budget, even though it has gone up by £3.1bn this year and will rise each year until 2020.
“No, the seven-day NHS can’t be delivered within existing resources. It needs additional resourcing. At the moment we are well staffed through five days but have a lower staffing ratio on the weekends, and that would have to change.”
Unison, the biggest health union, warned that it would ballot its members on strike action if a seven-day-a-week NHS operation was to be funded by cutting staff pay.
The Royal College of Nursing chief executive, Peter Carter, also warned that nurses would resist any changes to payments they receive for working outside office hours. Speaking to the Independent, Carter said: “The membership is quite clear: unsocial hours, weekend working, Christmas Day and bank holidays – they get a very modest higher level of remuneration. Any attack on that and I do fear it would result in industrial action.”
The health secretary, Jeremy Hunt, accused the unions of “jumping the gun”. He told BBC1’s Breakfast: “We haven’t made any proposals whatsoever about changing nurses’ terms and conditions … Eight days into a new government, I hope you’ll forgive me if I don’t negotiate on air about every single aspect of doctors’ and nurses’ conditions. That’s not our proposal.”
During the election campaign the Conservatives said they supported a plan produced by the NHS England chief executive, Simon Stevens, to fill a funding gap estimated at £30bn a year by 2020.
The BMA council chairman, Dr Mark Porter, said: “Crucially, the £8bn promised by the prime minister is the bare minimum needed for the NHS to simply stand still and will not pay for extra services.
“The real question for the government is how they plan to deliver additional care when the NHS is facing a funding gap of £30bn and there is a chronic shortage of GPs and hospital doctors, especially in acute and emergency medicine, where access to 24-hour care is vital.
“Without the answer to these questions this announcement is empty headline-grabbing and shows that, even after polling day, politicians are still avoiding the difficult questions and continuing to play games with the NHS.”
Hunt acknowledged that seven-day working would involve “some extra cost, which we will have to find”, but said it might be more cost-effective, for example, to boost capacity by using existing operating theatres at weekends, rather than building new facilities to use Monday to Friday.
Pressed on whether the government would be committing any extra money to the NHS, Hunt told BBC Radio 4’s Today programme: “If you look at what the prime minister is saying today he said ‘a minimum of £8bn’.”
Source The Guardian http://www.theguardian.com/society/2015/may/18/health-unions-threaten-to-strike-if-seven-day-nhs-means-pay-cuts
NHS England chief: cash shortages could hit plans for seven-day health service
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