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The Lords Committee on the Long Term Sustainability of the NHS

We issued a press release 12 months ago following the first Lords’ debate saying this was the beginning of the discussion which would lead to the introduction of charges. Although the conclusion was to stay with tax funding for the NHS, a report or commission of some kind was also proposed.

This was followed by a call in January this year for a Commission from Norman Lamb, backed by Alan Milburn and Stephen Dorrell, both heavily involved in early stages of the NHS ‘reform’ process which has led to lower funding, privatisation and increased management consultancy involvement in endless re-dis-organisations.

This commission, we were informed, was not going to be pursued. The Commons then followed with a debate on the same subject, following which the Lords’ committee was set up with no fanfare on 25th May and has met four times in private before its first public meeting on the 12th July.

The King's Fund report, Deficits in the NHS 2016 published on the 11th July 2016 argues that due to increased level in demand of services the NHS is fast becoming ‘unsustainable’. The report urges the government to be honest with the public about ‘realistic capacity’, the need for a reduced workforce and impoverished services. The report forecasts that we will see the biggest financial deficit in the history of the NHS. The NHS, so recently the pride of the country, is now visibly on its knees and facing the same levels of inadequate funding for many years to come.

That ‘honest’ conversation that the public needs to hear may finally be stepping out from behind rhetoric and into plain language.

In the first public session of the Lords Committee into Long Term Sustainability of the NHS the very first question was on precisely the issues raised in the King’s Fund report.

Andrew Baigent, Director of Finance for the Department of Health, referred to previous debates held on the issue of ‘sustainability’ led by Lord Patel who had clearly stated himself that payment through general taxation is the most efficient way to fund a public service. As a public servant working for a government which has often stated a full commitment to an NHS free at the point of need, Mr Baigent said that the Department of Health had been making its projections on this assumption.

The Lords were critical of this approach yesterday and Lord Willis came out directly saying that he finds it unthinkable that the Department of Health has not addressed the issue of ‘sustainability’ he explained that by this he means, what can be removed from ‘free at the point of delivery’ and put onto ‘pay lists’.

Mr Baigent replied that NHS England are considering taking certain ‘low value procedures’ out of ‘free at the point of use’ and this is included in the 5 Year Forward View.

Dr Paul Hobday, interim leader of the NHA has said, “We have consistently said that when the government or NHS England talk about ‘sustainability’, they mean the introduction of co-payments or other kinds of charges and limiting what has become known as the NHS offer. This is a clear statement that a comprehensive and universal NHS is no longer possible with such consistently reduced funding. This is now the accepted position from every direction; political, civil service, and think tanks all say the same. The NHA says this is not an acceptable position.

The NHS is affordable, it needs the political will to put the needs of the people of the country first. Any Lords’ Committee worth its salt should insist the government stops this long term and consistent de-funding of the NHS and call a halt to the 5 Year Forward View which is accelerating the break-up of the service. Health needs will always have to be paid for. The approach currently under discussion simply removes the cost from the government and adds a financial burden to the individuals in need.”