Ben Bradley is MP for Mansfield.
News that huge funding increases for our health service are to come forward in this November’s budget is to be celebrated. It’s clear that our services are under great stress as demand grows and diversifies, and as more and more people are managing long-term conditions. In my own constituency, 50 per cent of all GP appointments are taken by people with long-term illness, and that is growing as the population ages. We need to look seriously at the way in which we fund, manage and treat patients.
As a Conservative, I’m rarely keen on tax rises, but I agree that most people accept that there are major challenges in our healthcare system and are, if not willing, then at least less grumpy about the prospect of paying a little more tax if it’s specifically for healthcare and the NHS.
There is the conundrum though. Where is the line? When we think of the NHS we immediately think of our hospitals, and much of the coverage about the pressures on the health service revolve around A&E waiting times, queues of ambulances, or the time it takes to get surgery. If we plough all of the additional money into our hospitals, though, we will never deal with the demand. It will grow and grow and soon outstrip any new funding. We’ll be back to square one.
What needs to happen is for government to look at preventative services. Prevention rather than just cure. That is, after all, what the long-term plans that are being developed locally have been centred on for several years. Sustainability and Transformation Plans are aimed at bringing services out of hospitals and focussing on community and primary care, effectively to keep people out of hospital and keep them independent in their own homes for longer.
Pretty much everybody agrees that is a good approach, but it can only be achieved if this new money continues to work along these lines. It needs to boost community services, primary care and GPs, adult social care services, drop-in centres and pharmacies. It needs to help put in place supported housing for older people who don’t need to be in hospital. It needs to be used to get everyone’s patient records digitised to make things more efficient, and so that services like pharmacies can be utilised to their full extent.
We also need to look to the future to plan for our prevention services. With a growing elderly population, we already know that we need to fund social care better to prevent long hospital stays, and as a society we need to face up to some uncomfortable truths. In England almost one in five adults smoke and almost two-thirds are overweight or obese. We need to focus funding on prevention services to keep the population healthy and to tackle preventable illnesses.
There are areas in hospitals that need attention too, of course. Mental health is the obvious one; many hospitals have to rely on private beds where none are available in the health service. That is an issue that is consistently raised by my local NHS Trusts as the priority area for them where funding is concerned. Mental health treatment mainly takes place in the community with therapists, psychologists, nurses and all sorts of clinicians providing support such as talking therapies and crisis services to help keep people out of hospital. We need to fund these services better, too.
The truth is hospitals are routinely bailed out by the Treasury above and beyond their budgets. Simply giving a Hospital Trust a budget boost won’t help if it means the Treasury pull the plug on the other end – we won’t get the full impact of the money. If ministers want to make a tangible difference to hospital funding they might consider things like PFI debt, which in my local Sherwood Forest Trust makes up something like 16 per cent of its overall annual spending. It would free up huge amounts of money if it was taken off their books and hospitals could focus their spending where they know best – on healthcare rather than building costs and maintenance.
To cut a long story short, extra money for our health services is of course excellent news and a positive proposal from Government. I’ve written to the new Health Secretary this week to lay out my thoughts and make the point, as other colleagues have, that it is prevention and not cure that is the key to making our health care manageable for the future. This will ensure that we can continue to have ‘free at the point of use’ NHS care for many generations to come.