‘To reverse years of underinvestment sustained levels of investment are needed’ – BMA council chair Dr Chaand Nagpaul

BMA banner on the NHS 70th anniversary march

RESPONDING to PM Johnson’s comments in the weekend’s Sunday Times newspaper, in which he pledged a £1.8bn cash injection into the NHS BMA council chair Dr Chaand Nagpaul insisted that sustained levels of investment were needed.

‘For the NHS to provide high quality services fit for the 21st Century and meet the needs of patients, it is vital that we have adequate facilities which are up-to-date and in good working order.

‘Yet for too long, capital budgets – meant for investment in premises and facilities – have been diverted to prop up the day-to-day running of the health service.

‘This has led to recent warnings about the perilous state of hospital buildings – from crumbling walls and ceilings to serious plumbing problems – with estimates putting the bill for current unfinished maintenance work at £6bn.

‘There is also an urgent requirement for funding for additional hospital capacity to avoid the near constant use of emergency ‘escalation’ beds which so impair normal hospital productivity.

‘Furthermore, GP practice buildings are increasingly unfit for purpose, frequently unable to accommodate enough patients or health professionals to meet the needs of their local area.

‘A recent BMA survey found that only half of practices felt their premises were suitable for present needs, while less than a quarter would meet the future needs of a growing population.

‘The announcement of 20 hospital upgrades and £1.8bn, including money for capital budgets, is a step forward, providing a vital injection of cash to spend improving hospitals – and we await details from the Prime Minister on where the money will go.

‘However, it is equally vital that new investment must be directed to address the impoverished state of general practice buildings so that there is increased capacity for GP staff and services, without which the Prime Minister’s ambition to reduce waiting times will not be achievable.

‘To reverse years of underfunding, it is critical for this money to mark the beginning of sustained levels of investment to ensure NHS estates are of the highest standard for delivering the care patients need.’

Government action on doctors’ pensions must include drastic overhaul of tax rules that are causing ‘grave threat’ to patients, insisted the BMA on Sunday.

‘Any attempt by the government to address the pensions crisis leading senior doctors to reduce their hours must include proper tax reform if it is to avert this “grave threat” to staff and patients,’ the BMA said.

A major survey by the BMA last week revealed that 42 per cent of GPs and 30 per cent of consultants have already reduced their working hours over actual or potential pension charges.

Of those who hadn’t reduced their hours already, 34 per cent of GPs and 40 per cent of consultants said they were planning to for the same reason.

The BMA, the campaign group Doctors for the NHS and leading BMA member Anna Athow have also responded to PM Johnson’s comments.

Dr Chaand Nagpaul said: ‘If the Prime Minister is serious about improving care and tackling waiting times he must give patients reassurance that senior hospital doctors and GPs will be able to continue to provide care, and not be forced out by absurd taxes on their pensions that mean all too often they are paying to go to work.

‘The BMA has led the campaign on this issue, and while it is good that the Prime Minister appears to be beginning to recognise the scale of the problem, flexibility alone is not the solution – especially without employers’ full pension contributions being recycled back into doctors’ salaries.

‘While flexibilities may help in the short-term, what is needed is a drastic overhaul of pension tax regulations, including the damaging annual allowance and tapered annual allowance, to stop this absurd situation and avert this grave threat to our NHS workforce and patients – and we will continue to push the Government for this crucial change.’

NHS campaigning group Doctors for the NHS (DFNHS), which campaigns for a publicly accountable and funded NHS, called for Johnson to give assurances about continued NHS funding and protection against privatisation in the wake of his announcement of an extra £1.8 billion for the NHS.

DFNHS Treasurer, Dr Peter Trewby (retired physician and previous President of the Association of the North of England physicians), said: ‘The extra money promised is of course welcome – every penny of it.

‘But as many others point out, this barely touches the cumulative under-funding that previous governments have failed to address.

‘Doctors and their colleagues are struggling daily to meet ever-increasing demands with reduced budgets and staff vacancy levels at an all-time high. GPs are facing intolerable and unworkable demands – and this money does not even pretend to address their problems.

‘On top of that, the government has yet to give us an assurance that our National Health Service will not be prey to private healthcare negotiations post-Brexit.

‘The public needs the government to reassure us that the NHS is top priority and that the people of this country deserve a health service at least on a par with those in European countries whether we are in the EU or not.

‘The last thing the NHS needs is to be made into an electoral bargaining chip or, worse, carved up in some trans-Atlantic private health deal.

‘We need to see ongoing commitment to funding levels that give the nation the public health service it pays for and still believes in.’

DFNHS President, Dr Peter Fisher, added: ‘This announcement of additional funds, like many which are being made in the past few days, raises a number of questions.

‘A precise figure of 20 hospitals is named. Which are they?

‘If the figure is to have any validity there must have been much preliminary investigation done as many more than 20 are in need and will be competing for this clearly inadequate sum.

‘Why has a party which has been in power for many years failed to realise that there was a growing backlog of hospital maintenance due to its governments’ funding policies?

‘The current awful situation at Whaley Bridge has highlighted the need for regular inspection and maintenance, particularly when lives could be at risk.

‘Surely the same should apply to our hospitals?’

Leading BMA member Anna Athow warned that the main purpose of PM Johnson’s NHS funding announcement was actually to oil the wheels of the Tories’ NHS privatisation programme.

Dr Athow said: ‘New PM Boris Johnson, writes in the Sunday Times, “Another £1.8bn for the NHS, then I’ll tackle social care.”

‘Johnson is aware that health and social care is a key issue in any general election.

‘But this interview points towards his support for US-style reforms of the NHS and social care in England.

‘Johnson promises that his new government will provide a further £850m for “upgrades” to 20 hospitals and £1bn for NHS capital spending.

‘But £6bn is required just to address the backlog of capital spending need in the NHS.

‘“Hospital upgrades”, far from being attractive, are often a euphemism for more closures or downgrades of District General Hospitals, to merge them onto fewer “upgraded” sites.

‘There is already speculation over the future of St Heliers and Epsom, Huddersfield, Telford, Hillingdon and Whipps Cross hospitals.

‘He says he will solve the problems with the pensions of Consultants and GPs which is driving them to drastically reduce the work they do for the NHS, because of a change to the tax pension rules.

‘However, the Sunday Times itself says that the NHS pension scheme will simply be remodelled a bit.

‘He claims: “This new government is helping good GPs to stay in their jobs – because it is my job to see you don’t have to wait three weeks to see your GP.”

‘This statement is code for support for the recent NHS Long Term Plan and national GP contract change, which is pouring £1.8bn into new funds to coerce GP practices into large networks as the building blocks of 42 integrated care business systems in England.

‘In fact the bulk of this money is being used not to recruit new GPs but to recruit 22,000 other non-doctors to do GP’s work.

‘Johnson boasts that his health secretary Matt Hancock and Sajid David the new chancellor have already met Simon Stevens, CE of NHSE, the author of the NHS Long Term Plan “to discuss his objectives.”

‘In this way, Johnson is indicating his support for full steam ahead to Stevens’ Plan for Americanisation of our NHS and social care system, towards health insurance.’