‘We don’t comment on leaked documents but our concerns remain about the competitive elements in the government’s NHS reforms,’ a British Medical Association (BMA) spokeswoman told News Line yesterday.
She was referring to a leaked September letter from government advisers, the Independent Challenge Group warning that the coalition’s planned reforms, contained in its White Paper, show a budget shortfall of up to £10bn a year unless the NHS delivers greater efficiency.
The leaked letter, sent to Treasury Chief Secretary Danny Alexander, questioned whether efficiency savings from quality, innovation, productivity and prevention (QIPP) would be achieved.
It also raised concerns about the cost of the government’s flagship policy of GP commissioning.
The letter said: ‘Taken together, the NHS could therefore face a significant budget shortfall by the end of the SP (spending) period.
‘The NHS typically deals with such shortfalls by limiting treatments, leading to increased waiting times.
‘The government will be faced with a choice between dealing with the fallout from increased waiting times or increasing the Department of Health’s (DH) budget, perhaps by as much as £10bn per year.
‘To avoid this unpalatable trade-off, the DH settlement needs to build in much greater non-QIPP efficiency savings from the outset.’
Details of the letter emerged in the wake of a warning from Royal College of Nursing general secretary Dr Peter Carter that plans to axe 27,000 nursing posts are putting lives at risk.
Writing in Sunday’s Observer newspaper, Carter said that the NHS in England is being told to make £20bn of ‘efficiency savings’, which is leading to the NHS experiencing ‘some of the most widespread cuts in its history’.
He expressed concern that ‘many more posts are at risk’ than the 27,000 due to be axed as hospital trusts search for ways to reduce their costs.
He warned that trusts are making ‘ill-advised short-term cuts to save money’, adding that ‘the worry is that we have seen time and again what happens when staffing levels are slashed without thinking of the impact on patient care.’
Referring to the Mid Staffordshire and Tunbridge Wells deaths, Carter added: ‘Take some of the well-documented examples in recent times of disastrous failings that can occur in part through staffing deficits.’
The RCN leader said the decision of many hospitals to reduce staff numbers to save money will leave nurses struggling to cope, ‘and there is no doubt care will suffer’.
Echoing Carter’s fears, the chairman of the BMA’s Consultants Committee, Dr Mark Porter said: ‘There’s a sense of mounting crisis.
‘The Department of Health’s official line is that “we are protecting the NHS”. But the service is palpably changing for the worse in front of our eyes.
‘We are already seeing lengthening of waiting times because delays and restrictions are being put in place by NHS organisations up and down the country.
‘For example, restrictions on non-emergency surgery, access to IVF treatment and, in one or two areas, knee replacements and other “non-urgent” orthopaedic operations are being restricted.’