OPERATIONS and drugs will be rationed in a ‘trade-off with improving care in other areas’, Head of NHS England Simon Stevens said yesterday, outlining the alleged progress made on his Five Year Forward Plan launched in 2014.
He refused to demand more money from the government for the NHS and instead insisted on an NHS ‘trade off’ in which he proposed to improve care in certain areas while abandoning the rest of the NHS to its fate.
Under this ‘trade-off’ patients will have to wait longer for ‘non-urgent’ but extremely necessary operations and go without some new drugs that are required for their treatment. He said growing pressures meant he could no longer guarantee treatment for hip and knee operations in the 18-week target time.
Clare Marx, president of the Royal College of Surgeons in England, said the delays could have more serious consequences. She warned: ‘Our concern is not only for hip and knee patients but those patients who perhaps are waiting for heart surgery. They may have a heart attack whilst they are waiting.’
Doctors union the BMA underlined that more government money for the NHS was the issue. Dr Mark Porter, BMA council chair, rightly insisted yesterday: ‘At a time when our hospitals are in deficit, GPs are unable to keep up with the number of patients coming through the surgery door and staff are working under impossible conditions, we need an honest look at the pressures facing the NHS and how to give the investment needed to match the promises made.
‘We spend less on health than other leading European economies and cannot continue to do more, with less. Above all, it’s time to end the chronic underfunding of our health service and put together a long-term plan to help solve the ever-growing issues around staffing and funding the health and social care system as a whole.’
Attempting to justify his position, Stevens spoke to NHS staff and press at a heath centre in Aldershot. He said: ‘These are practical next steps we can take to improve health care for the people of this country.’
Sky News asked: ‘The obvious conclusion to what you are saying is that there isn’t enough money in the system to do what you have been doing hitherto. Rather than having this conversation with patients telling them what they won’t get and telling the staff how much harder they are going to have to work, should you not be making this case to government to say you need to spend more money on the NHS. What are you saying to government about money?’
Avoiding the question Stevens answered: ‘We are saying that these are the things that the NHS can improve over the next couple of years. We understand that the budget for the NHS has been set for the year ahead. Within that budget, here is how the 1.3 million staff are going to do the work for the people we look after.’
Pressed again, he was asked: ‘You are not making the case for more funding when it is so clear that that will solve some of the issues you are setting out today?’ Stevens responded: ‘What we are doing today is setting out the actions we can take with the funding which the NHS has got.’
Grilling him further, another reporter asked: ‘You have indicated that there are trade-offs to be made, the NHS can do so much. It can improve in certain areas but on waiting times they will drift. Is that something that you just have to accept given the money and the resources you have got?’
Stevens replied: ‘I think that sorting out the pressures in A&E has got to be number one. Having done that over the next several years, we then, absolutely, want to make sure that we want to expand the availability of non-urgent operations so that we can keep waiting times short.’
Another reporter accused Stevens of not being straight about the situation. He said: ‘As a public servant, it is surely your job to be straight with people about the things that they are losing. People are losing certain things on prescriptions, they are going to have to wait longer for certain operations.
‘You are telling the health services that there are priorities. So what is your message to patients who now have to wait longer in pain or discomfort because there is not enough money in the system?’ Stevens made no response to this question.
Deputy chair of London BMA Anna Athow said: ‘The relaxing of the Referral to Treatment Target (RTT) of 18 weeks is a massive step backwards by NHS England.
‘Elective patients today become the emergency patients of tomorrow.
‘Patients with hernias. gallstones, arthritic joints, cataracts and heart problems, may be just coping today with their symptoms, but the longer they are left, the more likely there are to be fatalities. This winter, because of the closure of 37,000 hospital beds in the last decade, hospitals were ordered to stop performing elective work to make room for emergencies.
‘As a result, £1bn worth of elective procedures were performed in the private sector, at the NHS’s expense. The corollary of abandoning the RTT, is that patients will be forced to resort, if they can afford it, to the private sector themselves for relief of their symptoms.’
Athow concluded, ‘The BMA and all trade unions cannot accept this “trade-off” which will endanger the lives of thousands of patients. They must inform the government that they will not accept it and demand proper financing for the NHS. This will mean strike action by health trade unions and all trade unions to bring down the government and bring in a workers government that will find the necessary finances for the NHS.’
