We need emergency investment in a publicly provided NHS
To stop the continued worsening of the crisis in the NHS we must force the Government to take immediate, concrete steps to relieve the crisis in hospitals, mental health, primary and community care and social care, and make a major U-turn, to review and revise the Spending Review. Repeating the mantra that the government has introduced the “health and care levy” – releasing a dribble of extra funding from April onwards – does nothing to restore morale or tackle current pressures and problems.
SOS NHS is demanding these immediate measures:
- All limits that curb spending on temporary staff to fill vacancies and keep services running safely must be lifted at once
- any temporary provision of extra beds must be matched by safe staffing
- NHS staff in public facing roles must all be issued with improved FFP2/3 masks to combat the higher infectivity of Omicron, and adequate supplies of suitable, safe PPE
- immediate steps need to be taken to improve ventilation in workplaces.
- Workers must receive pay justice now
To ensure no more billions are wasted on private contracts, such as we saw during the pandemic, the government must also invest much more in our NHS – to restore and expand NHS capacity; repair or rebuild crumbing hospitals; and reopen the unused NHS beds. It’s vital to increase investment invest in staff, with new targets for recruitment, training, and levels of pay that would prevent the service losing staff. We also need to build a properly resourced, publicly run national care and support service, and invest in public health and policies to tackle huge and growing inequalities in health.
This Government has shown it won’t change course without pressure from below: but U-turns have occurred. It’s up to us to pile on that pressure.
How much do we need?
£8bn needed now to rebuild crumbling infrastructure & reopen beds left empty since Covid-19 struck
The bill for backlog maintenance to repair crumbling buildings and replace clapped-out equipment has soared to £9.2 billion – double the £4.5bn capital allocation to NHS England. The lack of maintenance causes thousands of incidents each year that interfere with clinical care and put patients at risk. To tackle the most urgent of these issues will cost around £5bn: in addition, up to £6bn needs to be made available sooner rather than later to rebuild a dozen or so hospitals built in the 1970s using reinforced autoclaved aerated concrete planks, which are in danger of collapse.
West Suffolk NHS Foundation Trust is so concerned over the threat that it has hired a law firm to assess the risk of being charged with corporate manslaughter should any hospital collapse and kill patients, staff, or visitors. Several of these hospitals are in such a dire state that it could be cheaper to knock them down and rebuild – but there is no capital to do so.
An additional £3bn is needed to reorganise, rebuild and in some cases refurbish hospital buildings to enable them to reopen almost 5,000 beds that were closed in 2020 to allow for social distancing and infection control, and remain unused today. Sufficient capital is also needed to build new community diagnostic hubs and surgical centres without any private sector involvement. The latest desperate short-term moves to create “mini-Nightingale” hospitals in tents in carparks or under-used areas of NHS hospitals do nothing to address the long-term problem of inadequate NHS capacity.
£3bn capital and £5bn over 3 years in additional recovery revenue funding to equip mental health services to cope with the increased demands since the pandemic and expand services for adults and children, as called for by the Royal College of Psychiatrists.
Rebuild public health
More investment is also urgently needed at local level to reverse recent years of cuts and rebuild public health services that have been foolishly cut back and are now straining to support the fight against Covid.
Fund a fair pay deal
NHS and care staff need pay justice that keeps pace with inflation, and restores lost wage value, not the insulting 3% pay offer. This is essential to help restore morale and livelihood. The Government decision that the money must come from within NHS funding is an unacceptable further cut on frontline resources. Each 1% increase in England is estimated to cost £340m – but generate increased tax and economic activity that mean over 80% of any increase flows back to the Treasury: Rishi Sunak must be told to pay up to enable the NHS to grow the workforce to meet health needs.
In addition to the emergency funding
Another £18bn+ will be needed to ensure the promised ‘new hospitals’ can be built as planned. The £2.7bn allocated to build six, and then eight prioritised ‘new hospitals’ was completely unrealistic to begin with. But it’s even less plausible now that the New Hospitals Programme insists the same pathetic pot of cash must stretch to cover costs of eight previously existing schemes – including two long-delayed PFI hospitals.
The New Hospitals Programme itself, which during the summer instructed all the priority schemes to submit new plans costing no more than £400m – implying drastic cutbacks – has now admitted few of the prioritised projects will be completed by the next election in 2024.
Estimates in 2019 suggested the full cost of 40 new hospitals could be as high as £24 billion, and not less than £18bn. To get any projects started Rishi Sunak needs to be told to make the necessary funds available as soon as clinically viable plans have been locally agreed and received planning approval.
Meanwhile, as The Lowdown has reported, the government has invited trusts to bid to be one of eight additional hospital projects to be funded, bringing the total schemes to 48 – but so far has allocated no additional capital. A clutch of schemes have been published, adding up to a total cost between £3.4bn and £5.1bn.
We’re asking for £20bn NOW – an amount we believe is well within the power of Government to fund. But it will only do so if we make it.
£20bn is an adequate down-payment to ensure these investments can go ahead as soon as suitable plans are in place and public consultation complete. Of course a lot more will be needed to fulfil government election promises, expand the workforce and restore NHS performance to the levels they reached before the austerity squeeze on funding.
Beyond this Spring, we will need legislation and change at the top to re-establish a fully publicly funded and provided national health service, protected from private companies who put profit before patients. We need a national care service, and we need to make the NHS the default provider for health service provision. The NHS was once the best health care service in the world. It can be again.