The head of the NHS has revealed that George Osborne has still not agreed to his demands to ‘front-load’ extra health spending to cope with a 7-day service and other pressures.
Simon Stevens, the chief executive of NHS England, warned that he could not ‘manage current pressures’ unless 2016/17 and 2107/18 got the bulk of the £8bn extra cash promised by the Tories in the general election campaign.
With just a fortnight until the Chancellor delivers his long-awaited spending review later this month, Mr Stevens has told Health Service Journal that “considerably more progress is needed” in negotiations with the Treasury.
He had warned in October that the extra £8bn in cash for the NHS had to meet five tests including front-loading the cash, protecting public health and social care, as well as funding properly the Tories’ plans for a seven-day health service.
But Mr Stevens told HSJ: “I cannot confidently tell you today that we yet have a clear line of sight to those five tests being met (by the spending review).”
"As of today, considerably more progress is going to be needed before we can say we have a genuinely workable NHS funding solution for 16/17 and 17/18, but spending reviews usually come down to the wire, so hopefully we'll get there by November 25th."
Mr Stevens was speaking after an on-stage interview at the HSJ Annual Summit on Friday, which was held in St Albans.
He added: “The Organisation for Economic Co-operation and Development has just reminded everyone that we're already incredibly lean in our country's health funding, overall, and on a per person basis.
"So the government's funding commitment to 2020 was both highly welcome and absolutely necessary.
"But for the NHS, next year and the year after are where the rubber will really hit the road. The Forward View maths was explicit that the health service needed frontloaded investment in 16/17 and 17/18 - to manage current pressures, kick-start service redesign, and unleash major savings later in the Parliament.
"We were also crystal clear that any further cuts in public health and social care would impose extra costs on the NHS over and above the minimum funding requirement.”
Mr Stevens also warned that he would expect NHS deficits to “fall substantially” next year, so long as there is a “realistic funding settlement” and good progress on reducing agency staff spending, along with new savings through Lord Carter’s review of NHS productivity.
However, he said NHS England and NHS Improvement would “not necessarily” expect the deficits to be eliminated altogether, and are currently considering “financial sustainability and service transformation” plans with providers and CCGs in each health economy.
The Chancellor today struck a robust tone when he set out his determination to get a budget surplus by 2019, as he revealed that four departments had agreed to 30% cuts in spending by 2020.
Mr Osborne and Mr Cameron have made their £8bn pledge of extra cash for the NHS a centrepiece of the Conservative message on the health service.
But with NHS deficits still looming, the need to get £22bn in efficiency savings is proving difficult for some hospital trusts.
A Treasury spokeswoman said: “The Government is committed to spending an additional £10bn a year on the NHS by 2020. We will set out details of this at the Spending Review.”
Shadow Health Secretary Heidi Alexander said: "Simon Stevens is absolutely right to issue this warning about the pressing need for the Government to address the deepening funding crisis in the NHS.
"It is now clear that unless there is an urgent and significant injection of money into the NHS, then standards of care will go backwards and the promise of a seven-day NHS will never be realised.
"The uncomfortable truth for this Tory Government is that the pressures facing the NHS are of their own making. Cuts to older people’s care have piled the pressure on hospitals, and cuts to nurse training places have forced hospitals to drain resources hiring expensive agency staff."
Mr Osborne today used a speech to announce that his spending review will further increase staffing for MI5, MI6 and GCHQ to investigate, analyse and help disrupt terrorist plots.
"The changing nature of war, espionage and terrorism meant government itself had to change in its response," he said.