When the Chancellor makes his Autumn Statement tomorrow, it will not be good news for Britain's crumbling NHS. We already know the headlines: by 2020/21, overall spending on the NHS as a proportion of GDP will have fallen by 6.9% since 2010. Planned increases in spending will be eaten up by existing NHS deficits: £2.5billion in total. The BMA warns this week that the government's new Sustainability and Transformation Plans (STPs) amount to a £22billion cut over the next five years.
By 2020/21 the King's Fund say there will be a £1.9billion shortfall for social care, and we will see a cut to public health of £600million. Today the National Audit Office published a report which revealed that more than two-thirds of NHS trusts reported deficits in 2015-16, warning of "endemic" financial problems. Whatever Philip Hammond announces, if anything at all, the big picture is a health system being starved of cash.
Under Labour, investment in the NHS doubled to match the average spend in Europe. Under the Tories health spending has been falling to the same level as deficit-stricken Greece.
The health select committee has conducted an inquiry into NHS finances, and revealed last week the true extent of the financial crisis. Taking evidence from a range of NHS organisations, the committee called into question ministers' constant use of the figure '£10billion' as the supposed increase in health spending.
The committee showed that far from being awash with cash, the NHS is facing a cash squeeze. Ministers' '£10billion' figure is arrived at through some very creative accounting: adding an extra year to the spending review period, changing the date from which the real terms increase is calculated, and disregarding health spending as a whole. Increases to NHS England's budget are being met by cuts in spending to local councils' budgets for public health, and cuts to Health Education.
Demand for health services is not static. As our population gets larger, older, and expects new treatments and medicines, the demands on our health service increase.
One of the key areas where the Tory government has decided to see the axe fall is on prevention services which tackle a range of issues including smoking, sexual health, alcohol, drugs, mental health and obesity. This is such a tragedy.
Every penny we invest in public health saves the NHS the same amount many times over. Indeed the only way we can sustain the NHS for future generations is if we shift the emphasis onto preventing disease and ill-health, and away from treating people once they become unwell. We need a health service which focusses on keeping people in better health, for longer. This is not just the right thing to do, it also makes economic sense.
Another area being cut is social care. A report this week from the County Councils Network (CCN) stated that only one in ten directors of social services believed their budgets were manageable and just one in five believe the government's Sustainability and Transformation Plans (STPs) will protect social care. Again, this is against the backdrop of a growing number of elderly people in need of more care.
The Care Quality Commission reports that the fragility of social care is having an impact on the NHS in terms of increased A&E attendances, emergency admissions and delays to people leaving hospitals. This represents another false economy. We must, as a nation, invest more in care for elderly people, in order to save money within the NHS, especially A&E units.
A few months ago, I revealed through Freedom of Information (FOI) requests, that ministers are failing to honour their commitments to increase spending on mental health services. Of 128 clinical commissioning groups who responded to my FOI inquiry, 73 intend to reduce the proportion of their budget they will spend on mental health this financial year. That's nearly 60% not delivering the increases that were promised. Ministers claim mental health is a priority, but fail to match their warm words with the money to do the job.
The pattern is clear. Ministers assert that the NHS is getting the money it needs. The facts prove the opposite. Ministers play fast and loose with the figures, but those working in the NHS say their claims are false. And patients and their families know that services are stretched to breaking point. Ministers make cuts to the very areas which prevent ill-health and save the NHS money down the line. This is a perfect storm of obfuscation, cuts, and false economies. As winter closes in, and demands on GPs and hospitals shoot up, the cash crisis will soon descend into a care crisis, and the people to suffer will be the most sick and the most vulnerable.
The NHS and healthcare remains the third most important issue to the British people, after immigration and Europe, according to Ipsos MORI. Yet only one in four believe the government has the right policies for our NHS. Labour created the NHS in 1948 against a backdrop of austerity. The Attlee Government won a mandate to deliver healthcare free at the point of need, and pressed ahead with their plans despite howls of anguish from the Tories and vested interests.
A future Labour government will face no less of a challenge. The Chancellor's Autumn Statement tomorrow is expected to offer little cheer. The Labour approach must be to focus resources on keeping people well. We must tackle the widening inequality in health outcomes between rich and poor. We must transform how we contend with mental health, and deliver true parity between physical and mental healthcare. We must properly integrate our health and social care services. It will once again be incumbent on a Labour government to appropriately resource our NHS to ensure people live longer, healthier lives.
Luciana Berger is MP for Liverpool Wavertree, President of the Labour Campaign for Mental Health, and a member of the Health Select Committee