• Health and social care secretary’s digital push threatened by capital shortage, warns Confed chief
  • Dickson also calls England’s social care provision a “national disgrace”
  • Outgoing PM’s NHS legacy would have been “pretty dire” without 2018 funding boost, he says

Matt Hancock’s digital ambitions cannot be realised if the government continues to withhold capital funding from the service, the NHS Confederation’s chief has warned.

Niall Dickson challenged Mr Hancock to “lobby the Treasury” for more capital funding or face failure on the area he made his top priority.

Speaking exclusively to HSJ ahead of the lobby group’s annual conference, he added: “[The focus on technology is helpful but] the question back to the secretary of state is that you can’t [roll out technology projects] unless you have the capital in place. The story over the last few years has been of organisations being told to balance their books… by raiding the additional limited capital they have.

“I continue to welcome [Mr Hancock’s] focus on tech, but you have to give us the means of taking that forward. I also think he needs to be lobbying Treasury hard both on capital and social care funding.”

Mr Dickson’s comments came ahead of the conference, which begins in Manchester today. They followed an NHS Confederation survey of trust chiefs published yesterday revealing 83 per cent of respondents thought a capital shortage was inhibiting their progress on the NHS long-term plan.

The Health Foundation also warned cuts to capital budgets in recent years meant the UK was falling significantly behind other advanced economies in terms of how much capital expenditure it spent on its health services.

The think-tank said the other 36 countries in the Organisation for Economic Co-operation and Development were investing nearly double of what the NHS does on capital expenditure in terms of as a proportion of their gross domestic product - 0.51 per cent of GDP compared with 0.27 per cent in the UK in 2016, according to the most recent data available.

Some of this can be explained by the £5bn worth of controversial capital to revenue transfers over the last five years, but even without these the UK would still only be spending 0.3 per cent of GDP on healthcare capital, the think-tank warned.

And this follows the autumn 2018 budget planning for a large increase in the 2019-20 capital budget to £6.7bn. But the most recent plans estimate a 3 per cent decrease in the capital budget, with a fall to £5.9bn from £6.1bn in 2018-19, the think-tank said.

The Confed said extra investment was also needed in social care, education and training and public health, all areas not eligible for the additional circa £20bn allocated to services inside the NHS England ringfence by ministers last June.

Mr Dickson said the “shocking state of social care is a national disgrace”, adding that many NHS leaders viewed it as a priority for any extra future funding ahead of the NHS itself, a view also previously voiced by NHSE chief Simon Stevens.

Asked about Theresa May’s record on the NHS he said the out-going prime minister’s health legacy “would have been pretty dire frankly had it not been for the £20bn-plus injection [sanctioned on her watch]”.

“She made it a personal pledge to reform and properly fund social care in a way which would not adversely affect the health service. She has not been able to deliver on that… Very little progress has been made because of course her premiership was consumed by [Brexit].”

On Brexit, the former General Medical Council chief said he remained “deeply concerned about the prospect of a no deal Brexit and the fact patients’ lives could be put at risk”, despite NHSE having done everything it could have done in preparation for the scenario.

NHSE had “stepped up to the plate” in leading the health service’s preparations for the UK’s possible departure from the European Union without an exit deal, he said.