Chris Askew asks whether the budget will reverse the decline of access to timely and good quality healthcare
Years of stagnating investment, and steadily growing demand, mean the experts agree that the gap that needs to be filled to keep our health and social care services afloat is, for next year alone, well over £6 billion. With a projected NHS funding gap of £20bn by 2022, it is easy to lose sight of what such a funding gap means for the people who fall into it.
The Richmond Group of Charities – which represents more than 15 million people across the UK living with chronic and long term medical conditions – believe that this week’s budget needs to pass three important tests in order to reverse the worrying, dangerous impact this funding gap is having on our services.
It needs to do so, not because of abstract numbers, but because people recovering from a stroke, struggling with the impact of mental ill health, or looking after a loved one with dementia deserve better.
Test 1: Will this Budget reverse the decline of access to timely and high quality health and social care?
After nearly 40 years with Type 1 diabetes, Kate Baumber’s life has been revolutionised by new technology to manage her condition. But the Continuous Glucose Monitor that helps her prevent dangerous blood sugar highs and lows is not available on the NHS in her area. Kate, as a result, is self-funding.
It is profoundly worrying that in these times of pressure, more and more commissioners aren’t making the treatments, which bodies like NICE agree would benefit patients, available to them
But it’s an unsustainable situation. At £50 a week, Kate cannot afford to keep funding the technology that has revolutionised her life. This will mean she is forced to completely rethink how she lives, if she is to continue safely managing her diabetes. That’s a situation we believe is not good enough.
The NHS has a system in place to determine which treatments should be made available, because they improve people’s lives at sensible costs. It is, therefore, profoundly worrying that in these times of pressure, more and more commissioners aren’t making the treatments, which bodies like The National Institute for Health and Care Excellence agree would benefit patients, available to them.
Test 2: Will this budget ensure that sufficient numbers of health and care staff can give the compassionate and dignified care everyone deserves?
The health and care systems have only been holding up in recent years because hard working doctors, nurses and care assistants have gone the extra mile. People can’t work like this forever, struggling with rota gaps, and with too few staff looking after too many people.
Macmillan Cancer Support commissioned research looking into how cancer professionals view this situation. It does not make comforting reading. The From the Frontline report gives a stark warning of the problems that are inevitable unless staff shortages are urgently addressed; three quarters of professionals fear that shortages mean patients do not have enough time to talk through all their concerns, while 58 per cent believe that patients are not always treated as early as they should be.
One GP in England had to say about his work day: “Extreme workload pressure, not enough time to deal with complex patients with multiple problems, leaving not enough time to spend with cancer patients, but also fear of missing early diagnosis because of these extreme pressures.”
Staff deserve better. And so do patients.
Test 3: Will this budget treat public health, the NHS and social care as one system?
In recent years, the government has stated that the NHS has received the funding it asked for – but the NHS does not work in isolation. Training budgets, public health budgets, wider council services, and – crucially – social care have all been cut. All parts of the health and social care system will sink or swim together. And if one part can’t respond, pressures pile up elsewhere, with people caught in the middle.
The fact is that for too long health and social care services have been deteriorating
There are people like Poppy Hasted, from London, who has MS and was two years ago hospitalised after a pressure sore became infected. Despite being medically fit to go home after three weeks, Poppy remained in hospital for another month because of a delay in social services arranging her home care package.
Poppy’s carers make her participation in society possible, but the support they provide – due to funding – is so limited. In her own words: “If there was more money, a few more hours of care would make a huge difference. I’d have the freedom to be a grown up and not feel treated like a child.”
The fact is that for too long health and social care services have been deteriorating, at great personal cost to the 1-in-4 of us who live with a long term health condition: 4 million people are currently still waiting for planned operations; only a third of people asking for social care receive actual help with their personal care; and 80 percent of NHS trust bosses have said they fear they will be unable to provide a good service for the growing numbers of people seeking mental health support.
With the autumn budget just a few days away, the stark fact is that fixing the issues that continue to fracture our health and social care services will cost a significant amount of money. But the human cost; the cost to people’s lives, is something the Chancellor cannot afford to ignore.