The key moments from the health secretary’s appearance at the Commons health committee today
- Jeremy Hunt on transformation fund: “We don’t have resources for very generous double running costs”
- Financial pressure on the NHS is “the worst it’s ever been in its history”
- Health secretary says “morale is not good in the NHS at the moment”
- He rebuffs scepticism about how achievable £22bn efficiency savings are
- Government to impose new contract on junior doctors
4.55pm The health secretary wraps up the session, saying its “fantastic” that the new membership of the committee has so much NHS experience. That’s all folks.
4.52pm Dr Wollaston asks Mr Hunt whether cuts to NHS administrative staff had gone too far. He replies that 18,000 staff losses were not excessive because they were mainly out of the commissioning system and not providers.
4.12pm Mr Hunt says there are early signs that the Better Care Fund is having an effect in reducing hospital demand, though this is not “definitive”.
3.56pm Health committee chair, Sarah Wollaston, grills Mr Hunt on the cut to the public health budget, which she says will hit “frontline NHS services”. Mr Hunt says he recognises concerns, but that the public health community also needs to make efficiencies.
3.39pm Mr Hunt says the chief executives being celebrated in the NHS at the moment are not the same type as those previously “put on a pedestal” in the health service. He says they are “good listeners, who the staff respect”. He mentions by name Clare Panniker, Tracey Fletcher and Sir David Dalton.
3.29pm Rachel Maskell, a former head of health at Unite, says that one nurse who went on strike last year felt “kicked in the stomach” by the last government’s decision not to accept the recommendations of the independent pay review body.
3.25pm Mr Hunt: “Morale is not good in the NHS at the moment”.
3.24pm Some breaking news: junior doctors will be forced to work under new terms and conditions from August next year, the DH has confirmed to HSJ.
The government said it will look to impose the new contract on junior doctors when they rotate to new jobs within the NHS.
3.18pm Asked why agency staffing costs have increased in recent years, Mr Hunt says it happened because the NHS “wanted to do the right thing” in relation to staffing in the wake of Mid Staffs.
However he says this has “gone far too far”, with some trusts now using agency nurses to make up their permanent workforce. This can have a divisive impact within the workforce he says. He refers to the controls the DH has introduced to try to tackle agency spend.
3.05pm Mr Hunt says that changes to consultants’ contracts to move to seven day working is “not something we’ve rushed into”. He says the DH has been negotiating for two and a half years with the BMA. He adds that its “highly likely” that services and radiology will also have to expand. He says the government will be setting out their plans for these services soon.
2.54pm A note of caution for those hoping for a big transformation fund in the spending review:
On calls for an NHS transformation fund, @Jeremy_Hunt says ‘we don’t have resources for very generous double running costs’
— Lawrence Dunhill (@LawrenceDunhill) September 15, 2015
2.52pm Mr Hunt says that about 20 per cent of the £22bn savings will come from new models of care.
2.42pm The health secretary says the NHS will have to make “smart not stupid” savings, and that it cannot just slash staff numbers in areas like elderly care.
2.37pm Mr Hunt is asked how he will ensure the need to make savings does not damage safety and the quality of care. “I think about that every single day,” he replies.
2.36pm With Rob Findlay warning a breach of the 18 week waiting target will only be “a matter of time” (see below), does Mr Hunt’s promise to maintain NHS performance mean additional funding will have to be frontloaded?
2.33pm Mr Hunt to tell the committee what he has asked from the Treasury in terms of the phasing of efficiency savings and extra funding. He says that it will be informed by the need to maintain NHS performance.
2.24pm When asked by new Labour MP, Rachel Maskell, about the scepticism of the Nuffield Trust and the King’s Fund towards achieving the £22bn, Mr Hunt says these think tanks have not seen the “detailed work” the DH has done. He promises to publish this in due course.
2.24pm Mr Hunt says the DH’s current push on findings efficiency savings is the biggest such exercise “in NHS history”.
2.22pm Immediately starting with the issue of finance, the health secretary says the financial pressures on the NHS are “the worst its ever been in its history”.
2.21pm Mr Hunt introduces new DH finance director, David Williams, as the man with “perhaps the most difficult job in Whitehall”.
2.09pm The health committee session is just getting underway, stay tuned for full coverage on HSJ Live.
1.19pm The future of cancer services is, as ever, a political hot topic and one which Jeremy Hunt could be questioned about this afternoon. Mike Birtwistle of Incisive Health has written for HSJ on how, contrary to popular belief, cancer services have actually been relatively underfunded in recent years.
He argues that implementing the recommendations of the recent cancer taskforce “will require expenditure beyond the now totemic £8bn” negotiated by Simon Stevens in the Five Year Forward View.
12.13pm Another subject which will continue to occupy the health secretary’s time in coming months is performance against the 18 week elective target. Rob Findlay, the Gooroo, has a new blog post on the target.
“At nearly 3.3 million patients – nearly 3.5 million if you include estimates for non-reporting trusts – the waiting list was the largest since January 2008,” Rob writes.
He has a warning for Mr Hunt about a coming breach of the target.
“July was the first full month since the perverse targets for admitted and non-admitted patients were rightly scrapped, so an improvement in patient scheduling – and therefore long waits – might have been expected.
“However, the growing waiting list is reversing those gains, and if it keeps on growing faster than demand, it is only a matter of time before the 18 weeks target is breached at national level.”
11.06am Professor Ham has a grim warning about the consequences of the NHS not receiving extra financial support this year:
“If more funding is not made available, the key turning point will be the arrival of the next NHS ‘crisis’, most likely during the winter when many hospitals run out of money and all other budgets have been raided to the point of exhaustion. With NHS hospitals unable to go bankrupt and having to find ways of paying staff and creditors to maintain continuity of service to patients, the Treasury will be forced to intervene or accept a rapid and serious decline in performance.”
11.04am The scope of today’s health committee session is pretty broad - nothing less than the “work of the secretary of state for health”. However it seems inconceivable that NHS finances won’t feature prominently.
So here’s some more pre-reading for you. Yesterday the King’s Fund published there submission to the spending review. The review, which concludes in November, is expected to set out the terms of the NHS’s financial settlement for the forseeable future.
King’s Fund chief executive, Chris Ham, argues that it is “inconceivable” that an expected £2bn provider deficit can be wiped out before the end of the financial year.
The Fund has argued that the NHS will need an emergency injection of funding this year to deal with the deficits, perhaps amounting to £1bn.
10.52am Ahead of the health secretary’s grilling this afternoon, here’s some reading for you on the perilous state of the NHS’s finances.
Last week HSJ revealed that clinical commissioning groups in England have planned for a combined surplus of £358m in 2015-16, which is less than half the surplus reported last year.
Twenty-two CCGs have planned for deficits this year, compared to 18 at the start of 2014-15.
The Midlands and East is the most troubled region financially, with a combined deficit plan of £39m.
10.30am Today Jeremy Hunt will give evidence to the Commons health committee for the first time since the general election. The session is expected to focus on NHS finances.
The Department of Health’s director general of finance, David Williams, and director general of social care, Jon Rouse will also appear before MPs.
The session is scheduled to start at 2pm.