HEE chief: Removing our budget ringfence would hit frontline care

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Removing Health Education England from the protected NHS budget would result in cuts to frontline NHS services, its chief executive has warned.

HEE chief executive says training budget must be protected by NHS funding ringfence
He said cuts would impact trust funding for junior doctor salaries or numbers
Up to £3.5bn is spent by HEE directly with NHS trusts
Follows reports that NHS ringfence could be redefined only apply to NHS England

Ian Cumming told HSJ the majority of money spent by his organisation went directly to NHS trusts that employed trainee junior doctors. He said any cuts to that budget would therefore have a direct impact on NHS provider organisations.

Mr Cumming’s comments come after senior figures at health policy think tanks last week warned that the Treasury, as part of the comprehensive spending review, was considering redefining the NHS ringfence to cover only NHS England’s £101bn budget.

This would leave arm’s length bodies such as HEE and Public Health England at risk of budget cuts.

Nuffield Trust chief executive Nigel Edwards said he had been told by several civil service sources that the definition of the ringfence would only apply to NHS England. King’s Fund chief economist John Appleby also understood this would be the case.

The majority of money spent by HEE went directly to trusts that employed trainee doctors, Ian Cumming said

Mr Cumming said HEE’s £4.9bn budget must remain part of the protected budget.

He said: “Absolutely the budget should be ringfenced because the vast majority of what we do is direct frontline expenditure on the NHS.

“Clearly out of a budget of just less than £5bn if we are spending £3.5bn on junior doctors salaries, and that is not within the ringfence, there is only two things we can do. We can either pay less to the trusts for those junior doctors or we can have fewer of them.”

He added: “The vast majority of the money HEE spends goes into our national health service and for the majority of junior doctors in this country we pay their basic salary.

“So if that money that we spend on the NHS is not put within the ringfence then we are taking a part of the budget that is actually being used for the delivery of very direct patient care and subjecting it to some sort of cuts that the [government’s] intention is the NHS will be protected from.”

He estimated between £3bn and £3.5bn of HEE’s budget went directly to NHS trusts, with the remaining money indirectly funding NHS services and being spent on university undergraduate education.

He added: “As far as I am aware the discussions are still very live and the spending review submission is obviously a matter for the [Department of Health] and other government departments. My view is very clear that HEE’s budget should be within the ringfence.”