Figures released this week paint a dire picture of the NHS’ finances at trust-level. According toThe Guardian, Barts NHS Trust in London is on course to run up a deficit of £134.9 million this year – the largest of any in the history of the National Health Service. Other trusts in and around the capital are also in serious trouble, with London North West Healthcare and King’s College each expected to be £88.3m and £65m in the red respectively. What is even more concerning is the rate at which these overspends are growing: Barts’ deficit has grown by 69% from its £79.6m overspend in 2014/15. This is unsustainable. The trusts’ combined £1.6bn deficit last year is a serious drain on the public’s finances.
Some commentators are quick to argue this is the result of overly-bureaucratic providers mismanaging their finances. While it is true that there are some trusts that are poorly managed and inefficient, the fact that 80% of them are in the red suggests that they are not equipped with enough budget to meet the demands placed on them.
It is easy to scapegoat spending as wasteful – and agency staff frequently come under scrutiny. Over the past 12 months, frequent examples of payments by trusts to agency staff have grabbed the headlines, with one doctor’s £11,000 weekend shift jumped upon as an example of NHS’ frivolity. The backlash against agency fees has grown so large that the Health Secretary has intervened, capping payments for locum doctors and nurses. However, what critics of agency staff fail to understand is that these staff perform an incredibly important role within the NHS, by providing patients with vital care when there is no one else available. While the fees trusts pay are sometimes high, this is simply a reflection of a lack of experts’ availability and is something that needs to be addressed.
Instead of focusing on vital areas of care provision like agency staff, cost-cutting efforts should focus on some of the huge expenses that the NHS faces and are manageable outside the health service. The bed-blocking crisis provides a perfect example of this, with the latest figures suggesting that the NHS is spending £900 million alone on patients whose needs could be largely met through social care provision.
In order to ease the burden that trusts face, policymakers should therefore look at how they can ease the pressures that the health service is under and strengthen other services such as social care.
