The Government has been accused of issuing “misleading” figures over its pledge to increase NHS funding.
MPs on the Commons Health Committee said the Government’s claim that the NHS would receive £8.4 billion by 2020/21 actually translates into £4.5 billion because ministers used a different calculation compared with previous years.
They concluded that health spending “will not increase by as much as expected from official pronouncements”, and the Government will not meet its commitment to fund the NHS’s vision for the future.
The committee said: “In previous years, spending reviews have defined health spending as the entirety of the Department of Health’s budget, but the 2015 spending review defines spending in terms of NHS England’s budget, which excludes, for example, spending on public health, education and training.”
And this could have negative consequences on cancer care.
In the wide-ranging report on the state of NHS finances, MPs also said the scale of the funding challenge facing the NHS is “colossal”.
Cancer Research UK highlighted England’s 2015 cancer strategy as the focus for how to spend health budgets.
Emma Greenwood, Cancer Research UK’s head of policy, said: “Money is always tight, but investing in the cancer strategy now will improve the outlook for patients and save the NHS money in the long run. This report rightly calls for investment in prevention, public health and the workforce, all areas in urgent need of attention. Whether it’s helping more smokers to quit through their local Stop Smoking Service or training the health professionals of the future, action is needed now to ensure a sustainable health service that meets the needs of the public and patients. It’s also vital that capital investment is used wisely. For example we need an urgent upgrade to radiotherapy equipment to ensure cancer patients get the best treatment.”
Nigel Edwards, chief executive of the Nuffield Trust, also told MPs there was also a problem with the Government’s expectation of realising savings through improved efficiency.
He said: “If you do not give the trusts the money that they need to deliver what they need and you set them efficiency targets that have never been achieved anywhere in the NHS’s history, do not be surprised if the income separates from the expenditure over time, particularly against a background of growing demand.”
MPs also heard that poor workforce planning has led to an increasing reliance on expensive agency staff, which has contributed to huge hospital deficits.
Anita Charlesworth, of the Health Foundation, told MPs: “The NHS was planning on needing fewer workers; its plans were not to grow the number of workers. We reduced the number of nurses we brought in from other countries in the early years of this decade, we reduced the numbers in training and we have also seen many fewer numbers coming through on return to practice.
“That was predicated, in essence, on both ability to reduce demand – the number of admissions that would come into the system – and a belief that we could work those nurses harder through reducing ratios. That proved to be unsustainable. We saw the numbers of nurses employed falling; then from 2013 onwards, crudely, we re-employed them but we employed them more expensively.”
Health Committee chairwoman Dr Sarah Wollaston said cuts to public health grants were also a false economy.
She added: “Similarly, the cuts to health education come at a time when the workforce shortfall is already placing a significant strain on services and driving higher agency costs.”
A Department of Health spokesman said: “We reject these conclusions – as the chief executive of NHS England said at the time of the Spending Review, we actively supported the NHS’s own plan for the future with the £10 billion extra requested, despite the public finances being tight.
“More than that, we’re providing support to help hospitals make efficiencies and improve productivity as well as national measures to reduce the use of expensive agency staff.”