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Bishop of Carlisle supports call to save NHS from short-termism
The Bishop of Carlisle has added his support to a report’s findings that successive governments have failed to plan effectively for the long-term future of the health service and adult social care.
The Rt Rev’d James Newcome - the Church of England’s lead bishop on health and social care - is one of 14 people to have sat during the last year on a specially convened House of Lords Committee on the Long-term Sustainability of the NHS.
Today (Wednesday 5 April, 2017) the committee has published a report after taking oral evidence from more than 100 people and written evidence from several hundred more. The report makes 32 recommendations for change.
It concludes that the Department of Health and senior officials are failing to plan for the long term and that a new, independent Office for Health and Care Sustainability should be established to look at health care needs for the next 15 to 20 years and report to Parliament on the impact of a changing demographic needs, the workforce and skills mix in the NHS and the stability of health and social care funding relative to demand.
Bishop James said: “I think the report’s findings are crucial if we are going to have an NHS in 2030. If the committee’s recommendations are not acted upon, then things will simply get worse. The strain on services will be intolerable.
“In Christian terms, this is a prophetic document. It may be raising issues which some people feel are obvious but it brings together many different viewpoints together for the first time. It’s a concerted effort to look at what needs to be done to safeguard our NHS for the long-term. Any government would be very wise to take this document very seriously.
“I welcome the fact that I was invited to sit on this select committee and that I was able to speak for ordinary people rather than those involved within the health service arena. It also emphasises the fact that the Church is concerned with the well-being of people as a whole: body, mind and spirit.”
The Committee concludes that past funding for both health and adult social care has been too volatile and poorly coordinated and future health funding will need to increase at least as much as the rise in GDP for a decade after 2020 if the NHS is to remain sustainable. The Government should agree NHS financial settlements for an entire Parliament to improve planning and allow effective use of resources and embark on a far more ambitious three-year programme to stabilise the funding of publicly-funded social care.
The Committee point out that service transformation is at the heart of securing the long-term future of the health and care systems. They argue that the model of primary care will need to change, secondary care will need to be reshaped and specialised services consolidated further. Importantly, a renewed drive to realise integrated health and social care is badly needed. However, the statutory framework established by the Health and Social Care Act 2012 is frustrating this agenda and in order for real progress to be made reform is needed to reduce fragmentation and the regulatory burden.
The failure to implement any comprehensive, nation long-term strategy to secure the appropriately skilled, well-trained and committed workforce that the health and care system will need over the next 10 to 15 years is, in the Committee’s view, the biggest internal threat to the sustainability of the NHS. They also underline the linkage between over-burdensome regulation, unnecessary bureaucracy, a prolonged period of pay restraint, low levels of morale and retention problems.
The Committee make clear that a tax-funded, free-at-the-point-of-use NHS is the most efficient way of delivering health care and should remain in place now and in the future. For that principle to remain many aspects of the way the NHS delivers healthcare will have to change.
Bishop James added: “There is also a huge process of education that needs to take place for the population-at-large so that people can understand how much it costs to run the NHS, what it costs to see a doctor and what the costs are to the service when people fail to turn up for appointments.
“That needs to be complemented with more education around public health and lifestyle issues because the cost to the nation due to obesity, alcohol, tobacco and lack of exercise is tremendous and impacts massively on the services provided by our NHS.”
The Committee makes 32 recommendations for change including:
• The money allocated to social care spending in the 2017 budget is ‘clearly insufficient’ and Council Tax increases to deal with the social care crisis are only a ‘stopgap’.
• Responsibility for all aspects of adult social care should be transferred to a new Department of Health and Care.
• The traditional small business model of GP services is no longer fit for purpose. NHS England should engage with GPs to examine alternative models and their contractual implications.
• NHS England and NHS improvement should be merged to create a new independent National Health and Care Executive.
• The pay of NHS Doctors, Nurses and other medical staff has been constrained too much and this is damaging morale and retention of staff. The Government should commission an independent review to examine the impact of pay restraint on the NHS.
• There is a worrying lack of a credible strategy to encourage uptake of technology and innovation in the NHS. The Government should do more to incentivise the take-up of new approaches and ensure negative consequences for those who fail to engage.
• Cuts to funding for the public health budget are short-sighted and counter-productive. Funding should be restored and a new public campaign to highlight the dangers of obesity should be launched.
• The Government should be clear with the public that access to the NHS involves patient responsibilities as well as patient rights. The NHS Constitution should be redrafted with a greater emphasis on these often overlooked individual responsibilities.
Notes to Editors
1. For more information about the inquiry, including transcripts of all evidence taken, please see its website.
For further information contact Dave Roberts, Diocesan Communications Manager, on 07469 153658, 01768 807764 or at firstname.lastname@example.org.
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