Care on the NHS is already being affected by redundancies, recruitment freezes and service cutbacks despite the Government’s pledge to protect frontline healthcare from severe curbs on spending, new research suggests.
Many hospitals are planning job cuts, while access to some treatments is being restricted in an attempt to save money, according to a survey by the British Medical Association of local staff organisations.
Forty per cent of respondents, all chairs of BMA local negotiating committees, warned that the country’s economic problems were already requiring their hospitals to ration services in some form. Two thirds said freezes on hiring staff were in place, and a quarter said that redundancies were planned.
Reported cuts included a reduction in non-essential procedures such as benign skin lesions, varicose veins and hernia operations, a tighter scrutiny of referrals and the use of vetting boards, and scaling back of blood tests.
Speaking on the eve of the BMA’s annual conference in Brighton, Hamish Meldrum, chairman of council, said that while doctors accepted that the current climate posed hard decisions for the NHS, indiscriminate cost-cutting would cause serious long-term damage.
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“There is a real danger that cutting back on health now will have a long-lasting impact on our ability to maintain high quality, comprehensive and universal care in the future,” Dr Meldrum said.
The warning came as a growing number of politicians openly criticised the Government for guaranteeing to protect NHS spending — echoing questions raised before the election by Vince Cable, the Business Secretary, who said it was “wrong, economically and politically” to exclude the NHS from spending cuts.
Last week George Osborne said that Whitehall budgets faced an average of 25 per cent reduction over four years with the exception of those for health and international aid.
Lord Lawson of Blaby, the Tory former Chancellor, described the commitment as “understandable” in the run up to an election, but added: “I think it won’t wash, it won’t work.”
Nadine Dorries, a Conservative member of the Commons’ Health Select Committee, also told BBC One’s Politics Show that it was “not tenable” to ring-fence the NHS budget. “I think we need to find the political courage to accept that there is excessive waste in the NHS and that it’s unfair to expect the other departments to take all the hits.”
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Both Alan Johnson and Andy Burnham, Labour former health secretaries, also criticised David Cameron’s view of the NHS as being “in isolation” and said it was illogical as it would do financial damage to other parts of the public sector, such as local authorities.
Dr Meldrum said that protection was essential for the NHS, and the BMA survey showed that even that would not prevent severe service reductions. NHS trusts have been told to find up to £20 billion in “efficiency savings”.
Dr Meldrum defended the relatively low response to the survey — 92 of 361 committee chairs — because he said that in many areas cutback plans were still being drawn up. “These are just the areas where they know where things are already happening. All the indications are that this is just the start.”
Some 72 per cent of the doctors surveyed said their health trust had postponed or cancelled clinical service developments because of financial pressures, while 42 per cent said there were limitations on prescribing. The poll found that trusts are trying to make annual savings of 6 per cent on average.
The survey found 24 per cent of hospital doctors had been told redundancies were planned in their trust. Most posts are non-medical, however, with consultants and career-grade doctors apparently spared.
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“We do feel that the NHS should be relatively protected but even that protection is not going to be enough,” Dr Meldrum said. “Our data shows that cuts are already being planned or becoming reality and that these will have an impact on doctors’ ability to care for their patients.
“Even changes to ‘back-room’ functions or administrative processes have consequences for frontline staff who, in many cases, may have to pick up the work themselves; this means less time for patients.”
Dr Meldrum said there may be areas “where there is a genuine need to examine ways of working” to ensure cost-effectiveness. “But all too often we see blanket bans, indiscriminate cost-cutting and decisions seemingly taken for political and financial expediency rather than because of good clinical evidence.”
He said patients, communities and NHS staff should be involved in decisions and the focus should be on eliminating genuine waste rather than “slash-and-burn” cuts.
A Department of Health spokesperson said the Government had been very clear that savings should be implemented in a way “that does not affect the quality of services”.
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“This is not about cutting the frontline services that doctors provide, but about finding the efficiencies to meet increasing demand. Better patient care can cost less, and doctors have a crucial role to play in improving the quality of care and making the NHS more efficient,” he said.
“The Government has been clear that the NHS budget is protected and will increase each year of Parliament.”
Earlier this month the Scottish government has announced that 3,790 NHS jobs would be lost this year, either by voluntary redundancies or by not replacing those posts that fell vacant.
Prescriptions for saving
· Cambridgeshire Addenbrooke’s Hospital is cutting 170 nurses jobs.
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· Up to 500 jobs will be cut from the payroll over the next financial year in a recruitment freeze
· Bedfordshire GPs have been told that patients with certain conditions should not be referred except in exceptional circumstances. These include benign skin lesions such as sebaceous cysts
· Buckinghamshire There have been reductions in treatment for conditions such as varicose veins and hernia, tighter referral management and cuts to mental health services
Sources: BMA/Pulse