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NHS Deficits

I feel that the gist of the Health Committee report was more critical than speeches so far have reflected. Not being a member of a major party, I can voice such criticisms more strongly, without being accused of political intent. My first criticism is of the form of the Government’s response. On Sunday afternoon, I set about trying to make sense of it. I plead with the Minister to at least include some cross-referencing in his Department’s next response, so that we can see what number recommendation and paragraph the Government response is addressing. It is incredibly difficult to do that without cross-referencing. I also make a plea for the Government response to be complete. There is no mention at all of several recommendations. Recommendations 3 and 4—the Minister will probably not know what they were, given the numbering system—refer to the underlying deficits and the large inherited deficits. I would like to have seen more about those in the response. A whole chunk is missing from recommendation 15 in its reprinted version in the response. The missing phrase is,"““The requirement that a hospital trust pay back a deficit while operating on reduced income is inappropriate for a healthcare service and in some cases impossible to achieve.””" That strong point was agreed by the cross-party Committee. Many hon. Members have mentioned the double deficit, but the matter was not adequately addressed. I shall abbreviate many of my comments, because lots of points have already been made. In relation to education budgets, at least the Government have admitted the severity of the attack. They promise that the cuts will only be short-term. In paragraph 64 of their response, with regard to the transfer of the multi-professional education and training money to SHAs, the Government say:"““This was done to allow SHAs greater flexibility to use resources to address local priorities including financial deficits.””" It is a real worry that financial deficits, rather than clinical need, have almost become the first driver, as many Members have said. I absolutely support the aim for financial balance, but the speed with which it is apparently being pursued will cause disadvantages in terms of clinical need. There are real worries about the funding formula. Our recommendation 25 states:"““There is concern about the fairness of the funding formula. We do not consider ourselves qualified to judge whether these concerns are justified. We recommend that the formula be reviewed. Consideration should be given to basing the formula on actual need rather than proxies of need.””" In a recent article in the British Medical Journal, headed ““Time to face up to ‘scandal’ of funding formula: The government is in denial about the effects of funding inequities on primary care trust deficits””, Nigel Hawkes writes that the Health Committee report "““rather glossed over the effects of the funding formula””." He also made a definite criticism:"““A government dedicated to reducing health inequalities, and with most of its MPs elected from areas favoured by the formula, has brushed these criticisms aside.””"