At the end of April it was revealed that the Defence Secretary, Philip Hammond, is in discussion with the Treasury with regards to transferring money that was destined for spending on health and education instead to reduce the effects felt by cuts in the Ministry of Defence budget. The sum is understood to be as much as £200million from the health budget and up to £120million from that earmarked for schools. Justification has been made based on the fact that a 5% cut in spending on armed personnel is expected to make thousands redundant and the Ministry of Defence already pays hundreds of millions every year to cover health care for those in the Armed Forces and to educate their children. As it is, the NHS is already struggling to meet savings targets that have been set and further cuts could cripple the adequate provision of health care.
NHS cost savings so far
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The NHS has a target to make efficiency savings of £20billion by 2015 and this is not going to be an easy one to meet. In 2012, £5.8billion in cost savings was reportedly made by the health service, which on the surface appears to have been a great start. However, over half a million pounds of the money saved was as a result of one-off measures that will not be repeated this year or next such as management cuts, and the evidence that these cuts were made is also lacking in 30% of cases. Additionally, the savings made in the first year have tended to be those easiest to make and some have not been well thought through. For instance, over 10,000 NHS staff have been made redundant to reduce wastage in the last three years and while pay rises have been limited and job freezes put in place to limit spending, this is unsustainable and risks patient health and safety.
Ensuring care is not compromised
There are real concerns that these cost savings within the NHS will lead to even greater rationing of patient care. While the Department of Health has issued a warning that no treatments can be completely disallowed to save money, with no way of being sure that patient care is not being compromised by way of restricting certain procedures, this is a real issue. Margaret Hodge, Public Accounts Committee chair, has emphasised the need for the NHS to monitor the impact that cost savings have on patients.
The only way that the NHS can continue to make savings whilst keeping up with increased demand for health provision, brought by an ageing population and the growing number of people with chronic health problems, is to modify the way that services are offered. According to Mike Farrer, chief executive of the NHS Confederation, the health service as a whole needs to be considered, with a focus of providing more services in the community in primary care where possible.
By Amy Millband