Press release: Reality checks for the NHS
17 Apr 2002
Commenting on the Wanless report and the continued and sustained commitment to long term investment in the NHS expected in today's Budget and CSR settlement for the NHS, the NHS Confederation said it is now time to set out realistic ambitions and trust the NHS and its management, both clinical and professional, to deliver on a long term programme of modernisation.
The Confederation set out four reality checks, some of which have been reflected in today's Wanless report:
1. Modernisation of the NHS is a long term programme and must be built on strong foundations.
Dr Gill Morgan, chief executive of the NHS Confederation said, "New investment will only make a difference if it is spent on both modernisation and catching up on the backlog created by underinvestment in the NHS over fifty years.
The fact that last year's targets were delivered is evidence that the NHS can deliver when resources are clearly targeted at a small number of top priorities. However, it is crucial that not all investment is made against tight targets for modernisation because there is a need to build core capacity in facilities, IT, staff, and the quality of services.
Local freedom is needed to invest in the infrastructure of the NHS and there should be recognition that this is investment in patient care - it is not going into a mythical black hole, rather improvements such as cutting junior doctors working hours."
The Confederation said the scale of underinvestment has been recognised by government and by the Wanless report, but the proof will be whether this recognition is either translated into targets for improving the foundations of the NHS or money is made available that is not linked to specific targets. Dr Morgan said, "The experience of recent years has been that money has been so closely tied to new targets that the relatively small sums of money necessary have not been available."
2. Productivity improvements in the NHS need to reflect real quality improvements.
The Confederation called for a much cleverer approach to recognising gains in the NHS and annual efficiency targets to be replaced by longer term targets.
Dr Morgan said, "More in the NHS does not necessarily mean better. There is a tendency to try to count gains only in hard numbers, for example, numbers of patients treated, rather than real quality improvements for patients.
Improvements in the patient experience might actually lead to lower activity. To give one example of how this works, if all dermatological outpatients were seen in GP surgeries using telemedicine, this would cut the numbers needing to attend hospital by 60%."
Given the need for the NHS to engage in radical redesign, the Confederation is seeking an end to annual targets for cash releasing efficiency savings. Dr Morgan said, "A longer term approach, for example, with targets for a three year period, is needed because real savings will come from reorganising clinical processes and investment which takes time."
3. Parallel investment in social care is necessary or the gains felt in the NHS will be seriously undermined. This has been recognised by Wanless.
4. The considerable management challenge means the government cannot try to run the NHS from the centre. This has been recognised by Wanless.
Ends
Notes for editors
- The NHS Confederation represents the organisations that make up the NHS. Our members include the majority of NHS trusts, primary care trusts and health authorities in England; trusts, health authorities and local health groups in Wales; trusts and NHS boards in Scotland; and health and social services trusts and boards in Northern Ireland.
Contact details
- Contact Media Relations Manager Joanna Clason on 020 7074 3306 or 07798 571078 or Senior Media Officer Amy Darlington on 020 7074 3304 or 07767 770309. For out of hours media enquiries, please call the Duty Press Officer on 07880 500726.
Back to media centre
