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This article examines the funding journey of the NHS over the past ten years, from Conservative spending plans to a funding boost under Blair and the impact of Wanless's forecasts. It discusses the slowdown in funding growth, the allocation of funds, rising costs, pay inflation, staff increases, reduced waiting times, meeting targets, ICT investment issues, value for money concerns, productivity measures, financial control, and overall satisfaction. Visit www.kingsfund.org.uk for more information.
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A brief history of NHS funding over the last ten years… Prof John Appleby Chief Economist King’s Fund
Bust, boom, bust? • 1997-2000: Stick to Conservative spending plans • 1999/2000: Blair announces NHS funding boost • 2002: Derek Wanless forecasts future funding needs • 2007 CSR: slow down in NHS funding growth…
…to £130 billion… A real increase of 110% From £44 billion…
…to £1 in 12 From £1 in 20 in the entire economy spent on the NHS…
After years of parsimony… …political decision to spend more… …but growth slows (it will feel like a cut)…
On target for Wanless recommendations?… …but now catching up… Historically, UK has lagged behind EU-15 countries…
…higher costs Inflation absorbed £18+billion…. …leaving around 56% of the cash increase to buy extra things
…higher pay costs Pay inflation: up 80% in ten years…. Large pay awards for doctors in particular as a result of new contracts ….
…more staff A quarter of a million new NHS staff over ten years…. But last few years have seen minimal increases as NHS deals with deficits and plans for a tighter financial future
…shorter waiting times Waiting list now at its lowest since 1974…. …and waiting times reduced massively: virtually no one waiting more then 6 months….
…more patients 11% increase in elective admissions….
…more, more, more! • Virtually all NHS Plan ‘shopping list’ targets met: • 100 new hospitals • Modernising 3,000 GP premises • 75% of all MRI/CT scanners and linear accelerators now new… • But, problems with ICT investment • …backlog maintenance…single rooms…
….value for money? • Higher unit costs • Lower admissions per consultant and per nurse…. • Official productivity measures show downward trend… • Poor financial control (deficits…)
…greater satisfaction? Net satisfaction with NHS overall highest it has been since 1980s….(shame about NHS dentistry…)