The National Health Service got its promised real terms rise in spending but at 0.1% a year experts said it was "the bare minimum ministers could get away with".
Funding will rise by £10bn to £114bn over the next four years – the equivalent of a 0.1%-a-year rise in real terms. In recent years, health spending has gone up by more than 4% in real terms and this is the first time there has been such a period of such small rises.
The austerity measures saw the coalition government scrap pledges made by the previous Labour government, including expanding free prescription entitlements for people with long-term conditions. One-to-one nursing for cancer patients and the promise that patients will only wait a week for cancer test results will also "not be taken forward at this stage".
Before the election, David Cameron and the health secretary, Andrew Lansley, promised a £200m-a-year fund for cancer drugs. The review said the fund would be "up to" £200m a year but no final decisions have been published. A source close to the health secretary said that the fund's size would depend on "demand".
Labour said the government had broken promises on cancer care, identified as a key voter concern, especially as during the election the Conservatives accused Labour of "scaremongering" on the issue.
John Healey, shadow health secretary, said: "Whenever we've highlighted the Tory threat to cancer services, Andrew Lansley was quick to accuse Labour of scaremongering, before saying how a Tory government would ensure the capacity to treat cancer patients sooner. Now, ministers are not only axing our plans for improvements in cancer care but abandoning their own promises on the NHS budget, letting patients down even further."
Economists say the ageing population, lifestyle problems and the cost of drugs mean at least 3% is needed just to stand still – far greater sums than those made available by the chancellor. Even with the new money, spending on investments such as buildings would drop by 17%.
John Appleby, chief economist at the King's Fund health thinktank, said the money was "the bare minimum to meet the coalition's pledge. It is the width of the proverbial cigarette paper."
The Department of Health said: "In the light of today's settlement, we will be seeking to publish our consultation on the cancer drugs fund as soon as possible. This will set out in detail the levels of funding and how we anticipate the fund will operate, but we plan to make £200m available each year of the spending review."
Appleby said pay pressures were building up in the NHS. He pointed out that there has been a two-year pay freeze for all staff on more than £21,000 and that by the end of the spending period GPs will have in effect faced a four-year pay freeze and NHS consultants a three-year one. "There will be real issues here for the NHS."
Many in the health service say the public has to accept that the NHS will be cutting deeper despite the cash. Peter Carter, of the Royal College of Nursing, welcomed "the commitment to a real-terms increase in NHS funding. However, the reality is that this small increase, at a time of soaring demand and the rising costs of health care, will still feel like a cut."
Unions said the NHS was being put under great strain by demands to find £20bn of savings while spending £3bn on an expensive reorganisation that it sees as a prelude to privatisation. Karen Reay of Unite, which has 100,000 members in the NHS, said: "There are two easy alternative strategies to ringfence the NHS: stop the expensive reorganisation and privatisation heralded in the white paper."
The NHS budget has also had £1bn taken from it to fund social care in a bid to prevent people entering hospital unnecessarily or blocking beds when they could be discharged into residential care.
Nigel Edwards, acting chief executive of the NHS Confederation, an independent umbrella body for organisations within the NHS, said the settlement "is as good as the NHS could have hoped for under the circumstances ... we have to be realistic as almost every other department is taking a big cut."
Comments in chronological order (Total 15 comments)
21 October 2010 12:52PM
Have a look at http://www.nhshistory.net/parlymoneypapter.pdf which states that "between 1997/98 and 2007/08, real-terms expenditure rose by 82%." Yes, that's 82%. So are a couple of years of spending about £100,000,000,000 annually really going to be that bad? That's about £1,500 for every person in the country.
21 October 2010 1:06PM
Perhaps it will teach them to be more commercial
Perhaps will deal with health tourism rather than provide an international health service free to all who turn up
Only in the UK do we run an IHS . Try turning up to a hospital in France and you will be deported if you do not have private health insurance under EU directive for non workers .
We are in breach and could save billions if we deported all non working EU citizens and others under these regs just like France , Germany and Spain
Sadly up to now everyone ignores but reality has set in
21 October 2010 1:31PM
Its time to get rid of the overpaid, unwanted bureaucracy in the NHS.
Its a recent invention and has not improved the service, only increased the costs and distorted the true statistics of healthcare provided.. As long as a manager is paid to 'provide' a certain statistic, they will do this at the expense of everything else. Genuine 'need' goes out of the window.
There are cost savings to be made in the NHS, but adding on layers of admin/managerial staff does not help.
21 October 2010 3:09PM
Oh bless, they're one of a handfull od departments to received increased handouts from the tax-payer and what do the do - moan.
The Dept for Health hardly comes cheap at £115bn a year, especially if you throw in health spending in Scotland (£12bn), Ireland (£5bn) and Wales (£6bn) its actually closer to £135bn or about 4 times the cost of the entire armed forces - and they managed to take a cut!
21 October 2010 7:33PM
@truthisgood
Do you not realise that the bureaucracy is present due the the socialised nature of the NHS?
21 October 2010 10:26PM
its time to privatise the NHS and reduce taxes. The NHS wastes too much money. A private company would make the NHS more efficient and allow only those who pay into the system to enjoy its benefits. The LIB cons are wasting too much money.
22 October 2010 12:00AM
What you’ve got to ask yourself is... if Osborne, Cameron and clegg loved our children as much as they love their own, would they be making the cuts in the National Health Service and putting their families at risk?
And if the answer was NO I wouldn’t put my family’s health at risk... at any cost, then they must not subject the nation to their double standards.
If they want Austerity measures imposed, then they must lead by example as public servants and use the NHS.
LEAD BY EXAMPLE – make cuts in your own lifestyles – be transparent.
And that goes for CEO’s and fat cats... LEAD BY EXAMPLE
22 October 2010 8:13AM
The NHS has been abolished.
22 October 2010 1:58PM
@remusp
In my working life I have seen many times when non UK residents have been billed for their treatment on the NHS. If they did not want to pay then they did not get treated. This myth of 'health tourism' is not why the NHS is unable to balance the books.
NHS trusts all over the country are currently busy cutting significant numbers of frontline staff and services to patients. Conveniently the tories have scrapped targets so the trusts are able to do this as they are no longer bound to waiting time limits etc.
Soon once the reorganisation takes place and all trusts are independent and need to be run in a more commercial manner then we will see just how much more efficient that is! I can see them prioritising the more lucrative services at the expense of others and closing many A&E depts and elderly care wards. If they dont manage to balance their books they will simply go bust. Ooops look what are we going to do? I guess we will have to privatise Mr Cameron will say.
This isnt just a case of those working in health moaning and not willing to do our bit, this is grave concern for the future of the NHS. To those who think you will be fine because you can afford health insurance I say what happens when you have a child with long term health needs the insurance wont cover? That would bankrupt most middle class families.
22 October 2010 2:11PM
£10 billion 'feels like a cut' ?
Get Real!
22 October 2010 4:34PM
Those complaining of overheads and admin costs in the NHS due to its socialized character ought to reflect on the fact that admin and overhead costs run 3 times higher in the market-oriented systems of North America, with no better outcomes and much poorer access for older and less affluent patients. Wait times remain worse in Canada than Britain, though per capita health care costs are significantly higher in Canada and the US (again triple Britain's in the case of the US). Also, the xenophobic crowd fails to recognize most everywhere gets stuck with most of the health care costs of visitors, visiting workers, asylum seekers and the like. Sure, in Canada and the US they will get a bill but it almost never gets paid, at least not in full. Stories of complete denial of service are apocryphal and obviously cannot accurately describe any civilized place.
The NHS, in spite of ill-conceived reforms under Thatcher and Blair, remains the most efficient and effective health system in the world. That's not to say it hasn't got its problems, but those pale in significance with the problems most of the world's health care systems face. And strangely, to British ears, the NHS is more affordable than the systems in place in France, Germany, Switzerland, even the US and Canada. Government is wise to avoid making any big cuts and would be wiser still to reconsider the ideologically-driven fundholding scheme and look instead at improving the Primary Care Groups and Hospital Trusts. The NHS has always been, and remains, an exemplary approach to providing care to a population & this is poorly recognized in England.
22 October 2010 6:05PM
The reason the NHS is getting a 0.1% rise in real terms is the soaring cost of the services the NHS provides. Like the rest of the public sector they need to work out what the most efficient way is to provide key services and live within their budgets. If the NHS was facing 19% cuts and also having to deal with the rising costs then that would be a difficult challenge for the staff of the NHS.
23 October 2010 6:10AM
I'm from the States. Whatever you do, do not let the private sector take over your NHS. Contrary to what you hear from the party of wealth (Republicans) that we should not go to a universal healthcare sytem. Why, because over here the Republicans view health care as a privalege. That is why the healthcare funding attack ads against it are just helping big health insurance industries fight against any type of health care Britain has. The majority of middle class Americans believe that healthcare should be a right. The majority of the Americans in the middle class believe health care is a right, not a profit for big Insurance companies. We know your NHS is not perfect but in comparision to ours it is a much, much better. Once you let Coporate Instreasts involved in your health care you can say goodbuy to it. About 65 to 70% of all Americans would change healh to your National Health Care.Don't give that away.
Take this for what it's worth.
23 October 2010 7:15AM
Fear all by the end of the condem reign of terror against the good people of the U K the N H S will be gone.It will go something like this in a year or so things are so bad we have transferred the N H S to private enterprise and you must take out private insurance.
We are NOT all in this together did you ever think we were in it with you.?
23 October 2010 10:42AM
popsb
thank you for your post rebutting the right wing ( and erroneous )rant of remusp
I had occasion to visit hospitals in the late 80's,early nineties and again last year for close family illnesses.
The transformation is astounding.
and will be reversed because the Tories are inflicting a sleight of hand . This 'increase' is to be swallowed up by the unnecessary and ideological re-organisation of the NHS ...to its detriment.