Stop the decline: NHS needs £20bn now – John Lister, SOS NHS, ahead of the #SpringStatement


“The reality is the whole NHS has been increasingly under-funded since George Osborne first slammed the brakes on spending back in 2010. Each year since then the cash increase has lagged behind the real costs”

By John Lister, Health Campaigns Together & SOS NHS

As Rishi Sunak prepares his Spring Budget statement, the NHS is now being plunged another massive period of austerity.

Hospital trusts, still struggling to cope with 93,000 vacancies, soaring numbers of staff off sick, continued massive delays in emergency admissions, and over 5,000 beds still out of action since they were closed for infection control in March 2020, are now being told to generate impossible levels of “efficiency savings”. Mental health services, with at least 1.4 million people needing treatment but not getting it, also face the real threat of further cuts in real terms spending.

Some hospital trusts, according to the Health Service Journal, are staring down the barrel of unprecedented targets of 5% “efficiency” savings in a year. Such levels of savings have never been achieved before, except by brutal cuts in staffing in the disastrous Mid Staffordshire Hospitals in the mid-2000s, where the resulting collapse of care created a national scandal.

The reality is the whole NHS has been increasingly under-funded since George Osborne first slammed the brakes on spending back in 2010. Each year since then the cash increase has lagged behind the real costs: by 2019 NHS spending in England was £35 billion per year (28%) below what it would have been if previous average increases had continued.

The pandemic distorted all the figures: but from April all extra funding for Covid ceases and all public health precautions have been scrapped, even with 11,000 beds filled with Covid patients on March 16th.

Rishi Sunak’s spending review last October boasted of an increase in funding averaging 3.8 percent in the next three years: but this is barely the amount needed just to keep pace with rising costs and increased demand, and does nothing to address the backlog of under-funding.

Much of the increase is already being wiped out by soaring energy bills and cost inflation. Even more would be eaten up by any significant pay award to 1 million-plus NHS staff, since even the miserly 2-3% increase proposed by the government is not fully funded, and inflation is expected to hit 8%.

Sunak even told health secretary Sajid Javid there’s no money for a further round of booster jabs to fight Covid without making cuts in other services.

But for the ‘extra’ money it has been given the NHS is somehow also expected to cut waiting lists and deliver 30% more elective treatment by 2024-25 than before the pandemic.

Last autumn, just after Sunak had announced the “settlement,” an NHS Confederation survey found almost 90% of trust bosses already believed the pressures on their organisation had become ‘unsustainable,’ putting patient safety at risk, and that the NHS was at a “tipping point.” Since then it’s all got much worse.

On Wednesday a Commons Public Accounts Committee report noted that the NHS in England has not met all eight key standards for cancer care since 2014. It accused the Department of Health and Social Care of overseeing “years of decline in the NHS’s cancer and elective care waiting time performance,” and failing to “increase capacity sufficiently to meet growing demand.”

The lack of capacity has been used, during the peak of the pandemic and now in all recent plans, as a pretext for using beds in the private hospital sector – even while thousands of NHS beds remain closed. In 2020 alone spending on private providers of clinical care went up a massive 26% in England, almost all of this down to a woefully poor contract with private hospitals that lined shareholders’ pockets but resulted fewer than normal operations on NHS patients.

At least as much spending on private hospitals is likely to continue until 2025. NHS England plans to continue this new, expanded role of the private sector into the future.

The only way to prevent this is to reverse the decline. Break from the policy of disinvestment – and pump new funds in to repair and rebuild the NHS, reopen the 5,000 unused beds, and invest in new buildings and staff for mental health.

SOSNHS is the new campaign, now backed by 51 organisations including health unions, the TUC, Keep Our NHS Public and a host of campaigns, that has led the call for emergency funding of £20bn as a down payment to kick start a revival. It also demands a decent pay increase for NHS staff – and for every extra pound to be spent on NHS, not private provision.

A brilliant Day of Action on February 26 had 85 local events, involving thousands of people, across the country. The petition at, to be handed in to Downing Street, currently has over 170,000 signatures.

Our aim is to build a movement broad enough and powerful enough to force divisions in the Tory ranks and pile pressure on Rishi Sunak for a U-turn.

£20bn is just some of the money that should have been paid up years ago.

The pandemic proved Sunak can raise huge sums of money to waste on crony contracts and bounce back loans. So he can raise it to invest in the NHS.

If not now, when?

“Where’s our £350 million a week? We’ve been living off claps instead.” Photo credit: NHS Workers Say NO!

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