Health Secretary Andrew Lansley: funding crisis threatens the NHS
The National Health Service is facing a £20 billion-a-year funding black hole that will threaten its founding principles unless the Coalition's controversial reforms are brought in to prevent it, the Health Secretary has warned.
In an article for The Daily Telegraph, Andrew Lansley says the core values of the NHS are under threat as never before from a "financial crisis" that will see annual health spending double to £230 billion a year without urgent reform.
While insisting he would never privatise the NHS, Mr Lansley warns that its future as a universal service, available to all and free at the point of use will be at risk "within years" if radical change is blocked.
Mr Lansley's remarks are his first since the end of the listening exercise ordered by David Cameron to try to rescue the plans, which have angered many health professionals and disgruntled Liberal Democrat Coalition members, including Nick Clegg, the Deputy Prime Minister.
While admitting that he is prepared to accept "substantial and significant" changes, the Health Secretary's article will be seen as a clear reaffirmation of his belief in the reforms, which would abolish two tiers of NHS management and allow GP-led consortia to decide whether to buy treatment from local state-run hospitals or private providers.
It will also serve as a warning to his Cabinet critics who have privately been suggesting that the Health Secretary might resign or be sacked over his handling of the NHS changes.
Mr Lansley's intervention in the debate comes on the day that a leading doctors' union describes a key plank of the reforms as "completely unethical".
The British Medical Association says plans to hand bonuses to high-performing GP groups risk "undermining patients' trust".
It also warns that giving GPs the power to buy £60 billion-a-year worth of treatment for their patients — the centrepiece of the reforms — may lead to accusations of conflicts of interest.
However, the Health Secretary makes clear that the changes are essential to cope with the "enormous financial pressures" generated by advances in medical science and a rapidly ageing population.
He says that unless "we act now", real terms health spending will ultimately double to £230 billion a year – or £7,000 a second – by 2030.
"This is something we simply cannot afford," he says.
His focus on the cost implications of allowing the NHS to continue as it is are part of the Coalition's drive to help explain why the decision has been taken to shake up the service fundamentally.
And the need for urgency will be seen as a move to block Lib Dem attempts to delay the Health and Social Care Bill.
NHS reorganisation has become Mr Cameron's most pressing problem. After spending his time in opposition trying to neutralise perceptions that the Tories were enemies of the NHS, often through using examples of his own experiences when caring for his son, he is now faced with accusations from inside the Coalition and from Labour that the reforms will cause widespread and detrimental upheaval.
The unexpected nature of the reforms – which critics argue were not in the Coalition Agreement – has led to heavy criticism. Mr Lansley, who has held the Conservative health portfolio for eight years and had been trusted to deliver the vital changes by Mr Cameron, has had his reputation battered.
Despite originally fully backing the plans, Mr Clegg is now threatening to block the reforms if substantial changes are not delivered.
Mr Lansley has been blamed for the poor communication of the aims of the reforms – something he attempts to address with today's article. He specifically addresses Lib Dem fears about so-called privatisation of the NHS. He says: "We will never privatise our NHS. But if we choose to ignore the pressures we face, the NHS will face a financial crisis within years, a crisis that would threaten the very values of our health service that we hold so dear – a comprehensive health service, available to all, free at the point of use and based on need and not the ability to pay."
The BMA has for several months opposed the Health and Social Care Bill, with family doctors fearing not just the back door privatisation of the health service and a fragmentation of care but also that they will be blamed by patients if things go wrong.
Its new warning is the strongest yet on the issue of performance-related pay, which would be available for new GP-led commissioning groups that do well financially under the reformed NHS.
Dr Laurence Buckman, the chairman of the BMA's GPs committee, said: "GPs are very concerned about the potential conflicts of interest inherent in the Health Bill. They are worried that their patients' trust in them may be damaged unless there are transparent processes in place to ensure confidence that commissioning decisions are being made in patients' best interests.
"Financially rewarding GPs by directly linking their earnings to their consortium's financial management, particularly when the NHS is under continuing pressure to reduce budgets, is completely unethical. We strongly urge the Government to listen to and act upon our concerns."