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Funding Settlement for the health service in England

Part of NHS Funding Bill – in the House of Commons at 2:29 pm on 4th February 2020.

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Photo of Justin Madders Justin Madders Labour, Ellesmere Port and Neston 2:29 pm, 4th February 2020

My hon. Friend is absolutely right: it is a matter of some regret that public health has not been included in the Bill. As we have said repeatedly, we have to look at the health system in the round and include public health and, of course, social care. We cannot deal with those matters in isolation and I believe that it was a mistake for the Government to restrict the Bill in this way.

Despite the many tragedies that we know about in maternity care, it is worth restating that we still have fantastic midwives and fantastic maternity care in this country. That is to be celebrated, but we also need to ensure that when things go wrong—when there are failures and safety issues—we address them and lessons are learned so that no more families have to experience such tragedies.

Amendment 3 is about genuinely giving trusts the certainty that the Bill only purports to do, as well as beginning to tackle the appalling maintenance backlog that has arisen on the Government’s watch. As we know, trusts are around £14 billion in debt to the Government and are currently predicting a £571 million in-year deficit. That is a truly shocking and unsustainable situation. Only short-term fixes have prevented the situation from getting even worse. Such fixes are a symptom of structural long-term underfunding, and like most short-term fixes they create bigger problems further down the road.

We have been absolutely clear that the funding settlement proposed in the Bill is inadequate and that it will not be enough to keep up with demand. As I said, that analysis is shared by just about every major health expert, including the Institute for Fiscal Studies, the Health Foundation, most royal colleges and NHS providers, and the BMA.

In that context, we are concerned that there will be a temptation, as there has been, to dip into capital budgets to paper over the cracks on a day-to-day basis. We have seen that happen five times in the last decade. This means that we now face a maintenance backlog that has spiralled out of all control, topping £6.5 billion. That is an 8% increase on the previous year, when the cost was just under £6 billion. In dollars, that might get us one Steve Austin, but it is not enough to fix the NHS—I suspect that that reference might not mean much to anyone under 40, although I understand that there will be a reboot later this year, so it might become a bit more relevant. However, the point is that this figure has been rising each year for the last six years and it is now 60% higher than it was in 2013-14. It is very clear that the backlog has risen much faster than the resources that have been made available to tackle it.

Over half the backlog represents high and significant risk. That accounts for an increasing proportion of the total backlog figures. High and significant risk represented about 34% of the backlog in 2013-14, but last year—2018-19—it had gone up to 53%. It is getting bigger and all the time, it also becomes riskier.