This is what the government says: "I am also committing to you, in the way that the Prime Minister has, that we will continue to maintain growth in health spending in (2011-14)" - Andy Burnham, the very new Secretary of State for Health speaking today.
And yet...the NHS Confederation forecast today that "the impact of the recession, allied to rising costs mean it is likely the NHS will face a real terms shortfall of £15 billion".
But was the Confederation pulling its punches? Only £15 billion? (And why, by the way, did the BBC report it as forecasting a reduction of "only" £8 to £10 billion, when they had said £15 billion?) After all, the NHS Chief Executive David Nicholson, had published his annual report only a fortnight ago and went rather further (page 47) "We must be prepared for a range of scenarios, including the possibility that investment will be frozen for a time. We should also plan on the assumption that we will need to release unprecedented levels of efficiency savings between 2011 and 2014 – between £15 billion and £20 billion across the service over the three years. This is so that we can deal with changing demographics, the implementation of the regional visions and cost pressures in the system." (my emphasis)
Whatever politicians protest about protecting NHS funding after 2011, it's abundantly clear that the NHS leadership is planning for less in real terms, not more. David Nicholson does not sound there like a man preparing for growth. I am told he was even more emphatic when he actually presented the report. And this is widely understood. I have been at two Health conferences in the last fortnight, with funding and commissioning central to both agendas, and the starting premise at both was that the challenge over the next few years is doing more for less.
Rigging the way in which we elect our politicians won't change our disregard for what they say, so long they continue to remain in some parallel universe where public spending can remain unaffected in the face of unprecedented deficits. It will change when they level with us, speak the truth, and debate the future on the basis that everyone else, including the NHS leadership, is operating.
