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How is the NHS going to spend its extra £9billion a year?

British taxpayers were warned today that Boris Johnson‘s manifesto-busting £30billion NHS handout will be ‘gobbled up’ permanently by the health service, with waiting lists and delays here to stay.  

The Prime Minister promised the extra £10billion a year to clear the mammoth backlog that has amassed during the pandemic, on top of £5.4billion cash boost announced for the NHS only a couple of days ago.

But the handout has been given to the NHS without any firm targets to meet, which has raised fears the money will simply be swallowed. NHS bosses have already complained the sum isn’t enough to clear the backlog. 

Under proposals, half of the £10bn a year will be spent on social care in 2023 before the full amount is devoted to the care sector in 2025 and, in theory, the NHS reverts to its normal budget. 

Critics have raised doubts about the plan, claiming that if the NHS goes on a recruitment spree to plug staffing gaps then those wages will need to be paid beyond 2025.

Announcing the tax hike yesterday, Mr Johnson said the cash would go towards nine million more checks, scans and procedures by the end of 2025, as part of the ‘biggest catch-up programme in the NHS’s history’.

He promised to boost NHS capacity for routine operations by 30 per cent compared to pre-pandemic levels, hire 50,000 more nurses and open new surgical hubs to deliver extra operations and other procedures.  

By 2025, around 40 per cent of all of day-to-day Government spending will go to the the Department of Health and Social Care, which funds the health service, according to the Resolution Foundation.

The conservative think-tank, the Institute for Economic Affairs, warned the cash boost will almost entirely be spent on hiring new staff and increasing wages, which will be hard to recoup after 2025.

The left-wing Institute for Public Policy Research (IPPR) said the funding is ‘nothing like enough to get through the backlog’, with the NHS alone needing £15billion per year to address the waiting list. 

NHS England was already 38,952 nurses short at the end of June and it is not clear how quickly surgical hubs could take to set up or how they will be staffed.  

A record 5.5million people were on the waiting list for routine operations and treatments — such as hip and knee replacements — at the end of June and with data for July due out tomorrow, that figure is expected to further soar. 

Some 5.5million patients in England were waiting for routine hospital treatment – such as joint replacement and cataract surgery – by the end of June, the highest figure recorded since records began in 2007. And 304,803 of those patients (5.6 per cent) had been waiting for more than one year. In August 2007, 578,682 people of the 4.2million-strong waiting list (13.8 per cent) had been waiting for more than 52 weeks, but this dropped drastically and remained relatively flat for nearly a decade. Some 1,613 patients had been waiting for more than a year when the Covid pandemic hit, which caused the figure to soar to a high of 436,127 in March. But those waiting 12 months or more began to drop in April as the country recovered from the second wave and the health service was able to begin working on the backlog

Patients forced to wait more than 18 weeks for routine surgery - the maximum time someone should wait under the NHS's own rules - reached a record high of 1.8million in April. The previous

Patients forced to wait more than 18 weeks for routine surgery – the maximum time someone should wait under the NHS’s own rules – reached a record high of 2.1million last July. The figure then fell in 2020, but began to increase in March as health chiefs urged those who avoided seeking treatment during the pandemic to come forward. Before the Covid crisis, the largest number of patients forced to wait longer than 18 weeks was 1.7million in August 2007

The health and social care budget reached £212.1million in 2020, £148.7million of which was planned funding, while the remaining £63.4million was dished out to cope with the Covid crisis. For the second half of 2021 and first half of 2022, minister plan to spend a total of £181.4million on the health service, £22.4million of which will be linked to the Covid response

The health and social care budget reached £212.1million in 2020, according to the King’s Fund. Some £148.7million of the sum was planned funding, while the remaining £63.4million was dished out to cope with the Covid crisis. For the second half of 2021 and first half of 2022, minister plan to spend a total of £181.4million on the health service, £22.4million of which will be linked to Covid recovery

The number of patients waiting for routine hospital treatment hit 5.5million in June, the highest figure since records began in 2007. And health chiefs have warned the backlog is going to get much worse before it gets better, with projections that it could soar up to 13million by the end of the year if no action is taken

The number of patients waiting for routine hospital treatment hit 5.5million in June, the highest figure since records began in 2007. And health chiefs have warned the backlog is going to get much worse before it gets better, with projections that it could soar up to 13million by the end of the year if no action is taken

The backlog was forecast to hit 13million by December without any action, with 7million patients expected to come forward who put off seeking treatment during the pandemic.

The health service also faces challenges from a surge of Covid and flu cases expected this winter and social distancing still being enforced in hospitals. Hospitals are aiming to keep two metres between patient beds and staff, which requires more space and can reduce capacity. 

It has also been told to prepare for mammoth vaccination programmes for Covid booster jabs and for all over-12s, as well as the country’s biggest-ever flu jab rollout, which is expected to reach 35million people. 

Professor Len Shackleton, editorial and research fellow at the IEA, said that lots of the extra funding would inevitably be gobbled up by wage increases.

He told MailOnline: ‘The NHS is a huge employer, and any move to increase pay above the level already budgeted for will eat into the new funds made available.

‘And, given that the plan to clear the backlog involves recruiting substantial numbers of extra staff while having many existing staff work longer hours, it is almost inevitable that pay will be increased.

NHS England waiting list could soar to FOURTEEN MILLION by autumn 2022 and keep growing, says think tank 

The NHS waiting list in England could soar to 14 million by the autumn of next year and keep growing, an influential think tank has warned.

If millions of patients who missed out on care during the pandemic seek medical attention, then the number joining the waiting list could outstrip the number being treated, the Institute for Fiscal Studies (IFS) said in a report last month.

Last month, Health Secretary Sajid Javid warned that NHS waiting lists in England could rocket to 13 million.

The IFS warned the number could top this figure if most of the near seven million so-called ‘missing’ patients return to the health service in the next year.

It said: ‘Under this scenario, waiting lists would soar to 14 million by the autumn of 2022 and then continue to climb, as the number joining the waiting list exceeds the number being treated.’

The IFS said it was unlikely all patients will return as some will have died and others might have had private treatment or chosen to live with their illnesses. 

‘A 1.5 per cent pay increase would cost about £1 billion. If NHS costs do escalate, improvements to social care provision will be slow and underfunded.

‘We should not assume that this clever political fix has solved the longer-term problems of health and social care provision.’

And job adverts online reveal that the NHS is hiring 42 new chief executives across the country, who will receive an average salary of £223,261. One in six of the new hires will be paid £270,000 – more than the Prime Minister.

Rachel Harrison, national officer at the trade union GMB, said the funding should be used to give NHS staff a retrospective 15 per cent pay rise, which would use up all of £10billion funding, according to Professor Shackleton’s estimates.

She said: ‘Morale among NHS staff is at a low ebb. They’ve faced ten years of real terms pay cuts and underfunding – leaving the health service with a massive 75,000 staffing black hole.

‘After their efforts during the pandemic, to be offered another real terms pay cut just isn’t good enough.

‘Any new NHS funding that doesn’t go towards giving staff a proper pay rise spectacularly misses the point.

‘GMB is calling for a restorative 15 per cent increase to make up for a decade of slashed pay under the Conservatives.’ 

And Richard Murray, chief executive of the King’s Fund think-tank, said wages are likely to go up, as medics have to work longer due to staff shortages. 

He told MailOnline: ‘If you put a lot of money into the NHS very quickly that they weren’t ready for – which is true in this case – they have to find staff.

‘You can’t invent extra doctors and nurses, the workforce is what it is.

‘This means you risk two routes – one is paying more people for overtime and bringing in expensive agency workers. So paying higher rates for longer hours.

‘You can also try to persuade existing staff not to drop out early or retire. Some of that can show up in pay, but it can also be in areas like training and career development to try and keep people longer than they would otherwise plan to stay.’

Mr Murray predicted some of the money could go on diagnostic equipment and extending opening hours at operating theatres, or perhaps even on new hospital buildings.

‘Britain has very few MRI and CT scanners. The Government has also promised a large hospital building programme too.

‘One thing to note is that the money that has been announced by the government is revenue spending and things like large scanners are taken from capital spending.

‘So either in the spending review we’ll see another slug of money appearing for capital spending or some of the money will be moved across from revenue into capital.

‘They said by the end of the period they want a 30 per cent increase in elective activity.

‘It’s hard to build completely new things so I think you’ll see them trying to draw on independent sector capacity.

The health service's budget in 2024/25 will be nearly four per cent higher than it was in 2018/19, according to the Institute for Fiscal Studies. It is projected to reach £160billion, according to the funding that was announced yesterday

The health service’s budget in 2024/25 will be nearly four per cent higher than it was in 2018/19, according to the Institute for Fiscal Studies. It is projected to reach £160billion, according to the funding that was announced yesterday

How is the NHS going to spend its extra £9billion a year?

‘And an attempt to make sure they’re using operating theatre and scanners to their full capacity and ensuring appointments aren’t being cancelled and these areas are being left empty.

‘Hips and knee replacements are huge areas in the waiting lists, so they’ll be an emphasis on giving more support afterwards.’

Mr Murray said hospital opening hours could be extended in order to reach the government’s target of boosting the number of elective procedures by 30 per cent, but it would be a ‘balancing act’ not to alienate staff with longer hours.

‘Hospitals could be run for longer hours, but you need the staff to do it,’ he said. ‘The risk is that if staffing hours aren’t going up then you’ll see them working longer hours.

‘It’s a fine path to tread not to get people to work so hard that they want to leave.

‘The government will be looking at what can be done with general practice, because quite a few patients are stressed about this and some dislike the digital route.

‘I’d expect to ministers see how they can use other staff like community pharmacists to try to ease the pressure on general practice.

‘Lengthening surgery opening hours produces the same risk of alienating an already frustrated workforce by making them work for longer.’

And adding to the concerns that extra cash will not be enough to cut the waiting list, NHS Confederation and NHS Providers, which represent hospitals and health service organisations, said the funding falls £3.5billion short of what is needed due to the ‘seismic impact’ of Covid and rising demand on the NHS.

Ministers should ‘manage public expectations about how long it will take to deal with the care backlog’, because the funding limits NHS ability to tackle the shortfalls in treatment and care, they said. 

The funding does not go ‘nearly far enough’, which leaves health and care leads with an ‘impossible set of choices about where and how to prioritise care for patients’, they added.

Chris Thomas, IPPR senior research fellow, said the NHS will be ‘deeply worried’ about its long-term financial position. 

He said: ‘The funding announced is nothing like enough to get through the backlog and deliver the transformation needed to build back better. 

‘This will have severe health and economic consequences for years to come, while also leaving the country fundamentally unprepared for future health shocks.’

Estimates have put the cost of the Covid backlog at £10billion per year, but IPPR said the NHS would need an annual funding boost of £15billion to treat those on the list, because its ‘performance and resilience were at record lows’ before the pandemic, the IPPR said.

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