Responding to the NHS Road to Recovery plan, as laid out in a speech by Secretary of State for Health and Social Care this afternoon, Dr Chaand Nagpaul, BMA council chair, said:
“While the Secretary of State articulated a vision for the future, ultimately this omitted the most fundamental element of any recovery strategy which is tackling the chronic workforce shortages in the NHS. The Government must now show how it will prioritise recruitment and retention otherwise patient care will continue to suffer.
“As of December 2021, more than 110,000 posts in hospitals are vacant, almost 8,200 of which are medical posts. In general practice, the Government is set to miss its target to recruit 6,000 more GPs by 2025, with England having lost the equivalent of 1,608 fully qualified full-time GPs in the last seven years alone. Meanwhile the BMA estimates England has a shortage of around 46,300 doctors when compared with the average doctor to population ratios of our most comparable EU neighbours.
“Without a proper and transparent workforce strategy the Secretary of State’s vision to encourage patients to change their care provider to reduce their wait will ultimately fail. Choice can only be provided if there are enough staff to deliver it, and currently there is no clear plan to achieve this. To this end, it would be a tragedy if the Government chose to overturn the House of Lords’ amendment on workforce planning to the Health and Care Bill, which provides a vital mechanism for ensuring we have a shared collective, national picture of the health and care staff we need to keep pace with projected patient demand, both now and in the future.
“Many of the proposals articulated today lack detail and the BMA will want to careful consider how they will be delivered. The Government talks about proposals to prioritise prevention, something the BMA has long called for, but has allowed the continued erosion of public health budgets and has made no effort to ensure public health leaders play a key role in Integrated Care Systems.
“Much of the speech considered how to ensure the best use of resources in the NHS. This must involve investing in the NHS which is far more efficient than private providers. It should be totally clear by now that having to rely on the private sector to deliver NHS services too often represents very poor value for money for taxpayers, with several private providers having failed in the past resulting in them closing their doors to patients. We should also be wary of private providers bidding for contracts which cherry-pick low risk patients while being unable to provide comprehensive care for those with more serious and complex needs. The right long-term strategy is proper investment in the NHS infrastructure and the Government must ensure that contractual arrangements for independent providers are transparent, so public resource is not wasted on providers that do not deliver.
“Digital NHS developments represent a critical part of the future of healthcare and is something the BMA has long called for. However, the Government must acknowledge the chequered history of investment in NHS IT. The Government says the NHS App will become the front door to accessing personalised care but it needs to be urgently and dramatically improved if it is to play this role, not least to allow it to provide patients with the correct information to make informed decisions about their care.
“Fundamentally, the public will want to see the additional investment from the health and care levy being invested in frontline staff. Many will therefore be concerned to see that for the almost £36bn promised over the next three years for health and social care spending, nothing has been mentioned in today’s plan about how to boost staffing. In addition, there remains a complete lack of clarity about what will happen for NHS funding after those three years. The NHS is currently facing a financial cliff-edge as that money transfers to deliver social care, with the Government once more offering short-term solutions to long-term problems.
“Immediate steps must be put in place taken to retain current staff, and this must include measures to reform punitive pension rules that are currently driving senior clinicians to reduce their hours or leave the NHS altogether, which is dramatically slowing down progress on tackling the backlog. The NHS is nothing without the people who work in it. This is an ambitious plan from Government, but one that potentially verges on being impossible if the workforce continues to be ignored.
“We look forward to receiving further details about the proposals outlined today and how their delivery will be made possible by a credible workforce strategy.”
Notes to editors
The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.