[political]

The Government will cut the National Health Service’s budget per person in real terms next year, ministers have admitted in official figures for the first time.

nhs.jpg (60.18 KiB) Viewed 1915 times

Numbers released by ministers show NHS England will face a sharp reduction of 0.6 per cent in real terms of per head in the financial year 2018-19.

The numbers corroborate claims by NHS chief Simon Stevens earlier this month that “in 2018-19, real-terms NHS spending per person in England is going to go down”.

The figures also fly in the face of the Government’s public insistence that it is investing more in the health service, with Jeremy Hunt and Theresa May repeating the mantra of an extra £10bn for the NHS.

That claim was debunked by the cross-party Health Committee in the summer, whose chair, Tory MP Sarah Wollaston, said the number was both “incorrect” and “risks giving a false impression that the NHS is awash with cash”.

The Liberal Democrats said the figures show Tory claims of investment were “disingenuous” while Labour said the Government should use the March budget to close the black hole opening up in the health service’s finances.
In a written statement to the House of Commons health minister Philip Dunne said NHS England’s per capita real terms budget would increase by 3.2 per cent in 2016-17 financial year.

However growth would fall sharply next year, down to just a 0.9 per cent increase in 2017. It would then go negative by 2018-19 with a 0.6 per cent fall in real spending per head in that financial year.

Growth would remain very low in 2019-20 at 0.2 per cent and 0.9 per cent in the years following. The wider health budget outside the NHS is facing even more sustained cuts, with two years of shrinking resource per head and a maximum growth rate of 0.4 per cent after this year. This includes staff training and public health.

The figures were revealed after a written question to the minister by Labour MP Luciana Berger.

Tim Farron, Lib Dem leader, told The Independent: “These Government figures expose just how disingenuous they have been with their claims that they’re investing more in the NHS.

“It is unbelievable that they keep asking health and care services to provide more services, for more people, with less and less resource. These vital services are already stretched to breaking point.

“We need a long-term funding settlement for health and care. Figures like this show just how essential this initiative is.”

Jon Ashworth, Labour’s shadow Health Secretary, said social care cuts were compounding the health service’s woes.

“Ministers have now finally admitted what I've been warning for some time – that head for head, NHS spending will actually be cut next year,” he said.

“Alongside cuts to social care this will simply compound the crisis the NHS is already facing. Theresa May needs to use the Budget this March to give the NHS and social care the funding our constituents expect.”

NHS trusts are reporting record deficits across the country as funding continues to tighten and fails to keep up with demand or inflation. The British Red Cross declared the system was facing a “humanitarian crisis” at the start of the year and said more investment was needed – but ministers have so far refused to release extra cash.

This week the National Audit Office warned that overstretched A&Es were also having a knock-on effect on other parts of the health service such as ambulances, which they said were increasingly missing targets.

The latest numbers of a per capita real terms cut relate only to England, because the health service is devolved to the Welsh, Scottish and Northern Irish governments – with Westminster’s controlling England’s system.

Anita Charlesworth, director of economics at the Health Foundation, a charity which scrutinises health policy, said the numbers actually downplayed the even bigger challenge the health service was facing.

“Obviously we’ve got an increasing population but the thing with the per capita as well is we’ve also got an ageing population,” she told The Independent.

“The pressures are bigger than even the per capita shows because as the population ages, healthcare costs are not consistent throughout our lifetime and they’re not consistent as we get older.”

She warned that it was likely that “very low funding growth may continue beyond this decade” and said Government commitments to improving areas like mental health, primary care, and utilising new life-saving drugs were in jeopardy with the current level of funding.

A Department of Health spokesperson said: “We are committed to the NHS and investing £10bn extra a year by 2020 with the budget increasing in real terms every year – funding per person will rise 4.7 per cent in real terms over the course of this Parliament. We frontloaded this money, rather than introducing it evenly, to kick-start the NHS’s plan to transform services for the future.

“We have introduced tough new financial controls to cut down on waste in the NHS – including clamping down on rip-off staffing agencies and expensive management consultants so every penny possible can be spent on patient care.”

NHS

[Bulaba Khan Jones]

Although a 0.6% cut isn't drastic, I don't think it takes much thinking to realize where these people are trying to go with this. The Tories, and many among Labour, have a long way to go before they succeed at dismantling the UK's healthcare system and replacing it with an American-style healthcare which works almost entirely for obscene profits through the imposition of outrageous personal debts and the unjustified skyrocketing costs of everything medical-related. Those people smell blood and money, however, and realize that overturning the NHS in favor of something privatized means a lot of money for a lot of people, and their hands will be first in that cookie jar.

[Kaiserschmarrn]

Claiming costs for services rendered, like a normal country, may go some way in saving costs.

NHS 'Scandal' As UK Pays Millions To EU

The UK pays more than £670m to EU countries for Britons' healthcare abroad, while claiming back less than £50m from the EU.

New figures show the NHS is paying out millions more for EU healthcare than it is claiming back from EU countries.

In what one MP described as a "scandalous failure", it has emerged that the UK pays more than £670m to EU countries for Brits' healthcare abroad, while claiming back less than £50m from the EU, even though there are significantly more EU citizens in the UK than UK citizens in the EU.

Under the European Health Insurance Card (EHIC) - countries can claim back health costs from other EU countries if their citizens use medical services abroad. The new figures reveal that nearly every country claims more from the UK than the UK claims back from the rest of the EU. For example the UK pays France £147,685,772, but France only pays UK £6,730,292 and the UK pays Germany £25,873,954 but Germany only pays the UK £2,189,664. Even in countries such as Poland where net migration is massively towards the UK, the discrepancy is four-fold in Poland's favour.

MP John Mann, who obtained the figures in a parliamentary question, told Sky News that "logically the UK should be receiving more than it pays out". He estimates "the real cost is a billion pounds a year". Mr Mann told Sky News: "Other countries are recharging and we are not. The figures are astonishing - we are paying them 70 times more than they are paying us. We are paying our bills and they are not paying theirs - because the British NHS is not recharging them. There is meant to be a comparable system in place - but it is not being applied in this country and that means we are losing out. Every single country is winning against us, be it the super-efficient Swedes or Germans, or countries like Malta or Greece. It's a huge scandal."

The Department of Health said: "This Government is determined to make sure our NHS isn't abused - our tough new measures to clamp down on migrants accessing the NHS are expected to recover more than £500m a year by 2018 and we're extending charges further to other parts of the NHS including A&E."

"We pay more out than we receive, partly because a far greater number of British pensioners live in other EEA countries." For example, there are 70,000 UK pensioners living with Spain. However, Sky News learned that while the UK does not reclaim A&E expenses for EU citizens - Spain is among countries that do. The Department of Health told Sky News: "It is up to each country in the EU about what health services they charge for."

Mr Mann described the pensioner explanation as a "myth". He told Sky News: "We're not sending pensioners to Poland, only 30,000 UK citizens are living in Poland. There are over half a million Poles in this country and yet we are paying four times more to Poland for health care recharges, than they pay to us. The NHS is losing out on huge amounts of money every single week."

Health tourism from outside the EU needs to be addressed too. The UK is apparently unable to check eligibility, whether that's for hospital treatment or GP visits, and GPs are actually obstructing any effort under the pretense that they are not "responsible for border control". Well, no, they aren't. They should be made responsible for checking a patient's eligibility to access NHS health care though. NHS payments to GPs could be made dependent on them providing proof of each patient's eligibility, for instance, otherwise they wouldn't get paid. If it's their own money at stake, I have no doubt that they would have no problem checking whether the people they are treating are eligible, but as it is now it's only tax payers' money they are wasting.

It's a ridiculous state of affairs and it has been going on for ages.

[skinster]

[AFAIK]

It's a ridiculous state of affairs and it has been going on for ages.

It's certainly a damning indictment of UKIP. They must be the most useless 'skeptics' on Earth.

[snapdragon]

Health tourism from outside the EU needs to be addressed too. The UK is apparently unable to check eligibility, whether that's for hospital treatment or GP visits, and GPs are actually obstructing any effort under the pretense that they are not "responsible for border control". Well, no, they aren't. They should be made responsible for checking a patient's eligibility to access NHS health care though. NHS payments to GPs could be made dependent on them providing proof of each patient's eligibility, for instance, otherwise they wouldn't get paid. If it's their own money at stake, I have no doubt that they would have no problem checking whether the people they are treating are eligible, but as it is now it's only tax payers' money they are wasting.

Everyone already has to provide a NHS number and proof of address to register with a GP, so I don't know where you'e going with this.

You're getting worked up over nothing.

[Kaiserschmarrn]

Everyone already has to provide a NHS number and proof of address to register with a GP, so I don't know where you'e going with this.

You're getting worked up over nothing.

You are wrong.

Patient registration for GP practices

The following guidance aims to clarify the conditions surrounding patient registration in GP practices. The advice applies to GP primary care services in England only.

Key point to remember

The overriding principle that applies to patient registration is anyone, regardless of nationality and residential status may register and consult with a GP without charge.

[...]

Registering without proof of identity and address

There is no contractual duty to seek evidence of identity or immigration status or proof of address. Therefore practices should not refuse registration on the grounds that a patient is unable to produce such evidence. Anyone who is in England is entitled to receive NHS primary medical services at a GP practice and applications for registration for any patient in England must be considered in exactly the same way, regardless of country of residence.

Registering temporary or permanent residents

The length of time that a patient is intending to reside in an area will determine whether a patient is registered as a temporary or permanent patient. Patients should be registered as a temporary resident if they are intending to reside in the practice area for more than 24 hours but less than 3 months.

[...]

[snapdragon]

No, I'm not wrong. You didn't bother to read the links contained in your example.
Below is from a GP practice chosen at random


https://www.drloveandpartners.com/pract ... treatment/

A person who is regarded as ordinarily resident in the UK is eligible for free treatment by a GP. A person is ‘ordinarily resident’ for this purpose if lawfully living in the UK for a settled purpose as part of the regular order of his or her life for the time being. Anyone coming to live in this country would qualify as ordinarily resident. Overseas visitors to the UK are not regarded as ordinarily resident if they do not meet this description.
[/i]

[Kaiserschmarrn]

Yes, you are wrong. As the BMA points out, there is no duty to check for eligibility. GPs can do so voluntarily, but they also have to be careful who they deny treatment.

Visitors can simply claim they are not visitors but that they have just moved into the area.

Edit: From the Home Office (2013):

Many temporary non-EEA migrants (i.e. those who come to the UK for more than 6 months) are presently allowed the same access to the NHS for free as a permanent resident. This approach is very generous, particularly when compared with wider international practice. Short-term non-EEA visitors (those here for 6 months or less) and illegal migrants also receive free primary NHS care. Whilst there are rules in place that restrict free access to most secondary care for these groups, these rules are inconsistently applied.

I will say that things seem to be moving in the right direction, at least on the surface. Some plans are outlined in the fact sheet and there has been some legislation since 2013. How effective these measures have been so far is another question of course. After all, even the restrictions that have been in place for access to secondary care, mentioned in the quote above, have turned out to be rather ineffective, and hence there has been a push recently for up-front payments of non-emergency hospital treatments.

Edit 2: On the ordinarily resident test, from the Department of Health guidance from April 2016:

In April 2015, changes were made to the way the NHS charges overseas visitors for NHS hospital care. These changes also affect some former residents of the UK. The changes were made so that the NHS does not lose out on income from migrants, visitors and former residents of the UK, who may be required to pay for their hospital treatment costs while in England.

Within England, free NHS hospital treatment is provided on the basis of someone being ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. The changes which came into effect from April affect visitors and former UK residents differently, depending on where they now live.

Treatment in A&E departments and at GP surgeries remains free for all.