NHS needs £102bn funding increase, economists and doctors warn

The NHS requires ten years of funding increases amounting to £102 billion over the decade if it is to continue to provide an effectivce service.

This is according to a critical evaluation performed by the London School of Economics (LSE) and Medical Journal the Lancet.

Among seven key recommendations made by the experts was a proposal for at least a 4% real-terms raise in funding each year over ten years.

“For many decades, the NHS was the envy of the world, and it remains one of the most comprehensive and equitable healthcare systems in the world. But for the NHS to be truly the envy of the world again, politicians will need to be honest with the public that this will require increased taxation to meet the funding levels of other comparable high-income countries,” Co-Chair of the joint Commission, Professor Elias Mossialos of the LSE, said.

Since 2010, improvements in life expectancy in the UK have slowed and the health of the nation now lags behind many other developed economies across the EU15 and G7. The experts pointed to government policy, especially austerity, as a leading factor in this decline and noted that the relatively high socioecononic inequality in the UK compared with comparative nations has given rise to increasingly marked health inequalities too.

“Given the major role of social circumstances in health inequalities, such as housing, employment, education and environment, it is crucial that this extra funding for the NHS and social care doesn’t come from cuts to other public services and welfare budgets.”

Co-Research Lead, Dr Michael Anderson from the LSE, added: “Without concerted action and increased funding, we risk the UK falling further behind other high-income countries in health outcomes and life expectancy, continued deterioration in service provision, worsening inequalities, increased reliance on private funding, and an NHS that is poorly equipped to respond to future major threats to health.”

“The NHS is under our custodianship and we have a responsibility to current and future generations to secure its long-term survival.”

The experts, who comprise 33 leading research, policy, management, and clinical experts from across the UK, said major reorganisations of the NHS should be avoided and the focus should instead by on investment, the integration of services, disease prevention, and reducing health inequalities.

“The NHS has been a world leader for universal health coverage for over 70 years, providing care based on need, not ability to pay, for over 66 million people from cradle to grave”, Co-Chair, Professor Alistair McGuire of LSE, said.

“It was envisioned as one element of a comprehensive welfare system, but decades of costly reorganisations, years of austerity, extreme cuts in funding to social care, and an erosion of public health capacity have widened inequality and left the NHS under-resourced and ill-prepared for the COVID-19 pandemic.”

Underfunding and poor pay has led to massive shortfalls in staffing levels, with around 200,000 vacancies across the NHS. The weaknesses that have emerged due to under resourcing have been exposed by the pandemic, the experts said.

“During the pandemic, the NHS has struggled in the face of poor decision making by government, including delayed implementation of social distancing measures, poor coordination with local authorities and public health teams, a dysfunctional track and trace system, and a lack of consultation with devolved nations”, Co-Research Lead, Dr Emma Pitchforth from the University of Exeter, said.

“Staff morale is at rock bottom because of real term pay cuts and the relentless workload, and the pandemic will leave a challenging legacy of additional mental health needs, a growing backlog of people waiting for elective care, and extra support needed for those living with the after-effects of COVID-19. The pandemic has also laid bare stark socioeconomic and racial inequalities in the UK, and the catastrophic consequences for health.”