Why do the NHS savings matter?


It is easy to be lulled into a false sense of security about NHS efficiency savings.

The doors to GP surgeries and hospitals remain open and, come what may, patients always seem to get treated - eventually.

In fact, the very term itself sounds rather innocuous.

But make no mistake: how the NHS fares in the next few years in achieving its £20bn target will go a long way to determining what sort of health service the country has in the future.

If it does not achieve what it needs to it will be patients who suffer.

The £20bn figure equates to a saving of about 4% a year until 2015. That is unprecedented for a health system.

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Despite the NAO [National Audit Office] calling it the first year of the savings, the health service has still had plenty of time to prepare for the savings drive”

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If the NHS does not become more productive it will simply have to cut what it does to cope with the rising demand from factors such as the ageing population and obesity.

And what is worrying about the National Audit Office (NAO) report - despite the praise for the good progress that has been made to date - is that there are signs this could be starting to happen.

The watchdog found evidence of rationing in areas such as cataract surgery. The tactic, which involves making patients wait until their eyesight deteriorates further before they get treatment, makes a huge difference to an individual's quality of life.

As does the trend - noticed by orthopaedic surgeons - of leaving patients in pain for longer before they are entitled to hip or knee replacements.

Public Accounts Committee chairman Margaret Hodge - like many monitoring what is happening - is worried about what lies ahead.

Responding to the NAO report, she urged the Department of Health to be careful that the efficiency drive did not lead to the NHS "shutting the door" on patients.

But what makes the watchdog's findings even more startling is that despite the NAO calling it the first year of the savings, the health service has still had plenty of time to prepare for the savings drive.

NHS chief executive Sir David Nicholson first proposed the target three years ago and told the NHS to start looking for them in 2010-11 - the last year in which it got a significant increase in its budget.

That is why inside the health service the alarm bells are ringing loud and clear.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 73.

    I used to get annual forms to fill in from the local Primary Health to "list all complaints made (by patients)" and describe the procedure in place to deal with them. There were no complaints, and if there had been I'd have dealt with them personally. I wonder if such systems exist to complain about the pen pushers and their political masters?????

  • rate this

    Comment number 72.

    The NHS should be abolished. It has been flawed from the start and is a huge waste of taxpayer money. Not only that it contributes to a social attitude toward personal health that is irresponsible.

    Health insurance and lower taxes with a safety net for the poorest and a publicly funded 24hr A&E service is the only viable solution in the long term.

  • rate this

    Comment number 71.

    I worked in/for the NHS for over 30 years and it was always a black hole for wasted money caused largely by inefficient pen pushers and box tickers.
    I always find it astonoishing that the breed which has proven itself to be so untrustworthy (politicians) have no faith in our professionals(teaching, health et al) and feel the need to measure, monitor and endlessly reorganise.

  • rate this

    Comment number 70.


    'NHS Manager now on third break in two hours.'

    and this is your comment number 5 in the last 4 hours. I can see how to make the NHS more efficient - take your PC away and get you doing some work!

  • rate this

    Comment number 69.

    "the rich MUST be taxed properly"

    Sorry, but I always wonder what is ment by such phrases, how much must someone have or earn to be rich (by your definition) and what is taxed correctly (10%, 50%, 100%?). The meanings of such a phrase is ambigious & depends on personal view not.

  • rate this

    Comment number 68.

    "exists to serve"
    Our Government?

    As our society 'exists to serve money' (the customer), so our government 'exists to reflect votes' (our priorities)

    If our votes are 'directed' by restricted 'offerings' from competing elites, 'priority' is accepted (in the market & the hospital queue) for 'our elite'

    Democratic "public good" can be 'known' only by a free people, in Equal Partnership

  • rate this

    Comment number 67.

    "losing front-line"
    £-divided & £-ruled

    With pensions set to rise with inflation, & final salaries set to fall in real terms, many 'timely' senior departures, without front-line replacement, and worse with loss of cultural capital, not just for development but for defence

    So, residual staff over-loaded, & at mercy of chaotic 'reforming' management, holistic care soon not even a memory

  • rate this

    Comment number 66.

    I worked in/for the NHS for over 30 years and it was always a black hole for wasted money caused largely by inefficient pen pushers and box tickers.
    The real NHS (the nurses, doctors, consultants) would feel like tearing their hair out as each new band of nonsense rules appeared, making everything worse, not better.

  • rate this

    Comment number 65.

    Now MUST be a good time to stop giving the obese gastric bands or similar surgery. In a few years time these people will be suing the NHS for the long-term harm caused from such drastic intervention. It's a quick fix without hope, when they suffer malnutrition & other associated health problems. Save money by sending them home with a diet sheet, TODAY.It's their choice&Obesity is not an illness.

  • rate this

    Comment number 64.


    Don't try and reason with Flomp!

    As an obvious Tory voter, he clearly has no reasoning powers at all! Everyone knows there have already been massive cuts in the NHS, and there will be plenty more under this loathsome Government, but in the fairy-dream-land of the Cameron supporters, all is fine!

  • rate this

    Comment number 63.

    The left seem to be in dream land.
    Some people who live in the real world have to sort out the mess left by their comrades in La La Labour.
    The austerity and reform will goon or sometime and the net result will be positive, especially for our children. The small pain now will pay benefits for future generations.
    The public sector have to be mature and responsible with OUR money

  • rate this

    Comment number 62.


    my post 55 was badly written. The point I wanted to show was that the 4% saving in the story = infalation %, If this % is so small that budget savings can maintain service then your post 32 is not appropriate. If however you stand by it then to make up the loss of purchasing power due to inflation you will need to say where the extra £ come from.

  • rate this

    Comment number 61.

    NHS Manager now on third break in two hours. Must be such a hard job.
    Gone Xmas shopping.
    If feel so disempowered and depressed.

  • rate this

    Comment number 60.

    Immigrants who have no status in this country should NOT be given NHS treatment. We should STOP spending £millions per day on Europe and international aid. The corporate and the rich MUST be taxed properly. GPs must RESTRICT appointments for those who are not "ill" - i.e. have finger ache or a cold. Antibiotic prescribing for colds MUST stop as they are completely ineffective for this illness.

  • rate this

    Comment number 59.

    Efficiency is relative, as are targets, to setters: are they representative?

    So far from democracy, spoiled inheritors of the priceless: what to expect?

    We leave our children to re-build, if time allowed to re-dream

    Society atomised by greed, oil gone, nuclear-dependent

    In fear, just one hospital, just one patient, 'alive' at all cost

    Equal Partnership not spurned: never thought of or offered

  • rate this

    Comment number 58.

    Surely the Government already knows how NHS costs compare with other health services and that is why a figure has been found for the amount of money which needs to be cut?

  • rate this

    Comment number 57.

    The NHS has undergone several major reforms in the last 20 years, with the current govt pushing through the biggest one yet, which virtually nobody wants. I've heard several staff remark that things have only recently settled down after the last shake-up and now it's all going to be different again. How on Earth can any organisation be efficient under those circumstances?

  • rate this

    Comment number 56.

    The NHS could say an awful lot of money. My partner had to have 3 CRB checks in 1 year, twice becuase she moved jobs within the NHS and once because her employer changed its name.
    She also had to waste a day of training learning how to move infim patients out of their beds in case of an emengency evacuation. She is a clinical psychologist who didn't even work in hospitals.

  • rate this

    Comment number 55.

    "I think their idea is not finding extra but 'save,' i.e. cut, so budget searching doesn't seem to figure"
    Allowing for inflation? Without extra £ for inflation less can be purchased (services or materials) so it is a tight line to walk or the 4% saving topic you that you rally against ist balancing inflation rate. That in turn negates the point in your posts 32 about the gov.

  • rate this

    Comment number 54.


    37 "The Govt have just cut their funding, leaving NHS Trusts to sack staff left, right & centre" - This is utter nonsense'

    Ermmm no, it isn't. I am sitting here with colleagues who are awaiting interviews tomorrow in our Trust which will determine which 4 staff out of 17 will have a job come April - and we aren't managers.....


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