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

Why are hospitals under so much pressure?

The NHS across the UK is already struggling to meet its A&E targets, and winter - the busiest time of year - has only just begun. Nick Triggle looks at why hospitals are under the cosh.

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  • rate this

    Comment number 93.

    If anyone thinks that these efficiency savings will not effect the front line then they are deluded. The savings are not coming from "axing back room staff" or managers ( no chance ), but from axing clinical posts and downgrading clinical staff. I know because I work in the NHS. So the next time a nurse does not have time to care, complain to the Tories

  • rate this

    Comment number 92.

    There is and will be progressive privatisation under the Con Libs some of it nicely slipping under the radar which is frightening.
    What many forget is who paid for training and educating the doctors, nurses and other health professionals was it the private healthcare companies or was it the taxpayer and NHS?
    Having worked in the NHS it often picks up the bill for sorting out botched private ops.

  • rate this

    Comment number 91.

    @ 90

    What other countries do is of no interest to me at all. In fact by shadowing others we end up with this merry go round of "so and so did this or that". We are capable of making our own decisions unencumbanced by the need to be mere sheep.

    The NHS is huge user of tax payer money. I don't think it is cost-effective and moreover I don't think it is fair. The least heathly benefit the most!

  • rate this

    Comment number 90.

    That last one was a bit off-topic, but I would say that smaller Govt wouldn't be a bad thing, as long as the alternative is actually better and cheaper, which in a lot of cases, it wouldn't be.
    The NHS, for all its flaws actually provides a cost effective means of heathcare. Compare us to most other "advanced" economies and you will see that per person, we spend less than most.

  • rate this

    Comment number 89.


    Obama care moved the US to a more inclusive system. Not a less inclusive one. Hence taxes have increased. Privatise the NHS and you will save £100bn+ per annum from the public purse. This is not naive, this is reality.

    The US will regret Obama-care when it fails to close its debt gap.


    The cold war may have ended, or it may have only suspended to re-emerge with new players.

  • rate this

    Comment number 88.

    See what I mean. Some real loonies out there.....
    Of course the government doesn't have "one sole object" to get rid of the NHS. You may not like them but they are decent enough people.
    Of course President Obama isn't a communist (or a Muslim or whatever crazy accusation that gets thrown at the poor chap). He is just doing his best.
    I think I'll go back to theatre

  • rate this

    Comment number 87.

    My take is that the NHS Healthcare is now a victim of it's own success
    New procedures and interventions, diagnostics, drugs etc have lead to more positive outcomes, but at a unsustainable cost, and something needs to give? even if we spent 100% of GDP, there will always be new ways of spending it? Have we(public) set expectations to high on what we expect regardless of cost?

  • rate this

    Comment number 86.

    This Government like every other Tory Govenment has one sole object in power is to get rid of the NHS and there is actually another that is to keep the gap between the rich and the poor so far apart, its very evil what they are doing focusing on the NHS yes we need cuts to help with the mess bankers of the world,

  • rate this

    Comment number 85.

    So this puddle of an article comes under the headline 'Analysis'. Unfortunately Nick Triggle misses the point, but then he is in good company. The abysmal record the BBC has in matters health is nothing short of a scandal. For a decent analysis see http://www.opendemocracy.net/ourbeeb/oliver-huitson/how-bbc-betrayed-nhs-exclusive-report-on-two-years-of-censorship-and-distorti#.UMZYqOUvFel.twitter

  • rate this

    Comment number 84.


    Who said I supported the government? Thats a pretty presumptious and self-righteous comment. I suppose you are a communist?

    I will however benefit from the tax rebate when that money gets spent in the wider economy and the multiplier effect takes hold.

    Anyhow, this diverges from the point of the debate. Which is about NHS sustainability. Which it is not.

  • rate this

    Comment number 83.


    If you think taxes would be reduced in the event of the NHS being dismantled then you are naive to say the least.

    If you think a private health care system would be better than what we currently have then take a a look at the USA. Obama-care will increase taxes more during a recession but, Obama just won an election. Why? Because they have seen the uncivilised alternative.

  • rate this

    Comment number 82.

    That was the whole point of having Trident during the Cold War, not now. Now it is just proving that the UK is a global player and possibly not relying on the US to do everything on a world stage. Now who do we need to worry about, N Korea, Iran!? I don't think their missiles will reach us.
    The danger now is much more from terrorists, Trident won't deter a fanatic.

  • rate this

    Comment number 81.

    I've just done a heart operation (coronary bypass) since my last comment. I hope that counts as reasonable use of NHS money. What comes out of what has been written whilst I was away is the way people project their own often entrenched political views from both left and right in the NHS. I am appalled by the bigotry I read from both ends of the spectrum

  • rate this

    Comment number 80.

    What about me? Do I get a nice lump sum payment, tax free as I don't have kids...so can I take the cash as I will not be using 9 months to a year in maternity leave...nor using free milk or free dentisry during my maternity leave..or using child benefit...or child care vouchers..or using the education system....I will take 20K,Or if you prefer, I will stop paying NI or tax for a while. Thanks

  • rate this

    Comment number 79.


    You hope Trident won't ever be used - that is the whole point of having it.

    I think we should be able to pick and choose for some services. I think government and the state should be smaller. I think that is the whole debate that we need to have.

  • rate this

    Comment number 78.



    Did you not see the massive tax rebate for millionaires in Osbourne's last statement?

    Did you not benefit from that?

    Shame, serves you right for supporting a Government which is only there to serve the interests of the Ultra-rich!

  • rate this

    Comment number 77.


    They don't chose to opt out though do they? They chose to opt in to another system. If we could all choose what we wanted to pay for that the government provides, we wouldn't have a society.

    Why should I have to pay for Trident if I think it won't ever be used? Why should I have to pay the wages of politicians if I think they are useless?

    We can't just pick and choose.

  • rate this

    Comment number 76.


    Why should they campaign? They choose to opt out of the state system because they want better healthcare. They should'nt have to pay twice for this choice.

    Would you pay for my fuel if you chose to walk to work. Would you pay for someone else's holiday? I think not.

  • rate this

    Comment number 75.


    Because it is their choice to "pay twice". If they think the state system is so poor then they should campaign for it to be improved.

  • rate this

    Comment number 74.

    Furthermore, I think it is an absolute disgrace that people with health insurance, or those who send their children to private schools for that matter, do not receive a rebate on their tax bill. Why should they pay twice?


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