Cash worries 'could harm drive to improve NHS care'

Nurse The Nuffield Trust is concerned money worries could undermine efforts to improve care

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Financial pressures could get in the way of the drive to improve care following the Stafford Hospital scandal, experts say.

Figures released last week showed nearly one in three NHS trusts is forecasting a deficit this year.

Now a review by the Nuffield Trust - published a year on from the Stafford public inquiry - said money worries could hamper efforts.

The warning was echoed by inquiry chair Robert Francis QC.

He criticised what he saw as the "oppressive reactions" of the system to hospitals that ran into trouble with budgets and hitting targets.

He said hospital leaders needed to be "frank" about whether they could provide high-quality care with current levels of funding.

"It is unacceptable to pretend that all can be provided to an acceptable standard when that is not true," he added.

'Safety and quality'

Mr Francis was responding to a report by the Nuffield Trust based on in-depth interviews with 50 staff at five hospitals and online feedback from chairs and chief executives of 53.

Many reported they were taking action to improve care, but their overwhelming concern was that the state of finances was going to harm their ability to succeed.

One hospital chairman said: "The one good thing Francis has done, the really good thing, is that it has ensured that safety and quality have become more prominent - that's really important.

Start Quote

Things are moving in the right direction. I believe people working in the NHS have a real appetite for change”

End Quote Julie Bailey Cure the NHS

"But I am left with a real concern about the doability of it all and the need for us to find a way forward."

But despite these concerns, Mr Francis said he was pleased with the reaction to his report, published exactly a year ago, as many of his recommendations had been accepted.

"The strong message sent out to the health service by government was that important and fundamental change was required," Mr Francis said.

But he added that this represented "only a start" and that the emphasis on quality of care needed to continue.

Julie Bailey, founder of Cure the NHS, the campaign group that led the calls for the public inquiry, said she was disappointed the government had not agreed to full regulation of healthcare assistants, as the Francis Inquiry had recommended.

But she added that overall she was pleased with the progress being made.

"Things are moving in the right direction. I believe people working in the NHS have a real appetite for change."

The publication of the report came after Health Secretary Jeremy Hunt praised the "Francis effect" in a speech to NHS staff in London on Wednesday.

"Twelve months on, we cannot expect to have solved everything or have completely transformed the culture of the country's largest and finest institution.

"But we have seen a real shift in priorities - new inspections, more nurses and a stronger voice for patients with compassionate care starting to replace tick-box targets as the major focus on boards and wards."


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  • rate this

    Comment number 315.

    Swing Lowe 313. Worrying about financing the NS when tax dodgers swindle the country out of £100 BILLION a year is the madness of Thatcherism and it should have been burned when she was.

  • rate this

    Comment number 314.

    @305.Sally the Rothbardian
    'Why should I flee your greedy hands because I live here?'
    Your attitude to personal greed is the problem that faces most of our society. Ppl who think they deserve 100K + saleries are nothing but leeches on society and not the wealth creators that the Tories claim as most pay minimum wage and expect the goverment to top it up to living wage.

  • rate this

    Comment number 313.

    Sadly the NHS is being dragged into the post Thatcher era kicking & screaming & with its historical state protected status, its a all a bit of a shock to the system, this new era we live in has become a bit of a surprise to those who were doing very nicely sitting back & letting cash flow through the system with impunity, they are now accountable and having to work for a living & they dont like it

  • rate this

    Comment number 312.

    Sally the Rothbardian = Laser eye surgery Spam

  • rate this

    Comment number 311.

    A huge part of the NHS budget is delivered by the private sector. The NHS does not make medical equipment, ambulances, uniforms, drugs etc, hospitals are built by the private sector, and many of the consultants are private and some run private clinics in parallel. As long as genuine healthcare (not spurious subjective stuff) is free at the point of delivery, Should it matter who provides it!!??

  • Comment number 310.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 309.


    "End of
    No argument
    Discussion over

    We will NOT accept privatisation of the NHS"

    Well they passed the white paper into law which pretty much allows a large section of the NHS to be privatised. I marched against this, I signed petitions, I wrote to my MP. I agree there probably won't be an argument or discussion, it will just happen piece by piece anyway whilst commercialism & apathy reign

  • rate this

    Comment number 308.

    @306. Drug companies sell their medicines to hospitals at a discount because the use there influences what GPs prescribe. The cost at the local pharmacy is full price. Two prices to the one NHS. Drug companies sell their medicines to GPs who dispense medicine. GP makes a profit on what he prescribes - incentive to use one drug over another.

  • rate this

    Comment number 307.

    Wait until you need real health care, Sally.
    I've seen the corrption in the US 'health system' first hand.
    They will literally bleed you financially dry, make you pay for totally unnecessary 'care', and then put you in a cab to nowhere to end up on the sidewalk to die when you've no more funds or insurance.

    I used to work for Bupa, Sally.
    I know.

    For whom the bell tolls, eh Sally ?

  • rate this

    Comment number 306.

    Here is a big way to cut NHS procurement costs: make it illegal for suppliers to charge the NHS any more than other customers. Many ordinary thing s in NHS hospitals cost double what they do on the high street. Make this law retrospective for 5 years and see the cash pore in!

  • rate this

    Comment number 305.

    Lasik eye surgery is not covered by the NHS, and every year it gets cheaper and better. Once only affordable by the wealthy, now average people can afford it, and still its prices fall.

    The opposite is true for the NHS because it doesn't receive the same incentives inherent in what it fears; competition. Our government insultingly assumes consumers, you, are too incompetent to make choices.

  • rate this

    Comment number 304.

    301 Adam C
    Of course and I would expect them to pay for their healthcare as I would pay for mine, if someone is a victim of negligence I would expect he who was negligent to pay for it. Lumping everyone together of all different circumstances is the issue I am objecting to.

  • rate this

    Comment number 303.

    296: the bloke
    You omitted the reason for the massive redundancy payments and re-employment costs. One Cameron who 'won't reorganise the NHS' and immediately did just that.
    The persecution of whistle blowers is not an NHS problem alone. My medium size employer shoots the messenger as well.

  • rate this

    Comment number 302.

    Publicly funded organisations always want more money. In fact, individuals and families all want more money. It is the way of the world, but there has to be a limit. We can only spend what we earn. What must be stopped ruthlessly is the gold-plated salaries and pensions paid out to top level "administrators" and so-called managers. This is where the NHS is wasteful.

  • rate this

    Comment number 301.

    295 Eat the Path

    Have you never heard of anyone who exercises and looks after their body becoming ill? Or perhaps no innocent has ever been injured in a traffic collision or fire? It must be nice in your purely karma ruled world but if you would like to join the rest of us on planet earth you might just open your eyes and see that bad things happen to all people.

  • rate this

    Comment number 300.

    295 - Eat the Path. "...look after those who didn't......"

    Far to big a paintbrush - more likened to a yardbrush methinks.

  • rate this

    Comment number 299.

    And for the more evil of you who think that privatisation of services including the NHS will be some sort of 'ethnic cleansing' of the poor and 'chavs' . .

    No . . since many will have kids before they get ill.

    And even if they are sent to prisons or work camps . . or war . . someone has to pay.

    No, privatisation results in the middle classes paying more and the rich profiting

    A slight of hand

  • rate this

    Comment number 298.

    It's a pity that your idea of freedom is: pay for my healthcare Sally, or leave. Why should I flee your greedy hands because I live here?

    Wanting individual choice in healthcare is "right wing"?
    You must be using AC's "dictionary".

    I read your non-apology. I'm sorry you must insult those who disagree with your questionable interpretations of definitions.

  • rate this

    Comment number 297.

    Sally, i have zero choice in which royal family i fund, if any and the NHS contributes a damn sight more to british society than any blue-blooded parasite. Grow up. Choice is capitalism's biggest lie, it doesn't increase competition or improve quality and always tends towards monopoly, look at News Corp's media domination for instance and there's no bigger free marketeer than Murdoch.

  • rate this

    Comment number 296.

    //Kitty NHS has cash worries... funding gets cut, yet they're supposed to have better service whilst meeting targets..//

    That might look convincing if it wasn't for stories like this....

    Money isn't the problem. NHS staff greed and incompetence are.


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