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 335.

    @316Sally the Rotsbottom
    The USA has the highest standard of healthcare ONLY IF you've the wealth/insurance to pay for it.!
    And YES ! Until recently people were put into cabs when they run out of means, and many died on the streets.
    And YES ! Corruption: Scorpion Antivenom cost Up To $12,467 Per Dose in USA - $100 in Mexico.

    Don't take it personally, Sally.
    We all have the choice to think.

  • rate this

    Comment number 334.

    End the BBC license fee now and use the funds to save the NHS.

  • rate this

    Comment number 333.

    Rothbardian nonsense won't save our NHS from the clutches of Jeremy Hunt.

  • rate this

    Comment number 332.

    In the building-trade a "hospital job" is one where you can charge what you want and take forever.
    We hear of hospitals paying £50 for a lightbulb.

    Ditch the suits, and ESPECIALLY the idiots who actually spend £50 of our money on a lightbulb. Also ditch private involvement - leeches are one thing but these parasites are scum.

  • rate this

    Comment number 331.

    would i rather the people providing my medical treatment were motivated by an effective provision of service or by profit for shareholders? I'd rather a doctor than a mercenary. Would I like free and easy service at the point of use or a wrangle with the equivalent of my car insurer's were i suddenly to become ill? Would i be happy for G4S to deliver my children? It's really just common sense.

  • rate this

    Comment number 330.

    NHS healthcare in the UK is NOT private; provision of food, clothing, cars and fuel are. People are muddying the waters with the word 'Privatisation' (probably for political reasons) and are confusing who provides healthcare with who pays for it.

  • rate this

    Comment number 329.

    This dog of an incompetent Govt is applying the principles of divide & rule to the NHS, and their ideology of privatisation of Profit, and the nationalisation of DEBT, means that they get great Press in their Media friends that are overflowing with bile, and looking after its friends in the Private sector who are making loadsa wonga out of the NHS from the contracts it is awarding them!

  • rate this

    Comment number 328.

    "Sally = Examples that competition in healthcare works"
    Thanks! :D

    Why shouldn't you pay for my Lasik eye surgery?

    It's a pity both of your stopped reading the comment after that sentence. The USA is not a free market in healthcare, and they suffer accordingly. Lasik eye surgery shows the fruits of competition, and we benefit accordingly.

  • rate this

    Comment number 327.

    Can we have a society that cares for one another properly instead of always making it an economic arguement? People working in the NHS surely have a right to good conditions and pay, with the obvious responsibility to the people in their care.
    Can we not manage that without all the wrangling over finance. Compassion from ALL of us, whether in the NHS or not, may be better at finding a solution.

  • rate this

    Comment number 326.

    Sally the Rothbardian
    2 Minutes ago

    The USA has the highest standard of healthcare because it has a shred of competition.

    In fact there is a survey commissioned by Bloomberg in Aug 2013. Showing that out of the best 48 healthcare systems the U.S.A came 46th.

    Also it is the 2nd most expensive only in Switzerland healthcare costs are greater

  • rate this

    Comment number 325.

    @316.Sally the Rothbardian
    'The USA has the highest standard of healthcare '
    Only if you are rich, if not it's worse than a third world country. Must be nice to have so little compassion. I suppose you want to adopt the system that some states in the US have for fire fighting so you have to pay the fire fighting service fee, if not they will watch your house burn.

  • rate this

    Comment number 324.

    320 Adam C

    I'd expect them to sensibly use the money they save from not being taxed to purchase health insurance. If they require more, they can appeal to charity.

    I would ask you to consider all those currently on minimum wage who are forced to pay for everyone else. Do you think it's right and fair for those who can barely afford it to pay for the smoking related cancer treatment?

  • rate this

    Comment number 323.

    There is one great solution. NHS v BBC. Do we really need to publically finance a TV company. Remove the license fee from the BBC and use it tofully modernise the NHS. It's not that we are every going to see auto-cue readers or heads of programming on the streets. The BBC are soooo liberal left wing these days that I bet even they would support such a move.

  • rate this

    Comment number 322.

    is hit by
    1) to many living longer - so why deal with obesity or other such diseases. I mean im fat and pay large amount taxes so that means if i die young i dont get a pension or cost anything as i wont live to old age.

    2) Immigration
    and to say they are younger - well thats means they can have children which means NHS usage.

    No to immigration - cheap border system

  • rate this

    Comment number 321.

    Much of the NHS is already at least part-privitised - because of 'cash worries'.
    A nice private company with lots of money comes in with all these promises and then ramps up the return payments like a loan shark or fails and jumps ship like that rail company/banks.

    It's disgusting but I fear it's too late now.

  • rate this

    Comment number 320.

    304. Eat the Path

    Imagine an innocent, healthy, law abiding person caught in a fire, severely injured, unable to pay because they are on the minimum wage. The fire was caused by an electrical storm so there is no one to blame. Are they condemned to a slow painful death by you?

  • rate this

    Comment number 319.

    Your health is only another govt. cash-generator.
    So they meddle with the NHS, Education etc. and run them down via the media.
    They are then sold cheaply to friends for backhanders, generating profit for all in on the scam whilst excluding the poor from healthcare/education. Or to put that another way, "Privatised".
    There is a running example of this called America if anyone needs verification

  • rate this

    Comment number 318.

    The people of Stafford are clear about what they want. 50,000 demonstrated in town last year to show their support for Stafford DGH and to protest against vital services being moved to Stoke (20 life-saving miles away) and cuts.

    Not much media coverage then. Julie Bailey is playing right into the Tories and private healthcare's hands.

    The struggle goes on. Fight the cuts.

  • rate this

    Comment number 317.

    This dog of an incompetent Govt is wrecking the NHS - with more & more targets being set & fudged just to please Ministers, and taking short cuts, will lead to a bombshell of litigation against the NHS, and diverting vital resources to unproductive duties, whilst this Govt is looking after its friends in the Private sector at the expense of the NHS. This Govt is addicted to DEBT!

  • rate this

    Comment number 316.

    The USA has the highest standard of healthcare because it has a shred of competition, and patients aren't thrown on the street if they break a leg without insurance. However, their system is dominated by a cartel of crony alliances between Big Pharma, the AMA union, and the big insurers.

    Attacking me, because I also decry that non-free market system, is bizarre. "DING DONG" indeed.


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