Billions squandered as the NHS fails to deliver

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A comprehensive, high-quality NHS will not be achieved unless issues Britain's growing obesity crisis is tackled, an influential report said today.

Sir Derek Wanless, commissioned by the then Chancellor to review the NHS in 2002, is regarded as the architect behind the £43 billion increase in health service annual budget over the past five years.

But in a damning report today, he says the huge increase in cash has been swallowed up by poor productivity, IT delays, and Britain's worsening obesity crisis.

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Sir Derek Wanless: NHS money has been squandered by Gordon Brown

The revelations come as the health secretary says patients should be able to get basic NHS care at schools, chemists and sports centres instead of having to go to GPs' surgeries.

Alan Johnson will say people with minor complaints are being let down by the inconvenient opening hours of GPs and he wants them to open at weekends.

In a speech that will anger family doctors tomorrow, he will say: "It is an anomaly that surgeries open as the nation starts work and close when we finish. In the 21st century, halfday closing seems incongruous and we should be able to see a GP at the weekend.

"We need to ensure there are more routes into primary care, including high street pharmacies, schools, sports centres or walk-in centres."

GPs secured a deal in 2004 which allowed them to give up out-of-hours work for a minimal drop in pay.

A patient survey carried out for the Government showed eight out of 10 people were happy with GP opening hours.

But in a report for the King's Fund, an independent charitable health foundation, Sir Derek Wanless says the NHS is far from delivering first-class healthcare.

He warns the health service will continue to require huge cash injections over the next two decades unless action is taken.

He states: 'Such an expensive service could undermine the widespread political support for the NHS and raise questions about its long-term future.'

In a move that will once again re-ignite the row over GP and consultants pay, Sir Derek questions the value of the huge rises handed out by the Government in the last contracts negotiated between 2003-4.

He says: 'There is little robust evidence so far to demonstrate significant benefits arising from the pay deals.'

The 300-page study will acknowledge that good work has been done to reduce waiting time and combat killer diseases.

Sir Derek will also state there have been improvements in the nation's overall health, with increased life expectancy, a fall in the mortality rate and a drop in the number of smokers.

But the gap between the health of the rich and poor has widened as Britain's obesity epidemic continues to worsen.

Current forecasts predict that 33 per cent of men, 28 per cent of women and one in five children will be obese by 2010.

A 2002 report into the NHS, compiled by Sir Wanless, proposed a huge increase in NHS spending, then running at £68 billion a year, to £184 billion by 2022.

As part of the huge cash injection, the health service was required to make productivity improvements.

Today's report states that the NHS has failed to deliver on those targets, with costs rising across all hospital services.

Doctors pay rises represent one of the main cost pressures. The average pay for GPs is now over £100,000.

The Public Accounts Committee urged the Government earlier this year to pull the plug on the crisis hit £20billion NHS computer project before it wastes any more taxpayers' money.

The programme is two years behind schedule and doubts over the National Programme for IT are rife among NHS staff.

Scrapping the project which started four years ago would lose the £2billion spent so far, but save billions more.

The official final cost of the project has spiralled from £6billion to £12billion – but experts think it will be £20billion because of continuing delays.

Britain's growing obesity crisis could become a serious problem for the NHS

OBESITY

Labour's failure to tackle obesity could bankrupt the NHS, Sir Derek warns. Despite Government targets to reduce the number of people who are dangerously overweight, the situation is spiralling out of control.

When Sir Derek published his 2002 report the Government planned to cut obesity rates by 2005 to just 6 per cent of men and 8 per cent of women. But these targets have been dramatically missed.

Now 23 per cent of men are dangerously overweight - double the figure a decade previously - while the proportion of obese women rose by 43 per cent to a quarter of the female population. Rises among children are even steeper, with almost one fifth of all children categorised as obese.

If the trend continues, as expected, a third of men, 28 per cent of women and more than 20 per cent of children will be obese by 2010.

Sir Derek says: 'It would be wrong to hold the NHS responsible.' But it means figures are at a much worse level than the most pessimistic estimate.

DOCTORS' PAY

Doctors have benefited hugely from increased salaries over the past few years but there is next to no evidence this has led to improvements for patients, says the report.

In 2002 Sir Derek called for above-inflation pay increases for NHS staff, but said they should be phased in over several years.

Instead, the Government negotiated new contracts with doctors and nurses which led to massive 'big-bang' pay increases.

Consultants now earn 25 per cent more than they did only three years ago, while GPs have enjoyed a 23 per cent increase. Nurses and other NHS staff are also paid more, costing the NHS an extra £1.8billion a year.

But while the new contracts have reduced vacancy rates, Sir Derek concludes: 'There is very little robust evidence so far to demonstrate significant benefits arising from the new pay deals.'

Across the Health Service, productivity has fallen by as much as 7.5 per cent since budgets were increased.

HOSPITAL CLOSURES

Badly planned changes to hospital services could put patient safety at risk, Sir Derek warns. And there is little evidence that the raft of closures and mergers being proposed will benefit patients.

NHS chief executive David Nicholson has called for at least 60 closures of A&E departments and maternity units. The Government wants to see more people being treated at larger regional specialist hospitals, with smaller departments at district hospitals closing.

But Sir Derek warns that there is a danger that any changes made to hospitals would mean the NHS would be unable to adapt to future, unforeseen changes in health needs.

HEALTH POLICY

Too many changes are rushed in without adequate preparation, says Sir Derek. This has led to poor-quality services, such as the telephone helpline NHS Direct, under fire for the standards of advice it offers.

Sir Derek found it had been introduced before the results of pilot studies, which could have helped iron out some of the problems, were available.

Reform of the NHS IT systems has been botched and the Health Service has been though 'a damaging reorganisation', which has seen the number of primary care trusts slashed from 303 to 152 and strategic health authorities cut from 28 to 10.

He also says the Government is too slow in dropping its target-culture in the NHS.

 

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