Government’s ‘flimsy notion’ of 7-day NHS condemned

Already under fire over his dispute with junior doctors, a report investigating the introduction of a “seven day” National Health Service will make tough reading for health secretary Jeremy Hunt.

The drive to create a seven day NHS, a Conservative Party manifesto commitment, has led Hunt to impose a new contract for junior doctors that reduces premium pay rates for weekend work.

This contract has sparked a dispute with the British Medical Association that has run since autumn and led to junior doctors striking for two days last month.  They say the plans are neither safe nor fair, and will take the already over-stretched workforce to breaking point.

Even though spending on the NHS will increase by £10 billion by 2020, it has been asked to make efficiency savings of around £22 billion, while also introducing the seven day NHS in attempt to ensure services can meet demand every day of the week. For 2015/16, the NHS budget was around £116.4 billion.

But the House of Commons Public Accounts Committee (PAC) in its report on supply of NHS clinical staff said there had been “no coherent attempt” to assess the workforce numbers needed for policy initiatives such as the seven-day NHS.

It said that the seven-day services have not been properly costed, workforce needs have not been assessed and that the £10 billion extra is expected to “cover everything”.

The PAC asked Hunt to report back by December with a summary of workforce implications.

The Committee said hospitals and NHS organisations facing “unrealistic” efficiency targets had attempted to cut costs, by reducing the number of staff in post – but this had led to gaps that had been filled by costly agency staff and increased spending.

It highlighted issues such as retention of existing clinical staff and an ongoing shortage of nurses that is expected to continue for the next three years. The PAC is also concerned that the abolition of nursing bursaries, which could deter mature students from applying to train to join the profession.

The report from the PAC follows a grilling for Hunt and NHS chief executive Simon Stevens from the separate Health Committee earlier this week, where they were asked questions on funding of the NHS.

There was also a discussion about evidence questioning the existence of a “weekend effect”, when more patients die because of lower staffing levels on Saturdays and Sundays.

Questioned on Monday about the bursary changes by the Health Committee, Hunt said he would “make sure the financial package of support is attractive so that we don’t have a negative effect.”

Hunt added that the NHS was on track to make savings on use of agency staff. He said spending on agency staff had increased from £2.5 billion to £3.76 billion in the last three years, but had begun to fall since October because of spending controls.

PAC chair, Labour’s Meg Hillier, said in a statement: “Taxpayers are being asked to accept uncosted plans for a seven-day NHS – plans which therefore present a further serious risk to public money.

“It beggars belief that such a major policy should be advanced with so flimsy a notion of how it will be funded – namely from money earmarked to cover all additional spending in the NHS to the end of the decade.”

Related stories:

Health secretary unswayed by “weekend effect” research as doctors talks resume

England’s doctors agree to five-day pay dispute truce

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