News / Investment in capital and revenue at heart of confederation proposals

Speaking to the representative body’s annual conference this week, confederation chief executive Matthew Taylor (pictured) said that the austerity decade had delivered half the growth that the service needed over that 10 years. As a result, the NHS went into the Covid-19 pandemic ‘already vulnerable’, with 100,000 vacancies and a crumbling estate. ‘We know that Covid hit us harder than it hit other health systems because of that,’ he said.

‘So we are going to need a decade of adequate revenue funding to be able to make up for that,’ he added. While estimates suggest the NHS has fallen ‘about £40bn’ behind other countries in terms of funding, he said the situation with capital was even worse. Capital was consistently half that of the OECD average throughout the 2010s, despite a huge backlog maintenance requirement and the need to invest in digital.

Mr Taylor said the lack of capital investment was a ‘huge barrier’ to innovation. And he added that the imminent workforce plan would also need to be properly funded.

He said the increase in funding needed to be accompanied by four other shifts that would carry the NHS into the next period with real confidence and the service’s 75^th birthday was the perfect opportunity to mobilise behind a shared vision for the NHS.

The other changes included the development of a health strategy rather than just focusing on policies for the NHS. The country had become sicker and poorer and problems needed to be tackled outside the NHS, with changes needed in social care and action to support healthier lifestyles and to tackle the social determinants of health.

He also called for real progress in moving investment upstream into primary and community care and into preventative services. The NHS was caught in the hamster wheel of meeting demand when it presents itself at the front door of the hospital, he said. This investment was not happening – while there are more hospital consultants, there are fewer GPs, he said.

The service should be made accountable for delivering this shift in resources and there should be support for practical initiatives that are starting to make it happen.

His final two changes were for greater downwards accountability and for a new social contract with the public that empowered them more to manage their own health.

Earlier NHS chief executive Amanda Pritchard also called for patients to be given more control over their own care, something she said patients were keen to do. And she highlighted the development of more integrated care as an opportunity to tackle some of the wider determinants of health. ‘The NHS can't create a healthier country on its own,’ she said. ‘The vast majority of what determines someone’s health happens way beyond the reach and remit of the NHS.’

‘It's only partnership working locally and nationally that will deliver what we all want to see, which is people living longer, healthier, and happier lives, spending more time at home and less at hospitals,’ she added.