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Redundancies, recruitment freezes and service cutbacks – these are the early signs of the impact the economic crisis is having on the UK’s health service, according to a BMA survey of doctors released today (27/6/10).
Launched on the eve of the BMA’s annual conference, where NHS finances are likely to dominate doctors’ debates, BMA research shows that, despite reassurances that front-line services will be protected, many NHS organisations are already taking actions which could have devastating and long-lasting consequences for the NHS.
The survey of local negotiating committee1 (LNC) chairs found:
- Around one in four respondents (24%) said redundancies were planned in their organisation. Redundancies planned are for the most part non-clinical and overwhelmingly non-medical.
- Almost two thirds of respondents (62%) said that there was a freeze on recruitment. Seventy per cent of respondents reporting a freeze indicated that it covered medical posts and 80% that it applied to nursing posts.
- Just over half (55%) of those with no explicit freeze indicated that there were unfilled vacancies.
- Nearly three quarters of respondents (72%) indicated that clinical service or infrastructure developments were being postponed for financial reasons and two in five that access to treatments or therapies was being limited.
- Just under half (45%) of responding LNCs were being consulted on cost and efficiency savings. The amount of savings being sought varied considerably around an average of just under 6%.
Commenting on the research, Dr Hamish Meldrum, Chairman of Council at the BMA, said:
“Whilst we accept that difficult decisions need to be taken in this tight financial climate, there is a real danger that cutting back on health now will have a long-lasting impact on our ability to maintain high-quality, comprehensive and universal care in the future.
“Despite the government’s best assurances that front-line services will be protected, our data show that cuts are already being planned or becoming reality and that these will have an impact on doctors’ ability to care for their patients.
“Even changes to back-room functions or administrative processes have consequences for front-line staff who, in many cases, may have to pick up the work themselves; this means less time for patients.”
Although the NHS is guaranteed growth in spending, in real terms, this is likely to be minimal and efficiency savings still have to be made. NHS trusts are already under pressure to make their funding go even further, eliminate waste and improve on productivity. The BMA accepts the need to be realistic and involving clinicians and local populations in decision-making is key.
Dr Meldrum added: “There may well be areas where there is a genuine need to examine ways of working and services being offered to ensure they are delivered in the most cost-effective manner. But all too often we see blanket bans, indiscriminate cost-cutting and decisions seemingly taken for political and financial expediency rather than because of good clinical evidence.
“Patients, local populations and health professionals should be actively involved in decision-making processes involving change and there should be genuine devolution of decision-making to the local level. We urge the government and NHS organisations to focus on those areas where they can truly eliminate waste and achieve genuine efficiency savings rather than adopt a “slash-and-burn” approach to health care with arbitrary cuts and poorly thought-through policies.“
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