Paediatric Continence Forum
Political and Parliamentary Monitoring
Week Commencing 15th October 2018
The Chancellor, Philip Hammond, has announced that this year’s Budget will be held on October 29th, as speculation rises that tax increases are in the pipeline to provide extra funding for the increase in NHS spending. Theresa May announced at the Conservative Party Conference that, by in large, austerity was over, and that Government spending would now begin to increase at a faster rate than the public had experienced over the last eight years.
Theresa May’s announcement, coupled with the Government’s plans for an additional £20 billion in funding for the NHS by 2021/22, will put additional strain on The Treasury, which has also committed itself to ‘fiscal restraint’. Now, Mr Hammond has said that “people will have to contribute a little extra in the future to pay for our ageing population”, adding “that will mean a little more tax to pay for the service”.
These comments have caused division in the Conservative Party, with Brexit Secretary, Dominic Raab, saying that he would much rather focus on cutting waste than increasing taxes. Pro-remain MPs, such as Anna Soubry, have also pounced on comments, questioning why the additional funding for the NHS is coming from taxation rather than dividend that the Leave campaign claimed could be injected in to the National Health Service.
At the same time, a group of health faculties and royal colleges have urged the Chancellor to use the Budget to invest long-term in adult social care and health services, or “risk the NHS failing to meet demands”. The letter, jointly signed by 11 institutions, including the Royal College of Physicians and the Royal College of Surgeons, reminds Mr Hammond that a healthier population is key to the long-term sustainability of public services.
The PCF will welcome any additional funding for the NHS, with the understanding the early diagnosis and treatment has the potential to save money in the longer term.
- Territorial injustice likely to increase
- School toilet policies breach child rights
- Charities fear over children’s centres cuts
GP trainee recruitment target surpassed for the first time
Secretary of State for Health & Social Care, Matt Hancock MP, has announced that nearly 3,500 GP trainees were recruited this year, above the 3,250 target set for 2017/18 and a rise of ten per cent on last year. Speaking to the Best Practice conference, Mr Hancock announced that “we have a record number of GPs in training”, adding that NHS England is on track to see an increase in the number of other staff working in general practice rising by 5,000 by 2020.
Celebrating the news, Mr Hancock said that working in General Practice should have the same prestige as being a consultant or a surgeon, because of their role as “the bedrock of the NHS”. Mr Hancock also announced that the NHS needed to explore new business modes, including mutuals, whereby clients own part of the business. Reacting to the news about GP numbers, Dr Krishna Kasaraneni, a British Medical Association GP Committee Executive Workforce Lead, said that, whilst he welcomed the news, we must not forget that new GPs take ten years to train and that, without urgent action and investment, more doctors will leave the profession.
Mr Kasaraneni added that “whilst the Health Secretary again promises an extra 5,000 GPs in the workforce, the Government continues to push the deadline for achieving this back as overall numbers dwindle”, adding that “while the news on recruitment is very welcome, there is still more work to be done on retention.” Additional GPs are required in the Health Service if it is to meet the rising demand. At the same time, this winter is set be the busiest on record, with multiple hospitals warning of staff and funding shortages.
The PCF will welcome the news that additional GPs are now undergoing training compared with a year ago, especially given the long delays in diagnosis, referral and treatment which many young people experience in the Health Service.
NHS Trusts turning to healthcare assistants to ‘plug nursing shortfall’
Healthcare assistant now account for almost three in 10 of all nursing team roles in NHS Trusts in England, a new study has shown, and their numbers are increasing at nearly four times the rate of registered nurses. Analysis by BPP University’s School of Nursing used data obtained through Freedom of Information requests to show that 29 per cent of nursing and support roles are now filled by healthcare assistants. Healthcare assistants are meant to help trained nurses, carrying out basic tasks such as feeding patients, answering call bells and helping them to the toilets. However, there is an increasing concern that they are now being used to perform tasks for which they are not trained, such as administration of medicines, or being left in charge of multiple patients.
The study by BPP says that the increase in the number of nursing vacancies over period has creating an “alarming picture”, with hospitals now reliant on healthcare assistants and agency staff. In the north west of England, nursing vacancies rose by 48 per cent between December 2015 and December 2017. Across all England NHS Health Trusts, the nursing and midwifery vacancy rate rose from 28,713 in December 2015 to 34,62 in December 2017 – a rise of 21 per cent. Overall, while the number of nurses rose by 0.5 per cent between December 2015 and December 2017, the number of healthcare assistants rose by 6.5 per cent, the analysis shows.
Joyce Robins, of the patient representation group, Patient Concern, said the trends were “frightening”, adding that “we are seeing far too much reliance on staff who just aren’t trained for the tasks they are doing.” Dr Anne Corrin, Head of Professional Learning Development at the Royal College of Nursing said that while healthcare assistants provided “vital support to registered nurses and other clinical staff”, it was a “very different role” to nursing and could not be considered a substitute.
This news will cause concern for the PCF. Trained nurses are essential for good continence care, and should not be replaced, or see their duties transferred, to the Healthcare Assistants. The PCF will contact the Department of Health to raise our concerns over this issue.
English councils brace for the biggest cuts since 2010
Councils in England are facing the biggest cuts to their budgets since 2010, despite unprecedented pressures on demand. The Revenue Support Grant, the main source of local government funding and which is transferred from central to local government authorities, will be cut by 36 per cent next year, the largest annual deduction in almost a decade and at a time when demand for health and social care services continues to rise.
An analysis by the Local Government Association reveals that, overall, councils will have suffered a 77 per cent decrease in the government funding for local councils between 2015/16 and 2018/19, dropping from £9 billion to £2 billion. Councils will instead receive grater control over business rates and local taxes, which they will now receive directly, and which will no longer be redistributed by the Ministry of Housing, Communities and Local Government. Once concern over the change is that those areas with a low proportion of businesses, or where business rates and land value is low, could be disproportionately hit by the new system, thus threatening local services.
There is continued speculation that public health spending could be squeezed further, as council prioritise social care and education. Andrew Gwynne MP, Shadow Minister for Communities and Local Government, said “The Government can no longer ignore this crisis”, adding that without additional investment into local services “councils will be in an impossible position” and many will face bankruptcy. In a statement, a Government spokesperson said that Council “are responsible for their own funding decisions”, adding that “ We are giving them the power to retain the growth in business rates income”.
This news will interest the PCF. Since the transfer of school nurses to local authority oversight, there has been growing concern about the future of local authority funding. The PCF reiterates in all meetings and events the need to ensure universal provision and protect funding.