Responding to the British Medical Association's survey of medical directors which reveals that one in three NHS trusts in England plan to reduce services, The King's Fund chief executive Niall Dickson said:
'This report again raises some serious questions about the state of NHS finances. Huge sums of money have been spent on the NHS in recent years, but we know that much of it has had to pay for new pay deals for staff and other cost pressures, such as clinical negligence, pensions and inflation.
'The government is pressing ahead with a radical reform agenda which is placing significant pressure on the health service. And these pressures will only get worse as targets become increasingly tough to meet and we get into the payment by results reform in a more serious way. From now on a higher proportion of hospitals' income will be dependent on payment by results, which means that those hospitals with high costs are entering a period where they will have to either reduce costs or save more. This makes it inevitable that some hospitals will either have to become more efficient or cut back services as today's BMA survey indicates.
'Once again, this makes it imperative that NHS organisations have the necessary financial expertise on their boards, are willing to adapt services and begin to sort out their deficits now. If not, the financial outlook in a few years' time could deteriorate even further. All the time the NHS is experiencing these significant deficits, it has relatively little flexibility to do other things - that's when patients will feel the brunt of poor financial management.'
Niall Dickson added: 'Many of the government's health care reforms are sensible in themselves, but the volume and pace of change concerns us and it's doubtful whether or not the health service can cope with all that is being demanded of it. We're already seeing the huge financial strain that new reforms, such as patient choice and payment by results, are placing on the service and the recently announced plans to reorganise the NHS will do little to reduce the burden on staff. The challenges facing the NHS have never been greater.'
Notes to editors:
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