The King's Fund responds to Health Select Committee report on public expenditure

Commenting on the Health Select Committee’s report on public expenditure, John Appleby, Chief Economist at The King's Fund said:

'The Health Select Committee is right to stress the severe financial pressures now facing health and social care – the reality for many NHS organisations is that they are already facing a difficult choice between meeting financial imperatives and maintaining quality of services.

'In the short term, finances are tightening significantly, with a growing number of hospitals now in deficit. This raises real questions about whether the NHS will be able to maintain its recent record of balancing its books at the end of the financial year. Beyond 2015, the prospects look even more challenging, with further cuts in public spending likely whoever wins the General Election. It is now almost inevitable that the next government will have to find more resources for health and social care if services are to be maintained.

'In the meantime, a combination of unremitting financial and demographic pressures is having a significant impact on social care services – although welcome, implementing the Dilnot reforms is only part of the solution. And while the establishment of the Better Care Fund provides an important opportunity to promote integrated care, it will not offset inadequate funding for social care and will increase financial pressures on hospitals.

'As the Committee points out, a more ambitious approach is needed to align health and social care resources around the needs of patients and service-users. This raises fundamental questions about whether to maintain the current separation between the NHS as a universal service, free at the point of use, and social  care as a separately funded, means-tested service.  This is why we have established an independent commission, chaired by the economist Kate Barker, to explore how the NHS and social care system can be brought closer together.'