Sunday, 6 January 2013

No 11's Daylight Robbery - @ No 10

"I say, I say, I say! When is an underspend a cut?" Arturo asked.

"Don't know - but I'm sure you're going to tell me."

"When it's daylight robbery!" Arturo chuckled. But, to be honest, I hadn't a clue what he was on about! Then, he pointed to the monitor.

Glancing at the screen, I immediately saw the word 'underspend' in a headline which was worded:
NHS chiefs ordered to explain £3bn underspend

James Illman had written an article in HSJ (Hospital Service Journal). He described how Stephen Dorrell, Chairman of the Health Select Committee, requested details of where the 'underspend' money had come from. Illman wrote:
Committee chair Stephen Dorrell told NHS chief executive Sir David Nicholson and his deputy David Flory they would need to elaborate in writing after deeming they had failed to provide a full explanation on the matter at a hearing this morning.

Mr Dorrell told HSJ: “The question is what has happened to the balance and how much of it is still available to the NHS?

“Could some of the £3bn that has gone over to the Treasury come back to the NHS and [if so] over what period?”

I read the screen without much interest - until I came to the £3bn!! £3bn!! I could hardly believe my eyes. I thought that I'd read only the other day that nursing posts were being cut; that certain vital medicines were not being prescribed because they were 'too expensive'! Now here, before my very eyes, was the phrase:
the £3bn that has gone over to the Treasury

How come 'Georgy' Osborne got his little hands on £3bn of NHS underspend? Now I know that the Treasury is desperate to mop up every spare penny it can - but this is daylight robbery, as Arturo had said!!!

James Illman's article continued:
Mr Flory (Deputy NHS chief executive) told the committee that the vast majority of the money was capital spending that came from national programmes such as Connecting for Health.

He added: “A large part of the number was underspend of capital monies associated with particular projects in the department which hadn’t progressed or progressed at the speed that had been anticipated.

“Capital monies in that sense are one-off by their very nature and can only be spent once and couldn’t support on-going investment in staffing”.

Maybe, the £3bn could only be spent once! But that's a heck of a lot of spending!! And why, as Dorrell implied, couldn't it have gone back into the NHS pot?

A great deal has been written in various journals, newspapers etc about this anomaly of NHS underspend money going into the coffers of the Treasury. Coalition supporters argue vociferously with Labour front-benchers. Figures go up and figures go down!

However, after nosing about, I came across the website of the Social Policy Digest. Its url is:
The site had several references to NHS spending. In view of the 'underspend' being presented lock-stock-and-barrel into the grasping hands of the Treasury, these were extremely disturbing . The first quotation was:
Financial problems in NHS trusts – report by MPs

A report by a committee of MPs said that an overall surplus of £2.1 billion across all National Health Service bodies in 2011-12 masked the fact that a significant minority were in financial difficulty. Yet the Department of Health could not explain how it would deal with a trust that went bankrupt; nor could it provide reassurance that financial problems would not damage the quality of care or equality of access.

Source: Department of Health: Securing the Future Financial Sustainability of the NHS, Sixteenth Report (Session 2012–13), HC 389, House of Commons Public Accounts Select Committee, TSO

Date: 2012-Oct

Further down the site, there was another quotation:
NHS finances in 2011-12 – audit report

An audit report said that National Health Service finances were healthy overall, but that a growing number of organizations were in deficit. Primary care trusts, strategic health authorities, and NHS trusts reported a combined surplus of £1.6 billion in 2011-12. Most trusts reported an improved financial position. But the number of trusts in deficit increased from 13 in 2010-11 to 31 in 2011-12.

Source: NHS Financial Year 2011/12, Audit Commission

Date: 2012-Sep

Further along still, there were two more quotations of concern:
NHS 'not able to cover soaring social care costs alone'

A briefing paper examined the demographic and financial realities of social care and how these were likely to place additional pressure on the health and care system in the years ahead. In the long term, it was not sustainable to expect the funding shortfall of £2 billion for social care to come from the National Health Service.

Source: Papering over the Cracks: The impact of social care funding on the NHS, NHS Confederation

Date: 2012-Sep

and next:
Mental health spending down for first time in 10 years

Total government expenditure on mental health services fell by 1 per cent in real terms in 2011-12, the first annual reduction since 2001.

Source: Tony Ingham, 2011/12 National Survey of Investment in Adult Mental Health Services, Department of Health | Tony Ingham, 2011/12 National Survey of Investment In Mental Health Services for Older People, Department of Health

Date: 2012-Aug

How can the Treasury justify taking the so-called 'underspend' in the light of :

NHS 'not able to cover soaring social care costs alone'

Mental health spending down for first time in 10 years

We all know that Europe, the USA and the UK are still in trouble as a result of the banking fiasco in 2007 - 2008. However, this Coalition Government cannot justify grabbing the NHS underspend to settle its debts! Bankers did NOT pay back their bonuses! The NHS is struggling! The so-called 'Reforms' have all but crippled it! Now it is suffering from Governmental Daylight Robbery - just as Arturo said!

I'm going to treat Arturo to a slap up meal tonight - I'm going into the kitchens of No 11! No doubt there'll be loadsa caviar lying round the cupboards. After all - what better way to celebrate getting an unexpected £3bn?


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