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The NHS Confederation warns that, even with protection of its budget, the health service will still be hard hit by spending cuts and called for political leaders to be frank and realistic about the impact on the public.  They expressed particular concern that cuts to local government budgets could lead to reductions in the provision social care and cause problems for the NHS.

Frank and honest debate needed

Nigel Edwards, NHS Conderation acting chief executive, said: “The country faces very serious financial issues and everybody has to play a part in finding the solution - for that to happen there must be a frank and honest debate about implication of the decisions being taken.

“The public need to go into this with their eyes wide open. The NHS may have some limited protection to its budget but it still faces a potent cocktail of financial pressures.

£15-20 billion of savings

“We need to deal with funding increases which while protected will not be adequate to deal with growing demand, one of the biggest reorganisations in the NHS’s history and the pre-existing need to find between £15-20 billion of savings.

“The  NHS is ready to meet the challenge of these pressures but we need to be realistic, it is going to require every reserve of skill and expertise to ensure any impact on the quality and availability of patient care is minimised.”

Mr Edwards added: “Cutting management costs is part of the answer, but doing only a small part. We are already on course to cut management costs by a hefty 45 per cent – quite a task during a major transition. 

“Even this drastic action will save less just £0.85 billion of the £20 billion we need to find. So I am afraid that there are no pain-free choices if we are going to make this happen.”

A survey published by Community Care recently showed that two-thirds of councils were only providing social care for people in either critical or substantial need, Mr Edwards said this reflected a growing trend.

Impact on social care

“With councils facing 25 per cent cuts, we are deeply worried about the potential impact on social care,” he said.

“It seems inevitable that we will see a significant withdrawal of support from some of the most vulnerable people in our society - before long we could see a majority of councils only supplying services to those with the most critical of needs.

“At a superficial level, this may ease pressure on the social care budget. But the needs of these vulnerable people and their families will not simply disappear - if needs are not met by social care, people will turn to the NHS.

“Some will present as emergencies in A&E departments and GP surgeries, others will find themselves trapped in hospital unable to get home, blocking the bed from someone else who badly needs it.  Everybody loses: the users of services, those who care for them, the taxpayer and the NHS. It’s a classic false economy. 

“We desperately need decisions on the long-term funding of social care, but nothing is set to happen until we are well into this parliament. 

“There is a strong case for an interim solution. Local and central government need to urgently work together to consider how they can mitigate the impact of this spending squeeze on some of the most vulnerable people in society.”