29th May 2015
Contents
- Queen’s speech reiterates commitment to NHS five year plan, seven-day care, and devolution
- New measures to tackle trust deficits by increasing productivity and capping agency spend
- Simon Hamilton replaces Jim Wells as new Northern Ireland Health Minister
- North East Essex CCG announces plans to restrict access to surgery for overweight patients and smokers
Queen’s speech reiterates commitment to NHS five year plan, seven-day care, and devolution
Wednesday saw the Queen announce the new Conservative Government’s plan for the coming year. There were no major surprises for health, as the Queen reaffirmed the Tories’ commitment to implementing NHS England’s Five Year Forward View, in particular through increasing the NHS budget and integrating health and social care. Her Majesty also expressed plans to ensure seven-day care for the NHS, and improve access to both GPs and mental health care. In addition legislation will be brought forward to ban ‘the new generation of psychoactive drugs’ – something the Local Government Association has campaigned for.
Other announcements included Bills on devolution for Scotland, Wales and Northern Ireland. The Scotland Bill will be based on the Smith Commission, which recommended the devolution of new powers to set income tax rates and thresholds. However, the Government has decided against devolving any further health powers, including on medical devices, to Scotland, despite a Smith Commission recommendation for further discussions to take place.
Conversely, changes will be put in place to ensure that decisions affecting England alone, or England and Wales, will require a majority vote among MPs representing the corresponding constituencies. There will also be devolution to cities, including of health and social care.
The Queen also announced ‘early legislation’ for a referendum on UK membership of the EU, for which a Bill was presented to Parliament on Thursday. Mr Cameron hopes to renegotiate the UK’s terms of membership prior to the referendum and has been busy meeting with other EU member countries’ leaders to persuade them to agree to the necessary EU reforms. Given the impact of EU regulations on UK health issues, such as data protection and restrictions to working hours, a so-called ‘Brexit’ would likely have implications for our NHS.
New measures to tackle trust deficits by increasing productivity and capping agency spend
After recent statistics identified a £349m deficit in the foundation trust (FT) sector, both health sector regulator Monitor and the Government are reported to be considering actions to reduce overspending by trusts. Despite plans for 2014/15 for a 44 per cent reduction in spend on contract and agency staff, these costs instead rose by 29 per cent at Q4.
According to the Health Service Journal, Monitor has set out plans for a three pronged approach to reduce the deficit, by visiting the 40 worst performing trusts to ensure they have plans for productivity savings; imposing tighter cost controls (such as on agency spend) on FTs in breach of their licence for financial reasons; increasing support available for struggling trusts.
Similarly the Cabinet Office and Department of Health are considering whether to introduce a cap on spend on agency staff, after the agency bill for 2014/15 came to £1.8 billion, over double the target of £766 million. However, there are legal considerations which may impede such an intervention, as it could lead to trusts refusing to pay agency prices above a certain level, potentially undermining competition law.
Simon Hamilton replaces Jim Wells as new Northern Ireland Health Minister
Simon Hamilton, Democratic Unionist Party (DUP) Member of the Legislative Assembly (MLA) for Strangford, Co Down, has been appointed as the new Minister of Health in Northern Ireland, replacing Jim Wells. Hamilton was previously Minister for Finance and Personnel, his first Ministerial role and a post that he held for almost two years, after serving as Assembly Private Secretary to Sammy Wilson when he held the Finance portfolio. Hamilton has no previous experience working at Northern Ireland’s Department of Health, Social Services & Public Safety (DHSSPS), but is expected to bring a degree of financial rigour to the post, that will align well with DHSSPS’ relatively new Permanent Secretary Richard Pengelly, a qualified Chartered Accountant. These appointments suggest a sharpened focus on the budget of DHSSPS, after cost saving reforms, proposed in 2012, were restated in the recent Donaldson Review into health and social care governance arrangements for Northern Ireland.
North East Essex CCG announces plans to restrict access to surgery for overweight patients and smokers
In order to tackle its financial challenges, North East Essex CCG will introduce restrictions to services including elective surgery according to the Health Service Journal. IVF, vasectomy and female sterilisation will no longer be funded under normal circumstances, and other elective surgery will be restricted to non-smokers and those of a healthy weight. ‘Failure to attend smoking cessation or weight loss programmes may have an impact on whether individuals could undergo their procedure’, said the CCG’s report.
A representative of the CCG argued that to stay within their budget, if these services were not restricted, others would have to be. They made the decision therefore to restrict access to ‘services where evidence suggests that the overall benefits to our population are small’.
The CCG follows in the footsteps of several other trusts which have introduced restrictions on access to surgery owing to financial difficulties.