Report warns of ‘crisis, cash, repeat’ future for NHS

A new report has warned that without better financial planning and reforms, hospitals could join prisons and social care in a cycle of ‘crisis, cash, repeat’.

The Institute for Government and the Chartered Institute of Public Finance and Accountancy (CIPFA) have said that better organisation, rather than further investment, is needed to shore up the public sector.

Alongside adult social care, police, prisons and schools, the report highlights that hospitals are facing bouncing from opening crisis to spending crisis having already been pushed to ‘breaking point’. Excessive pressure on NHS services is evident through longer waits for A&E and cancer treatment and a 40 per cent rise in delays transferring people from hospitals to social care.

Among several recommendations, the two bodies argue that assumptions behind spending decisions should be subject to independent scrutiny, and that a body, similar to that of the Office for Budget Responsibility, should be established for public spending to help embed efficiency within public sector decision-making and to prevent wishful thinking.

Julian McCrae, deputy director at the Institute for Government, said: “As we’ve seen with prisons, social care and now potentially hospitals, the government risks getting into a cycle of crisis, cash, repeat. This report is a call for better financial planning and reforms that are robust enough to survive public scrutiny.

“It is fundamental to increasing the effectiveness of these public services that ministers, officials and the public know how well government is performing and use this information to guide decisions.”

Rob Whiteman, CIPFA chief executive, added: “We know that for some parts of the public sector resources are stretched and that those working to deliver services are up against it.

“What is crucial is that we make the best possible use of the funds available. This means having a thorough understanding of how organisations are run and services are provided, using this information to think strategically and creatively about improving policy decision-making, which will ultimately improve service delivery.”