Daily Insight: 1950s revival

In 1951, then-chancellor Hugh Gaitskell had to choose between spending on the infant NHS and defence. The Labour MP made his choice, slashed NHS budgets and we still pay for glasses, dentistry and prescriptions as a result.

Now, the NHS is facing a funding squeeze of the same magnitude. New forecasts, shared with HSJ, reveal the service is looking at several consecutive years of real-terms cuts to 2025, as inflation is set to outstrip a budget that is being forced to absorb more costs than originally anticipated.

The situation is actually grimmer than the bleak outlook set out by NHS England chief finance officer Julian Kelly and CEO Amanda Pritchard earlier this month, and could end up worse than the austerity era, when the service managed to avoid real-terms cuts in all but one year.

Historically, the NHS has received spending increases around 4 per cent above inflation. Now, forecasts suggest the NHS budget in 2025 will actually be smaller, in real terms, than it was in 2021-22 – at a time when trusts are trying to dramatically scale up activity to reduce covid backlogs.

As NHS Providers put it, there is “absolutely no financial wriggle room” left to make cuts without affecting care.

In apology and listening mode

The agency that supplies blood to the NHS is now in full apology and listening mode, following months of turbulence around how it has dealt with concerns around racism.

A memo to NHS Blood and Transplant staff last week acknowledged the organisation has a serious problem, following a survey to which 600 staff responded.

It said 55 per cent of respondents felt racism at NHSBT is an “extremely or very serious” problem, while half had little confidence in the organisation’s recent efforts to tackle racial inequality.

When contacted for comment, an NHSBT spokeswoman said the results were “difficult to read” and added that “we are deeply sorry to those who have experienced negative behaviour”.

The survey was launched after HSJ’s coverage of leadership and race issues at NHSBT in recent months. A well-led review is expected to be published imminently by the Care Quality Commission, while former chief executive Betsy Bassis resigned in the summer.

There have been long-standing concerns among staff around racism at one of NHSBT’s sites in north London, with a 2020 report finding it was a “systemic” problem.

The issues over race and leadership come at perhaps the most operationally challenging period in NHSBT’s history. It is struggling to find enough staff for its donation clinics, which meant it issued its first-ever “amber alert” over blood supplies recently.