The Royal College of Physicians of Edinburgh (the “College”) have called on senior politicians from all parties in the UK to up their game on the NHS, during the final days of general election. The College, which represents thousands of members across the UK, said that although pledges to spend more on the NHS are always welcome, NHS staff and members of the public deserve to know how the proposed increases will be spent. Spending “soundbites” are not good enough, according to the College.

The NHS has unsurprisingly been a key political battleground during the general election. Healthcare remains one of the largest sources of public expenditure in the UK. In 2018/19, total health spending in England was around £129 billion - £115 billion of which was spent on the NHS England budget. The rest was spent by the Department of Health on things like public health initiatives, education, training, and infrastructure (including IT and building new hospitals). The total figure for health spending in England is expected to rise to nearly £134 billion by 2019/20, taking inflation into account.

In Scotland, total spending on health in 2018/19 was budgeted to exceed £13 billion (£13.4 billion).  

The College says that any uplifts in the healthcare budget must be sustainable, fully costed and well spent. They want the political parties to be clear and upfront about how they will improve training and working conditions for doctors across the NHS, to attract people to medicine, to ensure better care and public health outcomes for people in the UK.

In addition, as stated in the College’s general election health manifesto, they have called for the next government to set aside additional funding for a range of initiatives to improve public health:

  • Further prioritise the prevention of obesity, and retain so called “sin tax” policies including the “sugar tax”.
  • Implement Minimum Unit Pricing, which has shown early signs of success in Scotland, across the UK.
  • Continue to support targeted initiatives in order to see further long term improvements and reduce premature and preventable deaths.
  • Run visible campaigns to promote the messages that children should follow the NHS vaccination schedule for best protection.
  • Pursue policies which will address social determinants of ill health and improve circumstances which lead to poor health or social exclusion, including disability.

Commenting, Professor Derek Bell OBE, President of the Royal College of Physicians of Edinburgh, said:

We have, so far, been disappointed about the quality of the debate on the NHS during the general election. We have heard a lot about how much the political parties plan to spend, but we have seen very little detail about what the money will be spent on, and how the parties plan to invest in services and the workforce to ensure that the NHS can continue to deliver a high standard of care. Brexit further muddies the water around recruitment and retention of the medical workforce, and the next government must clearly set out a plan to ensure that our NHS remains attractive to overseas medical staff.

The recently published annual physicians’ census survey revealed continuing pressures on the medical workforce, demonstrated by ongoing problems with rota gaps, doctors’ pensions, unfilled posts and high levels of reported sickness absence. The survey showed that there currently aren’t enough doctors to fill vacant posts. Meanwhile, we’re spending a lot of money on expensive agency staff. This means that investment in the current and future workforce is absolutely vital to maintain patient care, including more medical school places and international recruitment. For our NHS to be sustainable, funding must be matched with initiatives which have been thoroughly evaluated for quality patient outcomes, and will lead to solid and sustainable improvements in the long term.

64% of adults in the UK are overweight, 14.4% of adults in England smoke, and the gap in life expectancy between the wealthiest and poorest areas is still wider than we would like. We want the next government to back our public health policies by putting forward costed plans on obesity, alcohol, smoking, vaccinations and health inequality so that we can become a healthier population over the next decade.

Regrettably, we have not heard from the parties in enough detail about how they will address these vital issues. We hope that in the final days of the general election campaign, politicians on all sides are challenged on their funding pledges for healthcare and asked about how they will spend money in a targeted way, to help address the challenges our NHS currently faces.

Paul Gillen

Contact: Paul Gillen p.gillen@rcpe.ac.uk 0131 247 3658