You could hardly hear the softest of muffled clunks, as the Gulfstream G650’s undercarriage folded into the wings.
Farnborough airport dropped away. I pulled the sunshade down, just a touch, to shield the mid-day sun, as it found its way around a bank of picture perfect, fluffy white cloud.
Jason, the steward, was on his way with a glass of fizz and Dianne had all the morning papers.
The toast; ‘Rishi, for cutting my travel and subsistence costs!’
If you’re jealous… don’t be. I’m actually sitting with a laptop on the desk. A cuppa-builders on the go. Although, looking out of the window, I can see a picturesque cloud.
What did you make of his Budget? There were a lot of moving parts. It’ll take a while to figure out where they’re all going to stop.
Taxes, as a share of GDP, the highest for a decade.
Personally, I’m in favour of a bit of Keynesian-ism.
Between 2021 and 2025 the Red Book shows an average uplift, in NHS funding, of 4.1%, which puts us back in the pre-banking-crash territory.
Also (page 48), a curious few words;
‘…HMG anticipates 30% more elective activity by 2024-25…’
That’s a big ask.
For every 100 patients we see now, in twenty four months time, we'll be seeing 130.
How?
More digital-first consultations? Improvements to pathways? More kit?
There’s £2.1bn for diagnostics and a £2.1bn uplift for technology.
My fear; the horrible confusion between NHSD, NHSX and NHSE, no digital-strategic-plan, means the whole lot could go down the plug-hole marked apps, innovation and snake-oil.
Somebody needs to decide who’s in-charge. Then:
come up with a clear idea of what we want to achieve, by when and how;
get a grip on central procurement;
avoid the on-cost and duplication of buying stuff;
make sure, what we do buy speaks to each other;
and the stuff we already have;
and fix the tariff, so there is an incentive to use it.
If the delights of the Red Book have entertained you enough, there is another little number that will help you drift into the arms of Morpheus…
‘… funding, to continue building a bigger and better trained NHS workforce…’
No it won't... and more rubbish like this;
‘… [the] number of NHS staff in Hospital and Community Health Services has grown by 20% since June 2011.’
This is totally meaningless.
There were around 76,500 full-time-equivalent, advertised vacancies in hospital and community services, between January and March 2021. It’s a guess because figures are based on aggregated data from Trusts.
We don’t know, accurately, how many vacancies there are.
BoJo and his gullible backbenchers keep saying we are set for 50,000 more nurses.
No!
It was an unfunded election promise. The headline number depended on retaining 19,000 existing nurses and a big chunk of (very tricky) overseas recruitment.
The true number will be under 31,000. By the way, between June 2010 and June 2018 the total number of nurses and health visitors increased by just over 200.
HMT, claim;
‘… this settlement will keep building a bigger, better trained NHS workforce… more medical students and nurses… new midwives and allied health professionals…’
No, it won’t. How can I be so sure...
... because, nowhere, in any of these document is there a reference to Health Education England’s budget. An arms-length organisation, who arrange and pay for all the training.
Either there’s a secret plan to dump HEE and give the money to the ICSs, let them organise workforce ‘regionally’,
Or,
HEE can plan nothing, prepare nothing and recruit no one, because they have no budget.
No19 and Amanda Pritchard look doomed to repeating the mistakes of the past. No workforce plan, no strategic funding, another year of hand-to-mouth uncertainty.
Who’s the stupid one here?
Us for believing there will be more staff, MPs for parroting clap-trap, or the Treasury for thinking only they can read.
Bojo’s aversion to resolving workforce issues is as bonkers as it is baffling. Making promises that are so easy to monitor and evaluate, and not keep them, is kamikaze politics.
There are three NHS issues that must be resolved before anything else can be done, developed, extended, organised, planned, expanded or improved.
The three things are;
workforce,
workforce
and workforce.
If HMG could sort out one of them… it would be a good move.
>> I'm hearing - GP practice appointments rose in September to the highest total since five months before the COVID-19 pandemic, with face-to-face contacts accounting for a higher proportion than at any time since March 2020.
>> I'm hearing -The pensions ombudsman has upheld a complaint against Capita and the NHS Business Services Authority for the ‘negligently’ handling the pensions contributions of a doctor who was later hit with a hefty tax bill.
>> I'm hearing - Isle of Wight chief executive Maggie Oldham is moving to NHSE to support other trusts.
