Bulletin July 2015 Number 171

During the turbulent election campaign, few would have predicted that the NHS would end up being overseen by the same Health Secretary, Prime Minister and Chancellor.

Jeremy Hunt's reappointment provides some reassurance the NHS will not face the kind upheaval that followed the last election in the form of the Health and Social Care Act.

Despite that relative stability, there are very tough financial challenges for the NHS which politicians can improve or make worse. With scores of major NHS trusts now reporting deficits Health Ministers (see below) will be pushing for July's budget to provide more money for the current financial year. In the medium term he will be negotiating for a sustainable funding settlement in the autumn spending review.

A longer-term gap of £30 billion was identified in the Five Year Forward View (5YFV). The View said that the service could find an incredibly ambitious £22 billion in efficiencies and then invited the political parties to offer the remaining £8 billion. The Conservatives duly promised a “real terms” minimum increase of £8 billion by 2020. Even assuming the NHS can find £4.5 billion of savings every year for five years new demands are being placed on the service.

Relevant Conservative Party manifesto pledges

  • Seven-day NHS’ by 2020
  • Access to GPs 8 am to 8 pm for everyone by 2020
  • Quality of hospital care to be same every day of the week
  • Same day appointments for all over-75s
  • National evidence-based diabetes prevention programme
  • Speed up access to new medicines by implementing the findings of innovative medicines and medical technology review
  • Increase use of cost-effective new medicines and technologies and encourage large-scale trials of innovative technologies and health services
  • Deliver the new strategy recommended by NHS England cancer taskforce through enhanced prevention, earlier detection and diagnosis, better treatment and care
  • Continue to support research to improve the diagnosis and treatment of rare diseases and cancers, including through decoding 100,000 whole genomes

Welcome though the Tory funding promise is, it does not cover the additional costs of their other health manifesto commitments. The cost, for example, of a “seven day a week NHS” and “a guarantee that everyone over 75 will get a same day appointment if they need one" will be huge.

At the same time shrinking social care services, which are managed by councils not protected from funding cuts, mean more pressure on the NHS. Mindful of all these pressures The College is making sure the interests of our members and their patients are being represented at the highest levels.

On his re-appointment as health secretary, Mr Hunt said that Robert Francis's report into the failings at the Mid-Staffordshire NHS Trust had “started a journey” to improve safety, care and quality.

One of the, as yet unfulfilled, requirements of the Francis report was the establishment of a national system of medical examiners. Before the election, this College secured a parliamentary assurance from Mr Hunt that the system would be put in place as soon as possible.

His continuation in the role allows our President, Dr Suzy Lishman, to press him on a firm timetable for this important reform overseen by the College and successfully piloted by College members.

Dr Lishman has already written to and spoken to Mr Hunt raising the issues of medical examiners, completing the National Laboratory Medicine Catalogue (NLMC) and ensuring that the right numbers of pathologists are trained, recruited and retained.

The College has also invited Mr Hunt to speak at the parliamentary launch of National Pathology Week 2015 on November 2, which will help convince ministers, MPs and partners of the need for this support.

With medical examiners, the NLMC and the right workforce pathology can play its part in delivering the incredibly ambitious programme set out in 5YFV.

That contribution will be vital as the NHS faces the challenge of dealing with ever growing demand caused by demographics, political promises and cuts elsewhere in the system.