Cross-Party MPs Say NHS Leaders Need To 'Step Up'
Health Secretary Wes Streeting and NHS England Chief Executive Amanda Pritchard (Alamy)
5 min read
MPs have slammed the NHS top leadership and accused senior officials of being “defensive” in their response to a cross-party committee report.
Geoffrey Clifton-Brown, the Conservative chair of the influential cross-party Public Accounts Committee (PAC), told PoliticsHome that for the NHS to implement change, it would need a “real willingness and an energy from those in charge who want to implement that change”.
PAC published a report on Wednesday that found a “lack of fresh thinking and decisive action” within NHS England and the Department for Health and Social Care (DHSC). The report said this was accompanied by “overly optimistic planning assumptions” as the healthcare service’s financial position continues to worsen.
However, NHS England responded with a strongly-worded statement accusing the report of containing “basic factual inaccuracies and a flawed understanding of how the NHS and the government’s financial processes work”.
“While NHS productivity is now improving at double pre-pandemic levels - far from being complacent, NHS England has repeatedly been open about the problem and the actions being taken to address it,” an NHS spokesperson said, adding that “reform is part of the NHS’ DNA”.
Clifton-Brown strongly denied there were any factual errors in the report, telling PoliticsHome that the details in the report were based on the National Audit Office’s (NAO) value for money report, which was agreed between the government's auditor and the DHSC. He added that PAC had drawn “entirely” from what NHS witnesses said in the committee hearing.
“We made some pretty detailed recommendations, which they [NHS England] have chosen to rebut in quite an arbitrary, off the cuff way.”
The committee chair added: “This inertia for change has to come from the top, and the top are very defensive about it.
“The most senior officials in the health service – the permanent secretary [Professor Sir Chris Whitty], [chief executive] Amanda Pritchard – I really earnestly ask them, instead of trying to defend a broken record, to look at the report and see how they can start to implement those sensible recommendations. And let's hope by the next time they come before us, they'll actually have something positive to say.”
He added that he recognised doctors and nurses “work extremely hard, so I don't think it's their fault whatsoever”.
Luke Charters, a Labour MP and member of PAC, told PoliticsHome that the report had shown NHS financial planning has been “more of a pantomime than a performance”.
“The government is steadying the NHS financially, but we need senior officials to step up and deliver the big changes the NHS desperately needs,” he said.
As the government is beginning to write its 10 year plan for the NHS and DHSC, Clifton-Brown said this was “a particularly opportune time for the NHS to take stock of how they could do things better and improve the outcomes for patients”. Improving productivity rates across the NHS will play a vital role in this.
“I think [the NHS leadership] are on the defensive because they know that their record hasn't lived up to what it should have done in terms of productivity, in terms of how they spend their money,” Clifton-Brown said.
Professor Sir Chris Whitty is the interim DHSC permanent secretary before a new permanent secretary is appointed (Alamy)
In an interview with PoliticsHome, NHS England chief executive Amanda Pritchard said that she wanted to dispel the narrative that productivity in the NHS is falling.
“Productivity is rising,” she insisted, adding that a “better” measure of productivity in the health service was needed to take community and primary care into account, rather than just acute hospitals.
One of the PAC report’s recommendations is to give the same amount of money – if not more – to local institutions rather than giving increasing amounts to hospitals.
“One of the things we feel very strongly about is the NHS should be concentrating ever more on prevention rather than trying to cure,” Clifton-Brown said.
“I don’t want to pick a fight with Amanda, I get on very well with her personally. But I just think the idea of trying to change the measurement of productivity to include these local organisations that are suffering badly already would actually probably make our figures look worse rather than better.”
He disputed her claim that productivity is rising: “Somehow, they think miraculously it's going to increase to 2 per cent by 2029… so they've got to tell us how they're going to do that.”
The PAC report also called on the government to give local health bodies earlier certainty about how much money they will have.
“It's a shocking way to run that service, really,” Clifton-Brown said.
“To give the board trusts – who are trying to implement the policies on the ground – an indication of their money and the guidelines on spending two or three months after their financial year has started… It’s a real example of how not to run a health service.”
He also said that he is “yet to see any real outcome” for the last government’s £3.6bn investment in new digital technology across the NHS.
“The fact that they're still using fax machines and far too much paper, really tells you that this is a really old-fashioned, huge behemoth of a government organisation.
“So I think they are very defensive in their press release, and if they actually looked at and started to implement our serious recommendations – which are carefully thought through and correct – every single patient would be better off in the NHS.”
The report called for plans to reduce the health service’s reliance on paper within 18 months, with a specific deadline to end the use of fax.
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