NHS Tayside : When "overspending" is actually underfunding

Marlyn Glen

24 January 2012

Earlier this month, it was reported that NHS Tayside had "overspent" its budget by £1.9 million, compared with its anticipated expenditure by November of last year.

The health board’s response was that "steps are in place to bring this overspend down to zero through identifying additional savings and cost reductions in the final four months of the year and we are currently on target to break even this financial year."

The health board’s "overspending" is a result of the Scottish Government’s underfunding of the NHS.

As Humpty Dumpty said to Alice in Wonderland in Through the Looking Glass " When I use a word it means just what I choose it to mean."

The real terms increase that the SNP government claim to have made to NHS Tayside’s budget that was supposed to have covered underlying cost pressures of 4-5 per cent has fallen short of price rises in health spending areas such as drugs.

Another example of the Humpty Dumpty-ism of giving a word any meaning that suits its user is the term " efficiency savings"

Outside the world of management-speak no one regards the term "efficiency savings" as anything other than an example of irony.

The SNP Government has compelled health boards in Scotland to find £300 million "efficiency savings" in their spending this year on their health services.

As the nurses’ professional body, RCN Scotland commented,

"The efficiencies target for the current financial year will squeeze even more money out of health boards that are already trying to make savings.

"Consequently, saving money by losing nursing and other staff from the pay roll looks set to continue which, in turn, puts standards in patient care at risk."

The " efficiency savings" have led to 2,000 nursing posts being lost over the past two years in Scotland – RCN Scotland’s figure.

Indisputably it is a very inefficient way of running a health service when 2,000 core staff posts are swept away.

Another example of "When I use a word it means just what I choose it to mean." is Health Secretary Nicola Sturgeon’s promise to " protect the health service budget for the duration of this Parliament"

Here, the phrase "protect the NHS budget " is an example of that figurative expression " attempting to square the circle" i.e. to do the impossible.

It is difficult to reconcile "protect the NHS budget" with the £319 million cut in health spending in Scotland over the next three years, and that’s money in real terms.

It is difficult to see how " protect the NHS budget" is consistent with a multi-million cut in health spending that includes the shedding of many NHS jobs.

RCN Scotland stated,

"It is clear to us that health boards cannot continue to save money by reducing the size of the NHS workforce, unless it wants to put at risk standards in patient care."

Moving from the meaning of words to the meaning of figures, can frequently bypass political spin with revealing results.

Scotland’s three previous Health Ministers, all Labour, left office with the number of nursing and midwifery staff subsequently increased during their Ministerial term.

Under the SNP, the numbers have fallen.

The official figures show :

Susan Deacon, Labour Health Minister from 1999-2001, an increase of over 800

Malcolm Chisholm , Labour Health Minister from 2011-2004 , an increase of 2,300.

Andy Kerr, Labour Health Minister from 2004-2007 , an increase of 2,500.

Under the SNP from 2007 to 2011, there has been a decrease of 740

On these figures, who of the above have " protected the health service"?


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