Labour MP and Public Accounts Committee (PAC) member Karin Smyth outlined concerns arising from a number of NHS-related PAC reports. She emphasised the need for Department of Health annual accounts to be published soon, and to explain the risks of Brexit, how they will be mitigated, and when Parliament will debate them.
Highlighting existing funding difficulties she said: “Within NHS England, NHS trusts reported a record deficit of £2.45 billion in 2015-16—almost £500 million worse than planned, and triple the size of the 2014-15 deficit.”
Although the health budget has been protected from cuts, spending growth cannot keep up with growing pressures on the service, she said, so the NHS has been asked to absorb pressures through improved efficiency. Quoting The Health Foundation she added: “There are opportunities to improve the efficiency and effectiveness of the NHS but realising these savings is proving to be a huge challenge—particularly against a backdrop of staffing shortage.”
Scroll down to watch Karin Smyth MP’s full speech
She highlighted the need for financial transparency, emphasising the importance of publishing last year’s Department of Health accounts, and this year’s budget before the summer recess so that Parliament and PAC can properly scrutinise them: “Given the size of the trust deficit and the implications for the budget of NHS England, which takes up by far the greatest part of the Department’s budget, there are widespread concerns about how the Department might stay within its departmental expenditure limit. Failure to do so would be an exceptional breach of control.
“Parliament will take a dim view if the Department’s accounts are not subject to proper scrutiny.”
The Bristol South MP pointed out that Brexit will create further pressures, especially around staffing, procurement and medicines.
She outlined her own professional experience in the NHS in creating risk registers. “The Department requires all its bodies to identify, assess and mitigate risks,” she said. “As anyone in any business knows, risk registers are an essential part of the planning process. Few if any risks to business could be greater than Brexit. I would expect the Department to have a robust Department-wide risk assessment process, and I would expect it to include Brexit.”
She concluded with a challenge to Ministers:
• What are the risks of Brexit that the Department must surely have already identified through its risk register or by other means?
• How are they to be mitigated?
• When will they be debated and discussed in Parliament?
Following the debate Karin Smyth said: “It was disappointing that in responding for the government, Health Minister Ben Gummer completely failed to address the concerns.
“The existing pressures on the NHS will be severely compounded by Brexit, but Ministers don’t appear to have a Plan B. In fact, given the delay in publication of last year’s accounts and this year’s departmental budget, it’s proving a headache to get them to reveal Plan A.”
Note: The Public Accounts Committee, the body that oversees taxpayer value, has this year published reports on issues on diabetes, the cancer drugs fund, services for people with neurological conditions, access to GP services, acute hospital trusts, NHS clinical staff and personal budgets in social care.