Patient care may suffer as a result of cuts to the NHS budget to fund the continuing costs of Covid, NHS leaders and Labour have said, after Sajid Javid refused to say where the axe would fall.
The Department of Health and Social Care is trying to make savings from its budget to fund free lateral flow tests for elderly people, Covid surveillance studies and genomic sequencing, after the Treasury refused its request for £5bn in extra funding.
Although the government announced an end to most free mass testing and contract tracing on Monday, remaining Covid measures are expected to cost more than £1bn.
The Treasury and the DHSC refused to say exactly how much cash would be needed or which services would have to be cut back, prompting fears that the NHS could have to find savings at a time of a huge waiting list backlog.
It is understood that DHSC officials are working on identifying savings in the department’s £178.5bn budget for 2022-23, to fund the measures agreed on Monday, including maintaining a “baseline” testing capability that can be scaled up if necessary.
They have ruled out hitting Javid’s plan for tackling waiting lists, but a government source would not rule out any other areas being affected, saying a “significant amount of money” would have to be found by “reprioritising”.
“There’s not any easy cuts to be made anywhere, but we are going to have to shift money from elsewhere towards this, because having this in place is the priority. It’s a significant amount of money, but we think it’s doable,” the government source said.
Wes Streeting, the shadow health secretary, said it was “pretty humiliating for Sajid Javid” after he lost the cabinet row with the chancellor, Rishi Sunak, over the extra cash for Covid.
“He asked for £5bn and has ended up with nothing. We know as a result of the chancellor stitching him up there is a significant shortfall facing the NHS budget and the health secretary needs to come clean about where those cuts are going to fall and address concerns of NHS leaders that funding cuts of this nature might compromise NHS care,” he said.
Saffron Cordery, the deputy chief executive of NHS Providers, warned the government against abandoning its commitment to give the NHS “whatever it needs” to tackle Covid and called for transparency about “where the impact of these extra costs will fall”.
“Trust leaders are understandably anxious over reports that the ongoing and significant costs of living with Covid will be met by ‘reprioritising’ the NHS’s existing budget,” she said. “There is a very real risk of trade-offs affecting the quality of patient care – something no one wants to see.”
The British Medical Association also raised concerns that the NHS may have to fund the cost of testing for its own staff. Dr Vishal Sharma, the BMA consultants committee chair, said it would cost “a significant amount for hospitals who are already under financial pressure and could be faced with having to make further difficult decisions about how best funding should be allocated which could leave a shortfall elsewhere”.
Hospital bosses are concerned that the Treasury’s refusal to give the DHSC any more money to cover the NHS’s costs of dealing with Covid could force them to either pay for the cost of Covid drugs and the enhanced cleaning regimes from their own budgets or use the billions they have been given to tackle the 6.1 million-strong backlog of patients awaiting hospital treatment.
An NHS source said: “Everyone’s been arguing about where the money will come from. Although it’s been reported that the argument is over and that the Treasury have refused to give the DHSC the money they asked for, discussions about this are still going on and we are waiting to hear the government’s last word on this. But the money may have to come from the money set aside for elective recovery or we might get more money in the next autumn statement.”
Ministers confirmed last month that they would cover the cost of personal protective equipment for NHS staff in England in 2022-23 at least.
