Budget offered a small fix for a large problem in the NHS, writes BMA regional chairman Dr George Rae

Dr George Rae, the British Medical Association’s North-East regional council chairman

THE NHS in the North-East is facing significant challenges in the coming years. Yet despite repeated calls for a commitment to long-term investment in this year’s Budget, the government has fallen short of what is needed to overhaul services to the standard they should be.

The recruitment and retention of doctors in the North-East is a considerable cause for concern as recent NHS figures show that the region has lost more than 100 GPs in the past year – among the worst rates in England.

Middlesbrough and South Tees have been particularly affected, suffering the largest decline in full time GPs in the region.

Unfortunately, the recruitment problems are not confined to general practice as medical specialities in the North-East had the second lowest fill rate in the country with areas such as general and child and adolescent psychiatry experiencing worrying shortages.

While the launch of a pilot scheme to recruit international doctors to the North-East will provide some relief, long-term investment must be set aside to deliver a sustainable workforce plan that facilitates the training and development of doctors throughout all stages of their career. Investment of this kind will lead to an environment where doctors feel valued and supported enough to stay within the NHS.

Workforce shortages have been impacting on service delivery for some time and following the Budget, it remains unclear what plans the government will put in place to boost the medical and clinical NHS workforce. Without this assurance, it is difficult to see how the situation will get better.

LAST winter, health services across the region were unprepared for the inevitable pressures that are part and parcel of the winter months. Emergency departments struggled to cope as they experienced one of their worst winters on record. The Chancellor’s recognition of winter pressures in this year’s Budget will be a welcome boost for services as they enter these busy months. The government must be realistic however about the impact that this funding will have in the absence of a longer-term solution as demand on services continues to grow year on year.

In the absence of adequate funding, hospitals in the region have come up with their own contingency plans to ensure the smooth running of emergency services this winter. The Northumbria specialist emergency care centre is, for instance, carrying out early assessments of frail and elderly patients to ensure that they receive more appropriate and timely treatment.

Encouraging as it is to see hospitals take responsibility for service delivery and the positive impact of cooperative working across health and social care, services need a safety-net. Failings in the delivery of care last winter led to the government scapegoating GPs and overstretched primary care services. The announcement of the extra £335 million this year to increase capacity over the winter period is a start - but they must go further.

The fact that health spending in the UK is currently more than £10bn behind that of other leading EU economies has seen significant pressure being placed mental and public health services which have experienced debilitating cuts. The office of national statistics reports that in the North East, death rates among 60 to 74-year-old men as a result of alcohol abuse have increased significantly. Whilst there are a number of factors to consider, health equality plays a large role.

There is a worry that despite government’s intention to introduce a new duty band for still cider and perry to target white cider consumption, their decision to keep duty rates on beer, cider, wine and spirits frozen could undermine these efforts. Tighter regulations on alcohol and smoking will be beneficial in the prevention of alcohol abuse and smoking related deaths but the money must be provided to ensure that services are in place to treat those who are suffering with health issues as a result of substance abuse.

The government reiterated their commitment to parity of esteem between mental and physical health and must continue to work hard to achieve this. The publication of a green paper setting out plans for the transformation of mental health services for children and young people is a vital piece of work but must be matched with the appropriate funding to help transform these services – the budget has not offered a financial solution.

With Brexit set to shake the stability of the NHS and the future looking ever more uncertain – the budget was a small fix for a large problem.