Seven-day NHS 'impossible' to deliver under current funding
Jeremy Hunt's vision for a seven-day NHS is "impossible" to deliver with the current level of funding and staffing, the head of one of the service's largest trade bodies has warned.
In a stark assessment of the financial difficulties facing the system, NHS Providers chief executive Chris Hopson said the service was already over-stretched and "something has to give".
He said the strikes by junior doctors were a symptom of the pressure being placed on the NHS as he called for more money from the Government.
Ahead of the November 23 Autumn Statement, Mr Hopson said health bodies were already being forced to cut services due to a shortage of funds.
"We have already seen, over the last three or four months, the beginnings of these kind of choices that need to be made. We had a CCG up in the North West that said it needed to postpone all non-urgent operations for four months."
He told BBC One's Andrew Marr Show: "We have now got hospital trusts having to close services, we have also got trusts who are saying that the only way to make the money add up is to cut the workforce.
"These are all things that have been done by other public service, but it's very different for the NHS."
He added: "They cannot provide the right quality of care and meet the performance standards on the money that is available and something has to give.
"We should have a proper debate about what should give, rather than pretending the gap doesn't exist or leaving it up to each individual area to make a decision about what should give."
Health Secretary Mr Hunt has set out his plans for reforms to make the NHS in England a seven-day service, with increased activity and cover at weekends.
Mr Hopson said: "Jeremy Hunt and others have made a very strong case for seven-day services but it seems to us it is impossible to deliver it on the current level of staff and the current money available.
"If something has to give at the moment, and we are trying to do what we are currently doing, it can't cover important new policies like seven-day services."
The move to a seven-day NHS has been one of the major drivers behind the industrial action by junior doctors, with week-long walkouts in October, November and December in protest over a new contract.
Mr Hopson said: "The junior doctors' strike is a really interesting issue. If you talk to junior doctors to ask them why are they so angry, the answer is because of the pressure they are under.
"The reason they are under pressure is precisely because we can no longer provide the quality of service, meet the standards, on the money we have available."
Writing in The Observer, Mr Hopson warned that senior hospital trust managers face a "stark choice" between investing the money needed or "watching the NHS slowly deteriorate".
Mr Hopson, whose organisation is the trade association for acute hospital, ambulance, community and mental health services, told the paper: "Thanks to the dedication of staff, NHS performance rarely goes off the edge of a cliff.
"As the 1990s showed, instead we get a long, slow decline that is only fully visible in retrospect. It's therefore difficult to isolate a single point in that downward trajectory to sound a warning bell.
"But NHS trust bosses are now ringing that bell - we face a stark choice of investing the resources required to keep up with demand or watching the NHS slowly deteriorate."
A Department of Health spokesman told the newspaper: "We know the NHS is under pressure because of our ageing population, but we rightly expect the service to continue to ensure that patients get treated quickly."
Chris Ham, chief executive of The King's Fund charity, said: "The clear message from the NHS leaders, doctors and nurses I've spoken to over the last few weeks is that they are increasingly unable to cope with rising demand for services, maintain standards of care and stay within their budgets. Cuts in social care are adding to the pressures on the NHS and both health and social care have reached a critical point.
"The Government must be honest with the public about what the NHS can deliver with the funding it has been given. It is simply not realistic to expect hard-pressed staff to deliver new commitments like seven-day services while also meeting waiting time targets and reducing financial deficits.
"Social care is rapidly becoming a threadbare safety net for some of our poorest and most needy citizens. Without additional funding, delays in transferring patients from hospital to the community, already at record levels, will increase to the point where hospitals run out of beds. If the Prime Minister is serious about creating a more equal country that works for everyone, then tackling the crisis in social care must be an urgent priority.
"With winter approaching, the Government should heed the warning signs rather than wait for a full scale crisis to develop."
Shadow health secretary Diane Abbott said: "Years of Tory underfunding of the NHS has made it is impossible to provide the right quality of service and meet performance targets.
"Independent observers and key practitioners have all made the same point. The Government needs to properly fund the NHS if it is to function properly. This is what Labour would do."
The Department of Health said the promise of £10 billion a year more in funding by 2020 would meet the needs of the seven-day NHS.
A spokesman said: "The money we have given the NHS to fund its own plan for the future - £10 billion more a year by 2020, and £4 billion just this year - covers our promise to ensure that standards of urgent and emergency care are the same across seven days.
"We want to be the first government to tackle unacceptable variations in care at the weekend, and have thousands more doctors and nurses to help us do so."