The government has no "credible plan" to make NHS savings of £20bn by 2014, a committee of MPs warns today. The figure would represent "unprecedented" efficiency gains if the quality of care is to be maintained.
In a report on public expenditure, the health select committee said it was concerned that health and social care budgets would be squeezed while bearing the cost of the government's radical reforms. The report claims ministers had "unfortunately neglected to provide even a broad estimate of the likely reorganisation costs".
The MPs also chided the health secretary, Andrew Lansley, for peddling a price tag for his white paper proposals that was produced for the last government: "It is unhelpful for the government to continue to cite the £1.7bn figure, as it does not relate to specific proposals."
Stephen Dorrell, the former Conservative health secretary who chairs the select committee, said the NHS chief executive, Sir David Nicholson, had warned that the 4% productivity improvements required by the £20bn cut had "never been achieved in the history of the NHS or any healthcare system in the world".
Dorrell said staff would probably face "bruising changes" as the NHS was redesigned to save money: "[It is] likely that staff will be bruised as the current structures and resources are redeveloped."
The MPs say there are a number of signs that cuts were being passed off as efficiency gains and cite reports that health trusts were "warning that their plans rely on huge cuts and spending all contingency funds''. Other trusts were reportedly ceasing to offer IVF treatment to new patients, stopping minor surgery at GPs' clinics, and delaying non-urgent hospital treatment.
It has also emerged that the coalition government's promise to protect the NHS budget will not be fulfilled. The report says there will be "a real cut of around £0.25bn by 2014–15 … the government's commitment to a real-terms increase in health funding throughout the spending review period will not be met."
The report considered the affordability of long-term care for the elderly, given that this spending is not ring-fenced. Demand is rising 4% every year as the population ages, but there are cuts of 14% to local government budgets. The MPs conclude it "will not be easy" to make savings in social care.
Responding to the report, Nigel Edwards, acting chief executive of the NHS Confederation, said: "The committee has hit the nail on the head with the concerns it has highlighted in its report. It has shown a thorough understanding of the fierce pressure that the health and social care sectors are now under."
He added: "All at the same time, NHS trusts are grappling with unprecedented efficiency savings, major management cuts and radical structural reforms. It's a mixture that is causing real anxiety among NHS leaders."