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The NHS in England and Wales has been given a 4% a year funding rise for the next three years, with an overall budget rise from £90bn this year to £110bn in 2010.
Announcing the comprehensive spending review, the chancellor, Alistair Darling, said that the cash would fund 20 new hospitals, 140 walk-in centres open seven days a week, and 100 new GP practices.
However, the funding is much less than the 7.2% that the NHS has had each year since 2002 and below the 4.4% recommended by Derek Wanless in his review of the future of the NHS published in September (BMJ 2007;335:529, doi: 10.1136/bmj.39336.545336.80). But it is more than the 3% that many NHS staff had been expecting.
Hamish Meldrum, chairman of the BMA, said it was vital funds were not squandered on “costly and poor value” deals with the private sector, where he said “profits are often rated higher than patients.
“Excessive use of the private sector in providing NHS care will fragment care for patients, could threaten the existence of many district general hospitals, and risks destroying the proven and trusted model of UK general practice,” he said.
Dr Meldrum added that the BMA would be seeking “constructive dialogue” with the government to ensure that doctors had the freedom to innovate.
He also welcomed Mr Darling's proposals to implement the recommendations of the Cooksey review into medical research (BMJ 2006;333:1239 doi: 10.1136/bmj.39059.559213.DB). This includes a commitment from government to bring in a combined fund of £1.7bn (€2.5bn; $3.5bn) for medical research by 2010-1.
The chairwoman of the Academy of Medical Royal Colleges, Carol Black, said that the extra money allocated for the NHS needed to be spent “even more wisely, effectively, and justly” than in the past to ensure that the NHS continued to deliver better care for patients.
The president of the Royal College of Physicians, Ian Gilmore, said that although the rise represented a slowing in growth in spending on the NHS in real terms, the money had come at a time when the NHS has gone through a “painful period of balancing its books.
“There is a genuine opportunity to make a difference if the resources are used wisely in direct patient care.”
Professor Gilmore also welcomed the increase in funding for medical research.
“This fosters the sound scientific foundations that should translate into real health gains while keeping the UK at the forefront of international research and development,” he said.
The independent think tank the King's Fund said that the onus would now be on the NHS to improve productivity and make progress in tackling unhealthy lifestyles.
The chief executive of the King's Fund, Niall Dickson, said, “Reducing the annual real growth from what it has been over the last seven years will feel like a cut.
“A slow-down in the growth of funding should not damage patient care and the delivery of better services as the NHS has been planning for this slow down.”
The Pre-Budget Report and Comprehensive Spending Review 2007 is available at www.hm-treasury.gov.uk.