NHS chief ’s plea to protect EU staff

Both Leave and Remain were united on the health service – but it needs to improve. Here’s how

FOREIGN NHS staff must be given “reassurance” that they are still welcome in this country, the head of the health service says today.

Simon Stevens, the NHS chief executive, calls on Theresa May’s new government to protect the rights of all employees in the wake of the vote to leave the EU because the health service relies on “committed health professionals from other countries”.

Setting out his post-Brexit blueprint in an article for The Daily Telegraph, Mr Stevens also says that money should be diverted from hospitals to GP surgeries to help save the NHS.

He calls on Mrs May to use the EU referendum as an opportunity for “radical change” in the NHS and argues that “headlines about hospital deficits obscure the fact that over the past decade their share of funding has grown rapidly at the expense of primary care”.

And he warns that GP surgeries and hospitals across the country are “overcrowded and clappedout” and calls on Mrs May to set up a new infrastructure fund to replace “buildings in need of a makeover if not a bulldozer”.

Following the Brexit vote, there have been repeated calls for the Government to guarantee the rights of EU citizens already living in the UK.

However, ministers have refused to do so unless there is a reciprocal guarantee to protect Britons living on the Continent.

Mr Stevens calls on the Govern- ment to give assurances to “every international NHS employee”. NHS figures for 2014 suggest 25 per cent of doctors are non-British, and 13.5 per cent of nurses – among the highest in Europe.

“As the largest employer in Europe, the health service needs to do a better job training and looking after our own staff,” he writes.

“New apprenticeships and ladders of opportunity for committed young people can help many of the left-behind communities most alienated from modern Britain. Even then we’re still going to need committed health professionals from other countries.

“Australian-style immigration points systems all give thumbs-up to nurses, doctors and other skilled health professionals. So it should be completely uncontro- versial to provide early reassurance to every international NHS employee about their continued welcome in this country.”

In his article, Mr Stevens also says that Mrs May’s new government must “urgently” set out a child obesity strategy, warning that it will cost the NHS billions of pounds in future.

Meanwhile the Government was accused of issuing “misleading” figures over its pledge to raise NHS funding.

MPs on the Commons health committee said the claim that the NHS would receive £8.4 billion by 2020-21 actually translates into £4.5 billion because ministers used a different calculation compared with previous years.

The NHS wasn’t on the Brexit ballot. But it often felt as if it was. Emblazoned on the battlebus, both Leave and Remain wrapped themselves in the mantle of a strong and better-funded health service.

This was curious, as on the NHS there is no overriding need to ‘‘take back control’’. We already make the big decisions about our health system largely as we please, as do the Germans, the French and the rest.

But if the referendum result revealed a country divided, on the NHS it confirmed a nation united – by deep pride and genuine concern for our most important social institution.

Would Brexit liberate £350 million a week for the NHS? Or would it dent the public finances just as the health service needs more public money? And how best to manage immigration, without inadvertently triggering hospital and care home closures, which have relied for years on 130,000 European nurses, doctors and other staff?

These questions matter profoundly, but the challenges facing the health service go far wider. They require bold and broad reforms.

First, if you’re concerned about life chances you need to act on prevention and health inequalities. While smoking explains half the difference in longevity between rich and poor, obesity is the new smoking: poor diet is now our biggest avoidable cause of ill health. Piling on the pounds around our children’s waistlines is piling on billions in future NHS costs. We now spend more on obesity than on the police and fire service combined. We urgently need an activist child obesity strategy, with comprehensive action on food reformulation, promotions and advertising.

Second, how NHS care is provided needs a major overhaul. Access to GPs was a repeated public concern during the referendum campaign. We make 300 million visits to GP practices each year, compared to fewer than 25 million A&E attendances. So if GP services fail the NHS fails. Yet headlines about hospital deficits obscure the fact that over the past decade their share of funding has grown rapidly at the expense of primary care, and hospital consultant numbers have expanded three times faster than GPs.

Every part of the country is now getting on with the NHS’s “Five Year Forward View”. It’ll mean better joined-up GP and hospital services, better links with social care, earlier cancer diagnosis, and streamlined access to urgent and emergency care – seven days a week.

And as Theresa May pointed out last week, mental health is the poor relation. Today, we publish a blueprint showing how a million more people will get the specialist help they need each year. It sets out chapter and verse on better mental health for young people and new mothers, seven-day crisis care to keep people out of the criminal justice system, and far wider help for depression, anxiety and other common conditions.

Third, many patients arrive each day for their GP or hospital appointment in what are – frankly – overcrowded and clapped-out buildings in need of a makeover, if not a bulldozer. Yet to help balance the books, the NHS is currently switching billions of pounds of capital investment into day-to-day running costs.

When you’ve got lemons, make lemonade. Government borrowing costs are the lowest they’ve been since the Napoleonic wars. Instead of inflexibly expensive PFI, how about a substantial NHS 70th birthday public fund for infrastructure? It would create optimism across the NHS, unleash major efficiencies, turbocharge the construction industry, and be welcomed across the country.

Fourth, as the largest employer in Europe, the NHS needs to do a better job training and looking after staff. New apprenticeships can help many “left-behind” communities alienated from modern Britain.

Even then we’re still going to need committed professionals from abroad. Australian-style immigration points systems all admit nurses, doctors and other skilled experts. It should be uncontroversial to provide early reassurance to foreign NHS employees about their continued welcome.

Fifth, while the NHS is the world’s cheapest high-quality health system, there are still major efficiencies to be had. Care is variable, procurement fragmented, assets used ineffectively. This year will see decisive action to get hospital finances back on an even keel, with last year’s deficit cut dramatically.

The most immediate need is social care. If home care disappears and care homes close, A&Es are quickly overwhelmed. We need creative solutions. Do we give retirees more personal control over how care, health and benefits funds are together spent on their behalf? Expand the ‘‘triple lock’’ on pensions to encompass care costs? Let councils take back democratic control over earmarked social care funding increases?

The need for radical change is now. We know what needs doing. Let’s get on with it.