Primary care continues to suffer real-term cuts
NHS England’s annual report explains how primary care was deprioritised for investment in 2022-23 due to inflationary pressures. NHS England was however able to fund more secondary care activity withs its underspend.
The NHS annual report states that the “real terms cut in core funding, combined with the high rate of inflation and operational pressures […] has made this a very challenging year for the NHS”. It reports that “NHS England delivered an underspend of £1,153 million”. £600m was used to “offset overspending by NHS providers” and the balance to “offset the pressure caused by provider technical issues”. It goes on to explain how inflation also meant it had to cut funding for “digital investment and for primary care”.
Meanwhile, GP funding has seen a 7% real-term cut since 2019, reports Pulse magazine. The British Dental Association has also said spending on NHS dentistry has fallen by more than 30% since 2010, with a real-term cut of £1bn. While the pharmacy sector has celebrated the rollout of Pharmacy First (see below), it told the BBC that pharmacies are “severely underfunded” and at serious risk of closure.
FODO has also raised concerns about real-term cuts to primary eye care funding.
Harjit Sandhu, managing director at FODO, said: “There have been significant and sustained cuts in real-term funding to primary eye care services in England, in the same way as GP, dentistry and pharmacy, and all these services are suffering as a result.”
He added: “Every election and NHS plan in living memory promises to shift care out of hospital and invest more in prevention and primary care. However, the hard economic evidence points to business as usual, with significant under-investment in primary care. The NHS will not succeed until it invests in all primary care professions, as these services are at the heart of keeping people well and out of hospital for longer. That is why we call for change in Principles and priorities and make the case for change by fairer funding for the sight test and more investment for enhanced eye care services out of hospital and closer to home.”
The Health Foundation has also called for a fundamental rethink. A recent report stated: “A larger proportion of the NHS budget was spent on hospital care and a declining share on prevention, primary and community care.” It has also called for a “new deal for primary care to tackle the mismatch between demand and capacity by increasing the share of NHS investment it receives.”