With most domestic policy initiatives on hold because of Brexit, the government has promised a \u00a320.5 billion spending boost by 2023-24 to back up its health plans \u2014 funds May said<\/a> will come in part from the windfall to be enjoyed when the U.K. stops sending money to Brussels.<\/p>\n But the reactions from health care providers focused largely on the uncertainties facing the NHS ahead of Brexit, both in terms of finance and the departure of EU27 nationals that will worsen staffing issues. (Few believe a Brexit windfall is likely despite Vote Leaves red bus<\/a>.) Lengthening wait times for services was another politically sensitive issue set aside in the governments announcement.<\/p>\n \u201cThis is not about miracles \u2014 money will be tight and staffing will remain a headache for years to come,\u201d Niall Dickson, chief executive of the NHS Confederation, which represents health service providers, said in reaction to the plan. Warning of the risks of \u201cover-promising,\u201d Dickson said: \u201cOur plea is that politicians be honest about the trade-offs that will be required and that we are realistic about what can be achieved given the ever-increasing demands of an aging population.\u201d<\/p>\n \nHealth groups say the \u00a320.5 billion budget increase by 2023-24 unveiled in June is not enough to get the NHS back on track following years of austerity.\n<\/p><\/blockquote>\n The announcement also suffered from the governments strategy of pre-announcements: Major policy initiatives from new cancer screening to mental health service improvements had been widely previewed<\/a>, leaving praise confined to celebrating the \u201cvision<\/a>\u201d of tying those initiatives together.<\/p>\n Heres five reasons why the plan failed to match expectations.<\/p>\n Health groups say the \u00a320.5 billion budget increase by 2023-24 unveiled in June<\/a> is not enough to get the NHS back on track following years of austerity. The figure amounts to a 3.4 percent increase in funding, but think tanks such as the Nuffield Trust say at least a 4 percent boost is needed<\/a> to \u201cput the NHS on a sustainable footing.\u201d<\/p>\n \u201cUltimately, there is a need for honesty about how far the \u00a320.5 billion over five years will stretch,\u201d British Medical Association (BMA) council Chair Chaand Nagpaul said<\/a> Monday. \u201cWorld-class care requires world-class funding and the investment in the long-term plan will still leave the U.K. falling behind comparative nations like France and Germany.\u201d<\/p>\n Britains Health Secretary Matt Hancock | Ben Stansall\/AFP via Getty Images<\/p>\n Plus theres concern a no-deal Brexit would deplete the promised funding \u2014 \u201cthe extra costs and tasks required would eat up the first instalments, stopping progress dead in its tracks,\u201d Nigel Edwards, chief executive of the Nuffield Trust, said<\/a> in a statement.<\/p>\n Health Secretary Matt Hancock has promised<\/a> the extra funds will be available \u201cirrespective\u201d of the outcome of Brexit talks with the EU, which doesnt quite fit with Mays suggestion it will come in part from money London will no longer be sending to Brussels.<\/p>\n Staffing shortages are top of the list for nearly 60 percent of U.K. voters when asked where the extra NHS cash should be spent, according to a poll by the Times<\/a>, but the governments plan kicks that can down the road.<\/p>\n The plan promises \u201cNHS staff will get the backing they need\u201d by balancing \u201csupply and demand across all staff groups.\u201d The funding for hiring, training and professional development of NHS staff \u201chas yet to be set by government\u201d and wont be published until \u201clater in 2019,\u201d it says.<\/p>\n \nStaff \u201care routinely struggling to cope with rising demand and, as a result, are subject to low morale, stress and burnout\u201d \u2014 Chaand Nagpaul, BMA council chair <\/em>\n<\/p><\/blockquote>\n The BMA, which represents doctors, and NHS Providers, which represents various NHS staff, cautioned the NHS will be hard-pressed to make good on the plans promises if it doesnt improve the staffing situation. One in 11 posts are estimated to be vacant<\/a> and the situation is predicted to worsen after Brexit, with the Kings Fund, the Health Foundation and the Nuffield Trust predicting a shortfall<\/a> of around 250,000 NHS staff by 2030.<\/p>\n Nagpaul of the BMA said doctors and staff \u201care routinely struggling to cope with rising demand and, as a result, are subject to low morale, stress and burnout.\u201d<\/p>\n The governments plan commits to reducing waiting times for mental health services across the board, ranging from children to adults and community-based care to crisis situations.<\/p>\n But as the NHS continues to come up short on waiting times for emergency care and routine surgery, the new plan offers no clear path forward other than to say \u201csufficient funds\u201d will be allocated to local NHS services to cut long waits.<\/p>\n NHS chief Simon Stevens | Tolga Akmen\/AFP via Getty Images<\/p>\n \u201cWe also need immediate, practical solutions and the necessary investment for hospitals to deliver both in the long- and short-term,\u201d said Nagpaul of the BMA.<\/p>\n NHS chief Simon Stevens said there should be \u201ctougher, faster\u201d standards when it comes to emergency room waiting times in an interview with BBC Radio 4 on Monday, and suggested the existing four-hour guideline by which NHS progress is judged needs to be updated. \u201cThe problem with that is it doesnt distinguish between turning up at A&E with a sprained finger and turning up with a heart attack,\u201d he said. He declined to commit to specific targets.<\/p>\n One of the main pillars of the governments plan is prevention \u2014 stopping health problems before they start by trying to reduce smoking and drinking or increase exercise, for instance.<\/p>\n While many groups support this move, they couldnt help but note the hypocrisy of the fact that government funding for local public health services has been cut in recent years. The latest projections are a cut of \u00a385 million<\/a> for 2019-20, to \u00a33.1 billion.<\/p>\n \n\u201cThe reforms we all know are needed to the way we pay for care have been kicked into the long grass again and again\u201d \u2014 Nigel Edwards, chief executive of the Nuffield Trust<\/em>\n<\/p><\/blockquote>\n Nagpaul of the BMA urged the government to take bolder stances on issues such as a minimum unit price for alcohol and restricting sugar in food.<\/p>\n \u201cThe reforms we all know are needed to the way we pay for care have been kicked into the long grass again and again,\u201d said the Nuffield Trusts Edwards.<\/p>\n U.K. Chancellor Philip Hammond hit the nail on the head when he wrote in the Daily Mail<\/a> on Monday: \u201cThe leaders of the NHS must now ensure they get the basics right. Alongside greater quality of care and ending waste, the public will demand that progress is made on the back of their investment.\u201d<\/p>\n The widely touted funding rise will leave people expecting a better and more efficient NHS, which requires delivery on the basics such as wait times that the plan doesnt address.<\/p>\n The governments major targets are focused around specific diseases: The plan aims to prevent 150,000 heart attacks, strokes and dementia cases, and 55,000 cancer-related deaths, and help 380,000 more people get treatment for anxiety and depression. As Conservative Party MP and health select committee Chair Sarah Wollaston noted, some of the priorities mirror those set out in the previous five-year plan, \u201cmany of which remain unfinished business.\u201d<\/p>\n \u201cThe last plan was undermined by the cuts to social care, public health, capital and training budgets and it is important not to see this repeated,\u201d Wollaston wrote in a blog post<\/a>.<\/p>\n Original Article<\/a> Theres life beyond Brexit, according to the U.K. government. No one else seems convinced.<\/p>\n Prime Min..<\/p>\n","protected":false},"author":1,"featured_media":110660,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48],"tags":[],"class_list":["post-110657","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"yoast_head":"\n1. Not enough money<\/strong><\/h3>\n
![](\"https:\/\/www.politico.eu\/wp-content\/uploads\/2018\/08\/GettyImages-934935028-714x476.jpg\"\/)
<\/a><\/p>\n2. Staffing woes ignored<\/strong><\/h3>\n
3. Hedging on waiting times<\/strong><\/h3>\n
![](\"https:\/\/www.politico.eu\/wp-content\/uploads\/2019\/01\/GettyImages-992195442-714x476.jpg\"\/)
<\/a><\/p>\n4. Mixed messages on prevention<\/strong><\/h3>\n
5. Raised expectations<\/strong><\/h3>\n
Read this next: German police raid home of 19-year-old in probe of data hack<\/a><\/em><\/h2>\n
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<\/a><\/h5>\n","protected":false},"excerpt":{"rendered":"