Tea trolleys and the folly of ring-fencing budgets

The decision to ring-fence the NHS budget is not a smart one. It places increased pressure on other budgets and as the NHS receives over £100 billion a year, this pressure is both heavy and unnecessary. Spending reductions can be made without affecting the quality of healthcare - as the increasingly large number of emails we receive from healthcare professionals testify. The case for ring-fencing the International Development is even weaker, but that's another story.

Today's Telegraph carries a story about NHS Grampian. They have decided to spend £70,000 on new tea and coffee trolleys, "improving fluid intake" for patients. This is not a spending priority right now, plain and simple. But perhaps such decisions are reached precisely because the NHS budget is protected. If the Department, SHAs and Trusts weren't given such guarantees, they would have to work far harder to ensure that every penny spent was worth it. With a ring-fenced budget, there's much less of a need to make difficult calls on what the main priorities are. Although the call wasn't so difficult in Grampian's case.

Saying that savings will be reinvested does not have the same impact as having to make genuine savings and to operate more efficiently, which is exactly what the NHS needs to do.

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