Should extra NHS funding depend on it first meeting efficiency targets?
The NHS in England receives multi-year real-terms funding increases under the 2025 Spending Review, currently requiring at least 2% annual productivity gains as a condition for financial balance and future allocations. In 2025/26 it delivered around 3% productivity growth against a 2% target, though the waiting list stands at 7.1 million. Extra funding above baseline is tied to efficiency delivery through the NHS Productivity Plan and Medium Term Planning Framework.
9 Opinions
Funding should be based in need, need should be assessed by an independent or centralised body.
No. Squeezing frontline care for "efficiency" is a trap. The cupboards are bare. To root out real waste, we must fix structural procurement and maintenance. The NHS pays extortionate, inflated prices on, for example hardware like pipework and heating systems compared to private firms. Worse, a lack of regular servicing slashes the lifespan of this hardware. The NHS needs a universal department for centralized sourcing and preventative maintenance. Stop overpaying middlemen.
I agree we shouldn’t pump money into it without fixing the problems, but 2pc efficiency gains is the wrong approach. Its overly bureaucratic, slow, and risk averse, a 2pc efficiency goal will be met with more layers of middle management, more pointless reporting, and zero structural improvements. Also its probably unfixable with its current unions and culture in place.
Throwing more money at a dysfunctional organisation without trying to first address that distinction is mad. NHS reform is essential
First and foremost, we need to identify why there is a never-ending requirement for more funding. I have some ideas on why and how to fix it, but there's no space here. High inflation drives a need for pay rises. And the public spending bonanza will fuel inflation. Public spending also includes... the NHS. Looks like a death spiral to me. No pun intended.
I don't think efficiency targets are appropriate for a healthcare system, we should have positive outcome targets and incentivised bonuses, make the NHS a proactive and positive healthcare provider with appropriate outreach and encouragement instead of this jostling between 'fear it' and 'avoid it at all costs' mentality we've engendered since COVID and the swingeing cuts of the Tory era. Properly fund, incentivise and promote at every level, and it will flourish. Easy.
The NHS is already efficient. Remwmber the cost of PPP hospitals is huge and swallows up a huge amount of funds. And the payroll is enormous. I see few opportunities for efficiency gains and the additional funding is needed now. Edited
Punishing the NHS for failing to meet targets just ensures the standard of care will slip further. There ate plenty of things we cut from the national budget - MP pay, private contracts for genocidal companies like Palantir or genocidal nations like Israel - before attacking a basic need like healthcare.