SUPPLEMENTARY
WRITTEN EVIDENCE
FROM DR
HAMISH MELDRUM,
BRITISH MEDICAL
ASSOCIATION (PEX 18A)
Many thanks for the opportunity to appear as
a witness on 9th November, I hope that the Committee found the
evidence session helpful.
You will recall that in the course of the evidence
session, I undertook to reply to Chris Skidmore's question on
the magnitude of cuts to social care budgets. Mr Skidmore asked
me whether I felt that the figure would be of the order of £5.6
billion if cuts were to be at a level of 40%. The short answer
is that spending on social care totals around £16bn in gross
terms and £14bn in net terms so we are talking about figures
of roughly the magnitude that Chris Skidmore quotes based on net
expenditure.
You will also recall that the Chair asked (Q231)
participants whether "given the pressures that are on the
public sector in general, is there a way of handling the present
situation in the Health Service that would mitigate some of the
effects that you describe?" Dr Carter referred in his reply
to there being "huge tranches of expenditure that are very
difficult to justify." We would like to take this opportunity
to endorse that and to point out that in the current climate,
rates of return to pharmaceutical companies and PFI consortia
implicit in expenditure on medicines and PFI unitary payments
respectively are very difficult to justify when the NHS is facing
severe cuts. These rates of return represent far more than could
be obtained through investment vehicles generally and it is inappropriate
for a public service to generate them at the expense of patient
care. We believe there is a case at the very least for increases
in PFI unitary payments to be deferred in the same way as staff
pay increases will be over the next two years.
I hope that you find this useful.
November 2010
| 
