Failing our way out of trouble

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Gasps of mock astonishment greeted the news that NHS trusts have missed the very reasonable spending targets set by the NHS’s financial optimism and improvisation body NHS Improvement and the pragmatists at HM Treasury.

Reckless spending on “keeping the NHS going” has left NHS finances in a deeper, darker hole than ever. By April, the deficit is expected to reach £930m, nearly twice as bad as the most pessimistic forecasts.

Trusts asked to deliver the impossible put in particularly poor performances. Not one of them managed to hit the unattainability targets they freely signed up to at the start of the financial year, despite encouraging phone calls from Mr Hunt and Guantanamo-style team building exercises led by NHS England regional directors.

Areas with credible plans, positive mindsets and nice photogenic leaders will continue to do well. Whingers will lose out.

A ray of hope promises to cut through the gloom.

The Department of Health and Social Care is making loans to help ailing trusts to achieve financial balance. The department is charging interest on the loans at 6%. That could amount to a £56m windfall based on the current deficit forecast and far more if deficits were to increase at a healthy rate in future.

If instead of making heroic efforts to balance the books trusts were to take decisive action to lower their game the effects could be dramatic. Deficit-ridden providers could start making a decent living from the money they lose.

Extend this principle to general practice, community services and social care and the NHS could soon be awash with cash again. The debt could be resold as junk bonds. Today’s struggling healthcare providers could be tomorrow’s sub-prime investment opportunities.

This sort of creative financial strategy has proved very successful in other areas of life. Investment bankers always seem to bounce back from their occasional cyclical setbacks.

We need to learn from the bankers. If we monetise our weaknesses we can fail our way out of trouble. It is hard to see what could possibly go wrong.

Editor: Julian Patterson


Reproduced at by kind permission of Julian Patterson.