Contemporary Welfare and Social Policy: NHS Funding Crisis Analysis

This essay critically examines the impact of the funding crisis on the National Health Service (NHS) and social care services in the UK, exploring the challenges posed by economic, political, and social conditions, including the influence of Brexit. It analyzes the sources of NHS funding, primarily taxation and national insurance contributions, and discusses the allocation of funds across various healthcare services. The essay highlights the pressures faced by the NHS, such as an aging population, increasing healthcare costs, and staffing shortages, and investigates the efficiency and effectiveness of fund utilization, considering the impact of government policies and budget allocations. It also addresses the impact of funding cuts on social care, the role of NGOs, and the potential consequences of financial instability on patient care, concluding with a discussion of social policy and its impact on the health and well-being of the population. The essay draws on various sources, including government reports and academic research, to support its arguments.

contemprorary welfare and social policy
[Document subtitle]

Critically examine the impact of the funding crisis on the NHS and Social Care services
Introduction
The social services is well known to bring range of public services, which is provided by
private, non-profit, and government companies. These services will finally aim to create
effective companies by creating strong communities, and promote equality. These services
include healthcare services, subsidised housing services, food subsidies, education, and
community management (Woolhandler, and Himmelstein 2017: 428). One availing social
service institution named as NHS, which was established in 1948 as a social reform to avail
healthcare services and treat patients free of cost (NHS England 2018). These services are
availed irrespective of sexual orientation, age, disability, race, religion, and belief. This essay
shows the importance of funding for social service and issues faced by them, where NHS has
strived to incur proficient healthcare services and delegate them to patients. NHS depends on
comprehensive support through local healthcare professionals who makes decisions regarding
the services towards patients and local communities (the UK’s independent fact checking
charity 2018). The regional teams of NHS strengthen the collaboration with the integrated
care systems, and sustainable transformational partnerships within the organisation. It is
already national health services, which is a practical expression of shared commitment across
generation and nations. This essay will analyse and critically discuss the funding issues on
NHS and social care service (Woolhandler, and Himmelstein 2017: 428). Although, NHS is
considered as one of the precious resource of society but it faces severe pressure from
economic, political, and social conditions. It is important to identify key ideas and concepts
for social policy, which brings principles such as social needs, social issues, social justice,
equity, equal rights, difference, and exclusion indicating and allocating rights to people
(Wilson, Tucci, Merson, and O'Donoghue 2017: 2511). NHS generates funds from general

taxation, local government, and other national insurance contributions (the health foundation
2019). NHS spends its most of its funds in hospitals, and 15 percent healthcare services,
which includes dentists, pharmacists, and opticians. NHS undertakes to spend 15 percent,
which does not consider spending by the individuals on social care (the UK’s independent
fact checking charity 2018).
Examination of funding crisis of NHS and other social services
With current changes in the political environment especially due to the influence of Brexit,
NHS faces funding crisis. With this impact, it is seen that there are other several factors,
which has changed the source of creating funds (Pappas 2019: 17). Recently, it is seen that
social care services have been facing current issues such as management issue, ageing
population, increase in obesity and diabetic patients, lack of personnel, funding issue,
performance, increasing cost of social care services, lack of medicine, and difficulty in
handling mental health. Lack of funding is one of the major cause of hurdles in serving
people (Fahy, Hervey, Greer, Jarman, Stuckler, Galsworthy, and McKee 2017: 2114). This
discussion will consider the examination of how efficiently and effectively NHS uses its
funds to bring towards the welfare of society by getting assistance from local government
grants and healthcare departments in last few years (the health foundation 2019). In 2018,
nearly Euro 110 billion was spent on NHS Budget, which included catering of services such
as public health initiatives, educational training and hospitals but at the same time it is seen
that these services had induced NHS to spend Euro 125 billion (NHS England 2018).
Furthermore, NHS reports have presented that only a small amount is generated through the
patient charges, which essentially includes dental care and prescriptions. Then in 2016 and
2017, Euro 1.6 billion was collected as the sum of prescription, patient charges, and dental
care fees. According to the assumption, UK would receive funding in real terms over Euro 20
billion by the end of 2023-24, which reflects 3.4 percent inflation. In 2018-2019, it is seen

that Theresa said that taxpayers are instructed to contribute fair and balanced way to finance
NHS and implication coming from taxation. Although, there are several reasons of decreasing
funds but Brexit is prime amongst all of them (Cookson, Mirelman, Griffin, Asaria, Dawkins,
Norheim, Verguet, and Culyer 2017: 210). NHS does not individually face lack of funds but
it is most common issue faced by other NGOs (Simpkin, and Mossialos 2017: 470).
Undoubtedly, NHS faces hurdles in attaining and garner sufficient funds for its work. This
will lead to severe consequences in long term especially patient`s care. For instance-
prolonged decrease in value of sterling, which will finally increase inflation and reflect higher
price for drugs and other medicines for NHS purchases (NHS England 2018). Alteration of
plan in HM treasury in which the taxes might rise and cutting of public spending so that
government can increase their revenue (Mugisha et al. 2017: 7). If these budgets are
improved then cutting in social care funding can have knock on impact on NHS because there
will be an intensifying gap in social care funds. Spending review shows that NHS needed
additional funding above especially in 2018-2019, which is obviously needed for catering the
patients. Below is the health budget estimation laid down by the department of health budget-
Table 1. The uk’s independent fact checking charity (2018)
With the upsurging ageing population, inflation, and need for medical needs, it is seen that
spending per person will definitely increase where UK`s political and economic instability is
another concern, which will increase the spending per person. NHS have been facing
additional burden because of increasing ageing population (Doetsch, Pilot, Santana, and

Krafft 2017: 184). The estimation conducted by the department of healthcare in budget will
fall short and it is still questionable whether the institute will be able generate appropriate
funds, which can be generated through asset sales, and other share in investments (Costa-
Font, 2017: 787). On the other hand, public budgets on the behalf of government continues to
reduce. Furthermore, government will reverse plans, cut public health budgets, and finally
renew their commitment towards the prevention. This commitment. States that there will not
be any additional funding in order to address any increasing challenges in public health in
budget (Fahy, Hervey, Greer, Jarman, Stuckler, Galsworthy, and McKee 2019: 953).
The money pledged in Budget will take and induce department of health budget to dedicate-
Year Amount (Euro billion)
2017- 2018 124.7
2018-2019 126.4
2019-2020 127.2
Table2. The UK’s independent fact checking charity (2018)
This was the estimations made by the office for budget obligations with the impact of
inflation. This estimation was decided after looking at the needs and long-term trends of
NHS. The need of NHS has increased by 4 percent every year since the time it has been
established (The UK’s independent fact checking charity 2018). Then the budget was altered
to avail Euro 1.9 billion as additional cash funding to NHS in 2018, which they tried to
increase with an aim to minimise the gap between the lack of resources and services aimed to
be provided (NHS Support Federation 2020). This additional funding will not avail any pay
rewards to the staff. While pacing the budget 4 percent each year, Budget has realised that
NHS will not be able to maintain the standards and accomplish the increasing demand for the
services (Bloom, Bunn, Chen, Mizen, Smietanka, Thwaites, and Young 2018: 570).

Figure.3: NHS Support Federation (2020)
The graph is based on the facts where it is marked in the reports that NHS is on the half way
where it has been recording underfunds throughout the decade where lowest average arises.
NHS budget is not prevented and the result is the cutting of the frontline service as far as the
public health is concerned. Underfunding stops the staff to perform properly, which indicates
that crisis through the recruitment of staff in NHS. Due to economic and financial crisis,
government spends less per head on NHS. Large cutting of the social care and the mental
health has added high pressure on NHS. From the above graph, it is seen that government has
further demanded highly efficient savings where several providers have ultimately founded
unachievable and finally drive the deficits. Due to deficits, NHS debts are at the priority
where STPs (local plan) is developed from 2016 leading to the lack of investment. This
situation has led to cutting of services across the nation, which includes closing of services
such as maternity units and A&E departments.

Accessing appropriate donors is quite difficult which creates limited mobilisation of resource
on local basis so they often wait for government assistance or international donors. Current
donors shift their priorities and often withdraw their funds (Fahy, Hervey, Greer, Jarman,
Stuckler, Galsworthy, and McKee 2017: 2115). Non-strategic planning and inability to
handle the project with limited resources and limited human resource is quite difficult
(Doetsch, Pilot, Santana, and Krafft 2017: 184). The strategic goals do not lie in
accomplishing project alone as it always maintains contacts so that they can continuously
progress depending on the beneficiaries. NGO undoubtedly wants to help individual and
more communities depending on the needs. For doing so, a NGO will need funds. Moreover,
NGOs often complacent and wait for efficient donors to support and focus on NGO causes
(Robertson, Appleby, and Evans 2017).
Social policy defines the plan and action of the state agencies, which includes social and
health services that benefit schools, bodies, and other welfare benefiting system. Welfare
systems have facilitated cooperation among the groups in society. Social policies has been
continuously having impact on social and economic results (Appleby, and Robertson 2016).
Health and social act, 2012 creates clinicians to bring commission, free up the providers to
innovate and finally empower the focus towards the health concerns (Medic report 2020). In
UK, social policy has improved the social conditions of people, who were exploited by other
actions (Appleby, and Robertson 2016). NHS policies has improved wellbeing and health as
it has prevented poor health conditions and promoting the healthy life style with an aim to
reduce the health inequalities and finally sustain NHS for the future generation (Robertson,
Wenzel, Thompson, and Charles 2017).
NHS has been always protected because government fight while securing future of NHS and
becoming cost effective. One of the action adopted by NHS is to move the patient care into
the clinics out of hospitals. This will lead to income generation of both hospitals and clinics

under NHS. Centralisation of services is a way through which government authorities tries to
address the funding issue (Medic report 2020). The recent government policies came out with
an aim to pledge extra £ 8 billion by 2020, which they think that it is minimum amount,
which is needed to survive. Furthermore, the authorities will also save funds by cutting their
social care budget but at the same time, it has to increase the funding towards the mental
health (Appleby, and Robertson 2016). They will not reduce the capital amount of income
whereas NHS trustees can engage in generating amount form the private patients (Powell
2019:34). This will help to create detrimental impact on services. There is a greater chance
when non-profit organisations rely on numerous funding system as being offered by
government offices, corporations, and other offices (Powell 2019:34). For example- NHS`s
board of directors can easily connect with other MNCs and induce them to incur CSR
activities towards healthcare sector. Moreover, federal funding opportunities availed to
organisations, which can allocate billions for the international grants (Watson, Husband, Yap,
Hetherington, and Pandi 2018: 30).
Looking in the website grant gov, which is a powerful way through which it can get wide
variety of grants optimising through NGO (NHS Support Federation 2020). Recently, the
Prime minister has proposed to contribute nearly £ 1 billion to NHS and need for GP
rationing of the specialist referrals when it comes to no surprise where NHS is already under
financial burden. The trading relationship between UK and other countries are quite unclear
due to Brexit, which is the reason of instable economic status finally no contribution towards
NHS (Fahy, Hervey, Greer, Jarman, Stuckler, Galsworthy, and McKee 2017: 2115). It is
quite uncertain of how leaving of EU (European Union) will affect NHS where government is
forced to cut public expenses. Other more impacts through Brexit has indicated that there has
been a greater impact on UK`s vote as soon as it will leave EU, that has severe implication on
healthcare. Significant political and economic uncertainties have led to high financial and

operational pressure on healthcare systems (McKenna 2016). From the reports and articles, it
is seen that 2016 and 2017 has already become a challenging year for NHS because service
providers has faced financial pressure and its performance on the key destroying targets
(McKenna 2016). In a sustainable way, most significant influencing factor on NHS funding
will lead to higher performance of economy. According to the articles, it is seen that voting in
favour to leave EU (European Union) will definitely lead to instable and uncertain conditions
and ultimately UK will become poorer (NHS England 2018).
Anyways, other medical professionals know it very well that NHS is better them anyone.
Their views can properly be addressed in today`s world. Furthermore, the solution to the
issue is that NGO currently has numerous partners who can fund the projects to foresee new
opportunities. Maintaining good relationship with partners will help to grow as an
organisation (Robertson, Appleby, and Evans, 2017). Here are some of the solutions, which
can solve the funding issues in NHS-
Overcoming the economic and political crisis so that government can again reach to the same
level of budget to its healthcare sector. Adding of the third tier emergency wards, which is the
way through A&E can become reserved for the people who actually need immediate
admission. This third-tier ward will help heart attacks, organ failure, and internal bleeding.
The second tier emergency will treat broken bones, and wounds. Delegating first aid box to
the public so that there can be easy treatment of the wounds, which can reduce the cost of
constructing buildings in every localities. The NHS can advertise to sponsor funds from other
nations, where people are interested in assisting the hospital sector to grow and treat as many
people they can. Furthermore, it is a way better to cooperate with the private sector with the
help of private finance initiates. It is important to clear the path towards the professional NHS
properties and have written documentation of these long-term assets because there is always a
scope of marginal initiatives that can be created by the total portfolio (The Guardian 2017).

Currently, the NHS does not have any detailed list of long-term assets and portfolio yielding.
For example- while claiming tfunds from the local government and healthcare department,
there is an analysis undertaken by the government regarding the NHS building, which are
unused and inefficient delivering better healthcare outcomes (The Guardian 2017).
Conclusion
From the above discussion, it is seen that lack of fund raising has proved that there is a
greater need to cut off the public spending then imply for services who struggle with the
existing budget, which is quite significant. However, NHS is the largest item of the
government spending. NHS will need funding because it wants to maintain its current
standards. This increase has to be higher so that it can improve the quality of healthcare
services availed in UK. Due to collapse of funding from the government and health
department due to financial crisis, it is seen that NHS is not able to caster the allocated
majority of funds, which it receives from Clinical commissioning groups and support them to
avail services on the behalf of the patients as per the evidence based on best quality
standards. The reasons are quite clean from the above discussion that EU leaving vote system
will create instability in political and economic system of UK and brexit, which have
adversely affected the fund raising procedure and sources of funding of NHS. In 2018 and
2019, funding from the government and healthcare department has raised by 0.4 percent but
spending per person was still increasing. The department availed temporary reliefs so that
extra money falling short will be used in maintaining standard care. Additional revenues have
been going to the acute sector, which promises to enhance investment in mental health
through which the progress can be made and also it will be able to develop new services.
Patients can access new drugs and finally deliver important efficient savings.
The health department of UK has been facing massive task of managing the funds due to EU
regulations. The government is quite engaged in repealing and replacing with UK drafting

alternatives. NHS will have to redraft its backlog of the policies publications holding the
publications running up to referendum and finally decide not to wait longer. With immediate
focus, there will be negotiation in favourable terms for working with EU after Brexit, which
has severe impact on health and social care.

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