The NHS budget and hospital service is now in significant crisis. 

Each year the government sets the budget “the tariff” for hospitals and other providers. This tariff is then subject to discussions with Monitor (on behalf of the government) and the Trusts themselves. These hospital trusts represent 75% of all work that is carried out by the health service.

The proposals for this year 2015/16 amount to a 3.8% cut in real terms.  This is not the first cut; quite the opposite. There have already been a number of reorganisations and reductions in funding.

The hospitals have responded by saying that they can no longer guarantee safe patient care.  Legally they are bound to provide a range of services in a safe manner.  The hospitals have announced that they may not be able to do so with the proposed budget.  A large part of the NHS is therefore saying that they will not guarantee sustainable and safe care from 1 April 2015 unless the proposed budget is increased. 

Hospitals are not the only services affected by cuts and resource issues. GP practices are also in disarray as indeed is the ambulance service.

Thus far the Department of Health have not indicated that they are willing to make additional funding available.

Legally there is an obligation on hospitals to provide safe care. However, safe care is not an easy concept to define particularly in areas of rapid surgical and technological development.

An injured patient seeking recompense for medical negligence has to establish that any reasonably competent clinician would have done something different. In many such cases this issue is easily identified if not easily established: a failure to diagnose, the incorrect procedure. But what of the delay in referral to another specialist? Further investigation? 

What if the standard of time for referral is delayed due to lack of resources? If this becomes the normal time, there is a possibility it would become the standard by which practice is judged. We are used to times being shortened, additional tests being ordered as normal practice. What if the process is reversed and the standard time of say 6 weeks for a referral becomes 10 weeks?