£17m bid to make sure NHS spending isn’t waste of money

A health think tank is to invest millions of pounds setting up a new independent version of the Office for Budget Responsibility for the NHS to hold the government accountable on health spending.

The Health Foundation charity is to invest £17m to create the new organisation which it hopes will match the OBR and Institute for Fiscal Studies in terms of influence over government policy and funding of health and social care.

Its director, Anita Charlesworth, told The Independent the Research and Economic Analysis for the Long term, or REAL, Centre, would provide “challenge and accountability” on ministers pledges.

She said governments were happy to “will the end but not happy to will the means” in healthcare adding: “The public are promised the equivalent of a week in Barbados for the cost of a weekend in Bognor.

“That is a mistake because it sets the NHS up for failure and over time people start to believe there is some sort of fundamental problem with the health service. We need to put in some system to stop that happening.”

She said the REAL Centre will spend around £12m commissioning new research to challenge what she labelled “urban myths” in healthcare and to provide decision makers in the NHS at a local level better evidence and tools to make decisions.

The creation of the REAL Centre, which will be part of the Health Foundation, follows a report in 2017 by a House of Lords select committee which examined the long term sustainability of the NHS and recommended an independent body, similar to the OBR, be established for the health service. This was rejected by the government at the time.

The new centre will be modelled on the Institute for Fiscal Studies, which was set up in the 1960’s to critique government tax and spending policy.

The new body will launch in June this year with an assessment looking back at some of the “urban myths” in NHS policy over the last decade.

Ms Charlesworth said examples of such myths included the belief the NHS could operate with fewer beds if it successfully moved frail elderly patients out of hospital. This had failed to consider the wider demographic changes and demands for NHS care which meant the NHS now had fewer beds than it really needed which was producing long waits in hospitals.

She said: “We want to provide some real challenge and accountability and improve the quality of decision making both locally in the NHS and nationally by the government. To provide quite sharp reality checks where the stated intent and resources are not in alignment.

“We are in this for the long term and will be putting a lot of money into commissioning new high quality evidence so that the terms of the debate are rooted in hard edged fact.”

There will be a core team of 15 experts based within the Health Foundation led by Ms Charlesworth and chaired by Sir Andrew Dilnot, a former director of the Institute for Fiscal Studies and chair of the UK Statistics Authority.

He told The Independent: “The NHS is one of the great creations of the welfare state – and one of which we are rightly proud. Since it was founded it has adapted to profound changes in society.

“The ability of the health and care systems to thrive over the coming decades depends on decisions taken today – for example about how much we choose to spend on prevention or the number of doctors and nurses we train. The REAL Centre will produce and fund the evidence and analysis needed to help policymakers understand the implications of their choices.”