Patients may wait years for improvement

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Patients may not feel the benefits of increased NHS spending in time for the next election, health service chiefs have warned.

The public appears largely happy to pay the extra 1 per cent on National Insurance contributions to fund improvements in the health service, as announced in Wednesday's Budget. But they may not benefit from them for years, and individual hospital trusts fear that they will not necessarily get all of the extra money earmarked for the NHS.

The chief executives and finance directors of three trusts told The Independent on Sunday of the other demands on the cash that could slash millions off the proposed Budget boost. They include stabilising the existing accounts, paying the bills for clinical negligence (£400m, according to the latest NHS figures), meeting potential pay demands from staff, and, ironically, paying the employers' increased National Insurance contributions, at a cost of at least £400m a year.

One warned that drugs and equipment companies could now put up their prices. All said that the key to providing a better health service was more staff. They believed that the archaic terms and conditions for NHS nursing staff discouraged recruitment, the length of time it took to train specialist consultants and doctors meant positions could not easily be filled, and poor pay pushed senior staff members into the private sector.

The three professionals envisaged it taking years for some improvements to be visible although initial changes, such as shorter waiting times, might be seen quite quickly.

Mark Britnell, chief executive of the University Hospital Birmingham NHS Trust, said: "It takes a long time to train a doctor. I don't think we're going to have all the doctors and consultants we need. We are going to have to think hard about how we employ and incentivise staff.

"I would hope as we increase the number of staff, patients will feel they are having more personal service. Whether that is enough, I think only time will tell."

Tim Evans, finance director at the Blackpool Victoria NHS Trust, said there was enough funding ­ if it went where it was needed. "There is a huge agenda but this level of funding, provided it reaches us and other stakeholders don't take most of it out before it gets to us, will keep us seriously busy and it will be enough."

David Highton, the chief executive at the John Radcliffe Hospital in Oxford, said he did not expect all the money to come "unbadged"; some would already have been allocated.

He added that in order to get people to work in the NHS in affluent places such as Oxford, where house prices were high, there had to be a recognition of living costs in the pay system.

In the aftermath of the Budget, the Tories have criticised the Government for failing to put reform before extra funding. The shadow health secretary Dr Liam Fox said: "Before the Government broke its promises and raised taxes it should have been insisting that the NHS was using its money properly.

"Without tackling the overcentralisation, the politicisation and the waste which are all part of Labour's NHS management, any additional taxpayers' money will be wasted."