In his first speech since re-election, UK Prime Minister David Cameron has again pledged to increase funding for the National Health Service and secure seven-day access to improve services and save lives.

Cameron reiterated the government’s commitment to increase funding in real terms every year during the Conservatives’ current reign, rising to at least an extra £8 billion a year by 2020.

Amid a stream of other promises, none of them new, he also said that by the end of this financial year 18 million patients will have access to a GP at mornings, evenings and weekends, and that this would be extended to everyone by the end of this Parliament.

A seven-day NHS is “just as vital” in hospitals too, he said. “It’s a shocking fact, but mortality rates for patients admitted to hospital on a Sunday can be 16% higher than on a Wednesday, while the biggest numbers of seriously ill patients arrive at the weekend when hospitals are least well equipped to handle them. So seven-day care isn’t just about a better service - it’s about saving lives”.

How will it be funded?

But while most seem to agree in principle, there remains a great deal of skepticism over how a seven-day service will be funded, particularly as the £8 billion a year extra is the bare minimum needed just to keep the NHS in its status quo, rather than expand any services.

“The real question for the government is how they plan to deliver additional care when the NHS is facing a funding gap of £30 billion and there is a chronic shortage of GPs and hospital doctors, especially in acute and emergency medicine, where access to 24-hour care is vital,” said Mark Porter, chair British Medical Association. “Without the answer to these questions this announcement is empty headline grabbing and shows that even after polling day, politicians are still avoiding the difficult questions and continuing to play games with the NHS.”

Nuffield Trust Chief Executive Nigel Edwards said the government “should be under no illusions about the impact a seven-day NHS will have”, as it will mean “significant changes to the way services are run across the country, and it will also require recruiting a critical mass of specialist staff”. 

Political bravery

“Making seven-day working a reality may also mean closures or mergers of local services, such as emergency surgery or maternity units. So, this will not only cost additional money beyond the £8 billion but it will also require political bravery,” he said.

“One immediate practical challenge is a shortage in the number of GPs available to deliver these changes and the need to increase both the intake of doctors coming in the system and training through the GP ranks,” added Paul Briddock, director of policy at the Healthcare Financial Management Association, while Nav Chana, chairman of the National Association of Primary Care, argued that “any increase in the number of GPs must be accompanied by more sophisticated approaches to recruitment and retention, as well as a fundamental review of the model of care in which GPs operate”.