The boss of the NHS in England directly contradicted Theresa May’s claims about how much the government is putting into the health service in a defiant performance in front of MPs hours after reports that Downing Street had lost faith in him.
Simon Stevens, the chief executive of NHS England, told the public accounts committee that the prime minister’s insistence that the service was getting more money than it asked for was not true and asked why under current plans real-terms spending on health would actually fall in 2018-19.
May was “stretching it” by claiming that the NHS was getting more than the minimum £8bn by 2020 it asked for, Stevens added, and he complained that health spending is already much lower than in many other European countries.
His evidence came as the winter crisis in the NHS deepened further. At least 23 NHS trusts in England have had to declare a black alert this week alone as hospitals implement extraordinary measures to cope with a surge in demand.
Freezing weather expected to imminently affect most of Britain could increase the pressures on already over-stretched hospitals, doctors are warning.
Earlier, May had clashed with Jeremy Corbyn at prime minister’s questions over the NHS.
The prime minister dismissed claims that the health service was suffering a humanitarian crisis as “irresponsible and overblown” in a series of exchanges over the situation.
Shortly after, the Labour leader responded by saying: “Our NHS, Mr Speaker, is in crisis, but the prime minister is in denial.”
At the select committee, Stevens held up a page from the Daily Mail to argue the NHS has fewer medics, beds and scanners per head than other countries in Europe, to contradict the suggestion that NHS spending was in line with the average for OECD countries, which he said included countries such as Mexico.
The chief executive also took issue with May’s claim that the government would be giving the NHS an extra £10bn by 2020, and described the cuts to capital expenditure within the health service as “robbing Paul to pay Paul”.
“Over the next three years, funding is going to be highly constrained,” Stevens told the committee.
“In 2018-19, real-terms NHS spending per person in England is going to go down, 10 years after Lehman Brothers [collapsed] and austerity began.
“We all understand why that is, but let’s not pretend that’s not placing huge pressure on the service.”
Stevens added it was “stretching it” to say the NHS would get more money than the £8bn it asked for, and revealed he will be updating his five-year plan to be published in March.
“It is a matter of fact that, like probably every part of public services, we got less than we asked for [in the spending review], so it would be stretching it to say the NHS got more,” he said.
Asked if there was a “clear gap” between the funding the NHS is receiving and what it needs, Stevens said: “There are clearly very substantial pressures and I don’t think it helps anybody to try to pretend that there aren’t.”
At one point, Stevens even appeared to take personal aim at May’s move from home secretary to prime minister, saying that dealing with the NHS was “quite different to the criminal justice system”.
Stevens is a former Labour councillor and adviser to Tony Blair who was appointed by David Cameron to run NHS in England in 2014.
His complaints about funding have led to reports of tensions between him and Downing Street, where aides are said to have expressed irritation in private about Stevens’ “unenthusiastic” approach to finding further savings in the NHS.
Following the reports, May’s spokeswoman said the prime minister retained full confidence in Stevens, but disputed his comments on NHS funding, saying he had welcomed the deal.
“The figures speak for themselves,” she said. “They will see an increase in real terms in its funding of £10bn. And at the time the NHS England chief executive said the settlement is a clear and highly welcome acceptance of our argument.”
The appearance prompted Labour to send a letter to May, asking if she agrees with Stevens’ version of events.
Following Stevens’ appearance, Labour’s shadow health secretary, Jon Ashworth, released a letter he has written to May, asking 10 questions connected to the NHS England chief’s testimony.
These included whether she agreed with Stevens’ assessment of funding levels, how it compares to levels in other EU nations and the effects of cuts to social care.
“If you do not agree with one, two or all of these statements then you are in clear conflict with the advice of the head of the NHS,” Ashworth wrote.
“Failure to take Simon Stevens’ warnings seriously would also risk deepening a crisis that has already pushed the NHS to breaking point.”
It comes amid continuing warnings about the pressure on A&E departments, with doctors saying patients are in danger and the British Red Cross claiming there is a humanitarian crisis in some areas.
May dismissed the Red Cross comments during a testy first prime minister’s questions of 2017, during which Corbyn repeatedly challenged her over funding for the NHS and social care.
“I have to say to him that I think we have all seen humanitarian crises around the world,” May said.
“And to use that description of a National Health Service, which last year saw 2.5 million more people treated in accident and emergency than six years ago, was irresponsible and overblown.”
The Labour leader responded by saying she was being unrealistic.
Asked by Corbyn about an occasion in which a 22-month-old boy was reportedly treated on two plastic chairs pushed together at an A&E department, May said she accepted there had been “a small number of incidents where unacceptable practices have taken place”.
She added: “We don’t want those things to happen. But what matters is how you then deal with them.”
May ridiculed the idea Corbyn could provide more funding, saying: “The last thing that the NHS needs is a cheque from Labour that bounces. The only way that we can ensure that we’ve got funding for the National Health Service is a strong economy.
Just before Stevens appeared, Chris Hopson, the chief executive of NHS Providers, which represents hospitals, warned that the health service as a whole is under threat.
“We have reached the point in the NHS where we can no longer deliver everything that has been asked of the NHS,” he said.