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The practical, spin-free guide to funding the NHS The practical, spin-free guide to funding the NHS
(2 months later)
Today, Sir David Nicholson, who has presided over the disastrous dismantling of the NHS over the past three years, casually lobbed another bomb at the battle-weary service and its staff. The NHS is apparently facing a £30bn funding shortfall and needs yet another "significant shake-up". The assumption follows that we can't afford the service, and the radio phone-in lines are already buzzing with answers to the inevitable question: what can we cut to save the NHS?Today, Sir David Nicholson, who has presided over the disastrous dismantling of the NHS over the past three years, casually lobbed another bomb at the battle-weary service and its staff. The NHS is apparently facing a £30bn funding shortfall and needs yet another "significant shake-up". The assumption follows that we can't afford the service, and the radio phone-in lines are already buzzing with answers to the inevitable question: what can we cut to save the NHS?
This is the wrong question, and falls straight into the government's trap. Their position is that the NHS is unsustainable, that "we can't carry on like this". But those who have watched the NHS brought to its knees by the coalition have questions to ask, and some solutions to propose that do not involve cuts or payments for service. For that is surely where this government wants this conversation to end up: the NHS is unsustainable. This is a convenient myth to explain the next myth, that "things can't go on like this". The fact is that it is not a given that changing demographics and new drugs necessarily lead to accelerated costs. We must challenge the myths and the figures.This is the wrong question, and falls straight into the government's trap. Their position is that the NHS is unsustainable, that "we can't carry on like this". But those who have watched the NHS brought to its knees by the coalition have questions to ask, and some solutions to propose that do not involve cuts or payments for service. For that is surely where this government wants this conversation to end up: the NHS is unsustainable. This is a convenient myth to explain the next myth, that "things can't go on like this". The fact is that it is not a given that changing demographics and new drugs necessarily lead to accelerated costs. We must challenge the myths and the figures.
So, where can we save money that would not involve cutting services, already being rationed by hard-pressed Clinical Commissioning Groups (CCGs)? Well, the market in healthcare has taken transaction costs from 6% to about 16% (an estimate, as the government won't tell us the figures). That's £10bn a year wasted on marketising the NHS – an experiment which has already proved an expensive failure, as daily headlines confirm. So end the market in healthcare, with GPs having to tender for all services and hospitals criticised for anti-competitive behaviour for attempted mergers.So, where can we save money that would not involve cutting services, already being rationed by hard-pressed Clinical Commissioning Groups (CCGs)? Well, the market in healthcare has taken transaction costs from 6% to about 16% (an estimate, as the government won't tell us the figures). That's £10bn a year wasted on marketising the NHS – an experiment which has already proved an expensive failure, as daily headlines confirm. So end the market in healthcare, with GPs having to tender for all services and hospitals criticised for anti-competitive behaviour for attempted mergers.
Want more savings? One London hospital is rumoured to be spending £4m a year on management consultants. Multiply that across the country, and we can save millions by eliminating the people who steal your watch and sell you the time of day.Want more savings? One London hospital is rumoured to be spending £4m a year on management consultants. Multiply that across the country, and we can save millions by eliminating the people who steal your watch and sell you the time of day.
Want more? Stop using the private sector, which is neither cheaper nor innovative. Policing them is proving expensive and ultimately impossible. And if you want yet further savings, end the expensive PFI programmes which are crippling hospitals.Want more? Stop using the private sector, which is neither cheaper nor innovative. Policing them is proving expensive and ultimately impossible. And if you want yet further savings, end the expensive PFI programmes which are crippling hospitals.
What about those expensive health tourists? Forget them, and concentrate on the big stuff. So-called health tourism is estimated to cost between £12m and £200m a year, certainly less than 0.2% of the NHS budget. This is pure distraction politics and a sop to Ukip – look over there at those people abusing the NHS, don't look over here at these politicians wrecking it.What about those expensive health tourists? Forget them, and concentrate on the big stuff. So-called health tourism is estimated to cost between £12m and £200m a year, certainly less than 0.2% of the NHS budget. This is pure distraction politics and a sop to Ukip – look over there at those people abusing the NHS, don't look over here at these politicians wrecking it.
Where can we find the money to pay for a service that almost everyone bar the private sector and the politicians wants to remain comprehensive and free at the point of need? Avoid thinktank suggestions about top-ups and insurance, the slippery slope which will carry us away from the founding principles of the NHS. The current way of funding the service has been repeatedly shown to be the most cost-effective and fairest. If we cut the waste and the NHS still needs more money, we just need the political will to raise it. Deal with tax avoidance and evasion, calculated to cost the country up to £70bn a year, enough to pay for over half the cost of the NHS. Join 11 other EU countries in adopting the Tobin tax, and assign the extra billions raised to the NHS. And if this is not enough, what do you think the public would prefer: a decent health service or Trident?Where can we find the money to pay for a service that almost everyone bar the private sector and the politicians wants to remain comprehensive and free at the point of need? Avoid thinktank suggestions about top-ups and insurance, the slippery slope which will carry us away from the founding principles of the NHS. The current way of funding the service has been repeatedly shown to be the most cost-effective and fairest. If we cut the waste and the NHS still needs more money, we just need the political will to raise it. Deal with tax avoidance and evasion, calculated to cost the country up to £70bn a year, enough to pay for over half the cost of the NHS. Join 11 other EU countries in adopting the Tobin tax, and assign the extra billions raised to the NHS. And if this is not enough, what do you think the public would prefer: a decent health service or Trident?
Finally the big question. Why has the NHS, in the space of three years, gone from being a popular, cost-effective and efficient service, to one that is constantly in the headlines for all the wrong reasons? Could it be that the last significant shake-up has been a disaster and that more of the same might finish off the patient? Don't let's get caught up in the government's strategy – run the service down, starve it of funds and then claim it has failed and needs yet another massive shake-up, helped by a good dose of the private sector. That's one remedy that we should avoid at all costs.Finally the big question. Why has the NHS, in the space of three years, gone from being a popular, cost-effective and efficient service, to one that is constantly in the headlines for all the wrong reasons? Could it be that the last significant shake-up has been a disaster and that more of the same might finish off the patient? Don't let's get caught up in the government's strategy – run the service down, starve it of funds and then claim it has failed and needs yet another massive shake-up, helped by a good dose of the private sector. That's one remedy that we should avoid at all costs.
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