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The NHS needs serious money, and our politicians are refusing to face it The NHS needs serious money, but our politicians are refusing to face it
(about 1 hour later)
The wonder of the NHS is its remarkable resilience. It’s no surprise that waiting times are higher than for years, A&E targets missed by miles and cancer treatment times falling. This analysis comes from the King’s Fund, the respected independent institute that does for health what the Institute for Fiscal Studies (IFS) does for tax and spend. The wonder of the NHS is its remarkable resilience. It’s no surprise that waiting times are higher than for years, A&E targets missed by miles and cancer treatment times falling. This analysis comes from the King’s Fund, the respected independent institute that does for health what the Institute for Fiscal Studies does for tax and spend.
Warnings came after George Osborne’s first budget, when the Conservative chair of the Commons health committee, the former health secretary Stephen Dorrell, said time and again that the NHS could not sustain 4% cuts year after year in “efficiency savings” without imploding. No health service, anywhere in the world, had done that. Technically Cameron kept his promise to increase funding – but only by 0.8% – or five times less than its average rise since 1948. Per capita funds fell as the population grew, as did numbers of people aged over 65 and over 80. Now add in 30% cuts in council budgets that saw 500,000 fewer frail people receive any social care: old people arriving in A&E were stuck in hospital beds for lack of services at home. Warnings came after George Osborne’s first budget, when the Conservative chair of the Commons health committee, the former health secretary Stephen Dorrell, said time and again that the NHS could not sustain 4% cuts year after year in “efficiency savings” without imploding. No health service, anywhere in the world, had done that. Technically Cameron kept his promise to increase funding – but only by 0.8% – or a fifth of the average percentage rise since 1948. Per capita funds fell as the population grew, as did numbers of people aged over 65 and over 80. Now add in 30% cuts in council budgets that saw 500,000 fewer frail people receive any social care: old people arriving in A&E were stuck in hospital beds for lack of services at home.
Related: Patient care will deteriorate as NHS heads for £2bn deficit, says thinktankRelated: Patient care will deteriorate as NHS heads for £2bn deficit, says thinktank
Add in the ruinous disarray of the £3bn NHS and Social Care Act, like throwing a mirror into fragments. In what was once unguardedly called “creative destruction” for public services by backroom Conservative ideologues, 90,000 people changed jobs, senior staff departed. The perfect financial storm came with the Francis report on Mid Staffs rightly commanding that there should be more nurses. But the government had cut nurse training places, so hospitals competed in a dash to hire them from abroad and agency-use sky-rocketed. Add in the ruinous disarray of the £3bn NHS and Social Care Act, like smashing a mirror into fragments. In what was once unguardedly called “creative destruction” for public services by backroom Conservative ideologues, 90,000 people changed jobs, senior staff departed. The perfect financial storm came with the Francis report on Mid Staffs rightly commanding that there should be more nurses. But the government had cut nurse training places, so hospitals competed in a dash to hire them from abroad, and agency-use skyrocketed.
This lucky government has had mild winters and no great flu or norovirus outbreaks. Last minute bungs to A&E have just about kept the wheels on, despite ambulances stacked up outside. This lucky government has had mild winters and no great flu or norovirus outbreaks. Last minute bungs to A&E have just about kept the wheels on, despite the ambulances stacking up outside.
The public remains relatively satisfied, at 65%, according to today’s British Social Attitudes (BSA) survey. Pollsters suggest people now tend to say they are satisfied with the NHS as a gesture of support, not an evaluation of quality. But those saying the NHS improved on Cameron’s watch fell from 40% in 2010 to 25% now. Only 10% support charging new fees – the fees rightwing thinktanks imagine would solve the crisis – though the US Commonwealth Fund year after year finds the NHS best for extracting the most bang for its bucks. Now the bucks have run out. The public remains relatively satisfied, at 65%, according to today’s British Social Attitudes survey. Pollsters suggest people now tend to say they are satisfied with the NHS as a gesture of support, not an evaluation of quality. But those saying that the NHS improved on Cameron’s watch fell from 40% in 2010 to 25% now. Only 10% support charging new fees – the fees rightwing thinktanks imagine would solve the crisis – though the US Commonwealth Fund year after year finds the NHS best for extracting the most bang for its bucks. Now the bucks have run out.
The parties are locked in a no tax rise contestThe parties are locked in a no tax rise contest
Neither Labour nor Tories pledge anything like enough. NHS trusts are £2bn in debt and its rising, with no chance of recovery without shutting vital services. Only out of fear of the impending election has the Treasury let debts arise. Whoever wins must find what NHS England says is a bare minimum of £8bn a year, admitting that the real sum is closer to £30bn. Neither Labour nor Tories pledge anything like enough. NHS trusts are £2bn in debt and its rising, with no chance of recovery without shutting vital services. Only out of fear of the impending election has the Treasury let debts rise. Whoever wins must find what NHS England says is a bare minimum of £8bn extra a year, admitting that the real sum is closer to £30bn.
But the parties are locked in a no tax rise contest which the IFS castigates as irresponsible and improbable. The BSA shows a small attitude shift toward paying more tax for public services – but still only 37% would, though 92% know the NHS has a funding problem. As ever, the public demands the impossible; Swedish services on US tax rates – and no party dare say there’s no free lunch. But the parties are locked in a no-tax-rise contest, which the Institute for Fiscal Studies castigates as irresponsible and improbable. Today’s attitudes survey shows a small attitude shift towards paying more tax for public services – but still only 37% would, though 92% know the NHS has a funding problem. As ever, the public demands the impossible; Swedish services on US tax rates – and no party dare say there’s no free lunch.
But the NHS is the one service for which an earmarked tax might be acceptable. Can both parties scrape through the election pretending the NHS is safe in their hands without at least pledging that £8bn? My guess is that both manifestos will have to, but what folly to cut off their main tax routes to achieving it.But the NHS is the one service for which an earmarked tax might be acceptable. Can both parties scrape through the election pretending the NHS is safe in their hands without at least pledging that £8bn? My guess is that both manifestos will have to, but what folly to cut off their main tax routes to achieving it.