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The £8bn NHS political row | The £8bn NHS political row |
(about 1 month later) | |
It's another sign of the power of the head of NHS England Simon Stevens in shaping the political debate over health. | It's another sign of the power of the head of NHS England Simon Stevens in shaping the political debate over health. |
As I wrote over Easter, the £8bn identified by Mr Stevens last autumn as part of his proposed solution to a looming NHS funding gap had generated a mixed response from the leading parties. | As I wrote over Easter, the £8bn identified by Mr Stevens last autumn as part of his proposed solution to a looming NHS funding gap had generated a mixed response from the leading parties. |
Now it has fuelled a heated series of exchanges dominating the campaign debate. | Now it has fuelled a heated series of exchanges dominating the campaign debate. |
To recap - Simon Stevens and other NHS leaders in England predicted a £30bn gap by the year 2020. | To recap - Simon Stevens and other NHS leaders in England predicted a £30bn gap by the year 2020. |
That's the difference between anticipated demand for health care from a rising population and a budget increasing in line with inflation and no more. | That's the difference between anticipated demand for health care from a rising population and a budget increasing in line with inflation and no more. |
More than two thirds, they said, could be covered by efficiency savings, in effect seeing more patients and carrying out more procedures for a set amount of money. | More than two thirds, they said, could be covered by efficiency savings, in effect seeing more patients and carrying out more procedures for a set amount of money. |
But that still left £8bn above inflation, they argued, which the government of the day would need to stump up in 2020. | But that still left £8bn above inflation, they argued, which the government of the day would need to stump up in 2020. |
That figure would be reached, it was assumed, after a steadily increasing injection of cash over preceding years. | That figure would be reached, it was assumed, after a steadily increasing injection of cash over preceding years. |
Manifesto pledges | |
The Liberal Democrats said a little while ago they would find the £8bn if they were in office. | The Liberal Democrats said a little while ago they would find the £8bn if they were in office. |
Some of this would be funded by identified tax measures, but the bulk of it would, in the words of Nick Clegg, come from the "proceeds of growth". | Some of this would be funded by identified tax measures, but the bulk of it would, in the words of Nick Clegg, come from the "proceeds of growth". |
In other words the Lib Dems assume they will find the money if the economy is growing normally in the years leading up to 2020. | In other words the Lib Dems assume they will find the money if the economy is growing normally in the years leading up to 2020. |
Now, after skirting around the subject and dropping various hints, the Conservatives say they will as a manifesto pledge commit to finding the £8bn in real terms in 2020. | Now, after skirting around the subject and dropping various hints, the Conservatives say they will as a manifesto pledge commit to finding the £8bn in real terms in 2020. |
Actually it will be "at least" £8bn and could be more, according to party sources. | Actually it will be "at least" £8bn and could be more, according to party sources. |
There are no revenue-raising plans linked to this plan. | There are no revenue-raising plans linked to this plan. |
The Tory line is that voters can trust them to deliver next time on the back of their record of increasing NHS funding over the last parliament. | The Tory line is that voters can trust them to deliver next time on the back of their record of increasing NHS funding over the last parliament. |
They say the NHS budget in England in 2015/16 is more than £7bn higher than in 2010/11 so finding £8bn by the end of the next parliament should not be a problem. | They say the NHS budget in England in 2015/16 is more than £7bn higher than in 2010/11 so finding £8bn by the end of the next parliament should not be a problem. |
'Funny money' | |
It's worth noting that the £7bn extra figure was reached over six financial years so over a longer time frame than a single parliament. | It's worth noting that the £7bn extra figure was reached over six financial years so over a longer time frame than a single parliament. |
So where does that leave Labour? Unlike the other main parties it has not signed up to the Stevens financial numbers. | So where does that leave Labour? Unlike the other main parties it has not signed up to the Stevens financial numbers. |
It is sticking with its pledge to raise NHS funding in England by £2.5bn a year from 2016, in effect making a start on the journey towards £8bn. | It is sticking with its pledge to raise NHS funding in England by £2.5bn a year from 2016, in effect making a start on the journey towards £8bn. |
Labour points out it has specific tax-raising plans, including the mansion tax, which cover this spending commitment. | Labour points out it has specific tax-raising plans, including the mansion tax, which cover this spending commitment. |
It argues this is real money and that the Conservatives and Lib Dems are guilty of promising "funny money" and making unfunded spending pledges. | It argues this is real money and that the Conservatives and Lib Dems are guilty of promising "funny money" and making unfunded spending pledges. |
The debate is in essence between "trust us, we can deliver" with a higher long-term spending pledge and a more cautious and funded shorter-run plan. | The debate is in essence between "trust us, we can deliver" with a higher long-term spending pledge and a more cautious and funded shorter-run plan. |
As always it will be down to voters to assess the arguments either way. | As always it will be down to voters to assess the arguments either way. |
In the end £8bn could prove too small a government top-up for the NHS. | In the end £8bn could prove too small a government top-up for the NHS. |
The efficiency savings talked about look extremely ambitious and may not be achieved. | The efficiency savings talked about look extremely ambitious and may not be achieved. |
And of course there could be unpalatable decisions about even deeper cuts in other Whitehall departments or tax rises to sustain cash injections required by the health service. | And of course there could be unpalatable decisions about even deeper cuts in other Whitehall departments or tax rises to sustain cash injections required by the health service. |
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