NHS funding: plenty of manifesto pledges, but fewer firm figures

http://www.theguardian.com/society/2015/apr/13/nhs-funding-plenty-of-pledges-but-fewer-firm-figures

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George Osborne (My NHS manifesto pledge, 11 April) repeats the mantra that the NHS’s problem is “an ageing population”, which is the case in every western country. Margaret Thatcher said “you can only have the services you can afford”, a comment echoed by David Cameron in his Paxman interview. But the UK does not afford as much as other countries and is at the bottom of the league table of the percentage of GDP devoted to health. The NHS consistently achieves more (reducing mortality rates) with proportionately less. We should at least match the European average, for if it was appreciated how relatively cheap the NHS is, modest tax increases would be accepted too. Professor Colin PritchardSouthampton

Why should taxpayers’ money be spent on accountants and lobbyists rather than on the provision of frontline staff?

• Not only has the proportion of NHS funding spent on primary care decreased under the coalition government, the number of new GPs entering primary care (800 over this parliament’s lifetime) has not even kept pace with the rise in population (King’s Fund, 2015). Mr Osborne ignores the 2012 statute his own government passed – which was to stop ministers interfering in day-to-day running of the NHS – by deciding that the over-75s should have the right to a same-day GP appointment. Inevitably, such a change will have implications for access to those equally needy who happen to be younger. The continual use of the NHS as a political football by the major parties is frankly demoralising for those of us working in it. Chris Gunstone, GPBurton-upon-Trent, Staffordshire

• George Osborne states the policy of every political party when writing “by supporting the most vulnerable we can improve their lives and ease the pressures on the NHS”. Since the financial crisis in 2008, all advice agencies, such as CAB and Z2K, have been supporting the most vulnerable, whose lives are being devastated by cuts, caps, sanctions, council tax and unmanageable debt, all of which have added to the pressures on the NHS. But the DWP never takes into account the cumulative impact of its draconian policies on the health of the poorest citizens; and the NHS never calculates the extra cost of its services due to that increasing poverty. Rev Paul NicolsonLondon

• Your headline (11 April) reports “Tories pledge extra £8bn a year for the NHS”. You have to read it very carefully to find out that the money is not £8bn per year but up to that amount by 2020. No mention of the reduced staffing levels since 2010, nor that the present government has only increased NHS funding by 0.8% (King’s Fund figures) over the current parliament – less than any government since 1948. Gillian PollerLondon

• However hard I searched Mr Osborne’s article, I was unable to find any indication of where this extra £8bn is coming from. There are the usual Tory mantras about savings, efficiency and a growing economy. The claim that the NHS has fewer managers and thousands more doctors and nurses is not borne out when millions are spent on agency staff. We are expected to believe this unfunded pledge from the party that introduced the Andrew Lansley plan to reorganise the NHS, a reform now widely admitted to be both disastrous and costly. After a second reading I am reminded of Ralph Waldo Emerson: “The louder he talked of his honour, the faster we counted our spoons.”Bill ThompsonPeterborough, Cambridgeshire

• In treating with suitable scepticism the Tories’ pledge of an extra £8bn a year for the NHS, Labour’s shadow chief secretary to the Treasury, Chris Leslie, draws timely attention to Ed Balls’s promise to his party conference that Labour will do “whatever it takes’’ to save the NHS. Balls has challenged the SNP to back Labour’s measures to do this, such as the levy on the bankers and the mansion tax. Another way for Labour to help rebuild the NHS would be to stop exposing key services to private tendering. Why should taxpayers’ money be spent on the accountants, lawyers and lobbyists essential to the tendering process rather than on the provision of frontline staff and treatment which are needed for patient care?Francis PrideauxLondon

The only coherent body of policies for fully de-marketising the NHS is in the NHS (reinstatement) bill

• Critics such as the King’s Fund (Report, 18 March) have stated that Labour’s policies for “rolling back” NHS privatisation are seriously flawed. Under EU competition rules they leave the NHS open to continuing privatisation as long as any part of it remains privatised, which Labour plans.

The only coherent body of policies for fully de-marketising the NHS and restoring it to its public service remit is in the NHS (reinstatement) bill drafted by barrister Peter Roderick and health policy expert Professor Allyson Pollock. This was presented in parliament by Green MP Caroline Lucas on 11 March and supported by 11 other cross-party MPs.

Labour’s pledges on additional funding will simply further prop up the marketised sectors of the NHS, rather than dealing with the central problems in its policies that the bill raises.

At the People’s NHS convention held by the People’s Vote for the NHS campaign group last Saturday there was strong support from the floor for the bill, with calls for trade unions and all campaign groups to put their weight behind it as a matter of urgency. I wanted to film discussion on these vital questions about Labour’s NHS policies for my documentary on the campaign group 999 Call for the NHS, who support the bill. I was regrettably refused permission to film by the convention’s organiser.

The central question posed by the bill remains – will the NHS really be safe under Labour’s present policies?John FurseLondon

• This article was amended on 16 April 2015. Because of an editing error, an earlier version placed Burton-upon-Trent in Nottinghamshire.