The Prime Minister’s claim that the NHS can expect a year-by-year increase in funding of 3.4% paid for – in part – by a Brexit dividend, is rightly deserving of ridicule. But, I can’t help but feel that it has also been successful in drawing attention away from the wider issue of how we fund – and the Tories underfund – our NHS.
As someone who works in the NHS I can assure you from first-hand experience that the proposed increase will do little to reverse the damage that has been inflicted upon it. We already know that the funding isn’t going towards public health budgets – proof if we ever needed it that the billions of cuts railroaded through the NHS by Sustainability and Transformation Plans with their mantra of placing preventative care at the forefront of future service planning is just that - a mantra. At the same time, we know that the money won’t be going towards medical or nursing training and so will do nothing to stem the retention and recruitment crisis. A crisis which incidentally Jeremy Hunt has only just come around to acknowledging, despite the fact that 5000 GP vacancies are left unfilled and nursing applications from EU countries have literally plummeted.
The announcement is merely the latest saga in the Tories continued approach of style over substance when it comes to the NHS. The devil is always in the detail, and the Tories track record in honestly representing their spending on the NHS is hardly squeaky clean. In 2016, the British Medical Council and Nuffield Trust exposed the Tories claims of a £10bn a year increase in NHS spending to be nothing more than accounting tricks moving money around within the Department of Health budget. And in 2012 the UK Statistics Authority had to repeatedly tell the Coalition Government to stop misleading the public by claiming that health spending was higher in 2011-12 than it was in 2009-10.
This latest smoke and mirrors announcement does nothing to address the real issues facing the NHS. If the government were serious about ending wastage in the NHS they would abolish the internal market and purchaser provider split. The current process of putting contracts out to tender to the private sector has been nothing short of a colossal waste of money running into the billions of pounds. And has done nothing other than demonstrate the voracious appetite of parasitic companies like Capita and Virgin who either put patient safety at risk or run outstanding NHS services into the ground. The announcement hasn’t been followed by specifying the policy measures that will ringfence the funding and make sure it goes to front-line services. So, its highly likely that in the perverse form of capitalism favoured by the Tories, i.e. the state stepping in to subsidise failing businesses, that this is just another pay-day for likes of Serco.
The other barometer of measuring the government’s sincerity is by looking at social care. Has the government pledged to bring social care back into the NHS and provide it with a similar increase in real terms funding? No. Without social care being integrated into the NHS and continuing to be subject to drastic spending cuts the NHS will continue to suffer. Beds will be blocked, people will wait longer in A&E, and in many cases, paramedics will be unable to respond to calls as they’ll be stuck monitoring overcrowded hospital corridors.
If you think I’m exaggerating by all means, feel free to look at the NHS England data which shows that in 2011 there were 98, 596 people waiting 4 or more hours in A&E which went up to 528, 360 in 2017. A 3.9% annual uplift in real terms for social care is the minimum needed. There should be no pretence that “integration” of health and social care, without extra funds for both, will solve the problems of either service.
There is so much more that the government could do to explore future funding that isn’t solely reliant upon hypothecated taxation. Government spending on pension subsidies now stands at £48bn a year, maybe it’s time to cut the current rate of tax relief on higher rate pensions, and require pension funds- the majority of which are stored in second hand shares- to invest up to 10-20% of new contributions in assets directly linked to employment creating investment opportunities. This would stimulate growth and the collection of tax receipts, a diametrically opposite effect to that which Brexit will have.
It is also common knowledge that companies benefit when their employees have access to strong public services but that a significant chunk of multinational companies in the UK are engaged in aggressive tax avoidance. If the political will was there, this money could be recuperated and put towards the NHS. At the same time, the government could consider implementing a financial transaction tax that would generate significant money for direct investment into the NHS and cost little to administer.
I am by no means arguing that these are silver bullets, but the fact the Tories refuse to consider these approaches demonstrates their lack of political will and imagination.
I would urge anyone who is concerned about the current mismanagement that the NHS is being subject to, to join the National Health Action Party, Trade Union Congress, the Peoples Assembly and Health Campaigns Together on the 30th of June at Portland Place London. At 12 midday, to celebrate 70 years of the NHS and send out a message to the government that we will not stand by and let it be failed.