All parties are determined to prove the NHS is safe in their hands. But with health finances in a tailspin, they're hard-pushed to come up with credible policies
If the NHS is the closest thing we have to a national religion, Jeremy Hunt is the nearest approximation to its high priest. And with a general election on the horizon, the health secretary is under pressure to rekindle public belief in the health service.
Renewed vows on hospital waiting times and personal budgets, new thinking on ‘co-commissioning’ and the promise of a ‘forward view’ five-year-plan – these are just some of the ideas being aired to convince the waverers that the NHS is safe in the government’s hands.
But a succession of bad news stories about rising GP and cancer care waiting times, plus increased levels of emergency admissions, have been spoiling the feel-good effect. NHS waiting lists recently exceeded three million for the first time since 2008.
Images of ambulances queuing outside A&E departments, amid tales of rapidly dwindling NHS trust coffers, are not the kind of shroud-waving headlines ministers want on the eve of their party conferences.
As we discuss in this issue of PF (Noel Plumridge and Andy McKeon), a number of authoritative reports indicate that the NHS could soon be heading into a financial tailspin.
According to the Nuffield Trust, the long-awaited health service transformation has not materialised. The NHS is ‘destined to experience a funding crisis this year or next,’ it says.
So what’s to be done? All the parties, acutely aware of the toxic role that negative NHS stories can play, are squaring up for a credibility battle over the health finances.
The LibDems are toying with the idea of a hypothecated ‘NHS tax’; something recent polls suggest could be a vote-winner. Labour is debating the issue, but is more cautious - focusing on debates over ‘preferred providers’ versus privatisation, rather than risk being accused of tax-and-spend financial profligacy.
The Conservatives, meanwhile, are conflicted over whether to uphold the cherished free-at-point-of-delivery model – or move in the direction of proselytising in favour of NHS charges.
Even with its hitherto ‘protected’ status, the NHS budget can barely keep pace with demand. Year-on-year savings of 4% – the so-called ‘Nicholson Challenge’ – are looking increasingly unsustainable.
Under these circumstances, as Mike Farrar argues, the best option is to be transparent about the true costs of running a world-class health service and the hard choices about funding that follow.
But opening up that discussion requires political courage – and another huge leap of faith.
This opinion piece was first published in the September edition of Public Finance magazine
