The King’s Fund have today published a review of the spending proposals for the health service from the three main parities.
Richard Murray, director of policy at the charity, said: “On the evidence available to us, the Labour offer looks the most generous, certainly in the early years.
“However, as the years go by, the Liberal Democrats’ approach of adding the impact of additional pay rises and bursaries to the health settlement will erode this lead.”
Murray described the Conservatives’ plans as “the most straightforward”, but he questioned their proposals for non-protected spending and the profile of the growth in their spending plans.
He acknowledged that all three parties had committed to investing £10bn in capital spending with the only differences being phasing or the source of the money.
His analysis of the revenue spending proposals is as follows:
Labour
Labour’s manifesto promises to provide £30bn more than current Tory government plans over five years, or £6bn a year.
This covers all revenue spending on the NHS, training and public health. Of this, some £3bn will be used to re-instate bursaries for nurses, leaving £27bn for other services or £5.4bn a year.
Murray notes that Labour plans to re-open current 2017/18 spending plans, providing an immediate in-year boost to health spending.
However, they have made a five-year commitment starting in 2017/18, which runs out in 2021/22 – before the end of the next parliament.
Labour has also pledged to scrap the current public sector pay restraint, which will have to come out of the £27bn.
- Murray estimates every 1% added to pay will cost around £500m if given to all staff, meaning year on year costs would mount if applied annually.
Liberal Democrats
The Liberal Democrats’ want to spend £6bn more currently planned on health and social care in 2019/20.
This is meant to plug the funding gap until two other manifesto commitments kick in: developing a dedicated health and care tax and using the findings from a cross-party convention to review the longer-term finances.
Murray states that £2bn of the £6bn is meant for social care, leaving just £4bn for the NHS itself – still representing an “early boost” for the health service but starting a year after Labour’s proposed increases.
The Lib Dems also want to end the public pay restraint and reinstate bursaries for nurses. The latter is costed at £488m a year in 2019/20, but will rise after that.
They plan to form a long-term solution, but if one is not in place by 2020/21 they have mooted increasing spending by 2% in real terms after 2020/21 in line with expected economic growth.
Conservatives
The Conservatives manifesto headline is £8bn more in real terms by 2022/23 than is planned in 2017/18.
This refers to NHS England spending only and therefore excludes public health, training and other Department of Health budgets, which were cut when this definition of spending was used in the last Spending Review.
There are no details on how current spending will increase each year up to 2022/23, other than to promise real-terms growth per capita in the NHS England budget.
This would result in a boost to spending plans for 2018/19 and 2019/20.
