The Conservative Party entered the last General Election promising to ‘ringfence’ the National Health Service budget. It was a shrewd political move: the NHS is the one public service the public would happily pay more tax to increase funding for. The Conservatives wanted to rehabilitate their image after public trust in their ability to provide functioning services was lower than ever. The pledge also put them at odds with the Labour Party, which at the time was advocating ‘salami slicing’ all government spending by about one-eighth. The message was: the Conservatives will spend more on the NHS than the other parties, and the service can remain unchanged. No cuts, and ‘no top-down reorganisation’.
In October 2013, the NHS semi-privatisation legislation has been in effect for six months. Demands for £20 billion of “efficiency savings” cuts have been inflicted on the service. And now, a new funding formula for the Clinical Commissioning Groups- the consortia of GPs now charged with local NHS budgets- is set to impose draconian cuts in particular regions.
Under the previous system, NHS trusts received grants based on population, age, labor and location costs, statistics on health issues and crucially health inequalities within the local population. Under the new system, age and population will be almost the sole factors, and health inequality (which is particularly associated with obesity) will be totally overlooked. As a result, the Midlands, West Country, South of England and East Anglia will benefit at the expense of London, Birmingham and the North. I’m sure it’s pure coincidence that the latter regions are Labour support bases, though. It’s not as if the Coalition has pulled a similar stunt with funding allocation to local councils (!)
Don’t ask me how its possible to remove several billion pounds from hospitals across the country and insist that this isn’t a fall in spending. The government is doing it though. Don’t ask me how a governing party can design a funding formula so blatantly designed to favour its own headlands. Don’t ask me why two political parties so in love with our NHS have come to drip feed poison in the public ears about the service. The government is doing it though.
The scope of these hidden cuts is huge. With the scrapping of so many hospital targets, we are all aware of increasing strain on our NHS. Waiting lists and A&E waiting times are slowly creeping up. Medical staff are under heavier workloads for pay that is shrinking in real terms. Dozens of hospitals are under threat of closure. And behind the scenes, the problem is even worse: earlier this week, the director of the NHS in London warned that the NHS can no longer afford to staff all hospitals at safe levels. Either hospitals must close, entailing more danger in health emergencies, or health funding has to rise.
If the Treasury is unwilling to add to the deficit, there is only one way to save our NHS, and that is to impose an emergency tax rise. For example, I think putting 1p on Income Tax for a direct cash injection into health and social care would be a popular tax rise, if you can wrap your head around such an oxymoron!
However, I think the Coalition has aims other than the long term survival of a quality NHS.
