After ridiculing health workers demanding more funding for the NHS and insisting there was no “magic money tree,” Theresa May seemed to have found it, writes John Lister editor of Health Campaigns Together.
The fact that there is any more money at all is because of sustained pressure from campaigners and the NHS itself, and the huge political popularity of the NHS in its 70th birthday year.
Under intense pressure after yet another predictable and avoidable winter crisis, May announced that her government would give the NHS in England a “long-term settlement” – although nobody knows where the money will come from
There are deep divisions among May’s own MPs. Some recognise that the majority of their party members and most of their voters support the NHS: but they mingle with backwoods reactionary MPs like Christopher “upskirt” Chope who wants to impose charges for treatment, many who favour private health insurance and many more who want an increased slice of NHS funding to flow to the private sector.
May’s idea of ‘long term’ extends only 6 years from now, and the “extra” money is a paltry £20 billion by 2023/24. Every expert immediately agreed this was nowhere near enough.
It’s certainly not enough to make up for the last 8 years of a brutal real terms freeze on funding imposed when David Cameron’s government took office. Since 2010, while the population has grown by over 4 million, successive governments have set out to reverse the decade of increased spending from 2000 which pushed NHS spending up towards European averages.
4% to keep pace
NHS Providers and the usual normally cagey think tanks, as well as health unions and professional bodies – indeed all of those with any detailed knowledge of the NHS – have agreed that a minimum of 4% real terms increase per year would be needed just to bring back some stability.
Additional funding is required above that to make any improvements to services possible.
May’s extra money was trumpeted by the government as worth 3.4% a year in real terms. But the money goes only to NHS England, and not to the larger Department of Health budget. So the overall increase is therefore 3% a year, not 3.4%.
This is £8 billion short of the amount which everyone has told ministers is needed.
The selective increase means that for six years there will be no increase in the £14bn spent on capital projects, training of doctors and health professionals, public health and research and development.
Nor is there any extra to boost spending on neglected and less prominent sectors run by NHS England – mental health for adults and children, GP services and primary care, or community health services.
There’s nothing for social care, either. This needs a 3.9% annual increase. Indeed when we look at the full picture it’s clear that all of the new money has already been effectively spent in advance.
For the next financial year, the actual ‘extra’ cash will be just short of £6bn: but this includes the previously planned increase of £2.6 billion from this year, leaving just £3.4bn.
This is not enough even to cover trust deficits (trusts borrowed an estimated £3bn last year to propup budgets), the £1.3bn cost of the pay increase just agreed, a hike in pension costs, and £1 bn-plus of urgent backlog maintenance.
And while ministers talk about demanding improved performance for the money, just to stop the 4 million-plus waiting list for elective care growing would cost £500m extra a year.
To make matters worse, even while they slashed NHS real terms funding, Cameron’s coalition also entrenched a costly, bureaucratic and fragmented market system in the 2012 Health and Social Care Act.
And the Private Finance Initiative, through which new hospitals were built at extortionate cost from 1997, still saddles the NHS with a rising £2bn a year bill into the 2030s.
So we do need more money for the NHS – but we also need action: to scrap PFI and privatisation, scrap the 2012 Act and the costly chaos of a competitive market in health care, and to reinstate the NHS on the firm foundations laid in 1948.
The 70th anniversary of the NHS is an important landmark: but the fight will go on for as long as it takes to make sure Our NHS is protected, and staff are enabled to provide good, safe care – Free, For All, Forever!