Jeremy Hunt: rise in national insurance to fund the NHS and social care was the easy bit – now comes the graft
My job as Health Select Committee chair is to hold the government to account, and I haven’t shied away from doing that during the pandemic. But that means also giving credit where it’s due.
NHS leaders, clinicians and the select committee have been warning about the precarious state of the NHS and care systems post-pandemic, and ministers have really listened. A Conservative government raising national insurance to invest in the NHS is a bold one-nation move that will be rewarded by voters, who testify time and again that nothing matters more to them than healthcare.
So it’s deeply disheartening to see opposition politicians who complain about NHS and social care underfunding week in and week out vote against giving the NHS an extra £12bn each year. This is politicking of the worst kind because the crisis in the NHS and care system is real, and the hard fact is that any wealth tax will not raise the kind of sums needed to care for an ageing population. If other parties can’t point specifically to how they would raise £12bn a year from April, then they can’t look their constituents facing long waits for operations in the eye and tell them they have a plan to help.
Even before the pandemic, there were structural reasons why we needed a proper conversation with the electorate about health funding. Last year was the first in human history where there were more over 65s than under 18s. In the UK, the number of people aged 65 and over is growing three times faster than the number aged under 65.
It is a wonderful miracle that we are living longer, but one with dramatic consequences for NHS and care spending. A 50-year-old man costs the NHS just under £500 on average – but by the time he is 85 it rises to nearly £4,000. Our hospitals will be 40 per cent busier in 15-years-time according to one study.
It was, as Sir Humphrey would say, “brave” for a Conservative Prime Minister to raise taxes but the next task of turning money into shorter waits, with proper reform, will be tougher still. As the cost of living increases on every side, voters will be angry if they don’t see tangible improvements fast in exchange for that rise in national insurance.
It could well be that getting the national insurance increase through Parliament was the easy bit
I know some simply see the NHS as a bottomless pit and fear the money will disappear without touching the sides. They are right to be concerned. As someone who has made their fair share of mistakes while stewarding the NHS, I believe we need urgent reform in several crucial areas to avoid that fate.
There is a real and rapidly deteriorating workforce crisis in the NHS. Our eye-watering waiting lists, lack of face-to-face GP appointments and even multiple lockdowns to protect NHS capacity stem partly from this pressing issue.
You can give the NHS £8bn extra for the next three years but without £8bn of extra doctors and nurses to do the work, nothing will change. The Health Foundation estimates it will take 4,000 more doctors and 18,000 more nurses to clear the backlog, but so far there is no plan to find them.
Long term there is only one solution, so far rejected by the government, to allow an independent body to make workforce forecasts, OBR-style, so we can make sure we are training enough doctors and nurses for the future.
It could well be that getting the national insurance increase through Parliament was the easy bit for ministers. Much now hangs on their ability to avoid the traps set out above. But they have taken a courageous first step in raising the money and they should be applauded for that. This is not, in the end, about big state versus small state politics, but whether we back the people’s number one priority: healthcare.
Jeremy Hunt is Conservative MP for South West Surrey and chair of the Health and Social Care Select Committee
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