The new NHS funding settlement falls far short of tackling the crisis
After years of austerity, the government’s cash-injection pledge still leaves the NHS chronically underfunded. Jon Ashworth offers an alternative prescription
Upon introducing the National Health Service in 1948, Nye Bevan described Labour’s creation as “the biggest single experiment in social service” ever undertaken.
The NHS was the first health system in any Western society to offer universal free medical care, and the first comprehensive system not to be based on the principle of insurance, but on the national provision of services for all regardless of wealth.
Seventy years on, Bevan’s great social innovation stands proudly as the envy of the world. So it is absolutely right that on the 70th anniversary of the National Health Service, we celebrate seven decades of success and progress. And that we celebrate the 1.6 million NHS staff who embody the very best of our national values and principles.
Back in 1948, life expectancy for women was 71 and for men 66, meaning half the population never reached the age of retirement. Today those figures are 82 and 79 respectively. Yet those early NHS pioneers would not want us to rest on our laurels. Recent IPSOS Mori polling on public attitudes to healthcare found that although public support for the NHS is ‘unwavering’, almost half of people expect the NHS to get ‘worse or much worse’ over the next few years.
Each winter we hear appalling stories of thousands of vulnerable patients left languishing in the backs of ambulances and on trolleys, because of acute bed shortages.
Our NHS is short of 100,000 staff, hospitals are quite literally crumbling and our children are among the unhealthiest of comparable leading nations.
Last year 2.5 million people waited over four hours in A&E, up from 350,000 in 2009/10. Across the same period 30,000 people waited over 62 days for cancer treatment, twice the rate of 2010.
Simultaneously, social care has been devastated by £6.3bn of cuts since 2010, leaving 400,000 elderly and vulnerable people losing out on free help to live at home.
Thanks to pressure from patients, overworked staff and the Labour party, the Government was recently forced to redraw the funding settlement. Yet every expert agrees this falls far short of tackling the crisis. It is at best a standstill budget after eight years of austerity when NHS budget increases averaged just 1.4%.
Theresa May tried to tell us the new budget would be funded from a ‘Brexit dividend’. Pull the other one. Future spending will be paid for by tax rises. Tory MPs now need to be upfront with their constituents – will VAT go up, will corporation tax go down? We will be challenging Tory MPs in their constituencies between now and the Budget to come clean on these Tory tax rises.
Given this reset will be paid for by taxation it begs the question as to why the Government has allowed the NHS to deteriorate to such levels. If it had followed Labour’s advice two years ago perhaps the winter crisis wouldn’t have been branded a ‘humanitarian crisis’.
The Government says the reset budget will allow NHS chiefs to plan ahead. But how will our local health trusts do so when public health, the repairs budget and social care were left out? That means new budget allocations won’t be on stream till 2020. This hardly suggests a long-term plan, more like a wing and a prayer.
So, when one factors in the Government’s omission of funding for social care, public health – which faces cuts of £800m by 2020/21 – staff training and a backlog of £5bn of repairs, it becomes clear that under the Tories patients won’t receive the quality of care they deserve.
By comparison, Labour has pledged almost £9bn extra for health and social care in the first year of a Labour Government compared to £4bn under the Tories. That investment will reverse the deterioration in patient outcomes since 2010, and enable us to adapt to changing demographics and the nature of ill health in the 21st Century.
By 2040, nearly one in seven people is projected to be aged over 75, whilst the number of over 85s is set to double over the next 20 years. Over 50% of older people currently have at least two chronic conditions, and by 2035 the proportion of those with four or more diseases is set to double.
To make our NHS fit for the future we must therefore find innovative solutions to tackle the marked shift from acute illness towards chronic conditions, multi-morbidities, cognitive impairments and long-term frailty. At the heart of Labour’s vision is preventative care, early intervention and tackling the widening health inequalities afflicting our civil society. Delivering genuine parity of esteem between mental and physical health will be front and centre.
Over the coming months we also want to engage in a debate about how we move to partnership, integration and planning in the delivery of healthcare rather than competition and markets.
Our NHS is one of the most powerful engines of social justice the world over. It is unquestionably the pride of Britain. On the 70th anniversary of the NHS, Labour will be leading the fight to ensure a properly funded, public National Health Service. One that would make Bevan proud.
Jon Ashworth is Labour MP for Leicester South and Shadow Secretary of State for Health & Social Care