How can we keep on paying for the NHS?

Conference season policy special: the Heath Service

Conference season is here, and Brexit will dominate. But none of the gritty policy questions have gone away. Prospect asked politicians to set out what they have to say on the practical issues—here, we tackle the NHS
September 13, 2018
The money question

Jay Elwes  Executive Editor of Prospect

The Conservatives have a new, young, thrusting health Secretary: Matthew Hancock, the first Secretary of State in history to have his own eponymous app. He cuts a different figure to his predecessor, Jeremy Hunt, who lasted longer in the job than anyone in history. Hancock has set out plans for a major NHS tech upgrade. He’s also bringing out an NHS app, where patients can book appointments, order prescriptions and so on. And £200m is going into new medical technological innovation centres.

He has made it clear he wants increased funding for the NHS. And that last point is really the clincher. The NHS needs more money and will continue to need ever more. Where is that cash going to come from? Jon Ashworth complains below that austerity has squeezed health services—even if that is so, Britain will spend £125bn on the NHS this year, hardly a stingy amount and that figure will continue to rise. Is the answer a hypothecated tax, perhaps? A charging system for appointments? So far Labour has failed to give an answer to the long-term funding question.

Hancock thinks technology will make a difference, and it will. But the hard question of funding can’t be answered by an app.


Stockpiling medicine because of Brexit? That wasn’t on the side of a bus

Jonathan Ashworth  Labour MP for Leicester South, Shadow Secretary of State for Health and Social Care

It seems almost daily we read of the dire straits our NHS and the impact that financial pressures, neglect and ministerial incompetence are having on patients. Last year, half of maternity wards closed their doors to expectant mothers because they could not provide safe care.

Meanwhile the waiting list for operations is at 4.3m. Treatment is supposed to be guaranteed within 18 weeks by the NHS Constitution. After eight years, NHS management say the standard can no longer be met while health ministers hint they want it downgraded. The consequence is a steep rise in those going private.

A&E departments are regularly in crisis—last winter was one of the worst we’ve seen. Over 185,000 vulnerable and elderly patients waited in ambulances in the cold for over 30 minutes to be admitted to emergency departments. 

Patients queue to leave hospital as well. Too often the care many people depend on in the wider community has been dismantled by £6bn-worth of cuts to social budgets. 

Many community health services have been privatised with contracts handed over to poor quality private operators. We’ve seen the grotesque spectacle of Virgin Health suing the NHS when it failed to win a contract. A Labour government would stop this privatisation. The NHS faces an acute workforce shortage. We have a vacancy gap of 100,000, including more than 40,000 nurses and 11,000 doctors. Despite Tory promises to recruit 5,000 extra GPs, GP numbers have fallen by around 1,000 nationwide. 

And then there’s the Prime Minister’s hopeless approach to Brexit—far from being a great boon for the NHS as dishonestly promised. There’s still no clarity for the tens of thousands of EU nationals who work in the NHS and no clarity on how Brexit will affect our supply of pharmaceuticals. Instead ministers glibly tell us they are stockpiling medicines. I don’t remember that being printed on the side of a bus.

What would Labour do? We start from a commitment to end austerity. In the first year of a Labour government we have pledged almost £9bn extra for health and social care. We would deliver fair pay for NHS staff and bring back the bursary to train midwives and allied health professionals. 

We must also invest more in community health services. A third of patients admitted to hospital have five or more health conditions, such as heart disease, stroke, type 2 diabetes, dehydration, hip fracture or dementia. This is up from one in 10, a decade ago. 

The truth is that health inequality is wide and getting wider. Because these stark inequalities often begin in childhood our ambition is to create the social conditions so these children can become the healthiest in the world. 

Labour will tackle the epidemic of childhood obesity, support mums and newborn babies with early years investment and carry out a radical upgrading of our child and adolescent mental health services. These will be the first stages of a new health programme for government where every child matters.

The NHS in its 70th year remains our nation’s most powerful engine of social justice, but after eight years of Tory austerity it’s crying out for a change of direction.