Thursday, August 20, 2009

The Oil Tanker of NHS Spending Must Be Turned Around

Be still my sinking heart. John Prescott today, via Twitter, challenged David Cameron to a debate on the NHS. The Manchester Evening News published David Cameron's response...
"The real question is why won't Labour match the Conservatives' pledge for year on year real-terms increases in NHS spending over the next Parliament"

David Cameron would have been well advised not to respond to Prescott, who holds no position and is just living up to his nickname of The Mouth of the Humber. But let's ignore Prescott and look at the substance of what Cameron said. I understand the politics of it, but is it really consistent on the one hand to make speeches about how serious our debt crisis is, and then on the other hand tell everyone how NHS spending is ringfenced, and not only that, it will be increased year on year regardless of economic circumstances.?

I do not advocate cuts in frontline services, but neither can I advocate increased spending in a government department which has already been stuffed with money over the last twelve years and failed to achieve the commensurate improvement in service levels.

David Cameron takes a different stance. In his speech today in Bolton he said...
The debt crisis means we need a new approach to public spending, to make sure we get more for less. But in the NHS, even that won’t do. The pressures on healthcare spending – from an ageing population, from medical advances, and from rising expectations – are simply too great... Spending on the NHS cannot stand still, because standing still would be taking a step backwards. That is why we have pledged real-terms increases in NHS spending - unlike Labour – a fact which, to put it mildly, takes the wind out of their point-scoring sails."
So far, so logical. But people understand the need for the government to rein in its horns in times of economic crisis. They understand a party that is honest with people and explains where cuts are going to have to call. What they find more difficult is to trust a party which then says it will increase spending in an area of policy which in the past has been politically toxic for them. To say that the NHS oil tanker of spending cannot be turned around is to give up. It won't be quick and it won't be easy, but it can be done.

We need to cut the levels of absenteeism (which is costing close on £2 billion a year) and increase productivity levels, which have dropped by nearly 5% since 1997. And no one is telling me there isn't waste and bureaucracy which can't be attacked.

If our levels of debt and borrowing are so serious that they threaten the very future of our economy, how can anyone justify ringfencing anything? Just askin'.

UPDATE: Tim Montgomerie has just blogged David Cameron's 12 reasons why NHS spending has to grow. Tim comments...

I readily agree that it is a persuasive list but it would also be possible to draw up similar lists for many other public sector budgets - budgets that have not enjoyed the growth of resources enjoyed by the NHS. My greater objection, however, is the question of affordability. Britain borrowed £8bn last month against an expected borrowing requirement of £500m. The BBC reports that the government's overall debt now stands at £801bn, or 56.8% of GDP, its highest level since at least 1974.



MikeyP said...

It is statements like this one from David Cameron that means that the Tory lead in the polls is not overwhelming. Of course we cannot spend any more on the NHS, We need to spend less on it and make it MUCH more efficient aqnd cost effective.

subrosa said...

Another lost opportunity from Mr Cameron to renovate our NHS and bring it into the 21st century.

We require first class healthcare not second rate treatment which is so prevalent throughout the country.

What is it with the people of the UK? Why do they accept this? Perhaps many have no experience of the standard of health care in Europe and therefore can't make comparisons.

It would seem we're so nearly fully socially engineered it doesn't really matter. 'Take what you're given' is labour's motto and Mr Cameron's doing nothing to improve that.

As for the old propaganda about increasing elderly etc - every European country has an increase in their elderly at this time and still they manage far greater successes in treatments of cancers, heart disease and longevity.

niconoclast said...

When people start demonising those who critique the NHS Socialist Healthcare system which has plainly not delivered and would bankrupt the country before it did, they are demeaning political discourse, patronizing the electorate, robbing them of a much needed debate and stifling free speech.Why the hell should we be stuck with an antiquated degraded and frankly corrupt healthcare system that kills tens of thousands of people every year and should properly be called the National Hollocaust Service? It is run by mediocre dodctors who think they are God and mediocre nurses who think they are doctors and is controlled by power-lusting politicians who hold the power of life and death over patients who are not customers but hapless supplicants of an insane system that does not work,never did work and is designed principally to keep in employment over a million employeees who are Labour voting fodder.How dare Tory politicians say that foisting such an insane and imoral system on the public via enforced extractions of taxes is moral and just?It is evil and obscene!

Anonymous said...

He's probably trying to counter the effect of Dan Hannan's comments.

The NHS should be there to SAVE lives meaning the following should be cut:

Plastic surgery
Tattoo removal
Works of art

Daniel said...

Isn't this all going according to plan?

Andrew Boff said...

We spend so LITTLE on healthcare in the UK it's entirely realistic to commit to see more spent.
How we spend should also be of concern but to decrease the overall expenditure on health is so daft I can't believe it is being seriously proposed by a Labour Government.
Or perhaps I can.

Sean said...

I think you are stalking me, Iain. I wrote Is the NHS Really Sacred last month. This isn't the first time this has happened ...

There's no room for waste in any government department. That includes the NHS. Like a fat child, we should put it on diet because we love it.

Anonymous said...

have you been watching Jon Stewart's "Daily Show" ?

Just askin...

Thomas Rossetti said...

Even though I now live in America, I often feel a thrill when I hear the latest piece of bad news about Gordon Brown. I hear David Cameron give him a going-over at PMQs and I get all excited...

Then I hear David Cameron come out with this spending commitment to the NHS and I despair.


Even France has private companies run their hospitals. Seriously, what is wrong with Britain on this one? What will it take for politicians to see sense? Are we to bankrupt the country to pay for these ever-increasing costs?

* This is true as far as I know. If I'm wrong, I'd be grateful if someone could put me right.

Anonymous said...

David Cameron is an idiot to say that a Tory government will throw more money into the black hole that is NHS funding, without committing to make it more efficient.

Paul Halsall said...

Let's raise our GDP spending on healthcare (8.4%) to the US level of 16%, eh? But do it through taxation.

Just imagine what we could

I would love this. MRIs and CAT scans on request; lots of new buildings; good salaries for staff; private rooms all round; decent internet connections.

Lots of new jobs.

Just imagine.

Fausty said...

I draw two possible conclusions from Cameron's stance:

1) He doesn't want to give Labour any attack angle on the NHS, whatsoever.


2) He supports the socialisation of medicine. This might sound far-fetched until you compare Cameron's stance with Dan Hannan's. Dan's is far more conservative.

Insider said...

Paul Halsall is spot on.

If you want the NHS to compare even better with the US then the spend needs to as well.

NB when looking at "waste" perhaps comparisons between admin costs could be part of your post Iain?

Unsworth said...

I don't care particularly if Cameron wishes to increase spending on the NHS, just as long as every single penny is spent carefully, wisely, and accountably.

It's an immensely wasteful service, with colossal amounts being spent on cretinous disasters such as the multifarious IT shambles, and new hospital buildings which are empty etc.

Time to throw out the admin staff, contractors and sub-contractors and reinstate the old hierarchical system of Matrons, Sisters etc. At least with those individuals you knew who was in charge and who was responsible for what.

Centralised control leads to abandonment of individual responsibility.

Quietzapple said...

Should the hapless Chameleon win the next election he won't last long.

Ditching him in favour of Osborne G, or some Hannan/Carswell "Flat tax/No Tax" thinking clone wil be the Billionaires' early intent.

Easy to ditch poor old Cameron's soundbites with the man himself, as they howl about National Debt, security & etc.

On some of the comments are far more prescient than the tendetious blog:

gixxerman006 points out that assumptions that all the assets on which borrowings put in to Uk blogs are worthless is nonsense, but common nonsense.

optimist99 essays that other western countries have and do run levels of debt like the UK's current debt.

RonaldCalitri points to UK deb=t beyond the period chosen by the blog's author.

The posts were closed after 8 comments, the last of which, by hal9k:

"It is a good thing that public debt is increasing. In future we should run the economy on a much higher public debt and much lower (ratio) of private debt. For, as we have recently seen, when bank-created debt gets too large, the system is unstable."must have tried the tory ridden Guardian too far . . Strange to read so much sense too.

The Billionaires will close down the NHS, if they get a chance, and the media knows it.

Old Codger said...

This is exactly what is wrong with Cameron, trying to garner votes rather than do what is best for the country. We need a conviction politician as leader not a poor copy of Tone.

Dan Hannan was right and Dave would have done well to explain why Dan was right and why he could not guarantee spending in any department. When, within a year or so, he does have to cut NHS spending, or accept the IMF, he will have destroyed the Tory party for many years. It will be a disgraced single term, or less, government.

The first duty of government is to safeguard the realm. If any department should have its spending ringfenced, or even increased, it is defence and he would be unwise to promise even that, beyond guaranteeing support for our boys on active service.

Jabba the Cat said...

The NHS "tanker" needs to be towed out to the deepest point on the ocean and scuttled with all aboard. Only then can a new NHS, lean mean and efficient, be constructed in it's place.

Eduardo de Aston said...

Good old David Conman. Totally out of touch with his own right wing party.

Trying to out "Blair" Blair.

He really is in for a good kicking, from his own kind.

But let's be honest we all know deep down he is just a Tory stooge. Noone in his own party believes his mindless, unrelenting rhetoric.

Yes he will get the Tories elected and then the fun will really start.

Major had his "Bastrds", let's see what Davey boy has.

Just don't turn your back Dave!

Anonymous said...

Any politican who replies to a question with "The real question is " deserves a punch in the face

wapping boy said...

Presumably any debate that involves Prescott will have subtitles so we can udnerstand what he is trying to say.

But why does anyone still listen to John Prescott? He made a total hash of every portfolio he ran, completely failed to generate any sort of coherent transport policy, punched a member of the public, cheated on his wife with his secretary (so abusing his office and position) and has a grasp of English that would shame a teenager. He is the embodiment of everything that is so wrong with the quality of MPs these days.

WV: diatoree

Any colour but brown said...

The good ship "NHS" will not deviate one second of a degree from its course as long as she is captained by Gordon "Edward Smith" Brown (First Officer Alistair "William Murdoch" Darling).

Lord Snooty said...

The Shallow Salesman really is revealing himself to be totally out of his depth. It will be a sorry day for our country if such a lightweight becomes PM.

Anonymous said...

"The Shallow Salesman really is revealing himself to be totally out of his depth. It will be a sorry day for our country if such a lightweight becomes PM."

That's exactly what Tories were saying about Blair 12 years ago...

Hannibal said...

john miller said...

The real oil tanker is the Conservative Party in Opposition.

They have been following a trail left by Labour and have unfailingly taken the wrong turns on policy.

Not only have they been unable to lead public opinion, but, having chosen to follow it instead, they have not kept up with it.

If you tell the man in the street that you are going to give the NHS a bigger share of a decreasing pot, what are you going to tell him when he asks you which public service you are going to decimate to compensate?