|The NHS ‘Black Hole’ sucks in both unlimited funding and political arguments|
Two inter-twined themes about the NHS last week.
In First Theme a new report from the Institute for Government and The King’s Fund considers how the creation of NHS England has failed to take the politics out of healthcare provision in England.
NHS England – once dubbed ‘the world’s biggest quango’ was established 5 years ago by the Health & Social Care Act 2012 as a statutorily independent board with the aim of ending ‘political interference in the NHS’. Yet the current Secretary of State, Jeremy Hunt, has been as closely involved in NHS performance & planning as his predecessors.
Nor has its creation led to the NHS being run on "quasi-market" lines as its principal architect, Andrew Lansley, intended. Instead – despite the fears of critics – the Act turned out to be the high-water mark of faith in choice & competition. It has been followed by a return to a more managed system, with the balkanised bodies it created being slowly, but surely, brought together & merged.
In the Second Theme the IFS argues that, with the older population growing rapidly, along with the numbers suffering chronic health problems, and a growing pay & drugs bill, demands on the health service will only continue to grow. Just to keep the NHS providing the level of service it does today will require us to increase spending by an average 3.3% a year for the next 15 years – with slightly bigger increases in the short run to address immediate funding problems.
At the same time, pressures on social care spending are increasing and, if we continue with something like the current funding arrangements, adult social care spending is likely to have to rise by 3.9% a year over the next 15 years taking an extra 0.4% of national income, relative to today.
Put these figures together and health & social care spending is likely to have to rise by 2–3% of national income over the next 15 years.
|Editorial Note: Regarding the IPPR proposal to ‘raise National Insurance by 1%’, one seems to remember that Gordon Brown did just that in 2003, but it doesn’t seem to have permanently solved the funding problem!|