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In his budget on Wednesday, Chancellor Rishi Sunak is set to unveil yet another 5 billion pounds for the National Health Service. That’s 5 thousand million, or 5 followed by nine zeroes.
That’s in addition to a £12 billion NHS maintenance fund uplift. And on top of the three-year £36 billion additional funding for NHS and social care announced just a few weeks ago – and which ministers have since admitted will overwhelmingly be allocated to the NHS.
The growth in the NHS budget over recent years has been astonishing.
The health department spent £212.1 billion in 2020/21 – that’s up from £150.4 billion in 2019/20, a 40% increase, which in part reflects the Covid pandemic.
As recently as 2008, the NHS budget was £118 billion. So we’ve seen a 78% rise over little more than a decade, a decade of “austerity” spending according to many.
During lockdown, non-Covid treatments were scaled back. As a result, nearly six million people are now waiting for routine operations, the longest NHS waiting list since records began. Life-changing procedures including hip- and knee replacements and cataracts are among the treatments most-longest delayed.
One in ten of us are now on an NHS waiting list, that represents untold human suffering. No wonder the government wants to be seen throwing money at the NHS. But is more money the answer? How about spending the existing NHS budget better?
The UK prides itself on free-at-the-point-of-use health care. This is a principle many of us are rightly proud of ¬– a principle I would robustly defend.
But surely there is a better way to deliver universal health care for all, without relying on a single, monolithic, often wasteful organisation employing an astonishing 1.3 million people?
We’re constantly told the NHS is “the best in the world”. Really? Check out these conclusions from a pre-pandemic study by the Institute of Fiscal Studies, the Kings Fund and the Nuffield Trust – three highly respected research bodies.
"Among its strengths, the NHS does better than health systems in comparable countries at protecting people from heavy financial costs when they are ill.
"Its main weakness is health care outcomes. The UK appears to perform less well than similar countries on the overall rate at which people die when successful medical care could have saved their lives.
"Although the gap has closed over the last decade for stroke and several forms of cancer, the mortality rate in the UK among people treated for some of the biggest causes of death, including cancer, heart attacks and stroke, is higher than average among comparable countries. The UK also has high rates of child mortality around birth".
Health Secretary Sajid Javid is setting up an “NHS delivery unit” to oversee an efficiency drive.
Other cabinet ministers privately warn “Sajid need to get a grip of NHS spending” –not only so additional money translates into more operations, clearing the huge backlog. There will also be serious political fall-out if our health service keeps drawing money away from social care.
It’s almost impossible to suggest meaningful NHS reforms – even if, like me, you insist on free-at-the-point-of-use provision. NHS insiders calling out inefficiencies have been drummed out of their jobs, or ostracised. Outsiders calling for change are dismissed as heartless or worse. Yet we can only improve the NHS – getting more and better healthcare for the huge sums we spend – if we stop deifying this complex institution, recognising its countless weaknesses and inefficiencies.Instead of pretending these don’t exist (or are only due to insufficient funding), they should be vigorously addressed.
And that’s why THIS question simply must be posed, repeatedly and with attitude.
The NHS – is more money really the answer?