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When the next government arrives in 2015, the cabinet minister for health will have to make a difficult argument that the NHS deserves more cash. Although the health budget would have been ringfenced for the last four years, this settlement was the stingiest the NHS has faced in half a century.
If other departments - like education, home office, environment - saw spending rise by a tiny 0.1% a year from 2015 to 2022, this would pay for the this NHS. That's a lot of police officers sacked, schools closed and perhaps a Beeching-style pruning of the railways for the public to wear.
What about keeping NHS spending constant as a share of GDP? So that means the NHS getting 2.4% a year extra while other public spending was restrained to about 1.1% rises annually. The result is a funding gap of about £15bn. Trident, the submarine system that can launch ballistic missiles with thermonuclear warheads, cost £9.8bn in 2005. In 2022 money that's about £15bn. So one way of paying for this NHS could be by the nation giving up its nuclear deterrent. Hard choices.
More likely is that non-health public spending is kept at 1% a year, roughly what the chancellor envisages after 2015. That still means some pain for benefit claimants, perhaps a smaller army and falling pay for public servants. But it means that the NHS falls short by £19.5bn. That's a about 5p rise in VAT. Alternatively one could could shut hospitals down. However this is small beer - the current plan, remember the toughest NHS financial settlement in 50 years - sees health managers making £4bn in "reconfiguration" savings.
What about charging? Each GP in the nation's 10,000 surgeries see on average 140 patients a week. There are about 40,000 family doctors so if each patient paid £67 a visit this would raise £19.5bn a year. Of course prices rise and demand falls so charging is not a panacea. You could of course borrow the £20bn, but that depends on whether the markets want to lend it to you. If there is no takers for UK gilts then why not just print money? Quantative easing could conjure up £20bn and the Bank of England could hold the investment in the NHS and argue that social returns will flow back into Britain.
Okay that's a little far out. Alternatively one could go for a bargain basement version of the NHS. The light green line is an NHS that would see its budget frozen. This be a health service unlikely to live up to the ideal of universal provision. No new cancer drugs or new hospitals and forget about the looming Alzheimer's crisis. But it would allow other budgets to rise at about 1.3% a year. That would mean money for nuclear power, higher benefits and perhaps an aircraft carrier or two.
The NHS reorganisation is, he believes, part of a planned enfeebling by the government of public services generally: "I think there's a very deliberate policy across all of the public sector to roll back the achievements that have been made in this country since the second world war – including the NHS – and that financial austerity is being used to pursue an agenda aimed at dismantling the state. "At the end of the war this country was hugely indebted but within a couple of years had free healthcare and free education for everyone – what an achievement! This government is putting a huge price on education, especially young people seeking to go to university, and is in the process of dismantling the NHS."
Scally completely rejects ministerial claims that abolishing primary care trusts and strategic health authorities (SHAs) and handing control of £60bn of patient treatment budgets from next April to clinical commissioning groups (CCGs), will – to coin a favourite Lansleyism – "liberate" the NHS. "What we're going through now is a systematic downgrading, if not destruction, of civil society in England with a de-layering of structures and organisations and, at the same time, a huge amount of responsibility being handed to the local level, especially to local authorities, at the same time as their budgets are being cut," he points out.
I don't mind you asking, but didn't want to derail your thread. I Have MRI scans twice a year or whenever I feel I might need one, 3 month appointments with Oncologist, bi annual appointment with endocrinologist. Every 3 months blood test and hormone injection at GP surgery. I've been costing the NHS a fortune for the last decade. I can't help it if they keep on keeping me alive. I can understand young and healthy people thinking they will never need the health service and begrudge paying for others, but you never know when you might need it. It certainly wasn't part of my lifes plan.
A UNION official says a 3.9% drop in staff numbers in one year at a Teesside hospital trust reflects a wider NHS struggle with Government austerity measures. North Tees and Hartlepool NHS Foundation Trust, which runs the University Hospital of North Tees in Stockton and University Hospital of Hartlepool saw staff numbers drop from 5,716 at the end of the financial year 2010 to 2011, to 5,491 by April 2012. Clare Curran, director of human resources, said the 225 drop in staff headcount was in line with the trust’s aim of reducing staffing costs. But Duncan Rothwell, regional organiser for UNISON covering North Tees and Hartlepool, said: “The NHS continues to suffer under the assault of the austerity programme imposed by the coalition Government. “NHS Trusts struggle to find more and more efficiencies whilst protecting front-line services.”
To be honest, the NHS today is in far, far, far better shape than it was in the 1990's, don't let the media scare stories about infections and poor treatment cloud the fact these are only a fraction of a fraction of the popel treated successfully.