Austerity puts a universal free NHS in doubt - think tank

Outrageous yet the inevitable consequences (and for me, plan) of the coalition government austerity programme. As a result of these cuts The Institute for Fiscal Studies says it is time to review the range of services available free at the point of use

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.

www.guardian.co.uk...

The options look minimal in how to effectively fund the NHS from tax reciepts following these swinging cuts. The options laid out above seem unlikely to be implemented. Our nuclear deterrent is an emabrrasment yet there is no chance of nuclear disarmament.

Any working person who voted for the Tories should be ashamed of themselves.

reply to post by Peruvianmonk


More from the article.

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.

www.guardian.co.uk...

Absolutely fantastic eh?

Some more on the coalition policies toward the NHS from a senior doctor who resigned to voice his concerns.

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.

www.guardian.co.uk...

We need to fight for the survival of the NHS or we will soon be arguing over insurance companies, mandates and excesses like the Americans. Lobby your local MP, send letters, phone-calls. This is priority number 1.

As someone who's life is pretty much in the hands of the NHS, any news about it's privatisation feels me with fear. I just don't know what's happening in this country. Everything is up for grabs and no one cares about anything anymore. It's all about the cost and not about the value.

I was watching Newsnights focus on the elderly last night, and the contempt shown towards the older people in this country was sickening. Talking about them like they are some kind of burden on us all. The people that built this nation payed tax all their lives, worked hard and brought up kids. A burden. It seems that once you have worked all your life and cant work anymore, you are now a burden on society. They squeeze everything out of you and moan when you expect the healthcare and pension, you've been paying in for the last 50 years.

Meanwhile we let the rich and the corporations not paying tax and allow a banking system that has been defrauding the nation, yet it is the elderly and sick who are considered the burden. God help us.

reply to post by woodwardjnr


There is an issue that we need to confront on how to look after our old people, it is costing billions. As for the privatisation of the NHS, I suppose we could all move to Canada?

reply to post by woodwardjnr


If you don't mind me asking, what services in particular do you rely on from the NHS? We can then dig around a bit deeper and see what plans are afoot for those departments?

Tax revenue 500bn, health expenditure 100bn, deficit 200bn. National debt 1.3 tn.
All approximates .

If cuts gradually leave the Nhs substandard what's the point of having it?

reply to post by woodwardjnr


That's why tax is a con, especially the income tax , NI contribution, people should plan for the own retirement, illness costs, the Govt needs to ensure everyone is able to freely earn, has equal opportunity. There will be winners and losers.

The NHS does an incredible job. The numbers treated that have never contributed towards it. The advances in what medicine can now treat since its foundation and still the NHS serves us beyond what any private service based on profit ever could hope for.

It is used as a political football by all parties that ignorantly tinker with it to serve some political ideal and still it cares for us.

The Tories see the NHS as an obstacle to profits to be made from illness and disability for their privileged friends and always have.

Don’t even try to tell me about waste because all industry has waste but none of them save the lives of our children, loved ones and friends.

Perhaps if the rich started paying tax and the multinationals were not let of huge tax bills they get while making huge profits from this country. The banks stop extorting money via interest rate fixing and the politicians stop using the NHS to further their putrid careers the NHS could be once again the envy of the world.

It is virtually the only thing left that we can take pride in in the UK. So yes camerwrong needs to be fought tooth and nail to protect OUR NHS.

Edit S&F BTW

reply to post by Peruvianmonk


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.

reply to post by Zngland


Well surely that is the aim? To reach a point where the NHS is so rundown and mistakes, infections waiting lists are so rampant and long that it will make more sense for the individual to purchase a private healthcare insurance package.

BUPA and the like must literally be licking their lips and rubbing their hands at the potential billions of pounds in profit almost within reach.

reply to post by woodwardjnr

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.

Mate that sounds tough.

The whole point of the NHS was that you did not have to worry, whatever age you are. Let's be candid you can get injured come down with a disease at any time as illustrated by your own case. We should all be worried now.

reply to post by Peruvianmonk


Firstly we as a population have to decide the limit to healthcare, in terms of service and cost, then calculate the
impact on total tax revenues, then decide whether a low tax v higher tax economy is most productive and whether
people should be economically optimal.
If we want a dynamic economy then tax needs to be low but still a strong NHS can exist , just not with all the govt services were used to.

Also costs of the NHS can be reduced by giving people the tax incentive to privatize their own health.
I agree of all the Govt services this is the most moral and special.

I think a general tax take of 15% of GDP should be the cut off point and all services funded from this and it's collection should be via indirect taxes.

The effects of austerity are only just beginning to hit.

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.”

www.gazettelive.co.uk...

reply to post by Zngland
Could I point out here the recent scandal of the defective breast implants fitted for profit by the private health practitioners who refused to replace them and so it fell to the NHS to foot the bill.

Private health care does in no way = better health care and certainly is not free at the point of use.

The care of our elderly that has been turned over to the private sector is also not a very good advert for life without an effective NHS.

It is bad enough in an advanced and wealthy country that we have a 1st class and cattle class railway system. That is not what I want to see with our health care but that is what will be the outcome.

reply to post by colin42


Agreed. Private healthcare will equal less oversight and less accountability.

This is coming people unless we vote the Tories out and force Labour to protect the NHS.

reply to post by Peruvianmonk


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.

Anyone who tells you the NHS is in desperate need of cash is pulling the wool over your eyes. It is simply poorly managed and top heavy with "management", coupled with piss poor business practices, such as spunking billions on an IT system that never worked (how on earth you can spend several billion £'s on a database is beyond me)..

Off the top of my head, I could save the NHS billions with some simple changes. Centralise administration for starters, instead of duplicating functions across the many NHS Trusts (same could be said for the entire Government) and cut the amount of managers, or at the very least don't pay these people £100k's a year. Also, limiting the amount of time a doctor can conduct private practice should be apriority. After all, many of these doctors got their training on the NHS so they should damn well give back.

Oh, one last thing, cut the pay of GP's. Some GP's are on more than the PM and yet they are the most useless of all medical practioners. Most, if not all, are merely glorified PA's who either give you anti-biotics for anything or just refer you to an actual doctor for diagnosis and treatment.

reply to post by Peruvianmonk




Labour protect the NHS?

It was they with their fancy PFI's that have saddled many trusts with decades of debt to pay back for Hospitals built, but at around 20 times the price of an actual hospital. For example, a Hospital could be £300 million. PFI stumps up the cash, then charges the Trust £50million a year for 20 years.... The Trust gets a hospital, sure, but they have to pay back a damned site more than if they had just paid for it themselves.

reply to post by stumason

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.

It is in far better shape because of the billions ploughed in by Labour over their period in office. This is about the near and long term future of the NHS not its shape right now. The Institute for Fiscal Studies is a non partisan think tank which has made it clear that as a result of these cuts, the continuation of free to use at point of sevice is in huge doubt.

The funding is draining away with no obvious replacement.

reply to post by Peruvianmonk


Indeed, it pretty much doubled over their 13 year period, but do you think service has "doubled"? Labour did do a good job there, but they have also crippled the NHS by doing other things, such as the massive amounts of managers and the huge debts the Trusts now face.

My point is, the NHS is affordable, quite easily in fact and the solutions have been touted for over 10 years. Everyone knows what is wrong with the NHS, but the politicians of all flavours use it as a football. Don't think for one minute that Labour is the "party of the people", they'll bugger it up in their own special way as well and they too are not averse to snuggling up to big business etc.