Tories = Labour

James Gubb, 28 February 2008

The Times today reveals the Conservatives are equally, if not more, committed to throwing yet more money at the NHS than Labour. The Shadow Health Secretary, Andrew Lansley has boldly so he thinks, and completely foolhardily so many of the public will think, pledged to increase spending on it by £28 billion per year to around 11 per cent of GDP.

As Derek Wanless so eloquently showed in his recent review of NHS performance for the King’s Fund, the NHS has used the massive amount of extra funding it has received since 2000 very badly indeed. And, with the more positive reforms still yet to bed in, it simply isn’t in a position to use such sums anymore effectively now than it was then.
To repeat a few statistics: spending on outpatients increased by 66 per cent between 1999/00 and 2005/06, yet activity only increased by 30 per cent. Spending on elective (planned) and emergency services rose by 47 per cent, yet activity only increased by 18 per cent. And much of this growth was accounted for by increased admissions from A&E departments – a symbol of supply-side inefficiency in itself. If the NHS had registered the efficiency Wanless thought would be reasonable in his 2002 review, it could have treated an extra one million emergency and elective patients in 2005/06 alone. Is this really how we want to be using taxpayers’ money?
And, another thing, why the moratorium on hospital closures? This is just plain electioneering. Hospital admissions are expensive and far too high in the UK. At a seminar this morning the CEO of PruHealth showed how their healthy lifestyles insurance package had decreased hospital admissions by up to 20 per cent in South Africa – particularly for those with chronic conditions. With this, and better clinicially integrated networks, more and more people should be seen in the primary care setting and able to manage their own care. This would entail some hospital closures; and this would be a sign of increased efficiency.
As Nick Seddon argued so persuasively in a recent publication for Civitas, the ailments of the NHS are systemic and deep-rooted. Chopping around the edges and throwing more cash at what is still fundamentally a Whitehall-facing monopoly will not work. The Tories should read it and take note.
And please, please, come up with some original policy.