Will the Tories regret their NHS spending bravado when it comes to government?

Simon

I assume this is a spoof. Only the kids on this blog could suggest the Tories pledge cuts in health spending now. Sometimes I wonder if Peter Mandelson writes these pearls of wisdom.

Bob

Health Spending WILL have to increase due to the every increasing aging population. What the tory position does do, is buy political capital to say "We are increasing the budget, but it will have to matched by a reconfiguration of that budget to meet actual needs not pet projects so loved by Labour".

Maggie

".a Tory government may find it essential to cut health spending..."
Damn right they will and there's plenty to cut. In times of plenty the NHS has added all sorts of extras to their repertoire and now that the nation's a bit cash strapped all things not essential to the care and treatment of the sick will have to go. Breast enhancements, gastric bands, gym membership and gender realignment. If there's a choice between expenditure on the alleviation of pain or a new birthing pool - the pool will have to go. If there's only enough money for x-rays or a quango to advise on the efficacy of x-rays - get rid of the quango.
The answer to the problems of the NHS is not more money but better management of the money they're already got.

J H Holloway

Nah. The NHS is to the incoming Tory government what the tax/spend issue was to incoming New Labour (well, at least for the first two years).

It's a promise that they have to make, to dispel lingering doubts. However, the truth is that while the Tories never actually cut NHS spending, even in real terms, Labour did have a history of tax and spend.

Tory tweeters should also point out the relative size of the government's tax take in 1996 v 2006. The UK economy was much smaller back then.

When the history of the New Labour project is written, it will conclude that its greatest achievement was to convince many people that 1979-1997 saw the country run into the ground, when the exact reverse was true.

J H Holloway

Nah. The NHS is to the incoming Tory government what the tax/spend issue was to incoming New Labour (well, at least for the first two years).

It's a promise that they have to make, to dispel lingering doubts. However, the truth is that while the Tories never actually cut NHS spending, even in real terms, Labour did have a history of tax and spend.

Tory tweeters should also point out the relative size of the government's tax take in 1996 v 2006. The UK economy was much smaller back then.

When the history of the New Labour project is written, it will conclude that its greatest achievement was to convince many people that 1979-1997 saw the country run into the ground, when the exact reverse was true.

Pete Hoskin

Simon: one consideration - pledging cuts, as you put it, is not quite the same as not committing to ringfence health spending.

But, having said that, I think it would be embarrassing for the Tories to go back on their NHS spending pledge now, and don't expect them to do so. But that doesn't stop it being a potentially damaging commitment once they're in government. That's my point above.

Dean

Could you please specify where the cuts should be made? Some GPs are certainly over-paid, so we could pay them less, sack some of them, and thus jeopardise service level standards in primary care. That would be really popular with floating voters.

I guess the Tories could also crack down on NHS-funded sex changes. This would please the Daily Mail, but cutting down on the number of transsexuals will, I imagine, probably not deliver the required savings.

Please specify where you think the cuts could/should be made. Please list the cancer drugs currently available that could be withdrawn by NICE to achieve budgetary savings.

Or perhaps you would like instead to charge £10 for GP appointments, resulting in more undiagnosed / late diagnosed cancers and thus more public money spent in secondary care on operations, chemotherapy and palliative care.

Let's have a real debate, focusing on the nitty gritty of what needs to be cut back and how, rather than high level ideological platitudes.

TrevorsDen

The tory policy is the tory policy and its one where they have stolen a march on labour.
If debt and deficit management become a problem we can always pull out of Afghanistan. Indeed a serious (ie properly resourced and funded) continued presence in Afghanistan is looking increasingly mega expensive and for a long period.

I do not see how anyone can criticise the opposition foir shoutin g about it - especially as the electorate - as opposed to some seriously mentally deranged tory backwoodsmen - support the policy.

The other important issue is that 'reform' does not come cheap. Any reform of the NHS which may indeed produce either future savings or better output (or both) will cost money so lets stop worrying about the deficit on that score.

Changing the entire NHS funding system promises to be such a gigantic upheaval that only the seriously deranged would contemplate it - the tories will have to work mighty hard to get through simple reform.

CCW

To suggest that we have to continue to increase health spending is ridiculous. We could easily slash millions from the budget without harming the system in any way.

If fact I have no doubt you could improve it whilst saving a fortune.

JohnAnt

I really can't understand why there should not be a tiered, contributory insurance scheme, with some point-of-service payments as well. At the moment the system is just a symbiosis between the bored, co-dependent, self-indulgent and ignorant time-wasters among the patients, and those who work for the NHS and are anxious to prove how essential they are.
As for NI - a gigantic scam.

JohnAnt

Dean - That people would put their health at risk to save the price of a packet of fags and a pint and a half of bitter really sums up the state we're in as a country.
Personally if they do make that decision, and risk late cancer diagnosis, I can't sum up the will to care about them more than they care themselves.

Chris, Birmingham

I actually think it is clever politics to ring fence health spending as it shows commitment to an area where clearly people support spending.

I think what they need to pledge is a review and they need to streamline services - why is social care with councils - that makes no sense to me. How about getting nurses to teach sex / health education in schools - much better than the embarrased teacher.

They can then make cuts / efficiency savings etc, and re-prioritise spending whilst offering a broader range of services.

Pledging to ring fence spending doesnt mean that they cannot do something extra!

The important message to voters should be we will review spending and try to improve the NHS (maybe even spending less) but we are committed to maintaining money / services until that point.

There is a human logic / psychology element to spending which is not often understood. People tend to equate spending more to getting something better. Underestimate this pop psychology at your peril!!

Peter

Burnham's 'unpatriotic' comment on Hannan's remarkss is the lead story on the BBC website.

Still cranking it out for the Government lads?

strapworld

Have any of you heard or read Cameron having any original thought that matches Daniel Hannan's?

Read what he says on the NHFive different BBC journalists have phoned today - That’s the Beeb for you, I suppose: I’ve been setting out my views on healthcare in some detail over the years but, since I’ve been doing so mainly in the Telegraph, our state broadcaster hasn’t noticed.

I am blogging from Dax where the feria is in full swing, the streets swaying with white-clad French people in red neckerchiefs and sashes. I love French ferias, and am still daydreaming of a repetition of this episode. But I am nowehere near a studio, so any journalists wanting a line from me will have to make do with the following.

1. In The Plan, published last year and co-authored with Douglas Carswell, I set out at length a scheme to replace the current government monopoly in healthcare with a Singapore-style system of personal health accounts. The Singapore system produces better outcomes than ours for half the price. If we spent the same percentage of GDP on healthcare as now, but put equivalent power in the hands of our consumers, it seems not unreasonable to suppose that we would be much healthier. (Incidentally, the state pays for those who can’t afford their own accounts in Singapore, as in every developed country. It never ceases to amaze me how many British people have been convinced that free healthcare for the poor is a unique property of the NHS.)

2. I am not the Conservative Party’s healthcare spokesman. I’m fond of Andrew Lansley, and I strongly support David Cameron as party leader. On this issue, though, I disagree with both of them.

3. When I was in Washington last week, I joked that, within minutes of my speech, John Prescott would be accusing me of “insulting our hard-working doctors and nurses”. I over-estimated the old bruiser: it took him a week. The idea that I - or anyone else - would set out to offend 1.4 million NHS workers needs only to be stated to see how silly it is. You see how the Left works, though. Any suggestion that the NHS might be improved upon is shouted down as an attack on the people in it - which is precisely the point I was making about how hard it is to reform so large a bureaucracy.

4. I particularly like Prezza’s idea that being “Progressive” means refusing to countenance any change to a system designed in 1944.

5. It seems increasingly obvious that American voters are turning against Barack Obama’s plans. That’s not to say that the Dems won’t get something called “health reform” through: they have invested too much political capital not to. But British-style state-administered hospitals - that plainly ain’t gonna happen.

6. Which raises the intriguing question of whether Britain would establish the NHS today.
S and find fault with this."

And we have the spectacle of Cameron and his tame pet Lansley promising everything on the NHS because they have not got the guts nor the brain power to argue that the NHS is in real need for root and branch reform.

Cameron is no leader he is a fraud. God help us if we get this charlatan as Prime Minister!

William Blake's Ghost

I agree with Peter. This NHS pledge will likely prove to be an anvil around their neck (25% of total Government spend and likely rising in share as well as real terms)of a Conservative Government. There is only so far the rest of the public sector can be squeezed when 25% of spend is taken out of the consideration.

Indirectly, this commitment could lead to Cameron's downfall down the line.

Laughing Gravy

What should the NHS actually cover? Leaving aside the differences arising because of devolution, the NHS provides health services in the following areas:
Primary care, including GPs, Dentistry, Chiropody etc: elective care, operations or treatment planned in advance at hospital level: emergency treatment, i.e. unplanned hospital treatment: longer term care, i.e. mental health, geriatrics, etc: public health, i.e. specific as in epidemic control, veneral diseases etc; general, as in local area surveys of health, health education etc; medical education and training. Although the aging population will impact on longer term care, there are still many areas for substantial economy without impact on front line services. The Tories aim should be to shrink the NHS to the core services that the majority genuinely believe should be free at the point of delivery. But not to worry about radical structural change to an insurance based system which will take years to implement - and is a totally unproductive arguement.

Hysteria

great post from Strapworld (well - from DH really - but let's not be picky)

I would be ok with team DC "keeping their powder dry" but I see no signs they actually get the scale of the problem, or have the philosophical bedrock against which realpolitik can be developed.

As Verity, Moraymint and others have posted - if the best we can do is just various shades of pinkish/blueish politics then we are truly, err - done for.

Conversation with one of my Yank friends today was along the lines of "well - that USA republic as a good idea - can we start again and get it right this time?"

Anne Wotana Kaye

There is a health scheme which I believe if superior to the NHS, and which Omaba would do well to use as an example of a system that works. Israel is a country which usually tops the list of the “most hated” in Nu Labour Britain. However, even the most rabid anti-Israel observer, must concede what an excellent health service this tiny country maintains. Every citizen, no matter what their age, sex, religion or racial denomination is covered by the Kupat Cholims Health Fund Clinics(there are four) which are run by the government, private insurers, religious parties and trade unions. All workers, this includes Arabs, make a small monthly contribution to the Health Fund of their choice, and all medical needs, including doctors, surgery, hospitalisation, etc are covered. Jews, Arabs and Christians are not only equal as patients, but staffing covers all races and religions. Israeli hospitals are oasises of peace in a troubled area! In general, the service is excellent, and medicines are supplied at a subsidised cost. The unemployed, disabled and elderly are practically excempt from charges. One of the excellent benefts is the existence of a data base, where patients can use their plastic cards (rather like credit cards) to obtain information concerning their medical results. No waiting around until a doctor decides whether or not you may see your own results, and no depending on the a bossy receptionist. One can receive blood test results, etc. without delay and then visit the doctor if needed. The clinics are open most of the day and evenings, and there are always doctors on hand if one doesn’r want to delay a consultation. There is no comparison with the British NHS, it is superior in every way.