Lansley refines his approach on NHS spending

Hysteria

"needs to focus on getting more for less"

sounds like cuts language to me

Ray

At last the ship is slowly turning around.

Carly

This is getting silly. This is the party that is supposed to be forming the next Government and they are in chaos. Their communication strategy is terrible.

Pete-s

The Tories did not have the cahones to say the finances are in such a mess; there will not be any sacred cows.

Ben Elford

Are these the green shoots of common sense and candour from Mr Lansley?

It has seemed clear for a long time that there has been a good deal of waste in the NHS, along with poor performance in some parts of it. Honesty with the electorate is surely the best policy.

Simon

This hardly a change of direction but a sensible move at this stage. However, I did laugh when I read that you thought Dave would not drop his commitment to continue to increase health spending because it would be too embarrassing! Possibly its got something to do with having political judgement. To be fair you seem to have refined your argument from boldly asserting that promising to cut health spending would be a vote winner. An assertion for which you failed to produce a shred of evidence in its support. No doubt we can look forward to an article by Fraser claiming that senior health service movers and shakers have lost confidence in George and Dave because they are more concerned with winning than cutting the health service down to size.

John Moss

This is sensible.

We ought to do the same across Government and hold the total spend at the £702 bn planned for 2010-11 right through to 2013-14.

That saves £104bn from Labour's plans and we can go further as we reform, repeal and change the way things are done.

Pete Hoskin

Simon: I've never "boldly asserted" that promising to cut health spending at would be a "vote-winner". I've just said that it's unwise for the Tories to commit to increasing it, and doubly unwise for them to drop a lot of rhetoric which makes it sound like spending is a good thing in itself. Which is a slightly different position.

I think they could have argued for cuts in health spending - and perhaps turned the debate into a vote-winner - if they'd started making those arguments a while ago. But, now, they've probably left it too late. They do need to retreat from their position of a few weeks ago, though, as I rather suspect they'll need to deliver health cuts in government. Lansley seems to be doing that now.

George Osborne came close to what I think the Tories should be saying now, when he claimed that they'd "work hard" to protect the health budget, which is a good deal more ambiguous than the spending, spending, spending approach we've heard over the past few months. Here's my post on that:

http://is.gd/36qtO

Kay

One can only hope they see sense on International Aid and accept this department cannot be immune from cuts also.

Robert Eve

The NHS should shoulder its fair share of the necessary cuts. Why should it be an exception?

HJ

Can anyone explain to me why both major parties seem to think that spending more on the NHS is a good thing, even were it not so hopelessly inefficient?

There is little or no correlation between spending levels on medical care and longevity in any advanced country. Other factors have a far greater effect on health and longevity (housing, sanitation, diet, exercise, smoking, etc.). The medical care which offers the most benefits largely comprises relatively cheap and routine treatments (vaccination, etc.). Over thalf the lifetime spend on medical care for a typical individual occurs in the last two years of life - which demonstrates pretty convincingly that expensive care does relatively little for longevity.

In addition, most people aren't too bothered about their health. Why else would most of the population be overweight, many smoke and drink to excess and so few eat their "5 a day'?

I just don't understand why we spend so much on medical care.

Tim Carpenter (LPUK)

Until you present entities with the hard reality of less income, it will be a painful, tooth and nail fight to get them to agree to reduce budgets.

The NHS, however, is a particularly bad case with such a disconnect due to a monopolistic Third Party Payer problem. Unless the systemic dysfunction of our health service is tackled - i.e. ending root-to-tip de facto State monopoly funded entirely from general taxation (in all but name) tinkering with budgets will be just that: tinkering.

My least worst system? Something around the Swiss-Singapore forms.

Jonathan_T

This is a good change of direction.

Although not ideal, I understand the logic of deferring health reform and concentrating on education and welfare in a first term. (See B. Obama for details of trying to do everything at once.)

Consequently, this perhaps represents a holding strategy for 4/5 years.

Nevertheless, assuming a £100bn starting point, 1% growth for 5 years versus 3% growth produces c. £32bn cumulative savings.

Ian C

This is coming at the time you would expect.

The overriding priority was for the dog whistle to be heard - 'NHS real terms spending safe with us.'

Now that has been heard and accepted by media, and by Labour as an obviou problem for them, and we are only 6-9 months from the election, the true message can be pumped out, And it is one that is now heard and is acceptable in the current political environment.

It is a very clear communications strategy and should work. But it has had the 'doubting right', certainly as represented here on Coffeehouse, on the edge of its seat demanding clarity long before it was necessary or politically sensible to provide the sort clarity they demanded.

Expect much more of this from now on up to the election, and starting properly with the last Conference before the election.

Any sooner would have not been effective in electoral terms.

TrevorsDen

'Hysteria' and 'Carly' are talking rubbish. As indeed is the Telegraph headline (I wonder why?).

The governments own published plans show a radical decline in the rate of increase in health spending.
Landsley is saying nothing new, he is merely emphasising reality and making sure people understand and do not misrepresent Tory policy.

Even with the present Labour proposals the NHS faces a difficult future. The budget will be pretty much the same no matter what party is in power. How the NHS is managed is the important issue.

BTW - Mr Eve says "The NHS should shoulder its fair share of the necessary cuts. Why should it be an exception?"

Because Mr Eve one day you, your wife, mother or children may fall sick!
I for one want a good Health Service, why? because I am selfish, I want good health care for myself and I do not want to be treated by a political football, rather a well managed and properly motivated and funded organisation.

cjcjc

If Lansley is supposed to be one of the Tories' top talents - which I assume he is given his portfolio - then God help us all.

Simon

Peter. Fair enough but it sounds like a your rowing back on your previouse stance to me. As it happens I agree there is no doubt scope for reducing state expenditure on health. I just happen to believe it is and is likely to remain politically impossible to do so. You may well be correct that if the Tories had tried to make the counter argument years ago there may have been a small shift in public opinion but I'm not so sure. In any case reforming health in any meaningful way is very much a 2nd or 3rd term issue. In my view to be successful it would also require the Tories to be faced with a broken labour party in opposition too.

Major Plonquer

No. I think Gordon Brown's position on the NHS is the best. If we increase the amount of money that we spend on the NHS then people will be healthier, happier and have more babies. They would take less time off work at the tractor factories and British tractors would lead the world. Maybe with all the extra brain surgeries we could make electric tractors and save the world (yet again).

And we don't want doctors having to work too hard for a mere pittance. Specially now they all vote Labour.

What the NHS really needs is FIVE MORE YEARS of Gordon Brown's management and leadership.

Anon

"More for less"?This will be a doddle to pull off.
1.Less- Bin the targets/box ticking
This will help staff do what they are paid to do...deliver a service to the public...NOT a set of statistics for the government to crow about.
2.More..the less target driven/box tickers we are the MORE service we can give the public.
Believe me this is a no brainer and you absolutely CAN get MORE for LESS.