Lansley keeps the spending taps on
Peter Hoskin 10:52pm
Struggles with the conference internet connection prevented me from posting on it at the time, but it's still worth flagging up Andrew Lansley's big speech on the NHS today. Why so? Well, because it exemplifies how the Tory message on health undermines their general rhetoric on public spending.
At the heart of the speech was a pledge that I'm sure many CoffeeHousers would cheer: to slash the money spent on NHS bureacrats by a third, from £4.5 billion to £3 billion. Good stuff, you might think. That's what governments should be doing in there difficult times. And you'd be right.
But the rest of Lansley's speech was at odds with this basic position. There were, of course, the familiar reminders that the Tories would increase health spending year-on-year. We're used to those. But, on top of that, there were specific spending commitments on dentistry and care for the elderly.
Funded how, exactly? Well, maybe they're funded by those health spending increases - but that rather undermines Lansley's claim that those increases are a natural function of an ageing population combined with greater treatment costs. So maybe, instead, they're funded by that money saved from cutting the health bureaucracy. But, hang on, weren't the Tories chiding Labour last week for making spending commitments funded by little more than pie-in-the-sky promises to "cut bureaucracy"? It's certainly difficult to square this particular circle.
In which case, it's hard not to arrive at one conclusion when listening to Lansley: that the Tories intend to turn on the taps when it comes to health spending, regardless of what it means for their message now, or for their wider agenda in government.
When Lansley rounded off his speech by saying that this is an "Age of Ambition" for the NHS, it could have been a neat soundbite. As it was, it just came across as a joke at the expense of those departments operating during an Age of Austerity.
Previous
Fatbloke on tour
October 5th, 2009 11:17pm Report this commentIt won't happen, warm words to keep the health establishment and the public on-side.
As usual the squeeze will be on those at the bottom of the wage pyramid and not the top.
nick
October 5th, 2009 11:44pm Report this commentThere's no choice. They will squeeze all.
If you're a worker, you have 300,000 pounds of government debt to pay off.
What's your plan for paying it off?
Nick
TrevorsDen
October 5th, 2009 11:44pm Report this commentWhere do you get all this from. We know that spending will increase to at least match inflation and you already point to 1.5 billion savings.
Labour are also saying that public sector salaries ae to be held.
So of course new things need to have money spent on them.
I despair at the despairing press.
luke
October 6th, 2009 12:02am Report this commentBut but but. Did he repeat the plan from last year's conference to offer everyone in the NHS a single room?
Or has he decided the 10BN required to do that is a bit tricky now?
Stewart
October 6th, 2009 3:42am Report this commentI see Labour are at it again, making policy announcements during the Conservative conference. Darling making an announcement on pay on the Day Osbourne makes a speech. Shameless.
Philip McNeill
October 6th, 2009 8:27am Report this commentIn my opinion, New Labour has been Wet Tories since Blair. In saying that the NHS is a victim of its own success in that at some point politicos must face taking unpopular decisions in curtailing what kind of service it offers to citizens. As salaries, medicine, aftercare costs spiral is it now fit for purpose in the 21st century? Should it simply be a safety net with a second tier for those who can afford it.
Ian Walker
October 6th, 2009 8:37am Report this commentThere is a small difference, even if the promise is the same. For Labour, reducing the size of the NHS bureaucracy involves firing compliant voters. For the Conservatives, it involves testing the "we're worth it in the private sector" myth in the most direct way.
Alfred T Mahan
October 6th, 2009 8:54am Report this commentLansley lets the side down again. He's an ex-bureaucrat who can't react to changing circumstances.
Methinks a very short career in government beckons...
Jim H
October 6th, 2009 9:07am Report this commentThey still don't get it do they? How's the pound holding up?
Elf for All
October 6th, 2009 9:12am Report this commentIf they get rid of only half the quango's operating within the NHS, that will create sufficient funding for his proposals yesterday.
I think Osborne may have been extremely clever here. Tell each would be minister that if they want something they have to get the money by cutting the quango's!
It will go down well with Joe Public.
Mark Demmen
October 6th, 2009 9:29am Report this commentHe's a plonker. Not a very constructive comment, but I'm past caring.
Moraymint
October 6th, 2009 9:34am Report this commentDidn't someone (an economist?) once say something like, "If things can't happen, they won't happen".
We're reaching a stage where individuals and organisations, private and public sector, across society will shortly discover there is neither the cash nor (yet more) credit to make things happen; so they won't happen.
One wonders how far we have to go before the realisation dawns on our politicos that when your organisation runs out of cash/credit, without planning or preparation for that eventuality, you experience what is known as a solvency crisis?
My concern is that the next parliament - regardless of which party is in power - will be characterised by one crisis after another if all of the parties keep talking such drivel about (not) dealing with the nation's staggering structural debt problem.
Throw in Peak Oil (pretty much here and now) and the UK's lamentable energy and food security status (not to mention all of the latent energy- and resource-related geopolitical and security tensions gripping the world today ...), and you have a recipe for interesting times. All the while, the nation is running out of money.
I know I sound like a stuck record, but my money remains firmly on socio-economic trauma in the next 5 years, and possibly worse within the decade. Ho hum.
All I would say is do not, whatever you do, rely on our politicos to guarantee you a smooth ride over the coming years; quite the reverse, in fact.
charles hercock
October 6th, 2009 9:35am Report this commentTimidity such as you are not on pensions.Why only slash the admin budget to 3bn.Clipboards become labour not the party of the future
Stephen
October 6th, 2009 9:44am Report this commentTime to become genuinely radical and look across to the channel to the mainland for a health system that yields a higher quality of service at a lower cost. Biggest problem ... well ... we don't like the French do we we?
Fatbloke on tour
October 6th, 2009 9:52am Report this commentPhil Mac -- Tip of the hat to you good sir.
Elvis has just left the building.
Rather the cat has just left the bag.
Thanks for the insight into SpectatorLand's hatred of the NHS. It just will not do that it offers the same level of service irrespective of income.
It just wouldn't do for the Duke to have the same standard of service as his driver.
We can't afford a modern, comprehensive, advanced service if it aims to cover 100% of the population, that is the jist of your argument.
Better to offer a cheap, bare bones, charity service to all and an all singing, all dancing insurance based service for the top 20% of the population if they can afford it.
Only in SpectatorLand.
Only in SpectatorLand!
Maggie couldn't do it.
Scratchy says he doesn't want to do it.
However what is the betting on a slash and burn raid on the NHS using the deficit as justification to downgrade the service.
Cost to the country will not fall.
Coverage will be down, quality for the majority will be down.
Cost to the taxpayer will be down, but only in the short term.
Consequently Americana here we come.
World class to those who can afford it .
Safety net like a worn string vest to those who cant.
Interesting to see that in Education the Tories are explicit about trying to change the nature of school provision but they are very wary about changes in Health.
Why the inconsistency?
For the record, schools will be voucher funded within 5 years of a Tory goverment.
Cashbacks available at the "Stack a pleb" units where the parents don't care. Work experience will be sewing mailbags / skivvying to the middle class for their two years of post 14 education.
At the other end Scratchy and Sniffy will get a voucher subsidy to send the sproggs to a private school.
William Hills should be running a book on when Scratchy will take his children out of the state sector and put them in a private school.
Another beard for a man whose has plenty.
HJ
October 6th, 2009 10:14am Report this commentLet's be clear about this. We are not talking about spending on 'health', we are talking about spending on the NHS, which is overwhelmingly a medical service (and all the international evidence is that increasing spending on medical services has very little impact on public health).
Derek Wanless's second report (the one that the government didn't want him to write and which was funded by the King's Fund instead) made it quite clear that half the increased spending on the NHS went not on bureaucrats, or even better equipment or drugs, but on increased pay and benefits for existing staff. We have the best paid medics and nurses in Europe.
The report also made it clear that the NHS totally neglects (and has even cut back the spending on) public health measures (i.e. the area where you get most 'bang-per-buck'for your health spending), despite the huge overall funding increase, in order to pay for all the staff pay increases. Public health is not an NHS priority.
Simon
October 6th, 2009 10:55am Report this commentOne day you will no doubt enlighten us all as to how to win an election whilst promising cuts in health spending. Until then this is just self indulgent posturing.
Moraymint
October 6th, 2009 11:09am Report this commentcharles hercock @ 9.35 am
You've lost me there.
John Ionides
October 6th, 2009 11:43am Report this commentIt seems to me that it is perfectly viable, indeed sensible, to up the spending on health as long as the books balance.
For instance, if we can get the health of the nation to the point where we can all retire at 70 and pay taxes for another 5 years then everyone gains.
Verity
October 6th, 2009 2:44pm Report this commentAll Lansley had to say was that the NHS was to be completely reconfigured along the French or Singpore system. Infinitely better service, infinitely less wasted money, and infintely better patient satisfaction.
And while I'm at it, no non-EU foreigner should be allowed through Immigration without showing valid, current health insurance. For travellers who "forgot" to buy health insurance at their port of origin, there should be a bank of those machines that already sell travel insurance from which one could buy short term medical insurance.
Fatbloke on tour
October 6th, 2009 4:51pm Report this commentHJ
Interesting point regarding the wage levels in the NHS. As always agree up to a point, the focus of the issue should be on the medical grades not the support and nursing staff.
I don't think all grades are in the same position but we have always had the highest paid doctors in the EU.
One of AB's few mistakes was to go big on the initial contract and the public have paid through the nose for it ever since.
Consultants on a big wage, bonus payments and private work are on very good money, one part of the establishment which has done well out of the NHS.
Limit the amount of medical students.
Run very tight and restrictive unions.
Shroud wave as appropriate.
They have it too easy.
Plus they are self regenerating.
They are now a form of priesthood / caste.
Jonathon
October 6th, 2009 9:54pm Report this commentHJ 6 October 10.14 am places great store in the Wanless Report - 'Derek Wanless's second report (the one that the government didn't want him to write and which was funded by the King's Fund instead) made it quite clear.....' Perhaps we should remind ourselves that Sir Derek Wanless was ousted from the 'old' Board of Northern Rock, having been deemed highly culpable, by virtue of actions and inactions that led directly to the multi-billion pound taxpayers' bailout. Sir Derek's quasi-jury was the All Party Treasury Select Committee. The Committee's findings were endorsed by the Prime Minister,Chancellor, Governor of the BoE, et al. Let us not be so quick to give credance to a judgemnet found so profoundly flawed in other areas.
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