The Spectator

Unhealthy spending

Since the Budget, economists have pointed out that Britain is turning into a health service with a government attached. The NHS was protected from what Philip Hammond calls ‘austerity’, yet it has emerged as the big winner from his abandonment of the old Tory idea that government should live within its means. The plan is for more debt, more spending, more tax and a lot more NHS. At the start of the last decade, the NHS accounted for 23 per cent of government spending on public services: this figure is now set to rise to 39 per cent. And then, no doubt, further still.

Simon Stevens, the chief executive of the NHS, will soon run an organisation that has more people and money than some European Union countries. Meanwhile, the budgets of many other government departments are to be frozen or even cut. The Home Office and Department of the Environment, Food and Rural Affairs will each lose £100 million — as will, bizarrely in the year in which we will leave the European Union, the Department for International Trade. Contradicting Theresa May’s promise to make housing a priority, the budget for housing and communities will be reduced by £300 million. The military will continue in its semi-emaciated state, while taxes rise to a 30-year high.

What is it about healthcare that qualifies it for largesse on this scale when other public services have not been protected? It seems Gordon Brown taught the Tories to see the cost of the NHS as the yardstick against which the performance of all other public services should be judged. And as another former chancellor (and editor of this magazine), Nigel Lawson, once observed, the NHS is the closest thing the English have to a religion. Yet sooner or later a government is going to have to be brave enough to ask whether the NHS is really the fairest and most cost-effective way of providing healthcare.

There is plenty of evidence to suggest that it is not.

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