Nhs

With this autumn’s Spending Review set to be one of the most important moments in the life of the coalition government, Coffee House has linked up with the think-tank Reform to investigate what could – and should – be in the final document. This first post, by Reform’s director Andrew Haldenby, is the first in a series of “What you need to know” summaries, looking at each of the main policy areas – in this case, health. Other posts will cover specific policies, examples from abroad and Reform events. We’re delighted to get the ball rolling… What is the budget? The NHS is the biggest public service budget in England

It was inevitable that the government’s re-organisation of NHS management would incur a large upfront cost, but I didn’t expect quite such a large figure. £1.7bn has been siphoned off to pay for the re-structuring of NHS commissioning, seven times more than the planned target for management cuts according to the BBC. This is a godsend for the opposition, obviously. Insulating the NHS budget from cuts may have been a political masterstroke in 2007, and ‘I will cut the deficit, not the NHS’ may have been a sharp election slogan. But it is idiotic to ringfence the NHS simply to re-arrange the bureaucratic furniture and destabilise the system. We’ve been

This is amazing. People could scarcely believe it. No less an organism than the Big Society was spotted briefly at PMQs today. Angie Bray, Tory member for South Acton, asked David Cameron to praise a voluntary programme which enables her constituents to share skills and expertise with their neighbours. ‘This is what the Big Society is all about,’ declared Bray, (with the quietly jubilant tone of one who knows her elevation to government will not be long delayed.) Cameron’s delight was palpable. He beamed at everyone. Then his eager ears picked up the groan of a Labour cynic opposite and he instantly switched into a mode of preachy dismay which

Quite why people are surprised that Andrew Lansley has stuck to his plans to introduce GP Commissioning is a mystery.  I’m struggling to recall one of his speeches or policy documents in recent years where it wasn’t mentioned. Anyway, let’s be clear, widespread control of commissioning budgets by GPs was where the NHS was headed until Frank Dobson took over in 1997 and unravelled a decade’s worth of market based reforms.  Rebuilding that position has taken another decade of circular re-organisations to fix.  No wonder the NHS is ambivalent about reorganisation.   These proposals are, of course, radical.  But they are needed to address the fundamental flaws in the NHS

Rachel Sylvester is on top form in the Times today, and I’d urge CoffeeHousers to delve behind the paywall (or borrow someone’s copy of the paper) to read her column.  Its central point?  That ministers are discovering ingenious ways to exploit and undermine the ringfenced health and international development budgets.  The Home Office is saying that drug rehab programmes should fall under health spending.  The Foreign Office is trying to pass off some of their spending as development, and so on.  And, crucially, the Treasury seems to be going along with it: “The Treasury seems to be tacitly endorsing this approach, with officials emphasising that departmental boundaries are artificial.” As

I think we all expected this election campaign to be fought a few inches below the belt.  But, as Iain Dale and Dizzy say, Labour’s tactic of mailing scaremongering leaflets to cancer sufferers is some new kind of low.  I mean, just imagine how it would feel to receive, as a cancer patient or an immediate family member, a leaflet which politicises the problem to the point of suggesting that your care would be jeapordised by voting for another party.  And then imagine how it would feel if you have been specifically targeted because of your connections with the illness, as seems to have been the case here.  Well, it

Labour’s plans for a national care service aren’t looking too sharp this morning.  Andy Burnham is expected to announce a cap on residential costs for the elderly later today – to be funded by freezing inheritance tax bands, raising the statutory retirement age, and (lo!) efficiency savings.  But the full, free-for-everyone-at-the-point-of-use service will have to wait some time – or at least until a new independent commission has decided on how it can be funded in the long-term.  In other words, the government has decided to park the death tax issue until well after the election. Presentationally speaking, this is proving difficult for the government.  I mean, just rewind to

One story which has been rumbling along in the background of Ashcroft and Chilcot – and, indeed, over the past few months – is the fallout from Andy Burnham’s claim that NHS bodies are now the state’s “preferred provider” of healthcare in this country. With those two words, in a speech last September, the Health Secretary appears to have pulled the process of reform back a few years – as private and voluntary sector providers have tried desperately to back out of a process which they now feel is weighted, impossibly, against then. Anyway, I’d recommend that you check out Nick Timmins’ excellent coverage of the latest develoments over at

John Rentoul rightly flags up the story in this morning’s FT that about 100,000 NHS patients have gone private and had the state pick up the tab, the private hospitals have had to agree to do the work at the NHS price. For those of us who would like to see the NHS move towards a model where the state pays for healthcare but it is provided by a whole panoply of providers, this is an encouraging step. This kind of consumer-focused reform is hard to reverse. The story, as John notes, hasn’t got as much coverage as it should. John blames this on the press’s lack of interest in

If we are going to have a sensible debate about the NHS in this country, we need to deal with the myth that the NHS is free. Yes, the NHS is free at the point of use, but we all pay for it through taxation. I suspect that slightly fewer people would still ‘love the NHS’ if they knew precisely how much they were contributing towards its costs through all the taxes that they pay. I say this as someone who has no desire to import the US system. Before I went to live in the States, I was quite a fan of the US healthcare system. But having lived