We can and must protect our NHS: it’s what the public expects

It would be fascinating to be a fly on the wall at today’s special cabinet discussion of the NHS, to witness the different political perspectives on what needs to happen next.

Who will prevail? Will it be the Brexiteers who want to see the “bus-pledge” translated into something tangible? Or will it be those who worry about committing to big decisions on future health funding when the economy is so finely poised.  

There will, of course, be ministers in other spending departments fighting their own corner, and those with a firm eye on the party political battles ahead who will worry that the Tories will be outbid on the NHS whatever they decide to do.

Addressing this long term funding challenge urgently requires a process and a timeline.

There is another view – one that must carry the day - of those who want to do the right thing for the health and care of the nation, and who recognise that we can no longer delay the process of working out its long term funding needs.

The context for the discussion is that we have reached a watershed moment. It has become absolutely clear that we can no longer meet the long-established care standards set out in the NHS constitution without greater investment and a long term funding settlement for health and social care.

Last year, for the first time, we missed all the main targets for A & E, routine operations, cancer care and ambulance responses. And this year we will miss them again. Targets are not everything, but as a proxy for the quality of care, they are the best measure we have.

The context for the discussion is that we have reached a watershed moment. It has become absolutely clear that we can no longer meet the long-established care standards set out in the NHS constitution without greater investment and a long term funding settlement for health and social care.

   

Addressing this long term funding challenge urgently requires a process and a timeline. In recent weeks we have heard lots of discussion about a possible Royal Commission or cross party review. But these are decisions with important ramifications for tax and other public services. It must be for politicians to make the call, as they did in the Blair / Brown era.

The government has the evidence and information they need from work carried out by the Office for Budget Responsibility, the Barker review and several parliamentary committees. The way forward is a government-led review encompassing health and social care that draws on this cross-party work.

The timeline should start with the social care Green Paper in the summer, leading to firm proposals in the Budget in November this year, and the process completed in 2019.

The way forward is a government-led review encompassing health and social care that draws on this cross-party work.

   

The review should establish long term health and care funding needs, the priorities for additional spending, how these should be funded, and how much “self-help” the NHS should be asked to provide in the form of efficiency savings.

We must move away from short term fixes and cash injections. If we want to ensure our health and care services are sustainable, we also need a clear vision of how they should develop, and how any extra funding should drive that process.

We can and must protect our NHS. It is what the public expects of our politicians. Time now for them to step up to the challenge.

 

This article was first published in the Times on 23 January 2018.