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by GK Strategy 21st October, 2014
3 min read

Health Spending: Where the political land lies

A key theme of the Party Conference Season was the focus on the future of the NHS. As those of us who work in health communication are aware, the financial sustainability of the NHS is not a new topic of discussion and this truism continued throughout the conferences as Hospital leaders and healthcare experts increasingly warned of an impending crisis in the service, just as the 2015 election is approaching.

So just as the 2010 election was dominated by Europe’s debt crisis, 2015 looks to be fought on the most controversial of public service issues.

Aware of the importance of this, the main parties have littered their conference narratives with health policy pledges. Ed Miliband has been promoting a mansion tax, a windfall tax on tobacco and a host of other measures to raise an extra £2.5billion for the NHS budget, albeit with no specific timeframe over the next parliament.

The Lib Dems have also been vocal in acknowledging that the service is overburdened and underfunded, that a crisis is likely and that additional funding is needed in the next financial year, not later on. Care Services Minister and Liberal Democrat Norman Lamb has accordingly announced a £1billion increase in spending on top of a rise in line with inflation over the next Parliament, beginning in 2015/16. David Cameron, for his part, has promised to protect the NHS in real terms, as with the current settlement.

Turning to the scale of that challenge, Monitor has just reported that a whole swathe of Trusts are in deficit, and that this is not likely to improve soon. Think tanks such as the Nuffield Trust have forecast that without substantial productivity improvements, a funding gap -the difference between demand and provision- of £30billion could emerge by 2020.

This leaves the conference pledges almost pale into insignificance in terms of plugging the potential hole which will be apparent over the next Parliament. It makes a crisis, whether of backed ups A&E departments, spiralling waiting list times or plummeting standards of care (or indeed all of these things), look far more likely to happen. The interesting question is then what sort of ‘burning platform’ response the government of the day resorts to when this crisis comes and what long-term impact this will have on the NHS.

Would a Labour government, for example, feel comfortable to borrow more or raise taxes to pay for services, would a Conservative administration look to the private sector, or more crucially to watering down the principle of free at the point of use to restrict demand? Or will any permutation of future government try to accelerate the process of integration and investment in public health?

This debate will be continue right up to and after the election – Those who can offer and demonstrate innovative ways of saving money and improving outcomes need to shape the debate.

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