I don’t want to be a cynical man. When I see Cristiano Ronaldo, Ashley Young or half of the Tunisian team tumble to the ground during a World Cup match I want to think “Poor lamb, he might be hurt,” as opposed to “Stop diving about like a giraffe on a trampoline, he never touched you”. But sometimes I don’t.
Similarly, when I get an email from someone telling me I’ve won a squillion pounds in a lottery for which I didn’t buy a ticket I want to believe – and yet I don’t.
Cynicism can descend like cataracts can’t it? Gathering over time and changing not only how we look but also how we see. I try to avoid it if I can and so I am going to try to avoid it now when I talk about the government’s much-needed cash injection for the NHS.
A 3.4% increase in the NHS budget in each of the next five years is a good thing. Granted, The King’s Fund, The Health Foundation and The Nuffield Trust have all said that a minimum of 4% is needed to meet ongoing need but let’s not squabble over 0.6% eh? It’s barely £1bn. And, yes, the Institute for Fiscal Studies did say we need a 3.3% increase over 15 years to sustain the current level of functioning but, again, stop it with the whining – this is a good start.
By 2023-24 we will be investing an extra £20bn in services. Most people are relieved aren’t they? Surprised, perhaps? Fearful that it will come with a catch? Like finding out it will be funded by selling Cumbria to the United States so they can turn it into a giant water park, or by offering to take in all of China’s washing every second Thursday. But it is good and I don’t want to be cynical. I would like to notice a couple of things though.
Back in the distant past that was 2002 – before electricity or Masterchef – Chancellor Gordon Brown accepted the recommendations of the Wanless report and set about an investment programme that increased NHS spending by an average of 7.4% in each of the ensuing five years. This meant a much needed 43% rise by 2008.
Now, we didn’t sustain that growth and the reasons for that rather depend on your political perspectives. Arguably, this illustrates the age-old squabble between Tories and Labour: one cuts or saves (depending on your point of view), the other invests or fritters (ditto). For me this simply reinforces a point I have been banging on about for about 15 years – NHS funding should be consistent and independent of government or politics.
Also, how do we pay for this ‘windfall’? The idea of a Brexit dividend is as much of an oxymoron as Trumpian empathy – so that leaves taxation.
The Resolution Foundation says that cancelling a proposed cut in corporation tax from 19% to 17% will raise £6bn, as would increasing VAT by 1p. An increase of 1p in the basic rate of tax would raise £4bn. A decrease of £1,000 in personal allowances would raise £5.8bn or increasing main employee National Insurance contributions by 1p would raise £4.3bn. These choices are available and they always have been. And sustaining something is always better than trying to rescue it, isn’t it? And, dare I say, cheaper. Why have we waited this long? People have suffered, services have disintegrated, practice has struggled. Why did we choose to govern in a way that induces suffering, I wonder?
Yes, I am relieved under-funding is finally being addressed and pleased that services and staff get some respite but the politics aren’t impressive are they? The NHS deserves a better strategy
Mark Radcliffe is author of Stranger than Kindness.
Follow him on twitter @markacradcliffe
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