In the first of an occasional series of Uncut posts that look at the policies and political positioning needed to win the next election, today we are looking at the NHS. Here, Frank Field sets out the policy case for a radical restructuring of how the NHS is funded.  

by Frank Field

A programme of fundamental NHS reform – on financing and ownership – could, paradoxically, convince the electorate of Labour’s financial competence and play a crucial role in rebuilding Labour’s fast collapsing core vote.

Labour has to combine two financially opposing objectives.  About two thirds of the structural budget deficit remains to be eliminated.  So, while cutting at twice the scale of the so-called ‘tough’ Coalition, Labour will face the mother of all NHS crises.  The Coalition’s pledge of maintaining the real value of the £95 billion NHS budget is now hardly a mirage.  Real cuts in the NHS budget have been in progress over most of this Parliament and there is an impressive array of witnesses reporting to this effect.

Differential NHS inflation, a growing aged population that makes disproportionate health and social care demands, and an abundance of advances in ever more expensive medical technology, will take an even greater toll on NHS budgets during the next Parliament.  NHS England estimates a deficit to end all deficits of £30 billion in 2020-21 – very nearly a third of current NHS expenditure.

The electorate senses the NHS is facing mounting difficulties.  They are willing to input additional monies into their NHS.  But, despite the supportive showing the polls for significant increases in NHS contributions, neither Labour nor the Coalition is currently prepared to address the issue.  They present getting through the election without seeking a mandate on NHS finance as what the clever boys do.

But, as events all too often show, the clever boys – and they are still largely boys in every sense of the word – have lost the plot.  Either the NHS is refinanced or, during the next Parliament, it will cease to exist as we have known it.

We can conclude that, as the collapse of the NHS as we have known it will send the electorate into a god almighty spin, there will be a major injection of new funds into the NHS during the next Parliament.  But, if the current cross-party evasion continues, the next government will have no mandate to raise new revenue.  Ever greater cynicism will be the result of what will inevitably be a broken promise. But will the current Tory position hold?

(more…)