It’s interesting, but hardly surprising, that the Chancellor has suddenly managed to find an “extra” £2 billion for the NHS; or that this has been carefully leaked to the Sunday papers ahead of this week’s autumn statement.
As outlined in a number of posts below, NHS trusts and foundation trusts are starting to get into deep financial trouble, there’s a good old “winter crisis” on the cards, and NHS England has bet the farm on a ‘Five Year Foward View’ that calls for better public health and new service models (code for fewer hospitals, more “integrated” working with/offloaded from councils, and lots more dealing with the public through call centres and apps).
Meantime, Labour has already promised an extra £2.5 billion for the NHS, via its mansion tax. Osborne’s announcement, if it turns up as billed, will deal with some of these issues more than others.
Some £200m is likely to go on trusts in trouble, but the National Audit Office reckons the total trust and foundation trust deficit is already three times that; and we haven’t had any proper cold weather or flu yet. If we do get cold weather or flu, then Osborne’s money will be too late, as it won’t kick in until the new financial year; but he’s not likely to draw attention to the dates, and must be hoping voters don’t fixate on that kind of detail.
This leaves most of the money to pump-prime Stevens’ reforms; which the Telegraph reports that Osborne is going to back when he actually gives his statement. Think-tanks are already hailing Stevens as a master tactician for coming up with a plan and then getting the money for it.
However, if Stevens has played a weak hand well, then Osborne has played a weaker one better. He’s got to announce £2 billion for the NHS, which sounds a lot of money, even though it’s a drop in the ocean, given that the health service spends £110 billion a year.
He’s got to say it’s new money, which it sort of is, because it wasn’t in the budget, but sort of isn’t, because £750m of it has been generated by the system, via underspends and “non-frontline savings”; which is another detail that Osborne must be hoping voters don’t notice.
He’s got to say that he’s backing plans drawn up by the NHS, so if they don’t work, it’s not his fault; even though the NAO and some think-tanks are deeply, deeply sceptical, not least because there’s no evidence that integrated care will save money, and quite a lot that it won’t (particularly if it goes on political gimmicks like the Better Care Fund).
Best of all, he gets to twit shadow health secretary Andy Burnham about finding the money faster than the mansion tax will come on stream.
Frankly, this money will make little or no difference to the long-term future of the NHS; but it might just make a difference to the Tories’ chances on 7 May. Which is probably all Osborne cares about. Although it’s no way to run a great institution.