Here comes a splurge of spending on the NHS — why do I fear it will make it fatter, not fitter?

Have you ever been to one of those birthday parties where the guests vie to win admiration by the extravagance of their gifts? Well, something similar might be happening with the NHS. On July 5 it will be 70 years old, and each of the Conservative and Labour parties will be vying to prove to the public that it is the more generous birthday benefactor.

It’s a strange sort of competition for the public’s affections, since the extra money can come only from voters’ own pockets. Opinion polls suggest that around 60 per cent of the public would be happy to pay more tax to increase funding for the NHS: but in practice it is a different matter.

I appeared on BBC1’s Question Time last week, and one of the questions in the West Sussex coastal town of Worthing was: is it political suicide to put up taxes for national healthcare provision?

Demand

This followed on from the joint report from the Institute for Fiscal Studies and the Health Foundation: it concluded that the sharp rise in the number of people of great age with chronic diseases meant the average household would need to pay around £2,000 a year more to cover the needed increase in NHS funding.

But as my fellow guest, the novelist Lionel Shriver, pointed out, since half the nation’s households don’t pay income tax, it means an extra £4,000 a year would have to come from those households that do.

My own response was that we don’t need a crystal ball to see how the public would react to a sudden demand to pay more to fund the care of an increasingly ‘grey’ population. We need only look in the political rear-view mirror.

The 2017 Conservative manifesto suggested some of the new funding for the ballooning bill should be paid from what amounted to a sort of post-mortem wealth tax: money would come out of the proceeds of the sale of the homes of those elderly people who had been receiving long-term care.

Dubbed ‘the dementia tax’ by Jeremy Corbyn, it was catastrophically unpopular on the doorstep, and abandoned by a panicking Theresa May almost as soon as she announced it.

Since that disastrous general election campaign, the Health Secretary Jeremy Hunt has added social care to his duties, so his remit now spreads right across this intractable political conundrum.

Mrs May attempted to move him to the job of Business Secretary, which would certainly have given him an easier life. But Hunt insisted on staying put. He has a genuinely heartfelt enthusiasm for the NHS: I have witnessed personally how moved he becomes when talking about the dedication of its doctors and nurses.

Frittered

Not surprisingly therefore, he is determined the Government will come up with a substantial proposal to increase annual funding — perhaps by around 4 per cent — in time for the NHS’s 70th birthday party. Labour hates the idea that the ‘wicked Tories’ should present themselves as the political friends of the health service, and will doubtless attempt to outbid them on generosity with public money.

What the public will not forgive, however, is if extra billions taken out of their earnings are frittered on management, bureaucracy and pay rises, rather than focused, laser-like, on essential patient care. The splurge on the NHS under Labour between 2001 and 2007 was a dreadful example of how not to do it.

Its own report, by Sir Derek Wanless, revealed that almost half the increased funding had gone into higher pay for staff and increased prices charged by suppliers. GPs were so amazed by the generosity of the contract they were offered by Labour that one of their negotiators told the BBC some years later: ‘It was stunning. Nobody in my position had ever believed we could pull it off . . . it was a bit of a laugh.’

Bluntly, we need more doctors, not just higher-paid ones. But if sufficient numbers are not being trained in this country, once again an increase in budgets will result more in pay increases for existing staff than in what the public wants: shorter waiting times for surgery such as for cataracts, which as the Mail reports today is being denied by two-thirds of NHS trusts to all but the most severely affected.

Pointless

at the same time, there must be scope for cutting down on unnecessary medicalisation. as the Mail’s serialisation of Dr James Le Fanu’s book Too Many Pills demonstrated, colossal amounts are wasted on pointless prescriptions which are perversely encouraged by the GPs’ contracts with the NHS.

Pills with minuscule medical benefits are given away in their billions — statins being the most egregious example — to meet an essentially bogus ‘productivity’ matrix. as Le Fanu points out, over the past 15 years the volume of medicines issued by the NHS has tripled, and something like 10 per cent of emergency hospital admissions are now related to adverse medical reactions to those indiscriminately prescribed pills.

and while Jeremy Hunt kept his promise to reduce management jobs in the NHS, it remains bewilderingly ponderous compared to an increasingly efficient private sector.

a friend who runs a medical instrument business recounts a recent meeting: ‘There were two people from my company, of which I was one: on the NHS side of the table there were seven people. Only one was medical. The other six were all admin staff, three of whom said nothing.’

So while the NHS will deserve congratulations on reaching its 70th birthday, for its own continued health it must become fitter, not fatter.