Solutions must be found for the NHS
The NHS is not working. Official figures released this week show the worst A&E performance in England for 14 years. Norovirus cases rose by almost a third. Flu cases threaten an epidemic. The Government insists that the NHS has been better prepared “than ever” for winter – and, if that is technically true, the fact that it is still doing so badly indicates that the health service’s problems are bigger than one funding round can fix.
The Left insists that all that’s needed is more money, and some on the Right have embraced the idea of a hypothecated tax – perhaps replacing national insurance with national health insurance – that pays specifically for health and social care. But that amounts to a rebranding exercise to justify an inevitable tax hike, asking voters to pay more for a system that remains unreformed. The long-term problem is that while the NHS was created for a smaller, younger population, Britain keeps getting larger and older. As local government social care budgets have been cut, by up to 40 per cent, the NHS has had to take responsibility for an estimated 900,000 elderly and frail people who, in many cases, have nowhere else to go.
The Government’s response has been to roll social care into Jeremy Hunt’s brief as Health Secretary, in acknowledgement that the two issues are now inseparable. Political attention is good, but what exactly are the proposed solutions? A new formula for social care costs was proposed in the Tory manifesto, only to be ditched when it proved controversial. If politicians feel they cannot debate this issue maturely then a Royal Commission – made up of people from all walks of life – should do the job for them. And nothing should be off the table: greater private investment, medical charges and old-age insurance. A commission should look abroad for new ideas.
For although it is true that, in some regards, the NHS is less generously funded than its foreign counterparts – it has fewer doctors per capita than most EU countries – those nations provide a stabler health service by using social insurance models that mix public and private provision. The Left, and some Tories, constantly invoke the principle of “free at the point of delivery” as if it was a masterstroke of both ethics and organisation. But what Britain does at present is neither effective nor, given the misery found in so many wards and hospital corridors, particularly moral.