Muddled Tory thinking on the NHS

Several people today, including Janet Daley and David Hughes of the Telegraph, have felt that the Tories have persevered too long with Labour spending plans in order to avoid criticism from Labour.

This is till largely true over the NHS, and perhaps Cameron's personal experience in the treatment his son Ivan received has coloured his thinking.

Everybody agrees that the NHS will have to spend more on new drugs, more expensive equipment, and even staff, as people live longer and disease comes more readily under control. This, I assume, was the basis of the thinking of the Confederation as they claimed that the NHS would be short of about £15 billion in funding over the three years after 2011.

But this is to ignore a number of things:
1) Since 1997 spending on the NHS has trebled, but productivity has gone down, according to the Office for National Statistics. There havebeen massive pay increases for some health practitioners, when the government negotiators succomed to the BMA negotiators.

2) The NHS is a monopoly, or near monoply, supplier, and has become producer orientated in recent years. Like any monopoly, it tolerates inefficient pratices and it has demarcation problems. Brown was warned that if he continued to pump in money but without reforming the organisation, it would become less efficient. Our having to accept poor health results in some areas, compared to Europe when we are funding at a similar level, is another symptom.

1) and 2) are clearly about the same problem, but there is a further point.

3) There are some services which arguably the NHS should not finance, such as IVF treatment, some cosmetic surgery, and injuries suffered through lifestyle (-rock or mountain climbing and other extreme sports.) If motorists are to be charged for ambulance,cuppa or whatever, after an accident, then there are probably others who ought to pay as well.

This is not a static situation. The Tories should guarantee expenditure, but only if a thorough-going reform is considered. Otherwise they will repeat the Brown mistake, with diminishing returns for extra money pumped in.