Shake that magic money tree for the NHS and social care

This is an edited version of a recent 999 Call for the NHS blog post – “We won’t stand for more austerity”

999 Call for the NHS exists to stop and reverse NHS cuts and sell offs, and to restore the NHS as a publicly owned, funded, run and provided health service that is free at the point of need and provides the full range of care and treatments to everyone, based on their clinical need.

We also campaign for social care to be fully publicly funded and provided and available to all who need it in order to live independent decent lives – not just as a means-tested privatised, residual service for those with substantial needs.

This requires adequate funding. But none of the three main parties’ 2017 Manifestos commits to this.

Why? We know there is a magic money tree.

fuckdup magic money tree

All three main parties fail the NHS and social care funding test

The Labour Party manifesto commits to £30bn NHS funding more than current (Conservative) plans over five years – or £6 billion a year up to 2020/1.

The Conservatives’ Manifesto commits to an extra £8bn in real terms (ie protected against inflation) by 2022/23  – although doctors and Sally Gainsbury, senior policy analyst at the Nuffield Trust, point out this figure is reached through the deployment of smoke and mirrors.

The LibDems commit to £6bn more than current plans for health and social care in 2019/20.

The way the Health Foundation analyses it:

“all three parties’ funding plans fall significantly short of the anticipated spending pressures. This will leave a funding gap, which will need to be filled either by a continuation of the drive for very high rates of efficiency and productivity growth in the NHS, or by scaling back what the NHS delivers.”

None of the Manifestos fess up to scaling back what the NHS delivers. So the assumption has to be that the NHS will have to deal with the funding gap by so-called “efficiency savings” at the same kind of level as required by the 5 Year Forward View Plan. For Labour the funding gap by 2022/3 would be £17bn, for the Tories it would be £22bn.

The balanced budget fetish

It looks like the more things change, the more they stay the same.

In his critique of the Labour NHS manifesto, Shropshire Defend Our NHS campaigner Pete Gillard said  that its failure to commit to adequate NHS funding levels was down to John McDonnell’s insistence on a balanced budget:

“McDonnell’s fear of Labour being accused of ‘tax and spend’ ran through the manifesto.”

Well, Labour didn’t win the election despite playing safe with its insistence on a balanced budget; and is it really credible that the late surge in support for Labour, which led to a hung parliament, would have been forestalled by a commitment to proper NHS funding?

Surely such a commitment would have found favour among these voters and could have pulled in even more, given the wide public support for the NHS and its importance as an election issue?

And as tax justice campaigner Richard Murphy says, there’s no reason to be afraid of BBC journos asking, “Where’s the money coming from?” since the correct and simple answer is “Out of thin air.”

Bernie Sanders points out – the specifics of NHS policy notwithstanding – that Labour massively strengthened its position precisely by campaigning against the Establishment and not kow-towing.

The (positive) argument needs to be: Don’t hold back!!! Don’t be timid and sacrifice your own chances.

Without NHS renationalisation, more funding will go to profiteering companies

Of course, unless the NHS Reinstatement Bill is passed – which would stop and reverse NHS privatisation – more funding would mean more money going to profiteering companies.

This is what happened to about half the additional £2bn that the ConDem Government put into the NHS in Autumn 2014, in order to boost their chances in the 2015 General Election.

NHS hospitals lacked the capacity to carry out operations and other activities, so private companies cleaned up. 12% of local Clinical COmmissioning Groups’ budgets is now spent on care provided outside the NHS.(Financial Times, NHS funds diverted to private sector, by Sarah Neville, 26.3.2017)

The need to pass the NHS Reinstatement Bill is urgent. Too bad this isn’t in the Labour manifesto – which merely commits to making the NHS the preferred provider and stopping excess profits being taken out of the NHS.

Why? A recent “Alternative Models of Ownership” report to the Shadow Chancellor of the Exchequer and Shadow Secretary of State for Business, Energy and Industrial Strategy says:

“[N]ational level state intervention is likely to become more, rather than less important. Achieving critical national policy objectives such as modernising infrastructure, providing decent health and social care and combatting climate change all require a long term strategic approach that is incompatible with commercial considerations…
Given the ability of state owned corporations to borrow at much cheaper rates than the private sector, public ownership is the cheaper and more desirably long term option, ensuring also that revenues generated can be returned to the public purse.”

The 3 main parties’ social care funding commitments won’t alleviate the crisis

The 2017 Election briefing note by the Centre for Health and the Public Interest finds that all 3 parties are proposing policies that won’t alleviate the social care crisis or do anything to reduce the pressures on the NHS which arise because of a lack of adequate social care.

Instead, they’ve have responded to the social care crisis with Manifesto commitments to:

“provide some additional funds to just about maintain a highly restrictive service, and protecting the assets and wealth of a small number of richer older people.”

They have all signed up to the 2011 Dilnot Report’s  proposal to keep means-tested social care, with a cap on an individual’s liability to pay at a certain level – beyond which the state will pay; and to increase the amount an individual can keep before having to contribute to the cost of their care.

The 2013 Dept of Health’s impact assessment on the Dilnot Report says it would benefit an additional 100,000 people, who would receive care they would otherwise have to pay for. This disproportionately benefits the rich at the expense of the poor.

Rather than this  – what would free social care for the elderly cost? One estimate is around £9bn/year (from the 2015 Green Party Manifesto).

This could be paid for by a combination of:

  • NHS cost savings (as a result of reducing A&E use and bed occupation;
  • savings resulting from ending NHS marketisation and privatisation);
  • cuts to corporate welfare including fossil fuel corporate subsidies, which costs taxpayers around £93bn/year ; and
  • increased revenue from a variety of tax measures including a wealth tax, Robin Hood (financial transactions) tax and a crack down on tax dodging.

This leaves around 285,000 people people with disabilities aged 18–64 years who receive long term social care. Means-tested and largely privatised, this accounts for 48% of adults social care funding.

999 Call for the NHS would argue that ALL adults social care should be publicly funded, provided and run and free at the point of need.

And as a cross party/no party campaign, we would also argue that – as the successful Stop Fracking campaigners documented in The Bentley Effect  found – it is essential for social and environmental campaigns to be free of any political party control or identification.


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