Cameron’s closing speech to the Tory conference centred on trying to reassure the electorate that the NHS was safe in Tory hands. But the evidence he produced to justify this proved the opposite. He promised to protect the NHS in real terms for the next 5 years from 2015 to 2020, the same as he promised for the past 5 years. But in neither case does this protect the NHS, for two reasons. One is that the NHS requires expenditure, not just to keep up with inflation, but also even more importantly to keep up with two other sources of demand – the steadily rising number of elderly people, who make by far the greatest demands on the health service, together with the steadily rising costs of new technology and new drugs, both of which grow each year significantly faster than inflation. Throughout its history the NHS has had real terms funding increases of 4% a year. Cameron is proposing a 0% real terms increase over the next 5 years, exactly what has happened over the last 5 years where the official figures claim a 0.1% increase since 2010. This is at least an annual 2% fall in what the NHS needs each year to maintain its existing standards.
Cameron also forgot to mention that his government has imposed a £20bn cut in NHS funding over the current 5 year period. That explains why it now takes much long to get to see a doctor, why waiting lists for operations are lengthening, why A&E departments are critically overloaded, and why nearly half of NHS trusts are now experiencing serious financial shortfalls. The total shortfall by 2021 is now forecast by the chief economist for the Nuffield Trust to reach £30bn. Britain has been falling down the OECD charts for health spending as a proportion of GDP and is now 15th, lower even than Portugal. Yet what Cameron is now offering is a pledge to fall further still, at a time when the numbers of the elderly over 80 are set to double and the national population is predicted to rise by 3.5 million.
What is really needed is a commitment over a 10-year period to raise NHS funding which is currently 9% of GDP to a similar level to that in Germany, France and Italy which is 11-12% (for comparison the US is 16%). This can scarcely be achieved by switches in the balance of public spending alone whilst austerity prevails. It requires a fundamental change in economic policy, away from endless cuts and instead the pursuit of growth via public investment to achieve a rounded and sustainable expansion of the economy and a halving of the dole queues within 2-3 years.