Oliver Middleton is a member of the Conservative Party and former Labour PPC.
Once again it falls to the Conservatives to level with the public.
Just days ago Keir Starmer treated us to the latest instalment of the NHS doom loop. It goes something like this: the government tells everyone what they already know; that the NHS is in a dire state, and blames the last government; this is followed by a package of ‘reform’, costing billions, but fails to address any of the structural drivers of these woes; eventually, enough money is thrown at the health service to get it to a point where it is just about managing, and said government crosses its fingers that gaze of voters eventually turns elsewhere; ad infinitum.
This has largely been the pattern for the past 30 or so years. But as former Health Secretary, Sajid Javid, alluded to after he left the department of health, those who have had the chance to look under the bonnet, know the truth; that unless we want to become a health service with a country attached, Britain needs a new model of healthcare.
Of course, certain politicians and supporters of the existing NHS model – and I was one of them for many years – will point to polls that show most people still support the principle of a tax-funded model of healthcare that is free at the point of use. This is true. However, believing something in principle is not the same as supporting something in practice, particularly as 65 per cent of us openly admit the NHS is ‘broken’.
Such polling also doesn’t account for the fact that politicians of all parties have for too long deceived themselves and the public about the viability of the NHS and the true cost of clinging to this woefully outdated model.
A big part of the problem is the eye-watering sums our NHS demands have begun to lose all meaning. The current cost of the NHS is £181.4 billion a year. A colossal number, of course, but – with the help of the brilliant ‘Days of NHS Spending’ – let’s put this into perspective. £181 billion is more than the GDP of nearly every African nation and a large chunk of Eastern Europe and Asia. The £25.7 billion increase in NHS spending announced in the Budget – mainly funded by the rise in NI for cash-strapped businesses – will provide just 26 days of additional cash per year. The £560 million tax raid on British farmers? Twenty-five hours of NHS spending. Livelihoods shattered, inheritances stolen, just for one day of the NHS.
But these are just the direct costs. We must also consider the indirect impacts of the NHS model, which are so often overlooked.
The NHS has always been perceived as politically off-limits – in so far as any cut in its budget or attempt at genuine reform is regarded as too much of a risk – meaning other public services have had to make up the shortfall. For example, why was austerity in the UK so visibly worse than in other comparable nations, which suffered the same economic shock? Cuts to other departmental budgets – especially education, defence, and transport – were far deeper to ensure that the NHS budget went up every year between 2010 and 2015. And even today, the schools budget is just 30 per cent of what we spend on the NHS.
What is truly staggering, however, is that despite being insulated against cuts and seeing its budget go up, NHS productivity has gone down, and – more infuriatingly – patient outcomes have worsened by almost every measure. The UK’s avoidable mortality rate, for example, is 69 per 100,000 people: that’s worse than the likes of Greece, Portugal and Ireland. The NHS waiting list now comprises nearly the population of London and has hardly improved since COVID-19. And don’t let anyone tell you that this is acceptable because the NHS performs well in treating serious illnesses and diseases. It doesn’t. In fact, our cancer mortality rates are higher than those of most other countries and are going up.
In a sad irony, the justification for creating the NHS in the 1940s was post-war Britain’s sick population. However, the evidence suggests that it is now the NHS itself that is making Britain sicker. Only last month, the Labour government hit the airwaves proclaiming how it will reduce the number of working-age Britons who are on long-term sick leave, which is costing us billions in welfare and through economic inactivity. But the government hasn’t mentioned in its lines that as of last year, the OBR estimated 2.9 million working-age people are on NHS waiting lists.
So, what about Labour’s so-called reforms? They are the equivalent of offering a patient waiting for a hip replacement a walking stick – which, in all probability, happens every day in the NHS.
The great Nigel Lawson once said the NHS is the closest thing the British people have to a religion. This is now only true in the Labour Party. And as is usually the case when it comes to Labour, its approach to the NHS will always be driven by internal politics first and foremost. I remember shortly after joining the Labour Party at 17, it was explained to me that Tony Blair’s cardinal sin as Prime Minister was not Iraq but the use of private finance initiatives to fund the building of hospitals. Labour members have never forgotten this and genuinely believe it was privatisation by the back door. These same members wield such significant internal power, especially when it comes to choosing leaders, no ambitious Labour minister – especially Wes Stressing – will have this argument.
Labour also sees itself as the party of the NHS and wears this as a badge of honour. It is not just that the NHS is a core part of the Labour psyche, but a vital tenant of the Labour ‘brand’ as one of their few genuine and lasting achievements while in office. Get rid of the NHS in its current form. What is Labour left with?
What is sad is the true victims of Labour’s window dressing and dishonesty are not the wealthy but the poor and most vulnerable, the same people Labour claims to represent. Research from the King’s Fund earlier this year found that people living in the most deprived areas in England are nearly twice as likely to experience a wait of more than one year for hospital care than those who live in the least deprived areas.
For all its talk of reform, Labour will never fundamentally alter the NHS model. This means the Conservative Party must be brave enough to at least start a conversation, reimagining our approach to healthcare, even if we don’t have all the answers straight away.
Unfortunately, Labour’s use of the NHS as a political football has meant previous generations of Conservative politicians haven’t wanted to ‘open a can of worms’ and leave themselves vulnerable to cheap political point scoring by broaching this hugely important subject. While understandable, this approach is now unsustainable. Besides, there is already evidence that the public mood on this topic is evolving, but a more fundamental shift will not happen without greater honesty from politicians about the true cost of the NHS.
This task has also been made easier by Nigel Farage now openly advocating for an insurance based model of healthcare. Cearly, Farage smells that public sentiment on this topic is shifting, or this would be no go territory, as it was when he was leader of UKIP.
It is about time we levelled with the British public and held Labour’s feet to the fire. From Churchill to Thatcher, the Conservative Party has a long history of delivering hard truths to voters for which the public has always thanked us in the end, even amid initial resistance. After all, this is leadership in action, and it is what the Conservative Party is built for.
Oliver Middleton is a member of the Conservative Party and former Labour PPC.
Once again it falls to the Conservatives to level with the public.
Just days ago Keir Starmer treated us to the latest instalment of the NHS doom loop. It goes something like this: the government tells everyone what they already know; that the NHS is in a dire state, and blames the last government; this is followed by a package of ‘reform’, costing billions, but fails to address any of the structural drivers of these woes; eventually, enough money is thrown at the health service to get it to a point where it is just about managing, and said government crosses its fingers that gaze of voters eventually turns elsewhere; ad infinitum.
This has largely been the pattern for the past 30 or so years. But as former Health Secretary, Sajid Javid, alluded to after he left the department of health, those who have had the chance to look under the bonnet, know the truth; that unless we want to become a health service with a country attached, Britain needs a new model of healthcare.
Of course, certain politicians and supporters of the existing NHS model – and I was one of them for many years – will point to polls that show most people still support the principle of a tax-funded model of healthcare that is free at the point of use. This is true. However, believing something in principle is not the same as supporting something in practice, particularly as 65 per cent of us openly admit the NHS is ‘broken’.
Such polling also doesn’t account for the fact that politicians of all parties have for too long deceived themselves and the public about the viability of the NHS and the true cost of clinging to this woefully outdated model.
A big part of the problem is the eye-watering sums our NHS demands have begun to lose all meaning. The current cost of the NHS is £181.4 billion a year. A colossal number, of course, but – with the help of the brilliant ‘Days of NHS Spending’ – let’s put this into perspective. £181 billion is more than the GDP of nearly every African nation and a large chunk of Eastern Europe and Asia. The £25.7 billion increase in NHS spending announced in the Budget – mainly funded by the rise in NI for cash-strapped businesses – will provide just 26 days of additional cash per year. The £560 million tax raid on British farmers? Twenty-five hours of NHS spending. Livelihoods shattered, inheritances stolen, just for one day of the NHS.
But these are just the direct costs. We must also consider the indirect impacts of the NHS model, which are so often overlooked.
The NHS has always been perceived as politically off-limits – in so far as any cut in its budget or attempt at genuine reform is regarded as too much of a risk – meaning other public services have had to make up the shortfall. For example, why was austerity in the UK so visibly worse than in other comparable nations, which suffered the same economic shock? Cuts to other departmental budgets – especially education, defence, and transport – were far deeper to ensure that the NHS budget went up every year between 2010 and 2015. And even today, the schools budget is just 30 per cent of what we spend on the NHS.
What is truly staggering, however, is that despite being insulated against cuts and seeing its budget go up, NHS productivity has gone down, and – more infuriatingly – patient outcomes have worsened by almost every measure. The UK’s avoidable mortality rate, for example, is 69 per 100,000 people: that’s worse than the likes of Greece, Portugal and Ireland. The NHS waiting list now comprises nearly the population of London and has hardly improved since COVID-19. And don’t let anyone tell you that this is acceptable because the NHS performs well in treating serious illnesses and diseases. It doesn’t. In fact, our cancer mortality rates are higher than those of most other countries and are going up.
In a sad irony, the justification for creating the NHS in the 1940s was post-war Britain’s sick population. However, the evidence suggests that it is now the NHS itself that is making Britain sicker. Only last month, the Labour government hit the airwaves proclaiming how it will reduce the number of working-age Britons who are on long-term sick leave, which is costing us billions in welfare and through economic inactivity. But the government hasn’t mentioned in its lines that as of last year, the OBR estimated 2.9 million working-age people are on NHS waiting lists.
So, what about Labour’s so-called reforms? They are the equivalent of offering a patient waiting for a hip replacement a walking stick – which, in all probability, happens every day in the NHS.
The great Nigel Lawson once said the NHS is the closest thing the British people have to a religion. This is now only true in the Labour Party. And as is usually the case when it comes to Labour, its approach to the NHS will always be driven by internal politics first and foremost. I remember shortly after joining the Labour Party at 17, it was explained to me that Tony Blair’s cardinal sin as Prime Minister was not Iraq but the use of private finance initiatives to fund the building of hospitals. Labour members have never forgotten this and genuinely believe it was privatisation by the back door. These same members wield such significant internal power, especially when it comes to choosing leaders, no ambitious Labour minister – especially Wes Stressing – will have this argument.
Labour also sees itself as the party of the NHS and wears this as a badge of honour. It is not just that the NHS is a core part of the Labour psyche, but a vital tenant of the Labour ‘brand’ as one of their few genuine and lasting achievements while in office. Get rid of the NHS in its current form. What is Labour left with?
What is sad is the true victims of Labour’s window dressing and dishonesty are not the wealthy but the poor and most vulnerable, the same people Labour claims to represent. Research from the King’s Fund earlier this year found that people living in the most deprived areas in England are nearly twice as likely to experience a wait of more than one year for hospital care than those who live in the least deprived areas.
For all its talk of reform, Labour will never fundamentally alter the NHS model. This means the Conservative Party must be brave enough to at least start a conversation, reimagining our approach to healthcare, even if we don’t have all the answers straight away.
Unfortunately, Labour’s use of the NHS as a political football has meant previous generations of Conservative politicians haven’t wanted to ‘open a can of worms’ and leave themselves vulnerable to cheap political point scoring by broaching this hugely important subject. While understandable, this approach is now unsustainable. Besides, there is already evidence that the public mood on this topic is evolving, but a more fundamental shift will not happen without greater honesty from politicians about the true cost of the NHS.
This task has also been made easier by Nigel Farage now openly advocating for an insurance based model of healthcare. Cearly, Farage smells that public sentiment on this topic is shifting, or this would be no go territory, as it was when he was leader of UKIP.
It is about time we levelled with the British public and held Labour’s feet to the fire. From Churchill to Thatcher, the Conservative Party has a long history of delivering hard truths to voters for which the public has always thanked us in the end, even amid initial resistance. After all, this is leadership in action, and it is what the Conservative Party is built for.