As a corollary to Lord Frost’s earlier article on the size of the British State, Juliet Samuel exposes the unsustainability of current funding models for Health and Social Care which the Chancellor’s Spring Statement does nothing to address:
“The net effect of Mr Sunak’s time in office so far is that the young, working population will hand over more and more of their income in order to pick up the tab for the ill and the elderly.
The pandemic was always going to generate a large deficit and a health backlog to service: more than a fifth of the population (perhaps even a third, by some estimates) will be waiting for hospital appointments by the time of the next election. But this isn’t a one-off. It’s an ongoing burden.
Mr Sunak has in effect admitted as much. The Health and Social Care levy introduced last year – really just a new name for a regular old rise in National Insurance contributions – is here to stay because the political imperatives underpinning it remain unchanged.
The levy’s proceeds are supposedly “ring-fenced” for health spending (a rhetorical device that is meaningless in fiscal terms) and, in Mr Sunak’s words, show the Tories’ “total commitment” to being “a government for the NHS”. I suppose this shouldn’t be surprising, given that the Government effectively spent the entire pandemic telling us that we must be prepared to die to “protect our NHS”.
The Social Care Levy effectively ties NHS spending to tax rises.
Whenever a future government wants to spend more on health, they will have to bear the political pain of raising the levy, he implied in his speech. “If [the levy] goes, then so does the funding,” he said.
The government are backing themselves into a hideous corner. They can’t win politically because
“no matter how much money they throw at it, the health service will never help them to win power. The Conservatives will never be “the party of the NHS”. All they can hope for, really, is to neutralise the fear that they are its destroyers.”
And economically it will prove disastrous too
“because with fewer and fewer workers now expected to pay for more and more healthcare for the sick and the elderly, healthcare productivity improvements are the only way to keep the whole thing afloat. Yet it’s unlikely the health service can innovate to the degree required without some quite significant reforms, which are politically toxic under a Conservative government.”
But current policy stands little chance of succeeding either: taxing your friends to appease your opponents is a high-risk strategy which will surely incur the wrath of both. Unless the government is prepared to contemplate fundamental, long-term reform of Health and Social Care, the entire system is in danger of collapse. We need to act now if we're to avert a further crisis down the line.
The full article can be read here with a link to the original beneath it: