Norman Lamb: It is a travesty that the NHS is celebrating its 70th birthday in such a perilous state
4 min read
The public would support tax rises if proceeds were ringfenced for health and social care, says Norman Lamb
Theresa May’s announcement that the NHS will receive an extra £20bn a year by 2023 was hailed as “bold and ambitious” by the health secretary and an “historic achievement” by one of her former ministers. In reality, this “70th birthday present” for the NHS was a wasted opportunity to put our country’s most treasured institution on a sustainable long-term footing.
The government’s plans will see NHS England’s budget grow by around 3.4% year-on-year. This might be enough to stop the NHS sliding backwards, but it falls well short of the amount experts such as the Institute for Fiscal Studies and the Health Foundation argue is needed to deliver a modern NHS with much-needed improvements to services. According to their analysis, funding will need to increase by closer to 4% for the next 15 years to meet this ambition, with an immediate boost of 5% annually over the next five years.
In the face of a growing ageing population and unprecedented demand for treatment, this shortfall will condemn the NHS and patients to an uncertain and dangerous future. The promised funding will not be enough to achieve the vital goal of equality for those with mental ill health, while we will continue to fall short of international comparisons on cancer survival rates.
Critically, it also ignores the desperate need for more funding for social care, public health and prevention – all of which are vital if we are to create a more efficient, preventative healthcare system that keeps people well in the community.
As the King’s Fund and the NHS Confederation have warned, difficult choices lie ahead. The public must be prepared for a dose of realism about what the NHS will be able to deliver with the resources available.
We are still in the dark as to where the extra money will come from. Any sustainable funding settlement for the NHS and social care needs to show that funds will be raised transparently, fairly and consistently on the scale needed. Yet the government has failed each of these tests with its plan to raise resources through a muddled mix of extra borrowing, unspecified tax rises and the frankly dishonest notion of a “Brexit dividend”.
My own view is that there is a solution staring the prime minister in the face, which could put the NHS on a strong footing as it enters the next 70 years. There is powerful evidence that the British public are prepared to pay more in tax to sustain the NHS and social care, but they must be confident that this money is actually being spent on these cherished services. That is why the Liberal Democrats have argued for a ringfenced “NHS and care tax” to raise the amount that experts say the NHS and social care need. This would be designed in a way that is progressive and fair between the generations.
Nevertheless, we cannot escape the reality that any substantial tax rise carries political risk, which is why I find it highly frustrating that the prime minister has refused to listen to my calls – along with MPs such as Sarah Wollaston and Liz Kendall – to set up a cross-party commission to explore how we can deliver a sustainable, long-term settlement for the NHS and social care. This would be the best way to take the heat out of political debate and facilitate a mature, rational discussion in the interests of the country.
For the NHS to be celebrating its 70th birthday in such a perilous state is a travesty. A long-term remedy is needed, but Theresa May’s inadequate sticking plaster won’t cut it. Politicians of all stripes owe it to patients to work together to confront the big challenges ahead, and ensure that both the NHS and the social care system give people the care they deserve in their hour of need.
Norman Lamb is Liberal Democrat MP for North Norfolk and was health minister from 2012-15
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