Nhs

I make no apologies for returning to government spending on health. The Tory promise in the election to ring-fence health spending and increase it in real terms every year even during a period of public spending cuts was distinctive and much-touted during the 2010 election campaign. A quick recap: during my extended interview with Health Secretary Andrew Lansley which went out live on the BBC News Channel on Sunday evening, I suggested that higher inflation than anticipated when the health spending promise was given would make it more difficult to meet the Tory promise of real annual rises. Indeed I put to him a projection for real health spending which

Before the election, the Conservatives promised they’d “protect” the NHS, which they defined as increasing its real-terms budget year-on-year. This is a rather dangerous promise because it makes ministers hostage to inflation. Now that inflation has surged, expectations have been revised upwards, and it looks like the NHS budget will suffer a real-terms cut. In its monthly update of City consensus forecasts, the Treasury has released new figures for inflation over the next five years.Apply the latest inflation figures to health spending in the last budget and it implies a £1bn shortfall . The graph below shows the change over five years: Back in March, the IFS said that the

For many years, it has been Government policy to move healthcare out of hospitals and into community units and homes, and concentrate specialist surgeries in centres of clinical excellence. This is politically contentious: former Secretary of State for Health Patricia Hewitt was closing local maternity units, but she had to deal with the humiliation of Ivan Lewis, a minister in her department, fighting her changes in his own constituency. But the time has finally come to break our national addiction to hospitals. In a report published today by Reform, Professor Paul Corrigan, who was a health special advisor to Tony Blair, argues that “the old model and concept of the

Thanks to Nadine Dorries’ amendment to the Health and Social Care bill, abortion rights have been discussed a great deal this week – both inside and outside of Parliament. In her cover article for this week’s Spectator (out today), Mary Wakefield says that this debate has revealed a “strange and unpleasant consensus… that abortion is not just a necessary evil, but a jolly good thing.” In the piece, Mary asks “Why are we so keen on abortion?”: “The fact is that unless you’re a fan of infanticide you’ve got to agree that somewhere along the slippery ascent from that little Alka-Seltzer of pluripotent cells to the birth of an actual

Tomorrow, MPs will debate whether to prevent abortion providers from counselling women seeking an abortion. The motion – put forward by Tory backbencher Nadine Dorries as an amendment to the Health and Social Care bill – is being opposed by the government, and pro-choice groups are backing a rival amendment, which reinforces the status quo. The amendement’s author, Lib Dem MP Julian Huppert says: “The present system which allows women access to evidence-based guidance works, therefore I cannot see why we need to change it. I do not want to see us opening the door to anti choice organisations which could prevent women making their own decision on such a

Just when everyone is all afroth about the murky connections between the political class and the media, a letter by Andrew Lansley to Danny Alexander has mysteriously leaked to the Telegraph. It was sent two months ago, and it concerns the government’s public sector pension proposals. For five pages, Lansley riffs on about why the reforms may not be such a good idea, particularly when it comes to NHS workers. “We face a real risk, if we push too hard,” he says, “of industrial action involving staff groups delivering key public services.” He suggests that lower and higher paid staff may just opt-out of the pensions scheme altogether, leaving the

The good, the bad and the ugly of the coalition’s reform agenda are all on display this morning. The good is the quickening of the pace in education. As Michael Gove tells this week’s Spectator, the 200 worst primary schools will now be taken over by new management, 88 failing secondary schools are to be converted into academies and any school where half the pupils are not reaching the basic standard of five good GCSEs including English and Maths will be earmarked for a takeover. Gove’s aim is remarkably simple: he wants good schools to take over bad ones.   The bad is yet another delay to the public service

Courtesy of ITV and ComRes: More here.

Listening is seriously damaging the coalition’s health. The Sunday Mirror carries a report that chimes with a week of rumours in Westminster: the NHS reforms are going to be significantly diluted to appease warring Liberal Democrats. The Mirror adds that Lansley is likely to quit in protest. Matt d’Ancona argues, in his essential column this morning, that this is not a listening exercise but a ‘full blown carefully orchestrated retreat’. It is, if you will, a political version of the battle of Arnhem: the NHS reforms were a reform too far in this parliament, so tactical withdrawal is now imperative. Clegg and Cameron’s signatures are on the original White Paper.

The British Medical Association (BMA) has always been a trade union with elements of professionalism on the edges. Its report this week on the NHS reforms was the work of unadulterated, self-serving trade unionism. Our modern trade union leaders would have been embarrassed to publish it, even Bob Crow. It tries to portray competition as the opposite of co-operation, when competition is the opposite of monopoly, in this case a public sector medical monopoly. Competition describes an arrangement under which teams of people co-operate with each other to find better ways of serving customers than rival teams of collaborators. The co-operation of which the BMA speaks is a weasel word

Nick Clegg’s speech on the NHS this morning was not as bad as many feared it would be. It recognised that there is a role for competition in the NHS, something that the Lib Dems were questioning last weekend, and that the NHS needs to be opened up to any qualified provider. But, on the other hand, the idea that any willing provider should be able to deliver NHS services — an idea which was in the manifesto of all three parties — will now only be introduced at a glacial pace. There’ll also be a two-tier NHS for the foreseeable future with some areas having GP-led commissioning, while NHS

I know most CoffeeHousers aren’t particularly enamoured of paywalls, but the Times has given you a persuasive reason (£) to dive behind theirs today. (Or least to borrow a copy of the paper.) It’s the first of three reports by Camilla Cavendish on the NHS, this one concentrating on the Way Things Are Now. It is both a disheartening read and a powerful reminder of how taxpayers’ cash is being funnelled into a system that is dysfunctional in the extreme. Here is one snippet for your displeasure: “Care in Britain ranges from world-class to shocking. Between 1998 and 2006, 1.6 per cent of bowel cancer sufferers died within a month