ED Miliband has pledged £2.5bn extra for the NHS and social care. This is a 2.2 per cent increase – lower than the 4.4 per cent real terms increase this Government has already given the NHS.
Labour also left many questions unanswered – here are six.
1. How can people trust them to increase the NHS budget given Labour’s appalling economic record? You can only increase the NHS budget – as we have done by £12.7bn in this Parliament – if you have a strong economy to pay for it.
When you lose control of the national finances, as Labour did in office, you risk secure funding for the second biggest department of state. Just look at what has happened in other countries that lost control of their finances: in Italy health spending has been cut by three per cent; in Greece by 14 per cent and in Portugal by 17 per cent.
But Ed Miliband said nothing about how he would deal with the deficit that led to cuts in all those countries – and nothing about how to grow a strong economy.
2. Where would £2.5bn really come from?
Ed Miliband couldn’t have been clearer in his promises to patients and NHS staff – more nurses, GPs, care workers and midwives. He said this would be funded by a mansion tax on properties over £2m, new measures to stop tax avoidance, and a windfall tax on tobacco companies, which together, he said, raise £2.5bn.
But even on the day of his conference speech, it became clear that there’s a black hole in his plans of nearly a billion pounds. Treasury analysis shows the claim £500m can be raised by ending two specific tax avoidance measures is wrong – in fact, this wouldn’t raise a penny. The Mansion Tax generates at minimum £350m less than Labour promised given their commitment to defer payments if people are cash poor.
Labour MPs like Margaret Hodge, chairman of Parliament’s Public Accounts Committee, and David Lammy have raised objections, and the director of the Institute for Fiscal Studies has said the mansion tax plans so far amount to ‘guesswork’ which couldn’t be implemented immediately after the election.
So either the NHS wouldn’t get anything like the £2.5bn, or the money would have to come from elsewhere. Which is it?
3. Is Andy Burnham proposing an NHS reorganisation?
In his speech to Labour conference, the Shadow Secretary of State attacked our health reforms, which have paid for an additional 6,000 doctors and 3,000 nurses since the election. But now he’s proposing a massive reorganisation of his own, forcing local GPs to report to hospitals which would become ‘integrated care organisations’.
That means reorganising 250 NHS Trusts up and down the country at a stroke.
4. Why no apology for Mid Staffs?
It’s been an unhappy theme for Labour – what the speakers forgot to say. Ed Miliband forgot a section of his speech on the deficit that had already been briefed to journalists. And just as Labour consistently refuse to apologise for leaving us with the highest peace-time deficit in our history, Andy Burnham still refuses to apologise for Labour’s target culture that led directly to Mid Staffs and problems in many other hospitals. As he was Secretary of State at the time, has he really learned nothing from those tragedies?
5. Labour’s health and social care integration policy doesn’t stack up. Where is the detail to support it?
In 2012, when he spoke to the Labour conference, Andy Burnham said that he didn’t have ‘all the answers’ on integrating health and social care budgets. It seems he still doesn’t. His speech, though heavy on rhetoric, was hugely light on policy detail. For example, when he integrates health and social care, will he remove means testing?
If not, will that mean some parts of the NHS start charging? What’s more, the scant detail that we do know about – the numbers of nurses, doctors and other staff Labour promised – has already been criticised. Who by? None other than Sir John Oldham, who was asked by Ed Miliband to write Labour health policy. Sir John said it would be better to allow local decision-making on community services than to ‘mandate’ staffing numbers.
6. What is Labour’s justification for saying the NHS is on its knees?
There are huge pressures in the NHS as it deals with the reality of an ageing population. But its performance is very impressive. Compared to Labour’s time in office, each year there are now nearly a million more operations, and nearly three quarters of a million more people have been treated for cancer in this Parliament compared to the last.
Record numbers say they are being treated with dignity and respect, and this summer according to the independent Commonwealth Fund the NHS was rated the best healthcare system in the world, ahead of France, Germany, the USA and Japan.
• Jeremy Hunt MP is the Health Secretary. This piece first appeared on the Conservative Home website.