The annual NHS argument

When Gordon Brown turned on the spending taps, in response to Tony Blair’s pledge to raise health spending to the EU average, the NHS was effectively given eight years to sort itself out. Even though the economic crisis of 2008 could not have been foreseen, it was known that the rate of increase in health spending would drop dramatically at that time and the NHS would have to adjust.

For all the improvements that were made, however, such as the reduction in waiting times, the opportunity was essentially squandered. The structural reforms that would enable the NHS to flourish in the lean years that would follow the years of plenty were never made.

As a result, the health service is once again left waiting for the annual round of plans and budgets – as shown in the Operating Framework published yesterday – followed by the demeaning shouting match that always follows.

Of course, the present economic situation hardly lends itself to long-term planning – another reason to regret Labour’s wasted opportunity – but a shortage of money should not necessarily mean a shortage of joined-up thinking.

For example, the new report which shows that cash intended for carers invariably fails to reach them is a reminder that splitting social-care budgets between local authorities and the NHS itself is a recipe for chaos.

Labour’s plan may have failed, but at least it looked to the long term. The problem for the present Government is that there is little in its confused reforms offering any hope that the NHS will not merely continue to stumble from crisis to crisis.