DESPITE all the hue and cry that preceded the General Election, the future of the National Health Service attracted very little debate. This was due, in large part, to the Conservative Party's success in neutralising the NHS as an issue by pledging to increase funding in real terms, a commitment that Labour did not promise to match.
It is a pledge that may well come back to haunt David Cameron as it becomes clear that health cuts are already impinging upon care. In reality, the NHS requires significant funding even above inflation simply to cope with growing demand for care and the cost of new treatments.
Health chiefs are belatedly looking at improving efficiency to find 20bn in savings, but the task is huge as the National Audit Office makes clear today.
Labour's years of largesse saw NHS productivity fall by 0.2 per cent each year from 2000 and as much as 1.4 per cent in hospitals, largely because the bulk of extra investment went into pay. Too little attention was paid to changing the way the NHS works, which is still too focused on past medical practice.
It estimates as much as 1.6bn could be saved by hospitals if the practice of all was the same as the best performers. It is a lot of money but, worryingly, it is still not nearly enough amid estimates the NHS needs productivity gains of six per cent each year to make the savings required.
By measuring the quality of services and outcomes of healthcare – and linking financial rewards to the improvements – Ministers hope that this will focus minds on what works best for patients and taxpayers.
Yesterday, they unveiled plans which will see dentists paid for the quality of treatments, rather than the number they carry out, in the kind of funding model championed by this newspaper in our long-running Stop the Rot campaign which called for better access to improved NHS dental care.
The new deal moving dental care from a treatment service to a health service should be one followed elsewhere in the NHS. But with deteriorating finances a reality as the Government simultaneously embarks on potentially ruinous reforms of the Health Service, it remains a distant goal.
The consequence will be the NHS, once again, becoming a major electoral battleground.