Sooty is fifty years old this week, and I shall be fifty next year, which makes us both nearly as old as the National Health Service; I can’t help wondering which of the three of us is in better condition as we approach our half-century?
Many people are unaware that the NHS was the brainchild of two great Liberals – David Lloyd George and William Beveridge. Tories and Labour were both opposed to the NHS: “Only the Liberals, as a party, accepted my plans for a national health service in 1942-3” said Beveridge. Sadly, I’m not at all sure that if he was alive today he’d have any reason to revise his judgement.
When the great Tory privatisation experiment began in the 1980s, Britain was near the bottom of the international spending league for health. But for life expectancy and chronic illness we were middling. In other words, we were getting good value for money from the NHS. There was no great crisis of ballooning expenditure on health as there was in the United States.
Nonetheless, Tory dogma, borrowed from the American Right, insisted that market principles be applied to health, in an experiment which nearly brought the NHS to its knees. Hospitals ceased to be places where you went when you were ill; they became ‘producers’. Local GPs, in addition to their traditional healing role, had to become ‘managers’, wheeling and dealing to get the best deal for their patients.
Under the Tories, the NHS gained 40,000 managers – and lost 45,000 nurses! Does this make sense to you?
Don’t forget, when you read comments from Southend’s Tory MPs about how proud they are of their record, that the final years of their 18-year rule saw the reappearance of Victorian illnesses like rickets and TB, illnesses we thought had been eradicated long ago. We heard enough about Victorian values from Mrs Thatcher; but we hardly suspected that she was talking about the reappearance of the undeserving poor.
Let’s be quite clear about this: rickets and TB are diseases of poverty. And 18 years of Tory government saw a huge increase in the gap between the rich and the poor.
Tories now attack the ever-increasing NHS waiting lists – but they overlook the fact that this is a result of their own spending plans. As Paddy Ashdown said in a recent speech: “Undeterred by either shame or hypocrisy, they condemn what they themselves proposed only months before.”
The New Labour government find themselves in an awkward position. By accepting the spending plans devised by the Tories, they tied their hands behind their backs. It is little wonder that Frank Dobson was so embarrassed by the record rise in waiting lists in Labour’s first year in power. The problem was that Labour did not provide the NHS with the extra funds they needed – all they did was replace Tory placemen on health authorities with their own placemen. That does not treat any extra patients. Thousands of people have joined the queue in the North Thames Region, waiting for treatment.
Gordon Brown’s announcement of more money for the NHS is, therefore, more than welcome. The government has acknowledged that committing themselves to Tory spending plans was a mistake, and that extras resources should be put into the NHS immediately. The Liberal Democrat Treasury spokesman, Malcolm Bruce, calculated a year ago that the economy was growing so fast that extra funds could easily be made available. They should have been provided then.
But even if they sustain the promised increase in spending on the health service over the last three years of this government, the current projection is that health spending will still have increased less over 5 years than it did under John Major. (Actual figures: In John Major’s first five years as Prime Minister real health spending rose by around 4.1% per year. The comparable figure for Mr. Blair’s first five years is now around 3.7%.)
£21 billion sounds a lot – but in the context of health spending, it is not as much as it looks. I suspect that a large proportion of the new money will evaporate thanks to inflation – at a rate of £5 billion for every 1% above the inflation rate forecast by the government. More will be spent simply putting right the disastrous Tory underfunding Labour accepted for their first two years in office. I hope a significant chunk will go to the nurses, doctors and other health workers whose dedication has kept the whole enterprise afloat in some stormy conditions. And I hope that the small amount left to improve basic provision will be spent wisely.
If my view about the link between poverty and health is true, the government also needs to do something substantial to relieve poverty. Early indications are that the New Deal is not doing a great deal to generate genuine new jobs. A major programme of public investment, including building the high-speed rail link to the Channel Tunnel, would probably have been a better idea. But an investment programme which would increase the wealth of the poorest in our country to such an extent that their health was not jeopardised by their poverty – now that really would cost money!
William Beveridge reckoned that only the Liberals were in favour of a national health service; the Tories practically destroyed it in the 1980s, and New Labour seem to be too timid to put enough of our money where their mouth is. It’s beginning to look, more than 50 years on, as if the NHS really would only be safe in Liberal Democrat hands!