Tuesday, 5 January 2010

Who do you think you are kiddin' Mr Cameron?

Professor John Appleby of the King's Fund examines some of the Conservative pledges on the NHS and finds that that their proposals, far from transforming and improving the NHS, have already happened.


Prof Appleby asks; "Choice of hospital for patients? Yes, since 2005. Semi-autonomous hospitals (foundation trusts)? Yes, since 2004. Financial incentives for hospitals? Yes, since 2004. Publishing data on performance of NHS organisations? Yes, since 1998. Linking GPs' pay to the quality of results they deliver? Yes, in one form or another, since 1990. More choice in and coordination of maternity services? As the Royal College of Midwives states, this is already happening. And it hardly seems worth going to the trouble of appointing an independent board to distribute the global NHS budget to local primary care trusts – a computer that allocates 80% of the NHS budget (one of the most sophisticated formulas for allocating public money anywhere in the world) could carry out this job.

Perhaps what is new is a commitment to provide separate public health funding to local authorities rather than the NHS. This money – again, a sum unspecified, but presumably not unadjacent to the £3bn or so the NHS is estimated to spend on public health – will be allocated on the basis of need with poorer and less healthy areas getting more money. The aim of this spending is laudable – to eradicate health inequalities. But as governments have found for half a century or more, reducing (let alone eradicating) disparities in life expectancy and mortality is a wicked problem and one not simply solved through public health activities or dividing up the NHS cake according to need."

The Tories are already exposed as promising £45billion of policy actions, with only £11billion of funding identified to pay for these actions. So I suppose that making promises that have already been fulfilled by Labour goes a little way to closing that funding gap.

Of course, these proposals are for the NHS in England. It's not clear which already implemented changes the Tories hope to enforce again in Scotland.

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