Picketing and demonstrations or a properly costed policy which will provide proper long-term funding for the NHS. Which do you think is the most likely to succeed? On Saturday Labour in Liverpool picketed the Royal Liverpool hospital in support of the NHS. On Sunday our Leader Sir Vince Cable, produced a costed policy document which would save the NHS by providing proper short-term and long-term funding and a host of other measures. Chief proposals in the short term are to raise income tax by 1p in the pound and in the longer term to combine National Insurance and council tax expenditure into one national fund to be delivered and managed locally which would ensure that funding is available and increases as national GDP increases.
I was a member of the panel representing local government who control the public health and adult care agenda. My conclusion is that we all love the NHS but it needs to change. We are using the same funding mechanisms and institutions that were put in place 70 years ago. A lot has happened in 70 years and the NHS, in the way we currently do things, is unsustainable. We need to find proper funding for it; seek innovation in the way it does its work and involve people much more in the crucial decisions about their own health and that of their families and community.
Summary of recommendations from the report
- We believe it is necessary for the Government to provide a rise in real-terms funding for the NHS in England, of at least £4bn in 2018-19. This is in line with the recommendations made by the NHS England Chief Executive and leading think tanks ahead of the November 2017 budget. This should be matched by equivalent increases in funding for the devolved nations under the Barnett Formula. We further recommend that this should be followed by an annual rise of at least £2.5bn a year in real terms, uprated in line with inflation at approximately 2 percent per annum, for two further years. This should be matched by equivalent increases in funding for the devolved nations under the Barnett Formula.
- We do not believe that further increases in council tax are a progressive, or sustainable, way to set health and social care services on a sustainable financial footing in the long term.
- We recommend bringing together health and care funding in a single, ring-fenced tax which would replace National Insurance. This should be combined with social care funding which is currently raised through council tax, to raise the amount needed to sustain good quality services.
- We recommend that additional funding for the NHS and social care should, for at least the next three years, be ring-fenced as an investment in out of hospital care.
- We recommend that, in the medium term, the NHS should move away from the tariff for the pricing of healthcare services, which has greatly increased hospital and A&E activity.
- We recommend that dedicated innovation funding should be made available in local areas to enable them to invest in innovative new ways of joining up local health and care.
- We recommend that additional revenue be made available for local government to invest in public health improvements.
- We recommend that the government look to introduce incentives to encourage people to save more towards the costs of their adult social care.
- We recommend that the government reinstate its commitment to introduce a cap on the costs of adult social care in order to give further clarity to individuals about the amount they should aim to save towards these costs, during their working life.
- We recommend that an independent ‘OBR for Health’ is established, to make recommendations to Government about the funding required for a five-year cycle. Their considerations should take into account the costs of meeting projected demand for services and the cost of meeting any commitments to extend services which the Government has proposed.