It took less than a week for some vociferous supporters of George Osborne’s £81bn spending cuts experiment to get cold feet about the likely consequences for lower economic growth. The government “cannot cut its way to prosperity”, business leaders warned on Monday.
David Cameron is promising private sector jobs to offset public sector losses. Some of them will, of course, be employees of private sector firms given contracts to deliver primary care. So it was unfortunate - also reported on Monday - that an agency worker was caught on a Wiltshire patient’s webcam accidentally switching off his life support machine. Andrew Lansley will not escape blame for such incidents.
I am more alarmed by what I see unfolding over the next few years, in severe welfare cuts obviously, but also in local government. Whitehall ringfencing of favoured programmes is out the window and councils are being told they are free to make the best sense they can out of their much reduced budgets and additional responsibilities.
This will have repercussions for the NHS, especially in medium size towns if caps on housing benefit rents drive people out of big cities, as seems likely. With the police less able (or less inclined?) to help out, a lot of the fallout could end up in accident and emergency. That famous 0.1 per cent annual rise in the NHS budget (an election pledge honoured, just) will not stretch far, not after efficiency cuts, redundancy payouts and the rest.
Labour and Lib Dem (Simon Hughes tendency) MPs were dismayed. But the counterintuitive side of me feels obliged to make a contrary point. Core aspects of the Osborne package could be described as “liberal.” Not just minister Anne Milton’s confirmation of 4,200 extra health visitors, part of the relative protection of the NHS budget which is politically popular (so far). Not just the much vaunted extra £2bn diverted to social care - which contradicts the no more ringfencing message to town halls. Increases in the international aid budget are far from popular, even brave, as are cuts to the police and defence budgets. So Labour MPs who dismiss the package as Thatcherism Mk II are not quite up to speed. The presence of Lib Dem ministers like Vince Cable, one of the good guys in the coalition, reinforce the metropolitan liberal instincts of Notting Hill Tories. How it works out is yet to be seen.
It is not shadow health secretary John Healey’s job to be generous, but to pick holes in health ministers’ claims. When The Sunday Telegraph reported the number of patients waiting for MRI scans, diagnostic test results and so on has doubled since ministers scrapped 18 week waiting targets in July, he moved with speed.
“After big improvements in patient healthcare over the past decade, ministers in this government have taken just five months to set the NHS on a backward course,” he said in a statement which included media-helpful links to articles. I have never seen that before, so watch out, ministers, he is Ed Balls-trained in the Rottweiler school.
Ministers will say they never committed to the waiting time target and it is just a snapshot, unrelated to the Osborne cuts. That will do for now, but not for long. A similar disdain greeted this week’s King’s Fund survey, the one that found GPs sceptical that Lansley’s reforms of primary care will improve the NHS.
In some ways that is a good result for Mr Lansley since it offsets routine claims that he is in the GPs’ pockets. Ah, but the survey also found that 60 per cent of GPs think they know colleagues in their areas with the capacity (my italics) to lead a GP consortium, so ministers will take comfort from that.
Life being what it is, mixed results will probably allow both sides to say “told you so”.