Duo have ideas above their station with headline-grabbing £10 a month service charge
By chance I was invited to attend the annual award ceremony for contrarians this week, but couldn’t go.
Might I have bumped into “Storming Norman” Warner, all-purpose ex-civil servant and Labour minister, now a 73-year-old contrarian backbench peer? He certainly knows how to make waves, even accidental ones.
‘No wonder Andy Burnham and - for once - Jeremy Hunt are lying low. Charges are toxic’
As you must have heard by now, Lord Storming chose to mark the arrival of Simon Stevens at the helm of HMS Health Service by co-authoring a pamphlet on the need for a fundamental reshaping of the NHS. It was published by Reform, the upmarket and pro-market think tank and cheerleader for shaking up public services with a bit more choice. It’s “independent”, but awash with Tories.
The Blairite moderniser last featured in this column last April when he broke ranks with his party to join Tory and Lib Dem peers in voting down Labour’s attempt to kill new NHS competition regulations. Far from enforcing compulsory competition, the regulations weren’t much different from Labour’s own and would help patients, he argued.
At the time I had some sympathy, still do. So do we all with his new squib, Solving the NHS Care and Cash Crisis (download it from Reform, many of whose remedies are close to being part of the near-consensus. Integrate health and social care? Why, of course. Turn many hospitals into community facilities and concentrate the clever stuff in fewer hospitals? That seems to be the future. Call the new settlement the National Health and Care Service (NHCS)? Well, if you must.
Daft name-changes are trendy, although NHS is a mighty powerful brand and bodies from Aviva to Unison must regret changing theirs.
Bless my soul, Lord Warner and his co-author, Jack O’Sullivan, a clever ex-Indy hack turned social policy consultant, even want their NHCS to have tighter financial discipline and efficiency savings because rising demand and squeezed budgets will (they say) create a £30bn budget black hole by 2020.
They’re on the right track there too, but money is where the duo surely get ideas above their station and go wrong.
Why? Because they propose to freeze NHS general funding in real terms (ie, inflation rises only) while topping it up with an extra £1bn a year hypothecated from unhealthy “sin” taxes - booze, gambling, cigs, sugar and so on. Plus higher levels of inheritance tax, our old chum, hospital “hotel” charges and other little wheezes.
The headline-grabber is a £10 a month “NHCS membership charge”. The idea is to engage voters in a “co-production” for their health self-improvement. The tenner will entitle us all to an annual health MOT.
Alas, Reform’s publicity machine got out of hand, as Storming Norm’ should have known. Charges are red rags to media bulls. Even sensible Tory MPs remind me: “The problem isn’t the NHS’s funding model, it’s what you do with the money you raise.”
He says: “We can’t get through this with the current funding model, and that’s not right. It undermines public consent for the discussion of reforms that we do need.”
Quite so. No wonder Andy Burnham and (for once) Jeremy Hunt are lying low. It’s toxic. Plenty of docs advocate charges, so do think tanks which don’t stand for election.
It may come of eventual necessity (£10 a month is a lot for the poor), but the NHS has more urgent tasks. When did the coalition last reject charges and repeat Nye Bevan’s “free at the point of use, based on need” mantra? Well into the Hunt era, last July.
Michael White writes about politics for The Guardian