NHS spending as proportion of GDP 'would fall under Tories and Labour'

The party has pledged a minimum £8bn extra in real terms for the NHS by 2022-23, above 2017-18 spending, while commiting to real terms per capita growth in every year.

This effectively extends the principle provided for in the 2015 spending review by funding the Five Year Forward View for another two years.

But it also suggests there will be extra revenue funding in 2018-19, because previous spending commitments would have resulted in a decrease in spending per person next year.

However, it appears the new commitment, and therefore the ringfence around health spending, will continue to apply only to NHS England’s budget.

This means that other Department of Health budgets could potentially be targeted for further cuts in order to help fund the increases for NHS England, although health secretary Jeremy Hunt has told HSJ he is “sceptical” that future savings could be made within the DH and other arms-length bodies.

The Nuffield Trust, a health policy think tank, said a “generous interpretation” of the Conservatives’ plan suggests the share of Britain’s national income going to the NHS will continue to shrink, from 7.3 per cent to 7.04 per cent.

It said Labour’s plans imply health spending would be £11.6bn higher in real terms by 2022-23, but would fall to 7.23 per cent of GDP, while the Liberal Democrat manifesto suggests spending would be £8.5bn higher, but fall to 7.07 per cent of GDP. 

Nigel Edwards, chief executive of the Nuffield Trust, said of the £8 billion pledge: “It is unclear how much new money this represents, or exactly when it would come onstream. We do not yet know whether promises of upgrades for buildings and IT will be backed by new spending, (and) the pledge does not apply to the £13.5bn of health funding not held by NHS England.

“Even under a generous interpretation of what will happen to these other budgets, the share of Britain’s national income going to the NHS will continue to shrink, from 7.3% to 7%. The same is the case for the other parties’ proposals as well: we are on course for more than a decade of unprecedented austerity.”

Another think tank, the Health Foundation, said the Conservatives’ plan implied real average funding growth of 1.2 per cent to 2020-21, compared to 2.2 per cent for Labour and 1.8 per cent for the Lib Dems.

The Conservatives’ manifesto also promises “the most ambitious programme of investment in buildings and technology the NHS has ever seen”, but does not set out details on how much extra capital funding will be provided.