Letters: NHS funding debate

Published: 20/12/2001, Volume III, No.5786 Page 22 23

Funding the NHS has vexed politicians since it was established. The Wanless inquiry is another attempt to sort out the problem. His interim report has the answer, though he does not state so.

The myriad factors influencing health - demographics, lifestyle, economic prosperity, technological advances, effective use of resources - demonstrate that determining an appropriate level for a single national social fund for healthcare is not possible. So why try?

In our personal lives, we know we could spend more money if we had it. The NHS is the same. If it receives more funding it will be spent, and a little bit more will be required.

But we also know that, in our personal lives, what we really need most are increases that match our needs, not only to maintain our standard of living but to cope with changes in circumstances, such as a growing or ageing family.

Chart 2.1 of the interim Wanless report has all the evidence needed to prove the current mechanism for funding the NHS is wrong.

Over the last 30 years, real changes in funding appear to have ranged from plus 11 per cent to minus 1 per cent, with no consistency from year to year. In our personal lives, how would we cope with such uncertainty?

The answer is not to focus on absolute levels of funding (though I intuitively believe there is a case for a one-off increase) but on the increase required year-on-year. The dilemma is that the myriad factors makes such an approach difficult. But there is a simple answer.

Many small investors know that, over the long-term, tracker funds perform better than the vast majority of fund managers. Tracker funds do not aim to beat the stock market, but to match it.

For the NHS this approach would mean tracking the annual funding increase for the seven countries identified in the Wanless interim report. It would probably have to lag one year behind, but such a small digression would be vastly superior to the stop-go funding so vividly demonstrated in the report.

If this were coupled with an arm's-length agency to regulate and monitor the NHS, we might have the foundation for a special health service across the UK.

Terry Dennis Director Healthcare Alliances Vale of Glamorgan