The NHS can’t go on like this. Infrequent winter “crises” have turned into an annual event. While the January pressures are as regular as clockwork, they still take the authorities by surprise, this year resulting in the drastic step of cancelling non-emergency operations. The first politician to break the NHS out of its downward spiral will deserve the electoral support that will follow.
On current showing, that politician will not be Boris Johnson. His call for an extra £5 billion a year for the health service won headlines and, by some accounts, a mauling at the hands of his cabinet colleagues yesterday. As a historian, however, the foreign secretary should ask himself why his emergency funds will change the game when similar bailouts in recent years have made little difference.
George Osborne put in £4 billion in 2014 to fund a programme of modernisation that never happened. Last year the NHS set aside £2 billion to fund the kind of long-term investments that will improve the way that the service runs. The opportunity was lost because the money ended up being spent on “current pressures”, as the National Audit Office put it.
An ally of Mr Johnson was quoted as saying that “every expert” wants more money for the service. In fact, the national director of quality and efficiency for the NHS, a practising orthopaedic surgeon, has said, “I do not think at the moment we deserve more money until we put our house in order”.
Speaking to this newspaper last year, he listed the many ways in which the service wasted money through delivering poor care. Basic improvements in infection control would save up to £300 million a year alone. He concluded: “I’ve now been to every single trust in England, Wales, Scotland and Northern Ireland and there is significant waste out there.”
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The real agreement among experts is that the NHS has profound problems in its organisation. In particular it drives patients into hospitals that are both painfully overstretched and the most expensive places to deliver care.
New research from the Reform think tank shows how modern GP practices, in some cases built with new technology and private capital, have significantly eased the pressure on A&E departments. Without ideas like these, the NHS will remain a £120 billion-a-year leaky bucket. Even £5 billion will be no more than a temporary top-up.
The NHS needs a saviour. Why not Boris Johnson? But he’ll have to do better than this.
Andrew Haldenby is director of the independent think tank Reform