What difference will this election make to the NHS?


This week I am going to write a series of articles on what differences there might be depending on who governs after May 7th. The main media concentrates on the spin lines from the major parties, which tend to hype  differences. They follow the daily diet of mistakes, gaffes and set ups which characterise a modern media driven election. Some of these should not matter and are usually trivial and of no lasting significance. My objection to David Miliband was not that he once carried a banana, which many others have done with no harm to their reputations. My objection was his uncritical love of the EU. My objection to Gordon Brown was not his unfortunate facial expressions when waiting for an interview in a studio when tired, but the way his banking and economic policies put us into the most violent boom/bust cycle since the 1930s. These articles will ask what difference will there really be? What matters?

Labour have sought to put the NHS at the centre of this election. They mean by that health in England. This General election will make no difference to the way the NHS is run in Wales or Scotland, where it is a devolved matter under their Assembly or Parliament.

Labour claim the NHS is only safe in their hands. There are no grounds whatsoever to take this view. The management of NHS England say it will need an extra £8billion a year by the end of the next Parliament. The Conservatives and Liberal Democrats have both promised to find this. Labour has promised less, but I assume were they to be in office they would also find the money. The UK bureaucracy is usually good at extracting money for public budgets, and will doubtless make a strong case. It seems unlikely that there will be a lot of difference on total NHS England spending between the parties.

Labour say they will stop people making money in the private sector out of the NHS. They do not of course mean this in most cases. It was Labour who set up a lot of the most expensive PFI schemes when in office, encouraging the private sector to profit from providing new NHS facilities. They will not be able to get out of these. Any government will have to buy drugs and medical supplies from with profit companies. All will stick with the system that most GPs are private sector contractors to the NHS. The NHS has always been a mixed economy system, a partnership between leading pharmaceutical and medical supply companies, doctors under contract, and directly owned hospitals with state employed staff. No main party is proposing any change to this pattern.

Labour dictates the terms of the debate on health. This debate prevents discussion of reform or change. This has been a very conservative election on health, with all main parties competing to keep it as it is, with more money.

Conservatives have promised to recruit more GPs to offer longer opening hours and week-end service. This would help relieve pressure on A and E if more people could get an appointment with their GP to deal with the things that do not need hospital treatment. That would be a practical change to offer a better service to patients, and to save money at A and E departments. I conclude there would be little difference to the NHS whoever wins, but Conservatives do have an attractive policy of improving access to GP services which I think could be a beneficial change. It has also taken a Conservative Secretary of State in the coalition government to expose the problems in some hospitals properly that had occurred under Labour, and to get improvements.




  1. Narrow Shoulders
    May 1, 2015

    Mr Redwood

    Why is private medical insurance offered across a company’s entire workforce a taxable benefit?

    Surely insurance should be encouraged not penalised.

    1. Lifelogic
      May 1, 2015

      Not only in medical insurance a taxable benefit but they even add insurance premium tax to it too 6% or 20% for travel insurance. Not much of an incentive to provide for yourself and not trouble the NHS.

    2. Roy Grainger
      May 1, 2015

      But as the private health sector uses many of the same consultants as the NHS it’s queue jumping, clearly a benefit, and should be taxed. I have private health insurance incidentally.

      1. Narrow Shoulders
        May 2, 2015


        I see your point but disagree.

        It is queue jumping at a premium in effect the tax has been paid by the insurer for the elevated rates paid.

        The additional earning potential that private patients bring sweats the assets including consultants of the NHS and make the whole shebang more viable.

        If the insurance is offered across the entire workforce the like childcare vouchers and cycle to work schemes it should not attract tax. [1]

        1 I am aware that those are salary sacrifice schemes but with medical insurance my wages would be higher so I am in effect sacrificing salary to have pmi

      2. Denis Cooper
        May 2, 2015

        A fair point.

      3. Lifelogic
        May 2, 2015

        Nonsense that NHS consultants get paid by the NHS for the work they do for the NHS. What they do outside that is clearly up to them it is not queue jumping at all.

        If the NHS is not getting value for what they pay the consultants then the NHS needs to get its act together & make sure they do get value. They after all issue and agree the contracts.

  2. alan jutson
    May 1, 2015

    Not much difference.

    In the whole scheme of things, you are probably right in the short term, however in the longer term some real hard decisions are going to have to be made by whoever is in Parliament at the time.

    Like the questioner on last Nights debates, the NHS already consumes increasingly vast percentages of tax receipts.

    1. alan jutson
      May 1, 2015

      Further to the Question time programme last Night, what a refreshing change from the normal format.

      I do not know who was responsible this time for the audience/question choice, but so much more revealing than another format, or any other interview and examination in this campaign.

      Few interruptions by Dimbleby.

      Clear and important questions by sensible people.

      A lesson here for many so called professional interviewers.

      For once I have no complaint about the BBC.

      1. Jagman84
        May 1, 2015

        Maybe the audience in the previous debate was far more hostile to David Cameron and Nigel Farage than they, themselves, anticipated. Consequently, last nights was less “cherry-picked”. Expect normal service to be resumed ASAP!

  3. Old Albion
    May 1, 2015

    If we had an English parliament, it would see to the needs of the English NHS. Of course what we actually have is a (dis)UK political establishment bickering over the English NHS. An establishmment that will brazenly use the votes of 117 non-English constituency MP’s to get their way.
    A scandalous abuse of political power that doesn’t even begin to fit with the word Democracy.

    One day, somehow, we will have to truly consider the way the English NHS is run and funded.
    We all want help when needed. We all love the NHS. But we cannot go on offering ever more treatments to ever more people. We will have to consider what are geuinely our needs and rights and weigh them against the misuse of the English NHS by both Englands residents and those from overseas.

    1. a-tracy
      May 1, 2015

      I actually thought it was a good idea to reclassify NHS treatment of ‘foreign nationals that aren’t paying regular NI contributions as the ‘foreign aid’ budget and charge it across so that we actually show how much aid and care we are providing.
      When UK born people who have paid NI contributions for over 39 years can’t get speedy treatment or are on waiting lists or get kicked out of beds too early you can’t wonder people are getting tired of our NHS model of free for the world.

    2. Bob
      May 1, 2015

      @Old Albion

      “We all love the NHS. But we cannot go on offering ever more treatments to ever more people. We will have to consider what are genuinely our needs and rights and weigh them against the misuse of the English NHS by both England’s residents and those from overseas.”

      This is in line with the policy of the party whose leader was excluded from BBC’s “leaders special” Question Time last night. Such unacceptable policies no doubt the reason for his exclusion.

  4. Richard1
    May 1, 2015

    One of the competitions at this election is which group of politicians can look and sound more guey eyed as they say how much they ‘love’ ‘our’ NHS and promise it ever more money whilst avoiding any suggestion that any aspect of the NHS is anything other than perfect, other than the amount of money it gets from the govt. Unlike almost every other sector of the economy or aspect of govt, there is no discussion at all of international comparisons in healthcare outcomes. It is axiomatic that the NHS is ‘the best in the world’. Underperformance against other countries in, eg, cancer and heart disease diagnosis and treatment is not mentioned. We do not focus on the horrors of the mid-staffs disaster.

    There are some politicians such as the (relatively) sensible LibDem Norman Lamb who say we should take the NHS out of politics and dispassionately consider the best solutions for it. I suspect however that they mean only within the constraint of the current structure, they don’t mean let’s look at much higher private sector involvement if that means better care, like in Switzerland, Germany, Singapore etc.

    1. libertarian
      May 1, 2015

      Richard 1

      I agree mostly with what you are saying ( according to World Health Organisation the NHS is a lowly 18th position in terms of efficacy )

      However you’ve just made the same mistake you accuse Lamb of, i.e. offering a solution before you’ve analysed the problem.

      Now I’m a free market libertarian however just privatising the NHS as it presently stands is no better a solution. We need a huge review and debate about the nature of health care needs in England and THEN and only then start to look at the various alternative ways of structuring/funding it.

      1. Richard1
        May 1, 2015

        Not at all – I am simply saying all options should be on the table, including the use of private hospitals etc (which btw I would not count as ‘privatisation’ which I would say means the sale of state assets). I don’t know what Mr Lamb’s views are other than he wants a non political approach to the NHS. I would say fine to that so long as consideration is not constrained by a requirement to have c 95% of it state owned and controlled. The point at the moment is there are no political parties, including UKIP, which are prepared to discuss this issue.

  5. Cheshire Girl
    May 1, 2015

    I noticed that on Question Time last night. David Cameron promised 7 day GP services. However only two days ago there was an Article in the Daily Telegraph saying that there was a shortage of GPs, due to an increased population, more older people and the fact that many GPs are taking early retirement.
    I think it is very dishonest of politicians to promise something they they know is unlikely to be deliverable, but they do this again and again and think that the electorate will not notice.

  6. JoeSoap
    May 1, 2015

    You’re right, little will change or be different whoever wins. Again, there are opportunities to improve organisation and streamline real needs to the supply of medical services, but it seems this will not happen whoever wins.
    Unlike the case of an EU referendum, people seem to be blinkered in the case of the NHS and politicians are happy to follow this lead.

  7. Denis Cooper
    May 1, 2015

    “It was Labour who set up a lot of the most expensive PFI schemes when in office, encouraging the private sector to profit from providing new NHS facilities.”

    But it was the preceding Tory government which started it off, apparently picking up the idea from Australia, and left it there for Labour to expand and abuse.

  8. Denis Cooper
    May 1, 2015

    Off-topic, I watched Nigel Farage answering questions from an invited audience on the BBC, with the presenter Jo Coburn behaving more like a heckler, and I was struck by the youth of the audience in Birmingham compared to that in Leeds earlier. One girl even appeared to be wearing a school blazer!

  9. Richard1
    May 1, 2015

    Off topic but has anyone got any idea why the BBC has failed to mention that according to polls Mr Cameron won last nights debate? The BBC have also managed to find a few selected members of the public who were critical of Mr Cameron but had praise for Mr Miliband. The BBC needs to come within Ofcoms regulatory ambit and needs to move to a subscription model. I can’t recall an election in which the BBc has been as biased as in this one.

    1. Roy Grainger
      May 1, 2015

      Amusingly the current chairman of the BBC has got all excited about the proposal to fund the BBC via a levy on all households whether they have a TV or not. Apparently they do this in Germany. He has hailed this as a “modern” idea despite the fact a poll tax dates from 1275 in England and I seem to recall the BBC reporting with relish the opposition to one under Margaret Thatcher.

    2. Richard1
      May 1, 2015

      The BBC did in fact draw attention to Mr Cameron’s victory in the debate on the Today programme

  10. Lifelogic
    May 1, 2015

    The “free at the point of use” NHS, as currently structured, with a top down, government run command system will never deliver top quality health care. The NHS will always have to be rationed by delays and other back door methods of non delivery. These NHS rationing & delay systems cost a lot to run, yet clearly deliver a negative output.

    True the US and other countries systems have huge inefficiencies and problems too. There are however far, far better ways to structure the system. Firstly at the very least make people coming into the country pay a deposit or take some insurance, get rid of the NHS litigation culture and expensive lawyers with an agreed (lowish) fixed level compensation system, get rid of (or at least charge) for homeopathic and vanity treatments.

    Sort out the protective and restrictive trade unions that over protect so much of the medical profession.

    Charge for GP visits, A&E, ambulances (for all but those who really cannot pay). This so people consider the alternatives of taking a taxi, going to the chemists or seeing a private doctor.

    Above all just encourage people to eat less, consume less fatty, sweet junk, smoke less, drink less and do some gentle exercise.

    1. Chris S
      May 1, 2015

      I agree with everything you say in this post.

      Mid Staffs and other scandals have not done enough damage to slaughter the sacred cow that is the NHS. Politicians are not nearly critical enough and the staff and unions play on it for all their worth.

      Like anything that is “free” customers do not demand enough of it. My GP surgery has a sign on the door saying it will be closed from 5pm this evening till 9am on Tuesday. Why ? Will less people fall ill over the bank holiday weekend ? Of course not. Do other essential services such as ourgas or electricity supplies stop working over a weekend ? Of course not.

      A large proportion of the NHS appears to be organised much more for the benefit of the staff than it is for the patients.

      This kind of service would not be tolerated if we had to pay for it directly.

      1. Lifelogic
        May 1, 2015

        “A large proportion of the NHS appears to be organised much more for the benefit of the staff than it is for the patients.”

        Of course it is but the same applies to the whole of the state sector that eats up nearly half of the UK’s GDP and delivers so little of value. The staff and bureaucrats have far, far more input to the system than the patients (or other service recipients) who have virtually no input, influence or power.

        A vote once every five years for a career MP (who will rarely even try to do what they promised they would) is hardly a serious or functional mechanism of control over the state sector? They are largely outside of any serious democratic or financial control – rather like the lefty loons at the BBC.

      2. ju
        May 1, 2015

        Stop your moaning. The general public don’t value anything that is free at the point of abuse. There’s widespread misuse of the service, a shortage of staff and/or insufficient funding for a 24/7 GP service. Emergency coverage is available. You get what you pay for.

      3. Lifelogic
        May 1, 2015

        Also being “free” at the point of use kills nearly all competition to it. They already have taken you money so most cannot afford to go anywhere else and so may private medical services find it rather hard to set up and compete with the “free” NHS service and still make a living.

      4. stred
        May 2, 2015

        Another example of NHS treatment last week. A neighbour has a serious condition resulting in severe tremor. Six years ago he was denied an implant which would have given symptomatic relief. He was almost 75 then and, despite paying his NI stamp all his career and being otherwise fit, did not have enough ‘qualis’ – as invented by NICE. Now we read that a leading consultant is saying that the implants are very successful and cost less than the alternative drug treatment after 3 years. He now cannot walk to his taxi but remains as intellectually sharp as ever. We will try to argue his case via the back door, as one has to do.

    2. Lifelogic
      May 1, 2015

      Also give some tax relief to people who make private provision rather than using the state. Rather than mugging they further for benefits in kind tax or insurance premium tax. Do the same for education too.

      1. ChrisS
        May 1, 2015

        Margaret Thatcher proposed a voucher scheme for education and maybe health as well but not sure on that.

        It makes eminent sense to allow someone to use their own resources to top up whatever the state contributes for education. It would allow many more parents to have wider choice for their children. At the moment private education and healthcare is restricted to those with enough resources to pay twice over.

        Of course, the socialists would just see a voucher scheme as another benefit for the rich. Their whole attitude is based on greed and envy rather than fairness and common sense.

        1. Lifelogic
          May 2, 2015

          Indeed the left is all about greed, envy, magic money trees, quack economics, tax borrow and waste and playing Father Christmas with other people’s money.

          Alas Cameron is rather too similar to them.

  11. agricola
    May 1, 2015

    Not a lot I would submit. The NHS has been allowed to become the equivalent of the scriptures and anyone who wishes to alter them does so at their peril. If business was run on this basis it would not last long because the market place is constantly changing.

    For me there is only one immovable tenet of the NHS, and this is that it should be free at the point of need. Maybe a bit of personal responsibility needs to be injected into this, but basically it should stand.

    How the service delivers at the point of need is up for debate. I am not fussed if it was all down to private enterprise should that prove the most efficient way of doing things. The end result is what counts.

    Opposition will come from trade unions involved because change could alter the degree of control they exercise in certain areas. Opposition will come from fundamentalist politicians to whom private is bad and government is good. You find much the same response in education.

    What we require is some out of the box thinking from key politicians with track records in successful business. People who are prepared to question the flat Earthers and offer a less mediaeval approach to navigating the seas of medical need among the population.

    A basic problem with this are the long term needs of the NHS as a business entity and the short term nature of politics. The NHS needs to be shifted sideways and as far as possible away from the day to day vagaries of political thinking. Establish a model and then let it get on with things. Governments function is to tell it how much money it can have to achieve it’s ends.

  12. Denis Cooper
    May 1, 2015

    Also off-topic, one of the many lies that Clegg told during the earlier programme was his claim that the LibDem position on an EU referendum reflects current law passed under the auspices of the coalition government, the European Union Act 2011.

    That is not the case. Under that so-called “referendum lock” law if a proposed change triggered a referendum then the referendum would be just on the proposed change, while under LibDem (and Labour) policy it would be an “in-out” referendum.

    So, to take an obvious example, the people would never be asked whether they wanted to adopt the euro, with EU membership continuing irrespective of the answer they gave to that question, instead they would be asked whether they would prefer to stay in the EU with the euro as their currency or leave the EU altogether.

    It should be obvious that it would be far more difficult for opponents of the euro, or indeed any other step towards an EU federation, to win a referendum structured like that, rather than a referendum just on the proposed change; and as for the Tory party, well they might have great difficulty finding anything relevant to say in the campaign for any such referendum, because their stated preferred option of staying in the EU but not joining the euro would simply not be offered on the ballot paper.

  13. agricola
    May 1, 2015

    At last a real debate last night with an audience of real and intelligent people and away from the controlled political soundbite news submissions.

    Cameron undoubtedly came out on top, but strong condemnation of the BBC for omitting Nigel Farage. He , as outright winner of the EU election deserved a place and the same scrutiny as the other three. The BBC should not be allowed the degree of political freedom they enjoy. They have almost become a party in their own right which is totally wrong for a public service broadcaster paid for by the general public and the EU. I conclude that they must be terrified of Nigel Farage and all he stands for. For those of you who find yourselves anti UKIP, ask your selves who will the BBC choose to ostracise next, it could be you.

    1. oldtimer
      May 1, 2015

      There was a separate half hour question time with Mr Farage in Birmingham broadcast at 10:50pm yesterday. It is or will be available on the BBC iPlayer I expect. It was an odd layout as he did not face the audience but was placed in the middle of it. He answered all the questions put to him directly and without hesitation. His advantage over the other political leaders is that he is not boxed in by Westminster group think – he thinks and speaks outside that box.

      1. Lifelogic
        May 1, 2015

        Also on most policies he is clearly sensible and right, On HS2, on quack energy, on the size of the state, on the EU, on tax levels and complexity, on defence, on non racist points based immigration……. But on the NHS he is surely wrong to defend the “free” at the point of rationing & a virtual monopoly/state provision (if they feel like it) system.

      2. Chris
        May 1, 2015

        Farage was excellent and displayed the honesty, conviction and statesmanlike behaviour that is so lacking in our current batch of Government ministers. UKIP’s manifesto for the NHS is way ahead of the other Parties as it is not afraid to identify and confront the fundamental problems which afflict the NHS, and offer common sense solutions.

    2. Lifelogic
      May 1, 2015

      “BBC think” – Endless green crap, EUphile and for ever more tax, borrow & waste, fake government enforced “equality” and for an ever larger and more intrusive state sector – pervades all of the BBC, the EU, most of the state sector and nearly all of LibLabCon. Cameron too is “BBC think” to his very core.

    3. Qubus
      May 1, 2015

      Just watched Nigel Farage’s last night’s performance on iPlayer.
      I don’t think that there was a single thing that he said that I disagreed with.

      He puts the other party leaders to shame.

      Reply Politics is both about good policies and having the necessary support for them in the Commons so you can implement them. UKIP is not going to be taking us out of the EU . Conservatives could get in to government to give us an In/Out referendum. The choice is yours.

      1. willH
        May 1, 2015

        Reply to reply, UKIP may not be able to” take us out of the EU” on it`s own at this election, but if enough of us vote for them they could have some influence in the next parliament. Many of us have no faith in Mr Cameron doing anything but a fudge to keep us in the EU. This is obvious from the way the EAW was pushed through and the way he tried to pretend he wouldn`t pay the increased contribution and then caved in a day or two later. If we keep voting him in we will just get more of the same. Don`t suppose you`ll tell us but did Mr Farage say much last night you couldn`t agree with?

        Reply I did not watch him as I do not think he and Ukip are going to do well this election, Ukip has taken quite a lot of the policies and views I have argued for as well as saying some things that I do not agree with.

        1. Chris
          May 2, 2015

          Reply to reply:
          You did not watch him as you thought he and UKIP are not going to do well? What an extraordinary answer. Does it not interest you what many millions of voters are concerned about and are voting for – voters who have left your Party and who feel that Cameron has radically altered Conservatism? Are they to be dismissed as not worth bothering about, in similar fashion to Matthew Parris writing about the inhabitants of a certain seaside resort? I find this very arrogant, highly concerning and merely confirms the gulf between the present Conservative Party and grassroots.

          Reply I know what voters are concerned about and have spent years trying to sort the EU mess myself.

      2. Lifelogic
        May 1, 2015

        Cameron will not be taking us out either, with all his favourite Ken Clark wing mates still there. He will never hold a “fair” referendum. Better than Miliband, true but not very much. At least with Cameron we might not get the insane landlord thefts and counter productive attacks on non doms and 52% income taxes.

      3. bigneil
        May 1, 2015

        Reply to Reply – – Really? – Conservatives will give a referendum? – if someone had carried through one of his infamous pledges/promises he wouldn’t be in this position now. I don’t believe there is a single person in this country who trusts him. He is the most devious untrustworthy thing ever known. “heir to Blair”? – -worse than Blair would be nearer the truth. I would rather trust a dozen cobras.

      4. Anonymous
        May 1, 2015

        Reply to reply

        John. NOBODY is going to be taking us out of the EU.

        The referendum will not give us an ‘out’ result – especially after the bias and scare mongering has done its work. And even if it is ‘out’ there will be another referendum, and another until we give the right answer.

        The reason I am voting UKIP is because I believe in what they believe in and that I no longer have any affinity with the Tory Party.

        I now realise that by voting tactically in the past I have been making a huge mistake.

        You have already indicated on this blog that Ukippers’ support for the Tories will disappear into a black hole instead of garnering respect for their sacrifice.

        When – because of this – the UKIP support collapses Tories will mock Farage and say “Where is UKIP now ???”

        Can you not see why his plain speaking and sheer common sense appeals ?

      5. Chris
        May 1, 2015

        Reply to reply: Mr Cameron is not trusted to frame a fair question for the referendum. You may find that truth unpalatable, but it is the reality, so a “cast iron/iron clad promise” from Mr Cameron is viewed by so many as absolutely worthless. That is one of the key problems facing the Conservative Party – the electorate’s lack of trust in the current Cons Party leader.

        1. stred
          May 2, 2015

          I have been trying to imagine how I would feel when voting for Eural instead of Faragein order to keep out Milliband/Salmond. Try thinking of something which would make you feel bad but unable to do anything about it, such as having a sudden stomach upset in Waitrose and finding there are no toilets.

          Here in Ireland, we are visiting nuns in a retirement home after being sent back from London after their convent was flogged off. They like Nigel Farage best, as they think he is the only honest political leader in both countries.

        2. Denis Cooper
          May 2, 2015

          There’s the question, and it is well known that the wording of a referendum question can introduce a bias one way or the other. But that inherent bias is usually only a few per cent, and it would pale into insignificance compared to the overwhelming effect of almost all of the mass media organisations being firmly in favour of EU membership and having no scruples about what lies they repeat, or even invent themselves, to make sure that we vote to stay in.

  14. formula57
    May 1, 2015

    There is a huge difference, material to the well-being of the NHS as the historical record shows, between your party and Labour and its rests on personalities. Your party will not appoint a Secretary of State who does the like of repeatedly refusing relatives’ demands for investigations into malpractice where hundreds died, approves trust status without proper scutiny of plans, and enjoys the distinction of being the only person in history to privatize an NHS hospital. The public have a right to be reminded!

  15. Bert Young
    May 1, 2015

    The NHS cannot continue the way it is presently run . Any huge organisation has to be broken down into different manageable units ; such units ought to be based on specialisations and localities . I have witnessed the appointments of individuals to the central controlling body with little or no connection to the health service , these appointments were wrong . Interaction with the Private Sector is inevitable .

    1. libertarian
      May 1, 2015

      Bert Young

      Totally agree

  16. Brian Tomkinson
    May 1, 2015

    JR: “Conservatives have promised to recruit more GPs to offer longer opening hours and week-end service.”
    I shall be interested to see your progress.
    Seven day working, guaranteed shorter access times, and more GPs and nurses—have been described by Mark Porter, the BMA’s chairman, as “outlandish and unachievable.” As I have written before, many older GPs are retiring early, younger ones are emigrating, particularly to Australia, New Zealand and Canada, and new recruits are hard to find given the pressures of the job and the unfavourable way GPs have been portrayed by some politicians and the media.
    I note that you didn’t mention the £30bn funding gap that must be filled. I understand that £22bn of that will require savings some of which will require efficiency gains never before achieved by the NHS. The other £8bn you have pledged from increased growth in the economy in other words mere speculation.

    1. a-tracy
      May 1, 2015

      I’m sure they mean just going back to the pre 2004 GP contract, when GP’s used to open their surgeries for emergency telephone triaged patients for an hour or two on a Saturday morning and the same on a Sunday evening. On rota between several local town practises. It worked for years until Labour broke it.

    2. acorn
      May 1, 2015

      “53,176 people were detained for more than 72 hours under the Mental Health Act in 2013/14”. One of many staggering statistics for NHS England. http://www.nhsconfed.org/resources/key-statistics-on-the-nhs . Look at the “International comparisons” bit particularly.

      Many years back, in pursuit of the Conservative Holly Grail, (privatisation of Education and Health that is); there was a plan knocking around to centre the NHS on what we call Acute Hospitals. There was to be a national infrastructure company, a national drugs supermarket that would buy train loads of aspirins and discount retail them to the hospitals.

      All the GPs, would be employees of the Hospitals. In fact everything cradle to grave, health-wise, would be centred on the Acute Hospital hub and spoke service integration. In todays terms, I guess each hospital would have had a budget approaching three quarters of a billion to look after a third of a million Englanders.

      Privatising such a system would be a nightmare. At present the Treasury sends £2,000 for each of us to NHS England, whether or not we use it. What if the state ran a health insurance scheme with the first £2,000 of treatment free and it paid, say, 90% of the rest of £9,000 for a hip replacement. How many fewer hip replacements would be done?

      Reply Conservatives never favoured such a scheme

  17. Roy Grainger
    May 1, 2015

    The election outcome will make virtually no difference to the NHS because all parties are scared to do anything significant to change it.

  18. Kenneth
    May 1, 2015

    The problem is that the media measures NHS performance on how much money is spent on it.

  19. Max Dunbar
    May 1, 2015

    Much as I admire you and your measured approach to most of the topics that you raise for discussion on this excellent site, I am disappointed that you appear to have allowed yourself to indulge in personal comments about former Prime Minister Gordon Brown’s facial expressions. The reference to Miliband and his banana is pointless. Would it not have been enough to say that the media made stupid personal attacks on these men?
    I don’t think that you would allow us, your correspondents, to air views such as these on your site however oblique they may appear to be?

    Reply I was not making personal attacks on them, but the opposite, and chose 2 politicians who are no longer involved in UK Parliamentary politics for obvious reasons with an election underway.

  20. Bill
    May 1, 2015

    Has anyone worked out:

    1. how many, if any, of the NHS’s problems are due to use of the service by immigrants, illegal or otherwise?

    2. how much the clogging up of the A&E clinics are due to changes to the working hours of GPs? If GPs worked at weekends as previously, we would surely not have all the A&E waiting times we now see flagged up.

    3. what percentage of the vast NHS budget is spent on management, what percent spent on medics and what percent is spent on equipment, cleaning, food, drugs, maintenance of buildings, lighting, heating and so on?

    Without basic information of this kind we cannot make any proper decisions.

  21. majorfrustration
    May 1, 2015

    There are only two things that politicians do as regards the NHS (1) talk about it (2) throw money at it.
    Agree with many points of lifelogic – especially the insurance cover for people visiting the UK. Also with EU visitors to this country any non payment by their countries for health costs arising in the UK should be deducted from our EU contributions.
    These do seem quite simple things to put in place but Government does nothing

  22. Antisthenes
    May 1, 2015

    There is a tremendous amount of waste, inefficiency and lack of accountability in the NHS as there is in everything the government runs; quangos, network rail, MOD the list is long. Of course this is inevitable as they are nearly all virtual monopolies and management has no profit incentive to motive them to do things to gain customer satisfaction or give value for money.

    So when you say there will be no difference whoever is in government after the 7th I do not believe that is true. Socialist policies and more money for the NHS will only make those who work for the NHS better off without improving services for the patient that much. Labour have done precisely that before and when you look at the likes of Mid Staffs and others it is almost certain they made it considerably worse.

    Conservative policies that involve reform of provision and funding by increasing privatisation ( I am pretty certain Mr Redwood you also believe that is the policy that should be pursued) will make a considerable difference in improving the NHS. I know that the coalition did not get very far with those reforms but it has started to. Without the dead hand of the Lib-Dims and with a clear majority to govern then despite the intransigence of public opinion (who cannot tell the difference between a sacred cow and a sick cow) the Conservatives can improve the NHS and bring it up to the standard of the French health service who do believe in considerable privatisation.

  23. mick
    May 1, 2015

    I have watched all the tv debates now, much to the annoyance of my wife, and can i say Mr Farage came top with Mr Cameron coming a close second on all the debates, also i think Mr Cameron played a good poker game in that getting Nicola Sturgeon in on the debates as helped hopefully for the labour lib/dem`s vote in Scotland to collapse, and that the tory`s can get the magic number to be the overall majority party with the help of UKIP MP`s to run our Great country again

  24. oldtimer
    May 1, 2015

    OT: Fraser Nelson has a good post on Labour spending during the Brown years and Miliband`s denial that the last Labour government overspent.

    He makes the point that Miliband probably believes what he said even though it is obvious to observers that Brown let public spending rip well before the financial crash.

  25. English Pensioner
    May 1, 2015

    Do our politicians realise how long it takes to train a doctor form “A”levels to a GP? Unless they bring in large numbers of foreign doctors, (which I consider to be morally indefensible) there is no way these promises can be met. The situation has not been helped as due to feminist pressure, more female doctors than male doctors are being trained although the overall total remains broadly the same. A female consultant friend of mine tells me that something like three-quarters of the female doctors in the NHS are working part time resulting a fall in doctor availability, something that has occurred at the practice which I attend. My last GP retired, telling me that he went into medicine to treat patients, not to meet targets, engage in politically motivated medicine and become an office clerk.

    1. Lifelogic
      May 1, 2015

      There is no need for it to take so long to train doctors. Many could be trained far more quickly perhaps, just for more specific fields of activity without needing six years.

      Many doctors do fairly repetitive jobs that you could train an intelligent person to do competently in less than six months.

  26. Ex-expat Colin
    May 1, 2015

    Quite a contrast between the QT audience last night and the mostly shallow brained young on: (BBC Birmingham also last night)

    Election 2015: Ask Nigel Farage

    The same old questions that have been constantly answered by Farage, but still the nark voices are present.

    So its Tory/Ukip I hope and that will not be easy unless of course the Tories start turning to common sense. A glimmer from a different Cameron last night I thought.

    Labour looses 2 candidates to expense fraud and drink driving of late (England and Scotland). Might get easier for you Mr Redwood if that kind of thing picks up speed?

  27. Mitchel
    May 1, 2015

    Difference…between Conservatives and Labour over the past 15 years or so?

    Judged by actions rather than words, a line from Isaac Babel’s great autobiographical collection of stories from the Russian Civil War,Red Cavalry,comes to mind where an old Jewish shopkeeper bemoans the depradations visited upon his community by both the Red and White armies with “tell me which is the revolution and which is the counter-revolution”.

  28. Denis Cooper
    May 1, 2015

    Bank runs in Greece because the government has run out of money to pay pensions:


    A fate which the Labour averted for pensioners here by getting the Bank of England to create £200 billion of new money and indirectly lend it to the Treasury.

  29. ian wragg
    May 1, 2015

    As I pointed out a few days ago, for the first time I have come head to head withg the NHS having lived and worked abroad for many years.
    I was appalled at the sheer waste of manpower and equipment.
    This was not A & E which I accept is usually busy, this was routine clinics with an appointment system. It would appear that the appointment is ignored as we arrived on time but was seen an hour late in a not too busy department.
    Going through into consulting rooms we were left for half an hour and then had a 10 minute consultation. I watched many staff congregated discussing a variety of topics, non NHS related. The Doctor was telling all and sundry about a conference he had attended and the goody bag he received.
    Eventually the temporary boot which had been fitted to my Mother in Law was removed, I asked if I should return it to the local surgery but they said no it would go to the incinerator.
    It was a day old appliance costing between 2 and 3 hundred pounds.
    She then had a cast fitted in about 15 minutes after an hours wait and we left at 5.30 which seemed to be close of play.
    In the cast room there were 6 fully equipped bays but only one in use even though there was an abundance of staff.
    The whole 30 minute actual work took us 4 hours and the lady is 88 years old.
    If we ran the power stations on the same lines, the lights would be out.

    1. stred
      May 2, 2015

      I asked why they don’t take crutches and walking stands back and was told it costs more to clean them than to buy new! Really?

  30. Anonymous
    May 1, 2015

    It really doesn’t help that a lot of GPs are women who have taken expensive NHS training and expect to be able to job share – or go on long maternity breaks.

    This goes for other jobs too – especially ones where unsocial shifts can be opted out of.

    More boys in medical school please.

  31. Ken Moore
    May 1, 2015

    The NHS is in need of root and branch reform to make it a service that puts the needs of patients above those of the GP’s and pen pushers. The answer isn’t spending more money – ‘bad money’ can do more harm than good in my view.

    Demand needs to be controlled and back office costs slashed in half.

    Unfortunately the Conservatives are showing the same weak and incompetent leadership that led them to endorse the Iraq war and Labours 2005 spending plans.
    They will never learn from their mistakes it seems.

  32. Jon
    May 1, 2015

    I don’t get it, spending on NHS has not been cut but politicians are allowed to say it has been.

    I’m no fan of regulation but our media and political framework allows for politicians to lie.

    This is an issue of constitution and media governance, due diligence. I think this area needs to be addressed. The reasons for the formation of the IFS, to scrutinise party economics was good. Do we need to expand this further?

  33. marg brandreth-jones
    May 2, 2015

    Theoretically correct, but plans are manipulated to serve the clique. You would not believe the way things are made worse and voices are given to those who have twisted the truth .Power given to the wrong hands is spoiling Community health and the political parties listen to those manipulators. It is so sad.

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