I don't often differ wildly from the ConservativeHome editorial line. I don't often stray too far from the mainstream views of Conservative members, save being a bit more obsessive than most about individual liberty and a tad more open to reform. But on this rare occasion I must disagree with 63% of you and support David Cameron's plans to "ring fence" NHS spending and continue to increase it at an above inflation rate.
You see it's not because I believe savings cannot be made in the NHS without directly cutting services. Savings can be made, lots. Billions upon billions. Local pay deals, better contracting, an end to Labour's bizarre management style and the introduction of more business like management - with greater use of the private sector - would and indeed will save a fortune. But all such savings will soon be gobbled up by the benign but extremely hungry health monster. New drugs, new treatmments, and an ever greater need for staff to administer these life saving marvels will be compounded by the aging population.
As more and more people live longer lives, and as more and more people live years on medication - perhaps from childhood in some cases, middle age in many more - the costs will continue to tick up. Here we are not alone, America - which spends 15.6% of its GDP on healthcare compared to our 8.3% (2005 figures) - expects to spend one-fifth of GDP on healthcare by 2018. Hopes of returning money from the healthcare budget to taxpayers or using it to partly plug the budget black hole just aren't realistic, and we'd be both fooling ourselves and worrying voters if we banked on it even as an option. In healthcare we must at least walk briskly to stay still.
But the biggest argument for increasing health spending is what I'd call the "Is this what we pay our taxes for?" argument. Currently we pay our taxes and in return get access to the NHS as and when we want it, or rather as and when it wants to. You wait ages for an appointment. You wait ages in A&E (only the NHS would have the cruel ironic joke of a 4-hour waiting target for a department with 'Emergency' in its title). You get shunted onto an open ward where a curtain and 18-inches separates you and a total stranger, the food is dire, the place filthy, the bathroom miles away, and the control of treatment in the hands of others... And so you complain to yourself (or I do anyway); "Is this what we pay our taxes for?" In short we have two options.
We could freeze or cut the budget, save a few quid but nothing to write home about, but get a poor service, ever more rationing of new drugs, etc. Call it the Relliant Robin option. Or we could spend a bit more (France spends 11.1% of GDP), reform a lot more, and get a Rolls Royce of a health service.
The axe may have to fall harder elsewhere, but healthcare is a life and death issue. We have all paid into it. We will all continue to pay into it, even if it was cut. So we may as well pay a little more and get what we want.
