A Labour government
could boost the NHS by committing a specified proportion of national wealth to
fund it and setting up a new independent body to ensure ministers give it the
money it needs, the shadow health secretary has said.
Labour is looking into the
practicality of having a new fiscal rule that would guarantee the health
service a minimum proportion of government spending, modelled on the existing
processes that allocate specified percentages for defence and overseas aid.
If that existed, a Jeremy
Corbyn-led administration might decide to try to get British health spending
back up to the European average as a share of gross domestic product, as Tony
Blair’s Labour government did in the 2000s.
“I’m attracted to the idea of having an OBR-type body
which assesses NHS finances, maybe at the start and middle of the parliament,
[and] assesses the state of the NHS,” Ashworth said in an interview.
“I’m attracted
to the idea of an independent body, because we’ve seen in recent weeks the
political arguments over the £10bn [that May claims her government is giving to
the NHS in England].
“An independent body would
give certainty and an extra level of scrutiny.”
An authoritative independent body
would both help ministers decide how much money the NHS needed to cope with
rising demand caused by an ageing population and check on the government’s
progress towards delivering those amounts, Ashworth said.
This month he told a House of
Lords inquiry into the sustainability of the NHS that he favoured the creation
of a watchdog that “gives periodic reports on the financial pressures on the
NHS, what is needed and what are the workforce pressures, and offers a degree
of objectivity in the planning which is sightly separate from the political
knockabout that inevitably happens in the House of Commons.”
Other opposition parties also support the creation of a
body to monitor government spending on the NHS.
Norman Lamb, the Liberal
Democrats’ health spokesman, has said he favours “an independent periodic
assessment of how much you need to raise to spend on achieving an effective and
efficient health and care system”.
Lamb told the Lords inquiry:
“In
an age when trust in politics and politicians is at an all-time low, creating
an independent process that gives people some sense of reassurance about the
amount that we need to spend makes it much easier to make the care for
increasing the amount people have to pay, if necessary, to fund the system.”
Philippa Whitford, the SNP health
spokeswoman, also backs creating a new watchdog but believes the OBR’s remit is
too limited, given that the National Audit Office issue regular updates on NHS
finances.
“What you require is an arm’s length body that is part of the
decision making so that it does not become nailed down into the five-year
[parliamentary] cycles,” she said.
Leading health thinktanks have thrown their weight behind
the calls for an OBR-style body, which the Lords select committee is
considering recommending in its final report due in March.
But critics say the
NHS already has too many bodies with overlapping responsibilities.
Prof Anita Charlesworth, chief
economist at the Health Foundation,
said:
“New bodies such as the infrastructure commission have been put in place
to improve decision making, transparency and accountability.
“There is a strong
case for a similar independent body in health – an OBR for the NHS.
“A new
independent body to ensure the the NHS is not just delivering high-quality care
today but has the resources (money and people) it needs to meet the challenges
of the future.”
“The NHS has gone through cycles of boom and bust and
we would welcome plans to create greater certainty on future funding.
“We would
also welcome regular independent assessments of funding needs, [but] these
assessments should include social care as well as the NHS.”
But Prof John Appleby, chief
economist at the Nuffield Trust, said a new fiscal rule could mean the NHS ends
up getting less money than it needs.
“Fixing a minimum target spend
for the NHS may have its political attractions but makes less sense in economic
terms,” he said.
“In practical terms, too, it is not clear what such a minimum
should be or on what basis it would be chosen.”
Charlesworth
agreed, saying:
“Fixing health spending as a share of GDP would be an
improvement on the funding outlook for this decade, but it is unlikely to be
enough to match demand pressures on the health system in the long term.”
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