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Editorial Wednesday 8 November 2017: Spreadsheet Phil will have to choose between the bus and the bust | Health Policy Insight
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Editorial Wednesday 8 November 2017: Spreadsheet Phil will have to choose between the bus and the bust

Publish Date/Time: 
11/08/2017 - 09:14

Fireworks Night was three days ago, but you wouldn't know it from NHS Commissioning Board boss Simon Stevens' bold intervention at the NHS Providers conference in Birmingham.

In a delightful display of political chutzpah, Stevens is using the '£350 million bullshit bus' to bolster the case for a meaningful funding increase in the Budget on 22 November.

Who's the audience for this intervention?

And will it work?

Bypassing the politicians
Ironically for a man who's better at politics than just about everyone currently working in British politics, Stevens is talking to Chancellor Philip Hammond ('Spreadsheet Phil) only indirectly.

Simon Stevens' re-use of the single most impactful and misleading political propaganda in the past decade is clearly meant to speak primarily to the British electorate - who are not political geeks (or by and large, wildly interested in politics).

If you can't beat the political liars, the reasoning seems to be, then steal their weapons.

The ethics of this repurposing of a big lie are debatable and interesting, but not today's principal issue. That is the issue of effectiveness. And it has won the media this morning, so it's effective thus far.

Will Spreadsheet Phil fold or hold?
The Treasury munchkins have been charmingly adamant that there is no more money for the NHS.

The numbers run by the Institute for Fiscal Studies don't suggest much room for manoeuvre. The Bank of England has started the process of hiking interest rates.

That would imply a need to raise taxes to get the extra money. Among other surveys, the latest British Social Attitudes survey shows some public support for that idea.

This is not a strong and stable Government, to put it mildly.

And with the shenanigans of Priti Patel and Boris Johnson working off licence (a couple of people you might think better-suited to running an off-licence), Spreadsheet Phil's dilemma is a spicy one.

Does he walk his party onto the blame for the explicit shit-fan integration that is surely coming to the NHS?

Or does he raise taxes to find the money?

To govern is to choose.