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Editorial Monday 22 September 2014: 'Let them eat mansions. And fags.' Labour edge towards reality on NHS spending

Labour have briefed the BBC's Nick Robinson to trail an announcement of increased NHS spending in Ed Miliband's leader's speech tomorrow - his last as leader before next year's General Election.

The annual revenue increase is understood to be £3 billion - yet the only definitive new tax revenue stream is the proposal for a 'Mansion Tax' on houses worth over £2 million. The IFS suggests this would raise about £1.7 billion. (It would have the political side-effect of not alienating particularly high numbers of probable Labour voters.)

(UPDATE: The Guardian's Patrick Wintour suggests that further funding could come from a windfall tax on tobacco companies.)

Now the NHS will almost certainly need more than an extra £3 billion a year. The transformation fund called for bypracticallyeverybodyserious might well need to be about £5 billion.

At some point, if the current economic recovery continues, it will no longer be tenable to hold staff wages flat, for example.

But it's a start: an acknowledgement of reality. It marks a move away from Mascara Kid Andy Burnham's  previous position that the NHS could have no further funding rise until every (naturally unidentified) inefficiency were driven out.

This is of a piece with some very worrying reports that various figures in the Treasury consider that the NHS has far more to do in productivity gains.

Reliable sources have suggested that some Treasury thinkers believe it may be possible for the NHS to do everything it does now with 20% less funding that it currently receives.


It's slightly disturbing to find such hog-whimpering stupidity in the Treasury, but there we go.

There is some inefficiency in the NHS, no doubt. There is some inefficiency everywhere.

Yet realists acknowledge that the NHS is showing all the signs of a serious financial and performance crisis.

The NHS also is just one of the claims on the public purse. Education, research and development, diversifying the economy, housing, transport infrastructure, decarbonisation and adaptation to climate change - oh, just go and read Flip Chart Rick's updated analysis of the figures.

There is also significant opacity over whether Labour's apparent policy to reunite health and social care will entail another redisorganisation of management structures. The Mascara Kid's latest major speech gives few clues.

Nonetheless, Labour has seen sense and crossed the psychological barrier of admitting that the NHS is going to require more resources next May - possibly with major urgency. Much depends on the severity of this winter in climatic terms, or a flu pandemic (which we are overdue).

Winter as a euphemism for pressure no longer has real currency in the NHS. Winter pressures are the new normal - inevitable, when you flatline the funding and demand rises from an ageing and more frail population.

But it's a start from Labour - an attempt to be candid that public services require proper funding. That is a positive glimpse of adult politics, and we should welcome it.