Editorial Wednesday 1 October 2014: The Curious Case Of Conservative Health Policy

With the delivery of Secretary Of State Jeremy 'Bellflinger' Hunt's conference speech yesterday and Prime Minister 'That Nice Mr' David Cameron's speech today, health policy fans have much to digest.

Let us start with Mr Hunt.

His tenure in office has been marked by a tension between the worse and better angels of his political nature. On the down-side, there is his Gove-ist, centralising performance management tendency ('good morning, chief executive, about your 4 hour A&E waits').

More positively, his frequently-stated commitment to patient safety and transparency has been welcome, and has gone alongside diligent recognition of just how hard the service has been working to keep the show in the road.

There are some contradictions. Mr Hunt voted at every stage in favour of the 2012 Act which aimed to decrease the Health Secretary's ability to intervene in day-to-day operational NHS management.

Curiously, in office, he has been an assiduous phone-caller to chief executives whose trusts are in breach of national A&E or other waiting time standards (the artists formerly known as targets).

In August alone, he chose to intervene in the day-to-day operational matters ranging from the huge of permitting managed breaches of waiting time standards to the less huge hardy perennials of car parking charges and hospital food.

Liberating the NHS?

Ahem.

Mr Hunt told the audience of lobbyists, hacks and partisans that his Government had "increased the NHS budget despite the financial mess Labour left behind ... we’ve just had the greatest squeeze on finances in NHS history because a Labour government lost control of our national finances".

Mmmmm.

Let's see. The NHS was in a £1.5 billion surplus for the last year of Labour's stewardship, data shows.

Any broader point about the 'financial mess' might be valid had the UK been the only nation whose finances were decimated by the global financial banking crisis. That was not the case.

Hard-of-thought, economically-illiterate journalists on national media brands have greedily lapped up and regurgitated Chancellor George Osborne's indefatigable, hog-whimperingly silly narrative of Labour profligacy as the root cause of the UK recession.

Lucky Tories. Lousy pundits.

(You might want to read this well-argued blog by Simon Wren-Lewis for more context.)

Currently, there is a £2 billion hole in the NHS budget for 2015-16, coincidentally.

The politics of Hunt The Shunt
Mr Hunt also warned Labour "don’t turn the National Health Service into a National Political Football and don’t use the NHS to divide us when it’s the fabric that unites our nation"; while also repeating his attack line that the "Labour Party that still refuses to learn the lessons of Mid Staffs", adding that "for Labour good headlines about the NHS matter more than bad care for patients".

The incoherence between these lines resonates with a hearty clang: a collision worthy of his near-namesake 'Hunt The Shunt'.

The contesting of which is the REAL party of the NHS during the general election campaign is unlikely to be pretty. Politically, it's going to be more cagefighting than football.

He also boasted that A&Es are "treating nearly 2,000 more people every day within the four hour target compared to 2010". This is of course true, but his Government's policy on the marginal rate tariff over 2008-9 level means that hospitals are losing money on the extra patients, to the tune of a cumulative £1 billion.

"There will be no more of those pointless reorganisations than aim for change but instead bring chaos"
Mr Cameron continued the theme of trying to fight on the NHS turf, recounting his 'how very dare you!' outrage at Labour "spreading complete and utter lies" on the NHS at their conference. he was curiously non-specific about what the lies were. Did Labour impugn the NHS's honour? Did they suggest it didn't pay its share of the damages on a Bullingdon piss-up?

He chose to put his personal experience of the NHS's care for his seriously disabled son centrally to his argument. Anyone with such experience has the complete right to do this. It does not afford the right for your record and arguments not to be scrutinised, and no doubt the Prime Minister will welcome that scrutiny.

Financially, he promised more of the same flat-real-terms funding: "The next Conservative Government will protect the NHS budget and continue to invest more". Inflation will account for the continue to 'invest more' bit.

Mr Cameron is a politician, and he will hear what he wishes to hear. Sources across the NHS, from providers to commissioners to system leaders, do not believe that the 2015-16 budget (for which £2 billion remains to be found, remember) is deliverable.

As things stand, there is going to be an NHS financial crisis. The only question now is how soon.