In the days following the publication of the Tory manifesto the Telegraph trumpeted “Tories pledge £8bn rise in NHS spending.” It added, “Conservatives would also triple the fees charged to migrants for using the NHS, to help raise more funds from overseas patients.”
The overt racism of this proposal shouldn’t surprise us. But what of the £8 billion pledge? The figure is over the course of the next government, so roughly £1.6 billion per year.
In 2010, the year the Coalition government was formed and the onslaught of policy designed to speed up privatisation of the health service began, only 5 percent of NHS trusts and foundation trusts overspent annual budgets. According to the Kings Fund, by the end of 2017 this figure will have risen to 51 percent with a predicted overall deficit of £2.5 billion. In other words, the first tranche of the “extra” cash won’t even cover the deficit so far.
The overspend trend is set to continue, even as we see more ward closures and staff cuts. Why? In large part as a result of these staff cuts. To make up for staff shortages the number of (much more expensive) temporary locum and agency staff has rocketed. This has exposed the nature of pay and workforce supply policies put in place to hasten cost cutting in a bid to enhance the NHS’s saleability to private capital.
According to The Perfect Storm, a survey of rising NHS costs, staff shortages are likely to persist bevause the number of nurse training places has declined by 20 percent over the last decade. The rising costs, resulting from policy initiatives, also provide a useful ideological tool with which to undermine the idea of a nationally funded health system.
The government’s Five Year Forward View, which outlines its plans for making “productivity” savings in the NHS up to 2020, encourages NHS Trusts to make cuts in permanent staff. The strategy is patently counterproductive for a centrally planned and managed national health service. It might make some sense if what you want to develop is a splintered, decentralised system of competing private health capitals.
So we might see the £8 billion in this light — as a temporary bung to Trust managers to support them as they progress towards full privatisation through lowering costs by increasing the rates of exploitation of fewer staff. The government is also helping with this project more indirectly by capping the hourly rates paid to agency staff, which currently run in excess of 60 percent more than the hourly rates of pay of substantive staff.
Meanwhile, PFI, though relatively less important than staffing cost issues, continues to leak millions out of the system each year into the pockets of private finance capital and speculators.