‘Billions more for the NHS’ pleads Boris

Cash injection: Figures adjusted for inflation, showing a tenfold budget rise in 60 years.

Should we give more money to the NHS? As hospitals are gripped by a winter crisis, Boris Johnson has urged the government to increase funding. But some say cash cannot save a broken system.

As the Cabinet met yesterday, all eyes were on Boris Johnson. Morning headlines claimed he would urge the government to spend billions more on the NHS — a demand beyond his remit as foreign secretary. In the end he did not raise “specific figures” during the meeting, but was “slapped down” by Theresa May nonetheless. She insisted that all Cabinet discussions must stay “private”.

Some are sceptical about Johnson’s passion for healthcare. MP Caroline Lucas accused him of “political posturing”. But the debate on NHS funding rages on regardless.

Right now the health service is gripped by a “winter crisis”. Patients are reportedly dying in corridors as hospitals are pushed to breaking point. Doctors recently wrote an open letter warning that the NHS is “chronically underfunded”, with people “dying prematurely” as a result.

Many think more cash is needed, with the Financial Times calling the case for extra funding “indisputable”.

However, some argue that spending more is not the answer.

It is all to do with how the NHS works. Almost 99% of its budget comes from taxes and national insurance. And for the majority of patients it is free to use.

But some say this creates problems. Journalist Jeremy Warner argues that in an effectively “free” health service, demand is “never sated”. According to this logic the government could constantly top up the budget but it would never be enough. More patients will always want treatment — particularly in an ageing society.

Instead, some think patients should pay towards the specific care they receive. Economist Kristian Niemietz argues that this would “limit unnecessary demand”.

Others think extra funding should come from compulsory health insurance. This is the system in Germany where people must pay for medical cover on top of taxes.

And then there is the case for efficiency; in other words, making the NHS do more with the money it has. Last year the director of clinical quality Tim Briggs claimed that the NHS does not “deserve more money” until it improves its “quality of care”.

So should we inject more cash into the NHS?

Life-support

Of course, some say. The case for extra cash has nearly unanimous support, and even the health secretary has called for "significantly more funding". Hospitals around the UK are being pushed to the edge, with thousands suffering unnecessary misery. We must give them the cash they need.

That just fuels a broken system, others respond. Of course the situation in hospitals is bad, but we must think long term. An ageing society is putting a bigger burden on the NHS than ever before. We must completely restructure how we fund and use healthcare, or else the whole thing will come crashing down.

You Decide

  1. Should we allocate more money to the NHS?
  2. Should those who can afford healthcare be required to pay for it?

Activities

  1. Some think that it would be good if the NHS did more to prevent illness by encouraging a healthy lifestyle. What are the main things that people can do/avoid in order to be healthy? Design a poster which encourages people to live well.
  2. Read the Financial Times editorial and the Jeremy Warner piece in Become An Expert. Which article do you find the most convincing and why? Should the NHS remain completely taxpayer funded?

Some People Say...

“The NHS will last as long as there are folk left with faith to fight for it.”

Aneurin Bevan

What do you think?

Q & A

What do we know?
According to the Institute for Fiscal Studies, UK health spending grew in real terms by an average of 1.3% per year in 2009-10 and 2015-16. However, this is below the average growth of 4.1% per year between 1955-56 and 2015-16. The 2017-18 healthcare budget works out at around a £2,200 spending for each UK citizen.
What do we not know?
We do not know if NHS spending will increase beyond what has already been confirmed. In response to Boris Johnson’s call for more money, Philip Hammond, the Chancellor of the Exchequer, remarked that he would simply “look at departmental allocations again at the spending review when that takes place”.

Word Watch

Billions more
For 2017-18 the planned spending for the Department of Health is £127.4 billion. In his Autumn budget Philip Hammond pledged an extra £6.3 billion to be spent on the NHS over the course of this parliament.
Open letter
Signed by doctors in charge of emergency departments in 68 hospitals.
99%
According to the King’s Fund.
National insurance
In the UK national insurance contributions qualify citizens for certain benefits and the state pension.
Majority
Charges are applied for dental treatment, eye tests, and prescriptions.
Ageing society
According to the King’s Fund, the UK’s population of over 65s is growing much faster than under 65s. In the next 20 years the population aged 65-84 will rise by 39%. This will put an additional burden on the NHS as it costs more money to treat older people.
Pay towards
Some argue that some treatments could be means tested. This means that richer patients would pay for care, while those unable to pay would be treated without charge.

Subjects

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