Yesterday Jeremy Hunt, the Health Secretary, wrote in The Observer, about the implications for the NHS should the UK decide to leave the European Union. He said:
“Investing in the NHS will always be a priority for this government, but the simple fact is this: an economic shock would put pressure on our finances. According to the OECD, Greece, Portugal, Spain and Italy all cut health spending per head following the economic crisis.”
The mention of those countries rather makes the point that being shackled to the European Union is no guarantee of a flourishing economy and the generous spending on health which accompanies it. Nor does being outside the EU mean that health spending would be under greater constraint. Switzerland has four time the per capita health spending as Greece, Norway spends almost five times as much as Portugal, Australia twice as much as Italy, New Zealand nearly twice as much as Spain. And so on.
Hunt partly makes the obvious point that the more money you have, the more you can spend – on stuff, including health. Ho hum. Where he is wrong is in suggesting this cause is advanced by remaining in the EU.
If we decided to leave and there was a debate about what to spend our £13 billion membership sub on, there is no doubt that Hunt would be pushing everyone else out of the way in the stampede to The Treasury.
David Laws, the former Lib Dem MP who was very briefly Chief Secretary to the Treasury, says in his book Coalition:
“The awkward squad were Home Secretary Theresa May, Business Secretary Vince Cable and Culture Secretary Jeremy Hunt.
“Jeremy Hunt had clearly already received the full Department for Culture, Media and Sport indoctrination in how to deal with the threat of the Treasury axe…. Jeremy then said that if he could not get a good settlement from me, he would be willing to appeal to the Chancellor. I wasn’t impressed with this attempt to bully me, and was confident that George Osborne would feel obliged to support me….I decided to agree a final figure that was lower than the minimum amount I wanted, but on the strict condition that Jeremy Hunt would have to deliver the full cuts in the next, far more serious, spending round that was to come.”
Needless to say, when the next round came along Hunt was still fighting like a tiger for maximum taxpayer spending on arts subsidies. Surely he would fight just as hard for the NHS?
But let us assume that instead, the broader view was taken that the long term priority for health and other public services was a strong economy. Would Hunt not agree that £13bn of tax cuts could have a rather beneficial impact in economic growth – say, for example, by cutting the rate of Corporation Tax to the level in Ireland?
Then Hunt has another argument concerning freedom of movement. He says:
“Another issue is the damage caused by losing some of the 100,000 skilled EU workers who work in our health and social care system. Uncertainties around visas and residency permits could cause some to return home, with an unpredictable impact on hard-pressed frontline services.”
So the contention is that even if the British Government said these workers could stay, they might decide to leave due to the uncertainty of being obliged to do so at some stage in the distant future. But having control of our immigration system would make it easier to find the skilled workers we need – for the NHS and elsewhere. This is because there would no longer be the pressure caused by an open door to all 500 million EU citizens – whether skilled or unskilled.
Where has the Labour Party been in all this? They have been a bit slow to rally to Hunt’s side.
Then there is the problematic issue of the EU-US Transatlantic Trade and Investment Partnership – popularly known as TTIP. Many Labour MPs, trade union officials, and left wing activists have been warning that this agreement would mean the “privatisation” of the NHS. This is a question of definition. For many Conservatives it is a practical matter of how the best standards can be provided to patients, free at the point of use, for the resources available. If this means a bigger role for the private sector – including “US corporations” – having the chance to tender for services then that’s fine. Many on the Left take a less sanguine view. They certainly have a point in saying that the decision about the extent of private involvement in the NHS should be a democratic matter to be resolved in Parliament – not a decision imposed by the EU.
Hunt’s intervention has the feel of pre-emptive strike by the Remain campaign. They know the Vote Leave campaign will be telling us rather a lot about how many doctors and nurses and new hospitals could be paid for with the funds currently being handed over to the EU. But I wonder if Hunt really has his heart in it. I suspect his enthusiasm for our EU membership is broadly equivalent to that held for it by his namesake, the Leader of Her Majesty’s Opposition.
One of the sorrier spectacles we have to look forward to over the next three months is of Ministers pushed in front of the camera to justify our continued subservience to our EU masters. Does Hunt really believe it? Does Sajid Javid? Does Oliver Letwin? To paraphrase Peter Sarstedt “are those the thoughts that really surround them when they are alone in their beds?”