Robert Halfon is MP for Harlow, a former Conservative Party Deputy Chairman, Chair of the Education Select Committee and President of Conservative Workers and Trade Unionists.
Remember David Cameron, when he said “I’ll cut the deficit, not the NHS”.
Whilst the poster picture may have been lampooned, the message wasn’t. It was well received by the public and, for a time, Conservatives were either level with, or had a short lead over, Labour in polls on the NHS.
Somehow, since the NHS reforms during the Coalition – despite the best efforts of Jeremy Hunt – Labour regained a strong lead over the NHS. Public perception is either that we don’t care, or that the Government is cutting/privatising services, even though this is far from the truth.
Moreover, newspaper reports seem to indicate that the NHS is viewed by Party strategists in entirely transactional terms, ie ‘because Labour are ahead, we should only focus on the areas we are strongest at’, or ‘we can only be competitive with Labour on the NHS’.
This is both wrong and dangerous for a number of reasons.
First, because there is an umbilical cord between the public and the NHS. The health service is almost, at least in terms of social capital, part of our political constitution. In return for taxation, the public want a service that is free for all at point of delivery. Woe betide anyone who does not respect that.
Second, negative perceptions – however unfair – of Conservatives in relation to the NHS play into the damaging perception that Tories are not on the side of the vulnerable and those most in need.
Third, attitudes, perception, and polls aside, supporting the NHS is the right thing to do. It should not matter whether our Party is either behind or competitive with Labour on the issue. Despite its problems, the NHS remains a remarkable institution and it is the health system that the British people want.
But it does need reform. There needs to be a stronger correlation between the service it delivers and how much is being spent by the taxpayer to achieve it. Every user of the NHS should not only know what they are paying for, but how much it costs. They should also have a say on what spending should be.
Not only could there be a new hypothecated NHS/Social Care Tax, but in addition the Government should legislate for a new NHS referendum, to be held every ten years, on how much spending on the NHS there should actually be.
A public guarantee would ensure that in a new ten-year plan for the NHS, spending would always go up in real terms, according to the needs of the population. The public would then be able to decide how much they would increase funding beyond that real terms rise. They would be given various options that would translate to, for example, however many extra nurses, doctors, treatments, or hospitals their spending would buy.
I don’t believe for a moment that people would always vote for the lower option, given that, apart from the super rich, the vast majority of the population use the NHS. If the new NHS tax was hypothecated, they would understand what they were getting for their money. Because the public would have a real decision-making role, it would decrease the complaints that the NHS was not getting the resources it needed.
Jeremy Hunt rightly wants a ten-year plan for the NHS. Why not give the public a yearly guaranteed increase in real terms spending, but also a genuine opportunity to have a say in that plan?