Jeremy Laurance: This option would hurt, however you did it

Share
Related Topics

Like a favoured son, the NHS grew fat during the years of plenty under Labour, doubling in size in real terms. Now it is suffering the envious jibes of rival departments, placed on starvation rations, questioning how it can justify its protected status.

Its size alone makes it a juicy target – £105bn for England in 2010-11 – more than education and defence combined. Could it sustain 25 per cent cuts in line with those being demanded of other departments?

From one perspective it looks do-able – cutting by this margin would take the annual budget down to £78bn in today's money, which is where the NHS was in 2004-5, according to Professor John Appleby, chief economist at the Kings Fund. But that was a health service with fewer staff, fewer operations and longer waiting lists. Reversing the improvements made over the last six years would have to be achieved in the next three. It would mean slashing and burning jobs and services.

The only practical way of achieving the required cuts would be to remove whole services. Dentistry could go, saving the NHS £1.6bn annually – many patients pay privately already and dentistry is being privatised across the world. NHS sight tests, fertility treatment and terminations could also be axed.

The NHS workforce of over 1.3 million is one of the largest in the world, and its paybill accounts for half the total budget (70 per cent of the budget in hospitals). Cutting jobs is the quickest way of saving money – but the effects would be felt in longer waiting lists. The Royal College of Nursing reports today that 10,000 posts have been earmarked for cuts, twice the number two months ago, as trusts struggle to meet £20bn "efficiency" savings demanded over the next four years.

Professor Appleby said measures on the scale needed would be "hugely painful". It would be impossible to protect patients from the impact which would make them politically unpalatable.

An alternative would be to charge £10 to see a GP or £25 for an overnight stay in hospital, raising several billions. People earning over a certain income might be forced out of the NHS (while continuing to pay taxes towards it) and required to buy private health insurance, as in Holland.

The net result would be a service that cost patients more and delivered less. Whether it would qualify for the title "National Health Service" is hard to say.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

SQL Report Analyst (SSRS, CA, SQL 2012)

£30000 - £38500 Per Annum + 25 days holiday, pension, subsidised restaurant: C...

Application Support Analyst (SQL, Incident Management, SLAs)

£34000 - £37000 Per Annum + excellent benefits: Clearwater People Solutions Lt...

Embedded Software / Firmware Engineer

£40000 - £45000 per annum + Pension, Holiday, Flexi-time: Progressive Recruitm...

Developer - WinForms, C#

£280 - £320 per day: Progressive Recruitment: C#, WinForms, Desktop Developmen...

Day In a Page

Read Next
 

Dominic Raab: If Western politicians’ vested interests protect Putin, take punishment out of their hands

Dominic Raab
Monday - Israel  

Between the wars in Israel, spending time in a kibbutz was about as cool as you could get

Peter Popham
Screwing your way to the top? Good for Lana Del Rey for helping kill that myth

Screwing your way to the top?

Good for Lana Del Rey for helping kill that myth, says Grace Dent
Will the young Britons fighting in Syria be allowed to return home and resume their lives?

Will Britons fighting in Syria be able to resume their lives?

Tony Blair's Terrorism Act 2006 has made it an offence to take part in military action abroad with a "political, ideological, religious or racial motive"
Beyoncé poses as Rosie the Riveter, the wartime poster girl who became a feminist pin-up

Beyoncé poses as Rosie the Riveter

The wartime poster girl became the ultimate American symbol of female empowerment
The quest to find the perfect pair of earphones: Are custom, 3D printed earbuds the solution?

The quest to find the perfect pair of earphones

Earphones don't fit properly, offer mediocre audio quality and can even be painful. So the quest to design the perfect pair is music to Seth Stevenson's ears
US Army's shooting star: Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform

Meet the US Army's shooting star

Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform
Climate change threatens to make the antarctic fur seal extinct

Take a good look while you can

How climate change could wipe out this seal
Should emergency hospital weddings be made easier for the terminally ill?

Farewell, my lovely

Should emergency hospital weddings be made easier?
Man Booker Prize 2014 longlist: Crowdfunded novel nominated for first time

Crowdfunded novel nominated for Booker Prize

Paul Kingsnorth's 'The Wake' is in contention for the prestigious award
Vladimir Putin employs a full-time food taster to ensure his meals aren't poisoned

Vladimir Putin employs a full-time food taster

John Walsh salutes those brave souls who have, throughout history, put their knives on the line
Tour de France effect brings Hollywood blockbusters to Yorkshire

Tour de France effect brings Hollywood blockbusters to Yorkshire

A $25m thriller starring Sam Worthington to be made in God's Own Country
Will The Minerva Project - the first 'elite' American university to be launched in a century - change the face of higher learning?

Will The Minerva Project change the face of higher learning?

The university has no lecture halls, no debating societies, no sports teams and no fraternities. Instead, the 33 students who have made the cut at Minerva, will travel the world and change the face of higher learning
The 10 best pedicure products

Feet treat: 10 best pedicure products

Bags packed and all prepped for holidays, but feet in a state? Get them flip-flop-ready with our pick of the items for a DIY treatment
Commonwealth Games 2014: Great Scots! Planes and pipers welcome in Glasgow's Games

Commonwealth Games 2014

Great Scots! Planes and pipers welcome in Glasgow's Games
Jack Pitt-Brooke: Manchester City and Patrick Vieira make the right stand on racism

Jack Pitt-Brooke

Manchester City and Patrick Vieira make the right stand on racism
How Terry Newton tragedy made iron men seek help to tackle their psychological demons

How Newton tragedy made iron men seek help to tackle their psychological demons

Over a hundred rugby league players have contacted clinic to deal with mental challenges of game