A conspiracy of vagueness over the future of the NHS

None of the parties has a credible plan for ensuring that more money produces better patient care

Sunday 22 March 2015 01:00

As was expected, George Osborne’s Budget was influenced by the imminence of the election. The Chancellor used the windfall of lower inflation and falling unemployment to make sure that Labour could not accuse him of wanting to go back to the 1930s. He adjusted his plans for public spending over the next five years to halve the difference between his plan and that of Ed Balls, his opposite number.

Mr Balls ought to take this retreat from the harsher shores of austerity, which was reportedly forced on Mr Osborne by the Prime Minister and his election chief Lynton Crosby, as a compliment. It implies that his argument for a slower initial path of deficit reduction is prevailing.

Naturally, Mr Balls has done no such thing, insisting that the Conservatives are still hell-bent on dismantling the welfare state as we know it. Labour’s new poster, “Next time, they’ll cut to the bone”, claimed: “The NHS can’t afford the Tory cuts plan.” This is not exactly scaremongering, but it is an unsophisticated rendering of a two-stage argument. Labour knows that the Tories have promised to protect NHS spending, but argues that deep cuts to local government would force more of the burden of social care on to the NHS.

The best that can be said is that this is at least an argument about policy substance, rather than the endless debate about TV debates, finally settled yesterday, or about who might do a deal with whom in a hung parliament.

But how much further all the parties have to go if they are to present you, the voter, with anything resembling an honest prospectus. Labour, the Liberal Democrats and Ukip have all proposed to increase spending on the NHS, but none of them has a credible plan for ensuring that more money produces better patient care. As we report today, bed-blocking by elderly patients is a growing problem and an indicator of growing pressures on the NHS.

More fundamentally, all parties aim to close the gap between getting and spending but remain hazy on the details. Paul Johnson, of the Institute for Fiscal Studies, was sceptical about Mr Osborne’s intention to cut £12bn a year from “welfare” within three years. “This will be difficult, and will inevitably hurt poorer families,” he wrote yesterday.

Mr Balls does not have to account for such a specific figure, but he has avoided spelling out the substantial cuts that he too would be obliged to make to reach his target of current budget balance over the next five years. The Liberal Democrats have been even less forthcoming, happy to hide behind the formula of “cutting less than the Tories and borrowing less than Labour”.

As for the minor parties (and we are not bound by Ofcom’s ruling that Ukip is a “major” party), their contributions have been less realistic still. The Scottish National Party has at least raised defence policy, questioning the UK’s nuclear deterrent, but its contribution to fiscal policy has tended towards easy sloganising against “austerity”. Ukip’s policy is whatever comes into Nigel Farage’s head the last time he was on TV and, as for the Green Party, it is probably polite to say as little as possible.

If this goes on, it will be close to a conspiracy of false accounting against the voters.

A general election ought to be a chance to weigh the big questions we face as a nation. How to make our schools better? How to protect the environment? What can be done to help young people find homes? What to do about Syria, Iraq, Isis and Russia? In too many cases, politicians want to change the subject, or offer gimmicks that fail to address underlying causes. The Independent on Sunday is committed to reporting on the choices the politicians would rather not talk about, and to holding them to account for their plans.

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