Theresa May's likely funding promises for the NHS have more to do with saving her party than our health service

The Tories should dust down New Labour’s manual and make some specific promises

Theresa May will get a rare opportunity to change the music from Brexit in the next few days when she announces a significant increase in funding for the NHS to mark its 70th birthday. The rise, likely to be between 3 and 4 per cent on top of inflation, will be in a “long-term NHS plan” designed to end the uncertainty caused by “feast followed by famine”.

May has made a big call: the Conservatives cannot go into the next general election with the NHS in crisis. Its current parlous state will only get worse without a step change in funding. Allies believe the ultra-cautious prime minister has made a bold choice, backing the health secretary, Jeremy Hunt – who has lobbied skilfully for a rise in line with the long-term NHS average of 3.7 per cent in real terms – over the chancellor Philip Hammond, who wanted to keep the increase closer to 2 per cent.

The money will make a real difference. The Tories should dust down New Labour’s manual and make some specific promises about how it will improve the service. Priorities will include cancer treatment, mental health, maternity care and hitting repeatedly missed targets for A&E services and operations such as hip replacements.

Still, although the extra billions will grab headlines, will it be enough? The annual budget rise will probably start with a 3, but a lot will depend whether it’s closer to 3.1 per cent or 3.9 per cent. Respected think tanks have called for a 4 per cent rise.

The Institute for Fiscal Studies said 3.3 per cent would merely allow the NHS to stand still, with an initial 5 per cent catchup rise, followed by 4 per cent later, needed to secure real improvements. So a key test will be whether the new money is front-loaded rather than spread evenly.

The safest bet in the world is that Labour will say it is not enough and that it will not match the £9bn a year the party has promised. More important will be the reaction of Simon Stevens, the chief executive of NHS England, as ministers need his seal of approval. So as they finalise their figure in what Hunt has called “difficult” negotiations, they would be wise to get as close to 4 per cent as possible. One official said: “We might end up in a grey area.”

May’s language will be studied very carefully. Brexiteers, led by Boris Johnson, are champing at the bit to call the cash boost a “Brexit dividend”. May might be tempted to nod in their direction; she needs all the friends she can get when neither the pro or anti-EU Tory factions trust her.

But the NHS money will be found despite not because of Brexit, and it would be misleading to trumpet it as a Brexit bonus. The UK’s divorce payment will be £40bn, and that’s before the hit to economic growth and knock-on effect on funding for public services. The NHS will not get a £350m-a-week cheque from Brussels.

In the real world, Hammond will increase borrowing and taxes. He does not want a tax rise that would require legislation, like Gordon Brown’s 1p rise in national insurance contributions in 2002, as he fears a Commons defeat. So he is looking at a more stealthy route, by delaying or scrapping Tory promises to raise tax thresholds. This will not please Tory MPs, who still clamour for tax cuts, even though having American levels of tax and European-style public services has finally become unsustainable.

May has made the right call: health could cost the Tories the next election. They need to show voters austerity is over and has brought a reward. With Labour committed to raising taxes, the Tories can afford not to promise to cut them.

The other test of the government’s announcement will be what it says about social care. Hunt wants to “truly integrate” it with the NHS, but Whitehall sources suggest health funding and a long-awaited green paper on care have been “decoupled,” which would be a mistake.

A timely report today by the IPPR think tank says that delayed discharges from hospitals cost the NHS £3bn a year. Lord Darzi and Lord Prior, who were health ministers under Labour and the Tories respectively, call for the NHS principle of free care to be extended to social care for those with “critical” or “substantial” needs (funded by a 1p rise in national insurance, and doubling the care budget to £36bn by 2030). They want to undo the parts of the 2012 Lansley reforms which act as a barrier to integrated care.

Hunt has changed his and his department’s title by adding social care to health. The government should now make them live up to their names, and allow the NHS to survive for another 70 years, by creating a National Health and Care Service.