In the run up to the general election I am wary of many statements I hear abut the NHS and social care. One general statement is that 'it isn't all a question of money'. This is true - of course it isn't all about funding. But what are we to take from such a statement. It is usually made when people complain about the level of funding. It is a 'catch all' reply. It is also somewhat disingenuous as a reply because it is meant to avoid the real issue, funding. We now spend 17% less on social care than we did I've years ago. This is not surprising because social care is mostly funded through local government, which has seen its financial support from central government cut by over 40 per cent in real terms since 2010. Yes, 40%! That is the nature of what we have been doing over the last 5 years to 'cut the deficit'.
In his budget last week Mr Osborne cut taxes on beer and spirits to try to generate a 'feel good' factor for the general election. It was a cynical ploy. His 'cuts' in taxes leave a £10 billion black hole in funding for public services. If he was serious about cutting the deficit then he wouldn't cut his tax revenue.
We have been in a strange state of hear no evil, see no evil in relation to 'the deficit'. One of the successes we might have been proud of in the decade running up to 2010 is that pensioner poverty had bee substantial reduced. Now that has been reversed with spending on the elderly cut by 17% in real terms over the last five years.
Overall spending on adult social care services was £14.6 billion last year with 46 per cent of that spent on people over 65. From April this year the Better Care Fund will transfer £3.8 billion from the NHS budget to support spending on social care. This should also benefit the NHS by reducing pressure on hospitals. But let's face the facts of this. It is arranging the deck chairs and not necessarily fixing the problem.
The NHS has endured cuts of some £20 billion in 'efficiency savings'. This is another euphemism I am wary of. There is an idea that we can cut funding in ways that does not affect 'front line' services. It is as if the 'front line' was not dependent for function on the back staff, when of course it is. We hear often of the admin work that front line staff have to do.
Another statement I am wary of is 'we are spending more on the NHS'. Again it is true, but it is disengenous. Spending on the NHS has gone up in real terms during the last five years by and average of 0.9 % per year. This is the lowest average annual change of any parliament. It contrasts with average annual increases of 5.7 per cent under the Labour administrations between 1997 and 2010 and 3.2 per cent under the Conservative administration between 1979 and 1997. Even Thatcher outspent this coalition government on the NHS!
Yet with massive cuts in funding for social care the burden has increasingly fallen on the NHS. The result: an NHS crisis.
So as we rejoice over a pint of beer let's think of the cost of that penny cut in tax.