The NHS is killing us – and gradually bankrupting the nation while it does so


Jeremy Hunt is right about one thing: if you think you’re overtaxed by the Tories, it’s guaranteed to be even worse under Labour.

In a speech on Friday, the Chancellor claimed that Keir Starmer would put up taxes “as sure as night follows day” to fund his big spending pledges. Arguing that the Tories were forced to dig deeper into taxpayers’ pockets to pay for the furlough scheme, the energy price guarantee and billions of pounds of cost of living support, Hunt claimed: “Conservatives recognise that while those tax rises may have been necessary, they should not be permanent. Labour do not.”

There would appear to be some truth to this statement, since Starmer has repeatedly refused to commit to tax cuts or unfreezing tax thresholds. On the contrary, I recall him speaking far more enthusiastically about who and what Labour would tax more – be it the “top 5 per cent”, private schools, non-doms, the air that we breathe, and such like.

The word “tax” formed only a footnote to Labour’s new pledge card, unveiled by Starmer in Thurrock, Essex, on Thursday, which proffered the woolly promise of “delivering economic stability”, and only a vague commitment to keeping taxes “as low as possible”.

But beyond all the flip-flopping and flim-flam, there’s a single reason why Labour will never be able to cut taxes and is more likely to raise them. It’s not the party’s multibillion-pound green prosperity plan or even its costly New Deal for Working People, designed to keep its public sector union paymasters happy. No, the real reason Starmer will never be able to bring down the tax bill is the NHS – revered as a religion in Labour circles.

If it wasn’t bad enough that Labour is set to inherit the sort of “no money left” scenario Liam Byrne passed onto his successor as chief secretary to the treasury David Laws in 2010, it will also be bequeathed a health service whose productivity has collapsed.

A comprehensive internal study of NHS efficiency published this week revealed that, despite an increase of £20 billion in funding and about 15 per cent more doctors and nurses, it is carrying out barely more routine treatments than before Covid. Productivity, admitted NHS finance director Julian Kelly, is actually “still lower than it was pre-pandemic”.

Consider that for a moment. Despite all the billions that have been poured in; everything we did during the pandemic to “save the NHS”; the recruitment of thousands more doctors and nurses – hospitals are 11 per cent less productive than they were before lockdown was imposed in March 2020. That’s a damning indictment of an organisation which received £182 billion of our hard-earned cash last year.

NHS bosses insist that around half of its productivity problem is beyond its control, arguing that the teetering social care system makes it much harder to free up beds, while an older, sicker population requires more care. They also blame a campaign of strikes for delaying hundreds of thousands of procedures and point to a significant maintenance backlog. 
Yet while a rise in delayed discharges may have been identified as a driver of lower efficiency, it surely only tells part of the story. The truth is that a lot of this has been of the NHS’s own making – and bosses’ tendency to bury their heads in the sand rather than take responsibility has only made matters worse.

As the Telegraph’s whistleblower exposé has highlighted this week, one of the NHS’s greatest failings is its lack of accountability. The story focused on the fact that doctors and nurses are being hounded out of their jobs for raising safety concerns. One consultant described it as “the biggest scandal within our country” after it emerged that more than 50 doctors and nurses have been targeted after raising concerns about upwards of 170 patient deaths and nearly 700 cases of poor care. We have been warned that the true number of avoidable deaths is “astronomical”.

What was notable about the investigation is that this problem is particularly acute in the NHS. Indeed, if private clinics ignored whistleblowers’ concerns, they could go out of business. In the NHS, however, there never seems to be a penalty for failure. In fact, the more it fails, the more taxpayers’ money it appears to receive. Meanwhile, the middle managers who preside over these sorts of scandals only seem to end up getting promoted.

The Birth Trauma Inquiry report, also published this week, provided another chilling example of history repeating itself in the NHS and nothing changing. Despite lessons supposedly having “been learnt” after maternity scandals at Shrewsbury and Telford, Morecambe Bay, East Kent, Northwick Park and Nottingham University hospital trusts, the report concluded that poor care is still “all too frequently tolerated as normal”.

Amanda Pritchard, chief executive of NHS England, said the experiences outlined in the report “are simply not good enough” without actually saying what the NHS was going to do about it.

And this is the problem. The question of who is ultimately responsible for NHS failings is a difficult one to answer. The public wants to hold ministers accountable – not least because the Department of Health sets the overall strategy, and funds and oversees the health and care system in England.

But what we have witnessed over recent decades is a passing down of responsibility to commissioners and arm’s length bodies, muddying the waters when it comes to where the buck stops.

Even NHS England seems to see its role as being accountable to Parliament, rather than to patients. And the waters of responsibility are muddied further by quangos like the UK Health Security Agency and the Office for Health Improvement and Disparities (both formerly collectively known as Public Health England), which prepare for and try to prevent problems – but, as we witnessed during Covid, lack accountability when the proverbial hits the fan.

So the NHS isn’t failing because of a lack of money or even a lack of staff. It’s failing for the very practical reason that aspects of it are very poorly run by unaccountable managers who not only do not take responsibility for their actions, but aren’t held responsible for their actions, either. That’s clearly a recipe for disaster that no funding formula can fix.

Wes Streeting, the shadow health secretary, might have you believe he agrees that the NHS needs reform, not reverence. But do we really think his party will countenance the radical measures needed to save the health service now? It’s spent far too long worshipping at the NHS altar – and is too in hock to the public sector unions – to make that likely. So the next time the NHS comes begging for money, Labour is likely to hand it over.

We’re damned to have a health service which not only fails patients, but which will bankrupt the nation, too.