It’s been a while since we had a nice big fat NHS row, but those who enjoy watching Andy Burnham and Jeremy Hunt fight over the ‘party of the NHS’ crown can rest assured that there’s a really bitter one coming up this autumn. NHS England has spent the past few months consulting on a change to the way clinical commissioning groups are funded that could end the current arrangement where more money per capita is spent on patients in deprived areas. The formula currently being considered would make the number of elderly people in an area a more important factor in the size of the grant that each CCG receives.
You can probably already guess how this will play out in the political arena, but firstly, here’s the argument behind changing the formula. The money for the CCGs funds hospital care and so on, not public health spending which might be quite useful in some deprived areas where poor health can be combated through certain educational and preventative drives. Currently the formula means that hospitals in rural areas with an elderly population receive a great deal less money, with considerably less being spent per capita in Cambridgeshire, for instance, than in Liverpool. But increased longevity means that elderly populations are becoming even greater sources of pressure on NHS spending because patients may well be living longer but they are developing increasingly complex and costly needs. This problem is only going to get worse, and it is part of the series of woes facing Conservatives representing rural seats that I list in my Telegraph column today.
MPs such as as Jesse Norman have already started making the case for this funding change – see his forceful Telegraph article on the subject earlier this week in which he links the hospitals in the Keogh Review to this funding imbalance – but I understand that Labour plans to make this one of its key campaigns for the autumn, along with warnings about a looming winter A&E crisis.
Andy Burnham will force a vote on the new formula in the House of Commons in November, and tells me:
‘It is nothing short of immoral to raid NHS funding of communities with the poorest health to give it to more affluent areas. This is not an issue of north vs south, but affects communities in all parts of the country. It cannot be right to take hundreds of pounds for every person living in more deprived communities only to give it to areas where life expectancy is already the longest.
‘It is a scandal and that is why Labour will lead a national campaign to oppose this pernicious shift and force a vote in Parliament later this month.’
Now, whether or not you agree with Andy Burnham, you’ve got to accept that he is a shadow minister who really knows how to campaign, and to deploy the most effective language and characterisations of his opponents in order to make their policies appear evil and indefensible. So he will create a row over this funding change, even if it is the right and sensible thing to do, and even though it is being considered by NHS England, which is independent, rather than ministers.
Incidentally, redistributing cash through a new formula will mean seats that tend to be Tory get more money, whereas currently seats that tend to be Labour benefit. So depending on which side you’re on, it’s easy to shout about gerrymandering with regard to one formula or another.
This is going to be a tough sell for Jeremy Hunt. One Tory MP who is not happy at all with the current arrangements remarked rather gloomily to me this week that ‘it makes sense, but of course we won’t sell it very well and we’ll end up getting slaughtered on it’. There is a clear case to be made for the formula changing to reflect the changes in our population’s healthcare needs, but it does need to be made, rather than there being any assumption that people will automatically understand it.Tags: Andy Burnham, Jeremy Hunt, NHS, UK politics