Blog 2023 Malcolm Blair-Robinson

The NHS is chronically underfunded, the more so if you include social care. The much trumpeted £20 billion a year extra  to be reached over five years is really inadequate, as the government very well knows. The budget of roughly  £125 billion sounds a lot but in the context of the entire health system it is not.

The problem is and always has been that you cannot provide an infinite service on a finite budget, so this is not really a problem of amount. It is a problem of structural funding where the resource does not expand as demand does. Until that problem is faced up to and resolved, the whole NHS argument will continue, because ever more problems of underfunding and understaffing will present themselves, whatever short term fixes are organised.

Therefore what we have to look for today in the much trailed and leaked 10 Year NHS Plan is a new funding model which relates income to demand, rather than the reverse. Such a model can be, as it is now, a public service, but it would require dedicated rather than general taxation to pay for it. With the government’s two flagship responsibilities, Universal Credit and Brexit in varying degrees of chaos, indicating a systemic failure of governance, we must not raise high hopes. Better a pleasant surprise than yet another disappointment.