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As far as the NHS is concerned, the budget’s impact is hard hats, high-vis-vests and high resolution screens.
A promise to pay for tech to ‘cut-admin’, (More cash for Palantir?) and rollout 250 Neighbourhood Health Centres… by a hybrid funding scheme, public and private, to be announced later. They'd better get a move on... 100 are promised by 2030…
… eye-catching headlines, but let’s have look under the bonnet.
Using NHS benchmark costs…
... a simple building refurbishment, say £2,500-£3,500/m², and...
... for a full new-build health centre, call it £3,500-£5,500/m²…
... all up, £4m a piece for a health centre. Mmmm...
Thats a lot of don't-mention-PFI-funding.
By the way, English local authorities take an average of 248 days (nearly nine months) to issue a planning approval for major applications.
The construction industry itself is struggling… labour shortages, spiralling costs, supply-chain instability, limited contractor capacity, and…
… new buildings don’t treat patients. People do.
Where are the GPs, nurses, physios and pharmacists going to come from? Or, is the plan to drive GP partners (working in their own health centres, we call surgeries) out of self employment, into a waged economy in, well… health centres?
Dunno.
The rise in the minimum wage will add ~£250m a year to NHS staffing costs. A largely invisible but unavoidable uplift driven by cleaners, porters and estates staff whose pay often sits on or hovers just above, the legal floor.
You might call them ‘working people’…
... to use the Chancellor’s vocabulary.
Collectively, ‘working people’ (and who isn’t), will be paying, one way or another, £8.3bn in extra tax, thanks to the budget.
How does any of this help ‘working people’ get quicker treatment in the NHS? It doesn’t.
We know the elective waiting list stands at around 7.2m. To get back to the 18-week standard, the list needs to fall by around 4m…
… shifting that lot by the next election? No chance.
So, ‘working people’, aka you, are to be taxed more, for what? How will it move you, yer other half, or kids, or mother-in-law any closer to the front of the NHS queue?
You know the answer.
Who can we look to for some guidance?
I’m tempted to say not NHSE board member, advisor to Wes Streeting and Milburn… Paul Corrigan.
In an interview with the HSJ, discussing who will take over from the Jim Reaper, Corrigan said;
‘… it is needs to be someone who recognises that the NHS is not a golden cow to be put on a plinth and revered above all other public services.’
This rhetoric is an attempt to create a new sound-bite on former chancellor of the exchequer, Nigel Lawson’s comment;
‘… the NHS is the closest thing the English have to a religion.’
It was an arrogant and thoughtless thing to say, by someone who thought himself a bit of a toff. Actually, I think he was a bit of a numpty.
In trying to be too-clever-by-half, Corrigan overlooked the fact that it is Hindus who revere cows; viewing them as a sacred symbol of life, motherhood, and selfless giving.
The NHS obviously isn’t a religion but it is full of people who care a lot about life, saving it and improving it.
Know all about motherhood and supporting it...
... and everyday are selfless in what they give to our NHS, above and beyond their wages and taxes.
Millions of ‘working people’, look to the NHS to take off their shoulders the worry of illness, accident, getting old and happenstance.
It was a stupid thing to say. Crass... but, Corrigan’s not all bad. He also said;
‘… when someone says ‘where’s the money going to come from [for improving NHS services]’… my answer is ‘we thought we’d use the stuff that’s [already] there’.’
He’s right about that.
The budget’s been a fiasco, more leaks that a colander but if there is £300m floating around, it could have produced much better, quicker and certain results in the NHS, if we’d used the money, as Corrigan says, ‘to make better use of the stuff we’ve got’…
… GP practices already exist, in the neighbourhood and Corrigan knows what a mess Darzi centres and polly-clinics ended up in.
The trouble is, we all know ribbon cutting is much more important to Streeting than cutting waiting lists.
Corrigan… have a word with him.
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