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Sunday, 4 June 2017

#GE2017 Conservative NHS spending openness and "real terms"

[ Short link to this article if you need it - https://goo.gl/g8GVjB - or retweet me ]

I'm slightly apologetic for posting a non-technical post in here but I'll make a thin connection by saying that in an era of openness and transparency where we can now use the internet and social media to interact and scrutinise policies more closely than was ever possible in the past, this makes for a curious case study. And it's one which the traditional media (from what I've seen) haven't yet taken them to task over. I should point out that in no way is this post intended as a general indication of any party policies or affiliation on my part, it's just the one that got my attention when I started spotted conflicts in the messages.

I'm confused, and I've read all of the manifestos. At the time of writing there is less than a week to go before the 2017 UK General Election, and I cannot figure out what on earth the policy of the incumbent Conservative (a.k.a Tory for those not in the UK) government is regarding spending on our National Health Service over the next parliament. The other major parties are each proposing somewhere around £30bn extra cash for the NHS to be paid for by increases on income tax. In contrast the Conservative manifesto (PDF) says:
"We will increase NHS spending by a minimum of £8bn in real terms over the next five years, delivering an increase in real funding per head of the population for each year of the parliament"
Now there are a couple of issues with this. Firstly it talks about £8bn over five years. That's not £8bn per year (which would be higher than the other parties) yet they say there will be an increase in real funding per head for each year. And that's before I get started on the ability to bend political statistics with the phrase "real terms" and variants thereof, which allows people on opposing sides to make conflicting claims using exactly the same data by including that phrase.

So assuming the population will increase - a topic that I'll come back to later on - there will be a real increase each year so the most obvious scenario is that they plan to put it in evenly so £1.6bn extra per year.

Except that 40m20 into the leaders debate - just after being laughed at for claiming they can be trusted - Amber Rudd, deputising for Conservative leader Theresa May who didn't want to appear, made this claim:

"[NHS] is getting £8bn/yr by the end of the next parliament"
Curious. Was this a slip of the tongue? Or is there really a policy to start throwing £8bn per year in? It appears to conflict what's in the manifesto.

On the Andrew Neil interview (13m08 in), Theresa almost reiterated the manifesto wording:

"There will be £8bn more money going into the NHS at the end of the parliament. That's a real terms increase, per head, every year"
I said "almost" because their seemed a crucial difference with that quote - she used the phrase "at the end of the parliament".  Which might suggest, taking Amber's comments into account too and on the assumption no-one made a slip-up, that they plan to put in a policy of £8bn/yr in place during the last year of parliament. So that would mean nothing for the first four years if it's going to be £8bn total as per the manifesto suggestion. But how does that tally with "real terms increase per head every year"? Maybe by drastically reducing immigration we'll end up with negative migration (we already have that in Scotland, though it's unlikely in the next parliament since even the Conservatives are only tentatively aiming for 100,000 net migration by 2022) which would increase per-head spending without actually putting money in. It dropped by 49,000 to 273,000 in the year to September 2016 which may be the start of a "brexit effect" with the value of the pound sterling dropping making us less attractive, or pro-EU citizens leaving the UK. The Conservative manifesto also proposes to double the "Immigration Skills Charge" for employing migrant workers, which may help with such a decrease. The only other option I can see is that "real terms increase per head every year" will be an average over the parliament, as opposed to a real increase in each year.

Also, unlike the other parties there's no publicised policy on where the £8bn will come from. The suggestion is that it is not new funding, but will come from redirections from elsewhere, or possibly from vague "blind faith" continued improvements in the UK economy - something that can't be guaranteed while we're going into the brexit process. If it really will be £8bn thrown in during the final year, that at least gives them some time to figure out where to take the money from. And cynically, it'll let them say "We're putting £8bn/year into the NHS" when they put their next manifesto together, unless they call another early election before five years - quite possibly since they also plan to repeal the Fixed Term Parliament Act. So if money is only going in during the final year of parliament, would we ever see it?

I did try asking my local MP but didn't get a reply ... To be fair I don't want politicians to be wasting time on potential twitter wars, but it would be nice to get a response to a clarity issue:
On the plus side, and to come back to providing a small justification for posting this on a technical blog, I've written and published this article before the Conservatives start trying to clamp down on the internet and regulate it more widely because "It is in no-one’s interest for the foundations of strong societies and stable democracies [...] to be undermined." - another manifesto quote from within their digital economy framework section. I really hope this doesn't start sending us down a road similar to China's State Subversion laws.



[ EDIT 7/6/2017: See also the BBC "reality check" summary of the parties'  NHS spending commitments and how they relate to spending over recent years ]