Labour laid the ground for Ed Miliband's NHS speech over the weekend by highlighting new figures showing that patients waited more than a week to see their GP on almost 50 million occasions last year. In his address in Manchester this evening, Miliband will offer his antidote.
He will unveil a "GP guarantee", promising that Labour will give all patients the right to an appointment within 48 hours if they want one - and on the same day if they need one. Under the coalition, the proportion seeing a GP within 48 hours has fallen from 80 per cent to just 40 per cent.
Labour plans to invest an extra £100m a year in family doctor practices, enough to pay for an additional three million GP appointments. One of the central aims of the policy is to reduce the burden on A&E and the number of avoidable hospital admissions. Labour cites studies showing that a 5 per cent increase in patients seeing their preferred GP could reduce emergency admissions by as much as 159,000 a year – saving the NHS £375m. The ambition, as a Labour spokesman told me, is to both "improve the health service and save money".
Labour plans to pay for the new investment by scrapping government rules which have led to unnecessary administration and legal fees (costing at least £78m) because NHS services are now under threat from EU competition law; and by cutting spending by the three main health quangos: Monitor, the Trust Development Authority and Commissioning Support Units.
The speech will be followed by an election broadcast tomorow night featuring Miliband volunteering at a hospital.
Miliband will say this evening:
In the year leading up to the next General Election and beginning in this local and European campaign the National Health Service needs to be on the centre stage of British politics. People remember the promises David Cameron made at the last election: the airbrushed posters and the three letters he said he cared about most: NHS. But we all know the reality now: the broken promises.
David Cameron said there would be moratorium on hospital closures.But he has taken on sweeping new powers to close services over the heads of local people. He said there would be no return to people waiting for hours in A&E. But last year more people waited for over four hours in A&E than for any time for a decade. He promised to protect frontline services. But a quarter of walk-in centres have been closed since 2010.
He promised that people should be able to see their GP '24/7' But a quarter of the public now say they can’t get an appointment in the same week. It’s a scandal that people are waiting that long, it is not how our NHS, the pride of Britain, should work.
And he promised there would be no more top down reorganisations.But he spent billions of pounds on a top-down reorganization that nobody wanted and nobody voted for which has put the principles of markets and competition at the heart of the NHS like never before: Aboost for the private companies and competition lawyers; a burden for everyone else.
Competition, fragmentation, and privatisation - that’s how the Tories see the future of our NHS and that’s why it is going backwards. David Cameron has broken his bond of trust with the British people on the NHS. He has proved the oldest truth in British politics: you can’t trust the Tories with the NHS.
"You can't trust the Tories with the NHS" may be a familiar Labour refrain, but it is no less effective for being so. Even after a concerted Conservative attempt to pin the blame for the Mid-Staffs scandal on the last government, the opposition continues to enjoy a 12-point lead on health. There is every reason for Labour to "bang on" about the NHS.
But while Miliband can reasonably point to savings that would be achieved by cutting bureaucracy, integrating health and social care, and devolving services, this will not be enough to plug te long-term funding gap.
At present, despite the common view that it has been shielded from austerity, the NHS is experiencing the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4%, but over the current Spending Review it will rise by an average of just 0.5%. As a result, in the words of a recent Social Market Foundation paper, there has been "an effective cut of £16bn from the health budget in terms of what patients expect the NHS to deliver". Should the NHS receive flat real settlements for the three years from 2015-16 (as seems probable), this cut will increase to £34bn or 23%.
If they wish to avoid a significant fall in the quality of the health service, this government and future ones are left with three choices: to raise taxes (my preference), to cut spending elsewhere, or to impose patient charges. With this in mind, Labour figures have begun the tough work of considering which taxes, most obviously National Insurance, they could raise in order to sustain a free, universal NHS. But that remains a battle for another day.