Jeremy Hunt delivers a speech during his visit with David Cameron to the Evelina London Children's Hospital on July 5, 2013. Photograph: Getty Images.
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Jeremy Hunt to meet Frank Field to discuss NHS funding crisis

Health Secretary agrees to look at Labour MP's plan to raise National Insurance to fund higher spending. 

Today brings yet more evidence of the NHS funding crisis. As the Nuffield Trust's Into the Red report notes, 66 trusts are now in deficit and require hundreds of millions of emergency funding, and the service is running a total national deficit of £100m compared with a surplus of £383m last year. Of the 78 health leaders surveyed by the group, 47 per cent said it was quite (33 per cent) or very (14 per cent) unlikely that the NHS would remain free at the point of use in a decade's time. 

Without a real-terms increase in spending in the next parliament, the funding gap will stand at £30bn by 2021. Demographic pressures, the rising cost of technology and the growth in chronic conditions all mean that merely ring-fencing the service from cuts will not do. 

In my column in this week's magazine, I look at how Labour is grappling with this issue. The most notable proposal has come from Frank Field, who has argued for a 1 per cent rise in National Insurance, accompanied by the lifting of the floor on contributions and the removal of the ceiling. He told me: "It both deals with the health service and deals with the double Ed problem, which is: does anyone believe them on the fiscal side?"

The plan is partly modelled on Gordon Brown’s 1 per cent increase in NI in his 2002 Budget, a move that proved more popular than almost anyone expected. Miliband, who as a Treasury adviser helped to design the policy, later described this act of social-democratic statecraft as his proudest moment. But, as I write, there is little prospect of a sequel. Shadow cabinet ministers, including Ed Balls, believe that is untenable for the party to speak of a "cost-of-living crisis" and then to argue for a rise in taxation on low- and middle-income earners. "It would be kamikaze politics," one tells me.

If Labour is to promise a real-terms rise in NHS spending, it will need to impose further tax rises on high-earners, or cut even more deeply elsewhere. Miliband will need to speak what Nye Bevan called "the language of priorities" ("the religion of socialism"). 

Meanwhile, as Field looks elsewhere for support, I can reveal that Jeremy Hunt has agreed to meet him to discuss his funding plan. While there might be little prospect of the Tories going into the election advocating an increase in taxation (indeed, David Cameron and George Osborne are determined to make tax one of their main dividing lines with Labour), it is significant that the Health Secretary is prepared to engage with Field, one of the few in Westminster prepared to speak the hard truths about the fiscal challenges that await the next government.  

George Eaton is political editor of the New Statesman.

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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.