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8 January 2018

It’s not the Cabinet reshuffle the government should worry about – it’s the NHS

The health service is on the brink and could be tipped over by the “Australian flu”.

By Stephen Bush

Today’s main theatre is the comings and goings around the Cabinet table but it’s the crisis in the NHS that could really threaten the government. 

A comparatively mild winter has brought the health service to the brink and the strains brought about by tackling the “Australian flu” might tip it over.  As far as the balance of forces at Westminster goes, it could quickly turn the reshuffle into a disaster – keep Jeremy Hunt where he is and he may have to fall on his sword forcing another reshuffle, move him and it will look as if any crisis that follows has been given the stamp of government approval if the man in charge during the run-up pops up in the Cabinet Office.
 
Labour has one solution to the crisis, which is to spend more money. The Conservatives have another, which is to spend more money but for Labour to promise not to attack them for the tax rises they use to do it first. Of course, that’s not quite how they’re putting it – they’re doing things like calling for a Royal Commission or an “honest debate” or to “take the health service out of politics”. 
 
The really honest truth about the health service is as with every health service in the world it suffers from the problem of being set up to deal with the medical challenges at the time of its foundation. But there is no painless way, either for patients or politicians, to move from a universal healthcare service designed for 1948 and tweaked over decades to a universal healthcare service designed for 2018. 
 
You can’t make that more palatable with a royal commission, nor can you get away from the fact that the only solution that is politically workable involves more money, whether financed through borrowing or increased taxation. Nor would any opposition party surrender the opportunity to cause the government pain – just Google “Andrew Lansley Andy Burnham death tax” if you want to relieve the last entry in the franchise before the sequel hits Westminster.

What the government can and should do is weather the storm of doing that now in order to avoid the much bigger one coming its way if it doesn’t. 

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