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By Frank McKenna

By Frank McKenna

Tax hike will not fix social care – and NHS needs reform as much as it needs cash

Heresy? Frank McKenna argues that the NHS needs radical reform more than it needs cash – and that this week’s tax hike will not improve social care as promised.

His critics will say that Boris Johnson is a serial confidence trickster. It would certainly be fair to say, whatever side of the argument you were on, that he was casual with the facts during the Brexit Referendum campaign. His role in the success of delivering the UKs departure from the EU was the main reason he became Prime Minister. During his time in Number 10, he has reneged on contracts that he had agreed with our European counterparts and is currently bemoaning the deal he pushed through to ‘get Brexit done’ in respect of the issues that would inevitably arise on the Irish border.

His George Bush snr moment “Read my lips, no new taxes” is the latest ‘fib’ he has been caught in. However, he will argue, and get some sympathy for the view, that when he made that pledge none of us were aware of the oncoming plague that is COVID-19.

What may be more difficult to defend as time marches on is that the tax hike he announced this week will not make any difference to the thing that he claims the extra money will pay for – social care.

Instead, all of the money raised will be invested in the NHS to tackle the enormous backlog it is facing – a challenge that the government was facing pre-pandemic, partly because of a near-decade of Austerity.

If, during the next three years, people recognise the pinch in their pocket, whilst their elderly relatives are still receiving care packages that, quite frankly, are not fit for purpose, then he may regret his ‘spin’ being bought by most of the media that this is the silver bullet to ‘fix’ the care crisis that has dogged government for years.

Perhaps this is the reason he did not rule out further tax rises moving forward – though you wonder what the appetite of his parliamentary colleagues, and indeed the Chancellor, is for such a policy shift. Hitting ‘hard working families’ again between now and the next General Election would be a huge gamble, even by Johnson’s standards – and going into that election promising more tax increases is not where the Tories will want to be.

So, expect a period of further cuts in other public services – local authorities will be hammered – and additional borrowing on top of what we have already seen to pay for Boris’ promises on police, education, and the ‘levelling-up’ agenda.

Incredibly, what this Conservative government appears totally shy of is a discussion about reforming the NHS to ensure that the money it does and will get will be spent efficiently.

I have sat on enough NHS Trust boards to know that it is not the ‘poor bloody infantry’ who benefit from additional splurges of cash on this most loved of British institutions.

Executives pay has rocketed in the sector over the past decade and more. GPs now earn a King’s ransom and deliver a poorer service. Billions have been wasted on dysfunctional IT systems. Golden Handshakes are often followed by the recipients of such deals returning to work as ‘consultants’ earning hefty fees. And the medical hierarchy within our hospitals still dictate what does and doesn’t happen in what they treat as their fiefdoms. In short, the NHS, despite it being heresy to say so, is at least in part in trouble not because it doesn’t have enough cash – but because the cash it does have is frittered away and wasted.

Not since Tony Blair, a Labour Prime Minister, has anyone genuinely tried to take on the vested interests within the NHS. His right-hand man at the time, who had a plan to tackle the shameless mismanagement that has existed for years, Alan Milburn, resigned his post as Health Secretary in sheer frustration at the intransigence not just of those within the NHS, but of the then Chancellor Gordon Brown and backbench Labour MPs.

You would think the Conservatives could have a more robust debate about ‘value for money’, but Boris Johnson is nothing if he’s not a populist romantic.

So, the notion of attacking the myth that we have the best Health Service on the planet, and that all we have to do to keep it that way is throw money at it, simply perpetuates. The myth that social care will be improved because of this week’s tax hike will not be as sustainable.

Downtown in Business