Westminster View

The NHS is 70 years old. It’s an institution the people of Britain very much admire, particularly its dedicated staff.

Everyone knows it’s been under pressure and there is a general appetite across the UK for it to be better funded.

The Prime Minister’s recent announcement of an extra £20 billion for it by 2023/24 will lead to even more world-class health care and I support it. She also made it clear taxpayers will have to dip into their own pockets to help meet some of the increased spending.

However, like many things, money is simply not the entire answer to the pressures the NHS finds itself under. Some in politics would like to portray it that way but it isn’t true.

Most research, including the Office for National Statistics, find the UK spends a little less of its GDP on healthcare than other wealthy G7 countries. Other studies say this is not the case. Why? Well, the fact is comparing health spending from different countries is tricky. For example, one country’s definition of health care might differ from another who could classify that service as social care and vice versa.

Spending on health doesn’t guarantee a long life either, as the ONS pointed out when it found life expectancy in the US, which spends much more on health care as a percentage of GDP than us, was lower than the UK.

I use these examples only to show the picture is complex and many other statistics can be used, but what I don’t think is in doubt is that an increasing and ageing population is having a detrimental effect on how our NHS functions as the cost of treatment and the numbers treated rise sharply. The facts speak for themselves. From 2018 to 2030, the number of people over the age of 65 will increase by around a third, and the number of those over 75 will treble. During the same time period, the working age population is set to increase by 2%. Something’s got to give.

To start, there needs to be reform of social care and better partnership between the NHS and social care providers to tackle this timebomb and the government is committed to doing that with a policy paper due in the autumn.

Reform is not really about money, it’s about doing more to tackle the challenges this country faces in funding health and social care and being smarter on how we deliver services. It is not privatisation either, as some would claim, but a desire to be more flexible and even more efficient.

The NHS was born in a different era where people did not live long at all. Many would retire and last only a few years, not the decades that is now the norm.

It was not set up to deal with this seismic demographic change but it must respond to it otherwise this institution will continue to eat up larger and larger chunks of the government’s spending and the country’s wealth.

And the question must be this: are we happy for this to happen; for us to continue to spend more and more on the NHS? The general answer is yes, but without reform and without smarter ways of achieving the best outcomes for the patient and taxpayers in the future? It’s an interesting debate.