Winning support for a 21st century NHS
Differential NHS inflation, a growing elderly population that makes disproportionate health and social care demands, and an abundance of advances in ever-more expensive medical technology, will take an ever-greater toll on NHS budgets during the next parliament.
It seems implausible that a funding gap projected to rise to the equivalent of one-third of current NHS expenditure by 2020-21 can be eliminated by savings without NHS patients noting a marked deterioration in the quality and comprehensiveness of their care.
This paper argues that Labour should respond to this challenge by supporting an increase in national insurance contributions, allocated to a new fund for the NHS and reconfiguring the NHS contributory base along progressive lines. Moreover, it suggests that for increased national insurance contributions to be most effective, they should be part, but only part, of a radical programme centering around remaking the electorate’s contract in their ownership of the NHS in the form of the creation of an NHS mutual. It presents polling data which indicates why the public may respond differently to an increase in national insurance contributions as opposed to an income tax rise, and argues that Labour could make serious inroads into the Tory vote were it to adopt the proposals in this paper.
About the authors
Patrick Diamond is vice-chair of Policy Network, lecturer in public policy at Queen Mary, University of London and a former adviser to Tony Blair and Gordon Brown.
Frank Field is MP for Birkenhead and a former minister for welfare reform.
Jonathan Todd is chief economist of Demos and deputy editor of Labour Uncut.