Continuing on from the General Election where all discussion was used to obscure how the NHS should be funded[1], on January 15 the government introduced its "mandatory" NHS Funding Bill 2019-20. The government has clearly stated that the additional funding will be spent by NHS England in the "NHS Long-Term Plan", which is a corporate-led direction that is wrecking the NHS and jeopardising its future.

The Bill[2], which was previously announced under Theresa May, states that the government commits to increase investment in the NHS in the years up to and including 2024. This will result in a £33.9 billion increase in cash terms by 2023/24, with total NHS England spending rising to £148.5 billion in 2024. The Bill was given its formal First Reading on January 15, and MPs will debate the Bill on its Second Reading on Monday, January 27.

The King's Fund, the Nuffield Trust and the Health Foundation have already responded that an annual increase of the NHS funding should be at least 4% a year rather than the average of 3.4% a year proposed by the government. This line of argument has been taken up by the Opposition in Parliament as well.

This may or may not be the case, but it does not address the present chronic lack of trained medical and nursing staff and the loss of NHS services going back over decades, as many critics have pointed out. Nor does it challenge the direction in which the NHS is being taken, its privatisation, the contracting out of services, and even more fundamentally whether the government's approach resolves the crisis in NHS funding.

Health care like education is an investment not a cost

What is being obscured is that health care is a claim of all on the economy which the people must make. Health workers provide vital and accessible health services to all and in doing so create value in the socialised economy by curing people when sick and injured and keeping healthy the human resources of society and all those who live and work in it. This value is consumed by big corporations in employing the labour power of a healthy workforce. This is value which should not be expropriated by these corporations but should be claimed by the government and their health services as value that can then be used to resource a fully-funded NHS. The Bill does not raise this vital question of the role the NHS plays in a human-centred economy where the NHS should become a human-centred system paid for at least out of the value it creates in the economy so that any extra funding contributes to meeting the needs of health care for all.

This Bill will not safeguard the future of the NHS and neither is it intended to. Even the claim that a "mandatory" funding by government gives some funding "security" to the NHS is false when it is combined with a a neo-liberal corporate direction that the "NHS Long-Term Plan" represents. The "NHS Long-Term Plan" is already reducing safe access to vital emergency, children, maternity and mental health services for whole swathes of the population. It is being further pursued in the present deconstruction of local District Hospital acute services with a massive loss of acute and long term care hospital beds and local GP services across England. This is the "long-term plan" to switch funding into an "integrated" Care Providers and systems that government intends to be predominately dominated by the private sector companies.

The conclusion to be drawn is that those big corporations that purchase the capacity to work of a healthy workforce must be obliged to pay for the value of that capacity added by the health service. Ultimately, decision-making power of the working people is required over society and its economy to create a human-centred health care system based on the right of all to health care.

Notes

[1] Obscuring How Wealth Is Created in the Economy
http://www.rcpbml.org.uk/wwie-19/ww19-21/ww19-21-01.htm

[2] For more details of the Bill, see the briefing paper in the House of Commons Library:
https://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-8798

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