Next Steps

Today has seen a flurry of publications from the Department of Health. First there is the response to the consultation on the NHS White Paper, which can be summed up as "we read the objections, but we are going ahead anyway". You have to admire the chutzpah of a document that says in one paragraph (1.14) that there was "widespread enthusiasm for the vision and principles" while in the next paragraph (1.15) it says that "a considerable number of respondents opposed the Government’s reforms altogether". This document suggests that there will be a Health bill in January, although the notable health service journalist Andy Cowper thinks that is optimistic.

The other two major publications are the Operating Framework for the NHS in England 2011/2012 and the PCT Allocations 2011-2012. The former gives the rules that GPs, hospital trusts and PCTs must follow from next April, and the later is the hard figures. The best analysis of this comes from Prof John Appleby on the Health Policy Insight website.

Prof Appleby says that the money for PCTs next year will be £89.1 billion, a 3% cash rise. He applies the "real terms increase" test using the OBR's forecast for inflation and concludes that this does  represent a real term increase of 0.3%. However, these are just raw figures. From the £89.1 billion the government will take £648 million and hand it to local authorities to pay for social care. Then, before the PCTs get their hands on the remaining cash the government will take more money (2% of the total) to pay for the re-organisation that "a considerable number of respondents opposed". Prof Appleby estimates this to be £1.8bn of money that should be spent on our healthcare.

So clearly when you have a barely "real terms increase" and then take £2.448bn out of it, that does not mean "real terms" at all. To echo Ed Miliband in the Commons this afternoon, this is yet another broken government promise.