Yes, the government’s 10-year plan will help the NHS – but no party can turn it into the service we imagine

Such a health service cannot possibly exist if it is to remain free at the point of delivery – particularly in a country with a rapidly ageing population – unless we are prepared to increase the public tax burden

With Brexit entering end-game territory, it is easy to overlook the fact that there are other policy priorities for the government and the country.

Today, the NHS gets a brief moment in the headlines, with the publication of a 10-year plan drawn up at the prime minister’s request. Those responsible for the proposals argue they will help to save up to half a million lives.

The primary focus of the plan is on prevention, which means the bulk of extra spending will be directed at GPs, mental health and community care. Given the difficulties faced by hospitals in recent years – especially in A&E departments – some have criticised the proposals for failing to boost hospital funding.

In and of itself, that is a simplistic criticism. It is abundantly clear that many of those who end up at accident and emergency departments do so because they have been failed by other parts of the NHS ecosystem. Past cuts to mental health care provision and the oversubscription of many GP surgeries are among the primary culprits: if those services can be improved, there will be positive knock-on consequences for hospitals.

There is also something in the argument made by the government that alongside additional spending in certain areas, the NHS must become more efficient in others. When a great many staff are working hard, that is a bitter pill to swallow. Equally, most NHS employees will acknowledge that the system does not work quite as efficiently as it might – for instance, because of a lack of co-ordination between different elements within it; or because of an excess of bureaucracy; or variation in procurement policies.

Nevertheless, the efficiency argument only travels so far. In part that is because enormous efficiencies have already been made (billions in the last financial year alone) – with savings largely swallowed up by inflation and by a reduction in spending per head of population. In part too, cutting costs and efficiency savings aren’t always one and the same thing. Indeed, while the argument that you can always squeeze a little more work out of staff is beloved of managers, there is a point at which the pips squeak.

In the case of the NHS, the sign of pips squeaking is persistently missed targets for waiting times, and good people leaving the service. In each of the last three years, 10 per cent of the NHS’s nursing workforce decided to quit. And a survey of GPs last year found that 39 per cent intended to resign within five years, the vast majority of those citing the stress of increased workloads. This is very obviously not a sustainable state of affairs.

All in all then, it isn’t difficult to conclude that the 10-year plan will not cure every NHS ill. And when the next general election comes around – whether in 2022 or before – it is entirely plausible that Labour will be much keener to focus on domestic health policy than Brexit, and not only because the party leader’s stance on the EU remains ambivalent.

Yet the truth may be that no party can turn the NHS into the kind of service we imagine it might be, with patients able to access every aspect of care they need or want without long waits and without endless, circular referrals. Such a health service cannot possibly exist if it is to remain free at the point of delivery – particularly in a country with a rapidly ageing population – unless we are prepared to increase the public tax burden.

That’s not to say we should somehow give up on the NHS, but rather that we should not decry the NHS to the point where its perceived uselessness becomes a self-fulfilling prophecy. Yes, it needs improvements, but it remains largely a bastion of professionalism and expertise in a country which at times appears set on its own destruction.

The government’s 10-year plan offers a glimmer of hope for an improved service. But if it proves unsuccessful, ministers will have to answer to the electorate.