Health check

Even though the NHS swallows up more than one- fifth of public

spending, it has not only had its budget ring-fenced, but the new Government is insistent that it receives real-term funding increases in each of the next five years.

At a time when Ministers are imposing sweeping cuts that will have a detrimental effect, such as the transport scheme shelved in Yorkshire, it is perverse that this criteria is not being extended to health policy.

Of course, hospitals face financial pressures of their own. They also have to meet the increased expectations of patients, coupled with the demands of an ageing society.

Yet this should not preclude every primary care trust, hospital and NHS service undertaking a root-and-branch review of their functions – and how these can be made more efficient.

The Government should have nothing to fear from this – David Cameron has made clear, on many occasions, that he is a committed supporter of the NHS. However, political considerations should not exempt the Health Service from the difficult decisions being taken in other departments.

Of course, Mr Cameron should make clear that the jobs of doctors and nurses will be protected. That goes without saying. But this should not extend to other aspects of healthcare and, specifically, the vast – and unwieldy – quangocracy that now complements the NHS. Furthermore, taxpayers are perfectly within their rights to expect hospital bosses, for example, to be more open to innovation rather than allowing the tired-old inefficiencies to persist because staff might resist, or resent, the concept of change.

As the Adam Smith Institute suggests, a more rigorous approach to spending may help the NHS meet the demands of the future – and also contribute to the savings being imposed by the Treasury to prevent Britain's debt interest charges spiralling out

of control.

It's time for that debate to begin.