Star Comment: Throwing down the gauntlet

The NHS England chief executive has pointed out that the NHS is not covered financially. He says it needs an extra £8 billion a year.

This analysis throws down the gauntlet to politicians of all parties. We are talking about an amount so huge that it cannot be ignored, and the financial exposure of the NHS cannot indefinitely be dealt with by muddling through and fiddling with the cloth.

The timing, too, is exquisite. If you have forgotten that there is a general election next spring, the politicians definitely have not and what Mr Stevens is saying foreshadows a crisis of such magnitude that it is flushing out the politicians to come up with a response.

There is an easy way to deal with it. How about putting a pledge in your manifesto to raise an additional £8 billion in taxes? As you sat on the opposition benches for the next five years you could rue your practical and principled approach.

Then there is that taboo, the p-word. Advocating the privatisation of the health service would be just another way to ensure you languish on the opposition benches.

What we are left with is a way forward which will involve a mix of measures, efficiencies, savings, and stealthy erosion at the edges of the free-for-all principle which underpinned the foundation of the NHS all those years ago.

Mr Stevens has come up with ideas including that large doctors' surgeries could provide hospital services. Fighting crime can be done both by catching criminals, but also by crime prevention measures. The future shape of the NHS looks likely to involve ill-health prevention measures. Mr Stevens' proposals include employers offering workers cash or shopping vouchers if they lose weight.

It would not be enough. The analysis warns that Whitehall funding for the NHS would still need to go up by another 1.5 per cent a year above inflation.

As Salopians know, the delivery of health services in this county is already under scrutiny in the Future Fit process. Mr Stevens' report is a worry because it means that however this county arranges the props on the stage, the whole theatre is creaking.

For the sake of the future of the NHS, Mr Stevens' report needs to be central to the general election campaign, and not shuffled on to the shelf.