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In March 2006 the Chancellor said, 'It is because our public finances are so strong that in the parliament we have also been able to meet the extra and unanticipated costs of Iraq, Afghanistan and the fight against terrorism'.¹

    Strange that he should have said strong in the parliament: how about in the country at large?

    Defence expenditure is currently a mere twenty-nine billion compared to the NHS, which is costing us all of ninety-six. So it does not look on first view as if the present restructuring of the health service, over 17% of our budget, is due to an overspend on the Middle Eastern wars: the MoD takes a measly 5% of the Exchequer’s lolly. The official MoD website gives few plain answers, though I found the following hilarious data amid the crowds of defence statistics: in 2005-06 we spent 332 million on ‘Helping to Build a Better World’. I’d love to know where.

    So why has it been necessary in the parliament to clip the wings of the NHS so soon after New Labour’s massive overspend? Three years ago there was a shortage of doctors and nurses, and we scoured the earth – mainly the Indian subcontinent – for new recruits; in all we poached some fifteen thousand doctors or 13% of the present complement. Seven thousand, many of these Pakistani or Indian, will be made redundant over the next year. Meanwhile eighteen thousand nurses are expected to lose their jobs. Brown will show how he appreciates those surviving the cuts, reducing their recommended 2½% salary increase to 1.9% by the ministerial legerdemain of spreading it out over two tranches. For the British sick what might prove yet more serious is that twelve thousand five hundred have been lost in the last three years despite warnings from the experts that this is a sure way of spreading MRSA and Clostridium difficile, respectively claiming in excess of two thousand and four thousand lives a year.

    So much for physical well being: a healthy balance for the NHS books will be made largely on the backs of the psychiatric services. After all, you can’t see mental health. Nearly two thirds of psychiatry units have been asked to discipline their spending

   Let’s return to the Chancellor’s prudent words: 'It is because our public finances are so strong that in the parliament we have also been able to meet the extra and unanticipated costs of Iraq, Afghanistan and the fight against terrorism.' Can he have been serious, or was he making a huge joke at the expense of the nation’s sick?

     There have not always been net deficits in the NHS account: from 2001 to 2004 there was a surplus amounting to three hundred and fifty-two million pounds; from 2004 to 2006, however, there was a total net deficit of seven hundred and sixty-eight million; figures for 2006-07 aren’t yet available, but the total gross deficit is known to be £1.2 billion, one hundred and twelve million less than in 2005-06. So, if the shortfall’s somewhat less serious than it was, why the panic measures to balance the books? After all, from 1997 to 2000 there had been a combined deficit of two hundred and sixty-eight million pounds, so you could say there have always been fat years and lean years.
4. Why the sudden panic about NHS spending then?

    I think we should look back at military spending. True, it has shrunk over the last ten years, but maybe not as fast as Brown would have wished: Iraq and Afghanistan are by themselves adding one and a half billion pounds a year to the defence bill, but this comes out of a contingency fund, not from the main defence budget. It’s quite a clever camouflage, but the money still has to be paid. If the Chancellor’s in real trouble such a budgetary landmine could have made the reduction of the ninety-four million pound NHS deficit a tempting side-issue. Even if he’d wanted to, he couldn’t have snatched the military toy from Tony’s grasp; as for the PM, there was no contest between the two sectors: with the NHS all he could do was smile his way round a few hospitals; war was a different matter: it enabled you to stand with the boys out there or pace resolutely through the ranks in defiant shirt sleeves. There was no competition, and therefore Gordon was obliged to play along with his boss’s post-adolescent need for a touch of military pomp.
                                                                         * * *
But going to war is not the only luxury this government’s let us in for. In a parliamentary debate in March 2007 Blair told us that a decision to commission new submarines to carry atomic missiles must be taken in or shortly after 2012, and that’s the very year we’re staging the Olympic Games. The initial estimate for this second plaything, 2½ billion initially, has now nearly quadrupled.

Between the two government toys it follows that we are spending an extra 13 or 14 billion, only a small part of which will be creamed out of Lottery funds. This makes a hole in the budget. But what the hell! it’s war and sport, both good manly occupations. Compared to looking after the sick, there’s no debate. And if you were Tony or Gord I’m sure you too would go after them at the expense of a few anonymous home casualties.
² Royal College of Nursing estimates
4House of Commons Hansard Written Answers for 15 Jan 2007 (excluding final figure, which is from the Ofspin annual report of 2006)