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EDITORIALS: Rudolf Klein A generous birthday present to the NHS BMJ 1998; 317: 224-225 [Full text]

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John Appleby   (4 August 1998)

Untitled 4 August 1998
John Appleby, Senior Lecturer, Health Economics Send response to journal: Re: this article	I am afraid that Rudolf Klein has got it wrong: the figure of £21 billion extra for the NHS in the UK over the next three years is an example of Labour's New maths rather than its new generosity[1]. Taking figures for England as an example, next year the NHS will receive an extra £3.1 billion; the year after, an extra £2.8 billion, and the year after that (2001/2) £2.8 billion. In conventional, if boring, accountancy, this adds up to an increase over three years of £8.7 billion - not, as the Department of Health's press release stated, £17.7 billion (the equivalent figure for the UK NHS is the much headlined £21 billion)[2]. The government have effectively counted next year's increase three times, the second year's twice and the third year's once to arrive at their inflated total. If the same accounting is applied to all the increases the NHS has received since 1948 we would expect this year's budget to top £602 billion - about 70% of money GDP! Similar mathematics were used to present all the spending plans announced by the Chancellor. In fact, the actual increases are not too bad, which makes the triple helping of hype somewhat hard to swallow. After allowing for inflation as experienced by the NHS, the impact of the minimum wage, paying off trusts' debts etc, the percentage increases each year till 2001/2 will probably work out at an average of 3%. Yours John Appleby Senior Lecturer, Health Economics School of Health Department of Health Policy and Practice University of East Anglia Norwich NR4 7TJ [1] Klein R. A generous birthday present to the NHS. BMJ 1998;317:224-5 [2] Department of Health. £20 billion boost for the NHS. Press release, 14th July 1998.