Feature Data Briefing

Manifesto pledges: more money for the NHS . . . problem solved?

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2109 (Published 22 April 2015) Cite this as: BMJ 2015;350:h2109
  1. John Appleby, chief economist, King’s Fund, London, UK
  1. j.appleby{at}kingsfund.org.uk

John Appleby examines the financial commitments of the main political parties and concludes that, whichever wins, the NHS is going to lose

As Ipsos-Mori has been reporting for some months now, the NHS is a big issue for the public, and now nearly half of all Britons surveyed (47%) say the NHS and healthcare is their top concern when deciding how they’ll vote in the general election.1 The public’s concerns have been reflected in the political parties’ manifesto promises—a combination of more money and usually a long shopping list for how the extra cash will be spent (more doctors, more nurses . . . 24/7 motherhood, and a free prescription for apple pie). But what do the promises add up to, and is the NHS safe in anyone’s hands? (And why is the politician’s favourite number 8 000 000 000?)

The manifestos’ focus on how much money should be spent on the NHS has been driven by a future funding scenario described by NHS England, Monitor, and other national NHS organisations in their joint forward look at how the NHS might fare over the next five years.2 Predicated on some upfront investment in infrastructure and operating investment (that is, keeping the business going), NHS England estimates that although the NHS needs a funding increase of £30bn (€42bn; $45bn) over and above inflation by …

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