Brown's health prescription

Extra funding for the health service was the jewel in Gordon Brown's Budget. It was, said the overwhelmingly upbeat media accounts, a cash bonanza: a £2 billion cash injection this year; plus a 6.1% a year increase over inflation for four years; a massive 35% real increase in funds by the year 2004! But was it all an accountancy con like the £21 billion they announced back in 1998? True, the £21 billion had been forgotten, swallowed up by the new increases, but adding it all up these are still substantial increases. Last January Tony Blair pledged to get the proportion of GDP which the UK spent on health care up to the European average. The 2004 figure will be around 7.6% (depending on the economy) and the European average is 8.6%.

The new money for health indicates that the Blairites have had to take some account of working-class expectations. If the UK economy - and therefore the bosses' willingness to accept such spending - hadn't been relatively buoyant and the government's budget deficit hadn't been so large, the budget might have been different. As it is, the money may not yet meet the hopes people have for a restored NHS.

The real sting has been that the promised cash is accompanied by a blast of Government invective about how the health service must "reform" and "modernise". In the health service this is New Labour-speak for more rationing, more narrow accountancy where the cost of one treatment to save one life will be weighed up against another which may save two, or three, or more lives. The cost benefit mentality will rule, now with added Blair-style sanctimoniousness and self-righteousness.

Another problem will be that the health service is so desperate for cash that the new money will be quickly sucked into a narrow rage of obvious areas.

This year's £2 billion cash injection will be used to finance an already agreed pay rise. The waiting lists which currently stand at 160,000 will have to be tackled but there is only likely to be a small increase in beds - one of the primary factors behind the waiting list crisis. Health managers are unlikely to back off from the dogmatic necessity in current fit-and-trim health economics to keep hospitals absolutely short of beds. From any rational point of view, much less a socialist one, lots of this new money will be simply be "wasted". Not on the bureaucracy and the other obvious evils often talked about. But on such things as clearing the debts of trusts and health authorities and spending extra money on drug treatments which are getting more expensive. The single most effective thing that could be done to restore the NHS is to nationalise the drug companies! The Tories and the bosses' top rep, head of the Institute of Directors, Ruth Lee, have used the focus on the NHS to relaunch their campaign for an expansion of private health care. And one of the imminent dangers is that the government will use the new money to give private health care (or the independent sector as Blair likes to call it) a boost. Many patients will be sent to the private sector to be operated on by surgeons trained and employed by the NHS because the NHS doesn't have enough beds or enough surgeons!

Whether this budget is a response to the criticisms of the likes of Peter Kilfoyle MP, an attempt to win back Labour's heartlands, or, more likely, a narrow concern with appeasing Labour back-benchers, it is a significant change in tack by New Labour. It shows that they are not invulnerable to political pressure. Working class militants will take heart from that. We need to step up our political campaigning on this issue, defending the principle of health care free for all at the point of delivery and linking the fight to adequate resourcing of all public services.

We need to argue against the Private Finance Initiative, for the nationalisation of the pharmaceutical companies, for further increases in wages for nurses and other NHS staff, and for measures to tackle the poverty and inequality which causes so much of the ill-health the NHS has to treat.