The NHS and the Brexit "Dividend"

There we were, innocently discussing Tory lies, and then the Prime Minister goes and drops a whopper. On Andrew Marr yesterday morning, she announced in her pre-recorded interview (naturally) that the NHS is going to receive £20bn in extra funding. That sounds a lot to a casual observer, but the monies amount to a 3.4% increase in the annual budget, putting it below the 3.7% average yearly rise since its foundation and well behind the cash pumped into the NHS over the Blair/Brown years. And how is this going to be funded? May puffed out her chest and without a shred of shame said it would be part financed by the Brexit dividend. Yes, you heard correctly, the Brexit dividend.

It is utter piffle. There is no such thing as a "Brexit dividend". Which is why Jeremy Corbyn would be wise not to talk it up either. This "dividend", according to May, comes from Britain not having to pay membership subs to Brussels. Okay, considering Britain must pay a divorce bill one imagines that's going to be sent in installments. And then we have to think about the customs arrangement or whatever relationship we have to the EU following Brexit. What is very likely once the transition period expires is a continuance of some kind of payment to keep "frictionless trade", or whatever it's called this week, going. There will also be costs arising from policing the border because, you know, taking back control. The duplication of EU agencies to ensure the UK remains "in alignment" with the single market demands resources, the "no change" pledge to farmers and the regions with respect to subsidies and infrastructure investment has to be in place. If it all goes belly up, there's the shady deal the government cut with Nissan whereby billions would be frittered away compensating UK-based big business for tariffs imposed by the EU. And if it doesn't, the UK can look forward to a permanent hit to the economy in terms of falling investment, the movement of business into the EU proper, rising unemployment and all the rest. In other words, there cannot be a dividend, no matter how you cook the numbers. We, as in Labour, have to be entirely honest. Brexit isn't about "opportunities", it's about finding the least worst, least damaging way of leaving the EU, doing the best we can to protect our people and struggling to ensure the elites, chiefly business and the rich, pay the costs for their elite project.

In an uncharacteristic moment of clarity, Jeremy Hunt said the NHS's "birthday present" couldn't be funded from this quarter alone, and would require tax rises, with economic growth picking up the rest of the slack. Huh. If leading Tories get their way, the only thing growing in Britain in the aftermath of Brexit will be the dole queue. Again, this is more never, never. Were Labour to announce their spending plans in such a cavalier, uncosted way its pledges wouldn't be met with indifference on the part of our press. See, for example, the case of the unfunded Tory pledges prior to the 2015 general election. Proof, as if it were needed, that the Conservatives play politics in easy mode.

Yes, this is an entirely cynical exercise. But it lays down a few teasers about how the next Tory manifesto is going to look and who May is targeting. In sum the election, whether it be this Autumn, next year, or 2022, will be fought on the grounds very similar to 2017's. May, or her successor, are going to stake out a Miliband-lite one nationist platform. The NHS focus is a risk, considering the last eight years of cuts, lengthening waiting times, rationing of treatment and downright failure but the hope is the big sum and the boosterist language surrounding it (helpfully, and uncritically amplified by the BBC as ever) will convey an impression of a caring Tory and paternalist government doing something about it. Using the language of a Brexit dividend is dishonest but not entirely stupid, politically speaking. Had Leave not managed to make the link between EU subscriptions and NHS funding during the referendum, then they wouldn't have won. What May is trying to do is short cut the hard graft of winning over new people and trying to ride this elision in the popular, Brexit-supporting imagination. It is an attempt to hold together the declining coalition of Tory voters. And by cloaking it in the divisive idiocies of Leave, it shows scant interest in appealing to younger people for whom the NHS is an issue but, as a general rule, are immune to Tory Brexit posturing.

This isn't to say there aren't problems with the NHS and it doesn't need a significant cash injection. The Tories like to talk about how people are living longer and increasingly it has to be equipped to deal with the diseases and ailments of old age. While true, an entirely unnecessary diversion of resources are soaked up by the administration of the markets in health care. Competition between providers are less the enemies of bureaucrats and more their best friends. And there is the small matter of private providers taking money directly out of the service to fill their piggy banks, tax compliant or not. More money is always welcome, but the inefficiencies built into the system are a Tory innovation, and it's these that are driving down quality and restricting provision. Ultimately, it doesn't matter how much cash is thrown at the NHS. Unless it is reorganised and market mechanisms are removed as the central means of delivering health care, the crisis will not end and bit by bit, more and more of the NHS will slide into private hands. Don't be fooled, more NHS money does not mean the Tories have abandoned their programme of privatisation-by-stealth.