sohois said:I am unaware that anyone has ever suggested public services do not benefit from better funding, the question is whether you're getting value for money from the spending increases. NHS spending has i think doubled in real terms since 1997, but has the quality of the NHS doubled? Note that i'm not saying it hasn't, I don't really have enough information to declare such a thing, and the article does not make any such judgments, but nor does it conclusively show good value for money.
Without meaning to be rude, the "value for money" chestnut is complete fabrication when it comes to the NHS. At least in the general sense it is used.
Expecting a delta 1 change i.e. 1% improvement for 1% increase in spending within a system that has rising costs due to ageing population, rising population and increased supply costs is not a position that you can hold. Of course you will not get 1:1. You are well into the negative convexity of the curve.
Doubling will have a beneficial impact, increases just higher than the marginal inflation rate will not since you are fighting a battle against overwhelming demand with a scarce resource whose costs rise faster than the CPI. It will never be good enough. You don't need numbers to work that out. Far better than any free market situation which would always result in multiple cascading market failures, but still with room for improvement.
Money into the NHS for the next decade will try to be a plug. It will be a battle to keep it at the current standard. Cuts will result in immediate falls in the access, provision and quality of healthcare provided since moving to the right of a curve exhibiting negative convexity leads to disproportionate falls.
So if you don't get 1:1 under the VFM criterion it is often framed as a failure and waste of investment and we should stop spending and start cutting.
Start cutting what?
The IT projects are attacked for over-running budgeted costs. Does this mean they are wasteful? A service which seeks to cover 60m+ people needs a system capable of handling the medical histories of these people. Why is this a waste in spending? Should they be using paper files and non-networked machines? Some of the criticism is wholly unjustified and plain mental.
If you cut the spending what are you going to do with the money you've "saved"? I say saved because you will not have saved anything, you've actually cut into the bone.
Arguing about "value for money" in order to justify cuts in a service which is unable to meet demand is nonsensical. The only defensible position is to argue for the money to be spent in different ways within the NHS. Not that the money shouldn't be spent.