Budget review

Back from holiday and straight into a BBC phone in on the 'Independent' Budget Review. This report is a predictable rehash of the business agenda from the usual establishment suspects. In fairness their remit was limited to implementing cuts, without any serious consideration of alternative strategies.

One aspect that is getting a particular media focus is the ring fencing of the NHS budget. In fact the ring fence doesn't actually add up to the claims that the 'health budget will be protected'. The most that is protected is the Treasury's notional inflation figure, that this year stands at 1.5%, when actual inflation is nearer 5%. Health inflation is even higher because of spiralling drugs pricing and the cost of PFI schemes, amongst other costs.

We also need to recognise that health spending and the NHS budget are not the same thing. Many other aspects of public spending have an impact on health. Not least social care, which if not available, will simply block up beds in NHS hospitals.

Even the 'protection' of NHS budgets is being whittled away. It is noticeable that ministers at UK and Scottish level are now talking about protecting 'front line' services. This is one of the most abused phrases politicians come up with when implementing cuts. It plays to widespread myth that the cuts can be made on non-essential bureaucracy. In fact health staff are a team and cuts in support staff simply shift administrative and other functions onto other staff, detracting from patient care.