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Mark Garnier
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NHS the Spending Review's biggest winner, but it needs change not just money

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Monday, 16 June, 2025
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Last week’s spending review saw the NHS as the biggest winner. Again. Indeed, it was the only winner, and has been for decades. Despite everyone saying it needs more money, more money has been poured into it at ever increasing rates. 

During the austerity years, sorting out the last mess Labour left the country in, whilst other departments saw cuts, the NHS saw a post inflation spending increase of 28%. Back in the 1990s, the NHS cost the equivalent of around 3.8% of GDP. Now it is closer to 14%.

The NHS has got particularly bad since the pandemic. Staffing has increased by 17%, yet consultants are seeing fewer patients, surgeons are doing fewer surgeries, and there is less emergency work per doctor. Productivity has collapsed.

So, it’s not money the NHS needs – its reform.

Health Secretary Wes Streeting is working up a plan to reform the NHS. Due to be published next month, it seeks to reimagine how the NHS works. There is a lot of speculation around what will happen, and details will come out in due course. But key will be using private sector providers for some of the work.

Remember how Labour warned that the Conservatives would “privatise the NHS”? That is exactly what Wes Streeting will do. Actually, as long as the first principals are kept – that medical care is available to all, free at the point of delivery – who cares who delivers the services. It’s a good idea, but it does illustrate how utterly ridiculous Labour politicians have been when trying to scare the community about the NHS.

The truth is that the NHS is trying to do things way beyond what it was intended for. When created, the average age was 65. Now its over 80. People used to die with just one condition. Now older people can live into their nineties with multiple conditions, each of which would have proved fatal years ago.

We are suffering an obesity epidemic, that costs billions to treat. The same with type 2 diabetes. Both largely come from poor lifestyle choices of individuals, and aggressive marketing of poor-quality food manufacturers and distributers.

I wish Wes well. He is about to do his best to resolve a massive problem. We all need him to get this right. But we need to respect this service. 7.5 million appointments were missed last year, without any warning. The NHS isn’t free. We all pay a lot of tax to pay for it.

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