NHS tax bill needs to triple

The full scale of Gordon Brown's colossal gamble to rescue the National Health Service - using taxpayers' money - was set out for the first time today.

The long-awaited Wanless report was published this morning, pulling no punches about the uphill struggle facing hospitals and Britain's entire range of health services.

But the real shock was the revelation of the huge sums of money required to put it back on its feet, the length of time it will take and the astonishing admission that the recipe might not work.

As much as £116billion a year, on top of present levels, will have to be found by taxpayers within the next two decades, according to Derek Wanless, the former chief executive of NatWest, who was commissioned by the Chancellor last year to to examine the long-term funding needs of the NHS.

He has concluded that the spending may have to rise by nearly triple the current level, from £68billion a year to up to £184billion, to ensure a decent, modern health service.

Even allowing for such a bonanza, it will not be until the year 2022 before the public will be ensured of a maximum waiting time for operations of two weeks.

Yet California, and some European-countries such as Germany, already enjoy such fast-track treatment.

The very large amounts needed to fix the problems of the ailing health service are spelt out by looking at three different scenarios showing how the future demands of the population and new technology might affect the needs of the NHS.

Under a best-case scenario - where patients take more responsibility for their own health and dramatic reforms are brought in - Britain will need £154million a year by 2022.

Under the worst-case scenario - where patients' health carries on deteriorating and few changes are made - £184 billion will be needed.

Those figures would see health spending rise to between 10.4 per cent and 12.5 per cent of national income within the next 20 years.

Mr Wanless' analysis paves the way for Gordon Brown to usher in a massive increase in spending, with a 7.1 per cent real-terms annual increase by the year 2007 - some £28billion a year more than at present.

The next 10 years would be the "catch-up" period, because Britain has fallen so far behind the standardsof other European countries. The second decade, from 2012 onwards, would see a slower " keepup" period, when average growth would be between 2.7 per cent and 3.5 per cent.

But the possibility of switching to an alternative method of funding for the NHS has been firmly discounted by Mr Wanless, who concludes that the British system, using general taxation, is the fairest form.

This afternoon, he denied it was ever part of his brief to look at alternative funding systems, which leaves the Chancellor open to accusations he has attempted to close down the argument over healthcare by looking only at the current system.

The 163-page review spells out the size of the problem: shabby, outdated hospital buildings, a serious shortage of all kinds of staff, but particularly doctors, the almost total absence of proper IT equipment and outdated working patterns.

Mr Wanless has revealed he was shown around hospitals where machinery, such as scanners, was lying unused because of managerial difficulties.

The report makes clear that money cannot solve everything. As he put it: " Higher spending inputs do not necessarily imply better health outputs and outcomes."

He warned that spending the proposed large sums of money wisely would be a "considerable management challenge" and that investment was useless without proper reform.

Staff should also be prepared to change their working practices, so that nurses can take on some of the responsibilities of doctors, and healthcare assistants could share the workload with nurses.

Doctors and managers would have to look at the way referrals to hospital are managed and clinics might have to be run more efficiently, to benefit patients.

Westminster must also be prepared to hand over power to local managers and to individual GPs and doctors, to allow the right decisions to be made.

The increasing number of ageing post-war "baby boomers" means there will be an enormous demand for healthcare in the future.

The report warns there needs to be two-thirds more doctors and one-third more nurses, beyond the numbers already planned.

This would translate into an extra £25,000 doctors, most of them GPs. But people must also realise they have responsibility for their own health.

Mr Wanless believes more money should be put into public health campaigns such as anti-smoking drives, which will ultimately save money on drugs.

He has made it clear there are no quick fixes for the National Health Service.

"This is a 20-year view. The issue will be the long-term sustainability of the various sources of funding and the generation of confidence among those who are responsible for delivering the services and for planning ahead."

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