A Prittlewell resident recently forwarded me a letter, and an email, that they’d received from the Conservative Party candidate in Prittlewell, Kevin Buck, in answer to questions they had asked him about the NHS and, more specifically, the current proposals from Mid & South Essex STP (Sustainability & Transformation Partnership) for the reorganisation of local health services.
The communications are incredibly revealing about the current state of thought within the Conservative Party as to the future funding of the NHS, with a general consensus seemingly stretching throughout the ranks – right up to the top of government.
I have published below the original Facebook post I wrote for the Save Southend NHS page, along with the full texts of these letters (with the recipients permission) – having received requests to see them in order that the published extracts can be viewed in context.
Post from Save Southend NHS Facebook page, 16/4/18:
We have been asking residents to question candidates on aspects of the STP and NHS services in the run-up local elections on May 3rd. Local Conservative Party candidate in Prittlewell ward, Kevin Buck, has called for a ‘Health Insurance Tax’ to fund the NHS.
He recently wrote to a resident:
“To re-iterate, my personal preferred option for funding the NHS is to have a direct ‘Health Insurance Tax’ (NHS Tax)…. This is my personal view for funding the NHS and if elected as a councillor, I would continue to lobby as such on this principal (sic).”
This flies totally in the face of the founding principles of the NHS and would demolish the NHS’s cornerstones of treatment: that it meet the needs of everyone, that it be free at the point of delivery and that it be based on clinical need, not ability to pay.
When Nye Bevan established the NHS in 1948, he explicitly rejected the idea of an insurance-based scheme to pay for it as “wholly inappropriate” also saying that “… we rejected the principle of insurance and decided that the best way to finance the scheme, the fairest and most equitable way, would be to obtain the finance from the Exchequer funds by general taxation, and those who had the most would pay the most.” 
Today, benefits like your State Pension and Job Seekers Allowance (JSA/Unemployment Benefit) are dependant on paying sufficient National Insurance contributions over a set period of time to qualify for these payments. If you don’t pay enough – you don’t get. Imagine being refused treatment by the NHS because you hadn’t paid enough into the pot! Will those who haven’t paid enough insurance have to pay privately or take out their own private insurance? Probably.
Bevan said: “I rejected the insurance principle as being wholly inapplicable in a scheme of this kind. We really cannot give different types of treatment in respect of a different order of contributions. We cannot perform a second-class operation on a patient if he is not quite paid up.” 
Mr Buck seems to be following Tory central government thinking and goes on to say:
“What I can also advise is that in the recent visit by Jeremy Hunt to Southend, along with others, I had the opportunity to meet with him. … Since his visit to Southend he has announced in the national media that he is looking in to alternative ways to try and raise more money for the NHS, which may involve some form of directly targeted taxation to fund it? I personally welcome this move, although for me it could go further, as I firmly believe that the NHS should be fully funded at all times by a direct ‘NHS Tax’.”
Additionally, Mr Buck incorrectly tells the voter that Southend Council is powerless to take action on the STP, wrongly asserting that it is only the Joint Health Overview & Scrutiny Committee (Southend, Essex & Thurrock) that has the power to refer the STP plan back to Secretary of State for Health & Social Care – it is not – it is the individual Councils that DO have the power to do this.
We don’t want to tell you who, and who not, you should be voting for. We want you to ask your candidates what their policies are.
Like Nye Bevan, we don’t believe an insurance-based method of funding is acceptable for OUR NHS.
 House of Commons Debates, vol. 592, cols. 1382?98, 30 July 1958. (https://api.parliament.uk/…/…/jul/30/national-health-service)
Text of the original correspondence.
Thank you for your correspondence.
I think before I let you know my position on the STP proposal, I would like to remind you of 2 key points that you should take in to consideration.
Firstly, whilst some may have forgotten, don’t wish to or can’t remember, or are ‘bored & fed up’ with the repetition of the message, I feel it is important to be reminded that the previous Labour government had effectively left the UK bankrupt by 2010. This is not political posturing by me or the Conservative party, this is a fact as stated at the time by the departing labour government’s own admission (remember the note ‘there’s no money left’!). It will take at least 1 if not 2 generations for the UK to fully recover from this irresponsible and politically motived poor financial management. A generation is considered to be around 20 years, so it could take up to 40 years for the UK to fully recover from this and to date, only 8 years have passed. Whilst some may consider this fact to be distant or old news, irrelevant, political rhetoric or not relevant today and say ‘we need to move on’, it is impossible to ignore the impact this will continue to have on me, my school age children, my disabled mother and her needs, you and your family and the generations of everyone to come. We may not fully recover from this until 2050, so someone being born today could be 32 years old before they no longer feel the financial impacts of the decisions made by the last Labour government? You may also remember that it was around this time that the UK lost its international ‘Triple A’ rating, which is a benchmark of its financial standing (effectively a Global Experian Credit Rating). The last time the country was in a similar position was in 1945 and it took until the 1960’s before things really improved! Politically motivated ideological promises may be comforting to the ears and tell people what they want to hear, but are rarely affordable. Don’t take my word for it, history has shown that for the last century or so, every time there has been a Labour government, they have over promised, overspent and failed to manage finances effectively. It has always taken a subsequent Conservative government to clear up after them and put the country back on a financial steady course.
Secondly, in relation to the Southend NHS Trust and the STP, there are some key facts to be
aware of. The most significant point to consider is that the local borough council has absolutely no power or control over how the local NHS services are managed or run. Anyone pledging or promising anything to the contrary in these local elections is giving misleading information to say the least. The NHS Trusts are run in a very similar way to that of Academy schools, autonomously and independently from local or county councils. They are allocated a budget by the department of health to run their facilities, have a set of guiding principles by which to operate, then run the facility within the allocated budget. Irrespective of the political party in power in the council chamber, no council or council leader has the authority or power to change this or manage the local NHS Trusts in any way. What the council can do is refer the STP to the Joint Health Overview & Scrutiny Committee (Joint HOSC). This is a cross party group of councillors from SBC, Thurrock BC & Essex County Council. If still dissatisfied, the HOSC can then refer that matter to the secretary of state for health. I will re-iterate, no council or councillor has the power or authority to change any decision made by the NHS Trusts. A recent vote in the Council chamber was simply to decide whether the council agreed or disagreed in principle with the current proposals. It may be this vote that you are referring to and the disappointment you felt with the outcome?
In relation to my views on the STP proposals I will say this. In an ideal world were money was no object, we would have every facility and service money could buy and all would be perfect.
A long and successful professional career along with parenthood of two wonderful children
has taught me though, to be a little more grounded, pragmatic and realistic. As a father of 2 school age children who use the NHS services quite frequently, as someone who now relies on the NHS for my own ongoing and continuous medical needs for the remainder of my life, as
someone who has an elderly mother who is disabled and as someone who had a sister who was
born with severe disabilities and was very well looked after by the NHS and adult social care system throughout her time with us, I can assure you that I am passionate and committed to the funding of our NHS services.
Some of the issues the Trusts are currently experiencing are not related to any funding matters.
The STP has said that one of the key drivers of this is that the clinical expertise to fully staff the current specialist units in the 3 separate hospitals is not available. There are currently vacancies for clinicians of varying qualification and expertise that are not being filled and this has nothing to do with the funding of these Trusts. The money is there now, but these posts are not being filled? Specialist units already exist in some areas of clinical treatment at the moment.
If you were to suffer severe burns at home today, you may go to Southend A&E, be assessed through triage, receive emergency treatment then be dispatched to the most appropriate facility for your medical needs. This may be a ward in Southend hospital, but you would most likely be taken straight to the burns unit at Broomfield hospital, so this practice already happens today in certain areas of clinical need. The STP simply want to expand on this principle and create dedicated and larger specialised units for other clinical needs that will be better placed to serve the needs of the people.
I can categorically state here though, that there will be ‘no loss of a hospital’ in Southend. The A&E department is not being downgraded, closed or reduced in any capacity or functionality whatsoever. We fought hard to keep it and have been assured that it is staying open and will continue to function as it does now, 24 hours a day, 7 days a week to serve the needs of the residents of Southend. In addition, some services may be centralised at another of the 3 hospitals, but others will be expanded upon at Southend. There are no plans to close or downgrade the hospital in anyway and some media reporting of this subject has been left somewhat wanting to say the least!
Under the aforementioned circumstances and given the current financial constraints the
chancellor of the exchequer and the secretary of state for health find themselves in, I can see the argument being made for 3 relatively close hospitals combining forces to create the
specialist units they have indicated. There are though, still some questions which remain
unanswered. Principally for me, the issue of transport to and from the 3 trusts, which remains unanswered. Until I have a satisfactory answer to this, which for me would mean a free and regular transfer service for both patients and family between them, I reserve judgment on this proposal. It would also be my intention if elected, that given my professional background of managing multi million pound budgets, to hold the STP to account to ensure that the quality of patient care and the efficiency savings indicated are realistic, achievable and ultimately achieved.
What I can also advise is that in the recent visit by Jeremy Hunt to Southend, along with others, I had the opportunity to meet with him. He has taken on board the concerns expressed to him over funding for the NHS services and has acknowledged that the NHS needs more money.
Since his visit to Southend he has announced in the national media that he is looking in to
alternative ways to try and raise more money for the NHS, which may involve some form of
directly targeted taxation to fund it? I personally welcome this move, although for me it could go further, as I firmly believe that the NHS should be fully funded at all times by a direct ‘NHS Tax’. This would mean that it can be fully funded at all times (as the level of the taxation applied would be reflective of the budgeted needs of the service), that it would continue to be free at the point of delivery but more importantly, be free from politics!
It is one thing to be ideological and have all the politically motivated answers people want to hear in an election campaign. The issue is that most ideology is rarely deliverable or affordable and reality soon sets in once the election dust has settled? Only you can decide who you genuinely trust the most to serve your best interests in Southend?
I hope you have found this useful and that it has helped you in your decision-making process
when it comes to May 3rd? I am passionate and sincere in wanting to serve the residents of
Southend because I believe I have the qualities and skills to be able to make a genuine
difference. The Conservative government will be there for another few years to come and as
local Conservatives, we can and do have a genuine influence with our colleagues in
I sincerely believe that I can achieve the best results for you and the residents of Southend, which will always remain my primary objective if elected as your Councillor for Prittlewell.
Thank you for your response.
The up and coming elections in May 3rd are to elect local councillors to determine and manage local council matters only. As explained in my previous correspondence, the Unitary Authority of Southend Borough Council has no control or veto over how any of the NHS services or facilities are run. The Trusts are independent from any local government management or control and manage themselves. To re-iterate, my personal preferred option for funding the NHS is to have a direct ‘Health Insurance Tax’ (NHS Tax) so that it is fully funded at all times, so will remain free at the point of delivery and more importantly free from politics. This is my personal view for funding the NHS and if elected as a councillor, I would continue to lobby as such on this principal.
As mentioned to you before, I would heed caution about anyone promising to change decisions being made by the local NHS Trusts if elected as a councillor. We have an excellent candidate in Cllr James Moyies (Standing in Thorpe Bay this year), who has worked tirelessly over a long period of time with the local NHS Trusts to have a positive influence with them. It is people like James, that have the genuine drive, understanding of the subject matter and professional negotiating and influential skills that we need to have in the council to ensure the best outcomes for all, rather than politically motived ideological but unachievable rhetoric.
I am not privy to any prior knowledge of national government policy, so cannot comment on this for you. If there is to be any change in the national NHS funding policy, it would be announced through the normal media channels. What we can do, is directly lobby our MP’s and those minsters responsible, as we have done so already and will continue to do so. I am happy to discuss your points raised regarding the national funding of the NHS at a future time with you once the local elections are over, but at the moment we must all concentrate our attention on the local issues pertinent to this election.
Thank you once again for your correspondence and I hope I can rely on your support in May?