“Spend, spend, spend, Jeremy doesn’t say it, but he makes promises and demands that do.”

To: Don Wise

From: Paul Servant

Re: Economics vs Politics

So do deficits actually matter? No doubt the regulators, national officials, economists and accountants will say yes. But since they cannot set a balanced budget themselves, produce a tariff that adds up and they get a budget bung of their own whenever they need it, we shouldn’t take them too seriously.

Jeremy Hunt seems to be in a happy go lucky mood at the moment. Thousands of extra staff. Free parking. Better hospital food. A 24/7 NHS. No accident and emergency or hospital closures. You want it? You’ve got it. (Unless it’s in mental health.) Just don’t worry about paying for it, because Jeremy isn’t.

The history of deficits seems to change with the fashions. Former Labour health secretary John Reid didn’t care what it cost to deliver NHS targets and election success. It cost a £500m deficit, which his successor Patricia Hewitt blew a gasket over, and lots of leadership types lost their jobs.

We then entered a period of “macho surplus grip culture”, where the NHS was told don’t even spend everything Parliament said it should. It saved so much that it ended up giving £2bn back to the Treasury in one year (go figure!).

That’s all gone now. Grip culture is dead. Spend, spend, spend, Jeremy doesn’t say it, but he makes promises and demands that do.

So what now? Perhaps follow the private sector example where many companies carry permanent debt and frequent loss successfully for many years? Take comfort in the herd, now that 75 per cent of providers are likely to end the year in deficit? Or know that if you are a leader or politician not expecting to be in health after the general election it doesn’t matter.

But if you need to survive winter and still plan to be around after the general election, spend now and prepare to ride the Hewitt-like fury of Hunt’s successor after May 2015.