Mr Hammond announced that under Conservative proposals, public service providers will be paid only on what they deliver, schools will only be paid for each pupil they attract, hospitals only for treatments they provide and the Conservative's welfare to work programme will only pay for each person they get into a "sustainable job".
A more short-sighted plan it is hard to imagine.
My main concern is the effect this will have on the National Health Service. Leaving aside the effects on other Government services, which would require a much longer blog than I plan to write, let us consider the Conservative's latest plan to weaken and devalue the NHS. For example:
Hospitals will have no incentive to invest in the prevention of illness.
Why stop smoking? The hospital won't get paid for that - but if you turn up, barely able to breathe, with a bad case of lung cancer: KERCHING!!! The Smoking Cessation Services across the country, that have helped people to quit smoking and eased the burden on the NHS will have to close.
The weight-wise programme will have to go!
Currently this service helps obese people to adapt their eating habits and stave off the potential heart disease, disability and cancers associated with their condition. All the obese people who urgently need this help can instead go and buy some chips! That way, the hospitals will get a nice windfall, when these non-patients start to keel over with a cardiac arrest or when they eventually need mobility care.
An End to Palliative Care
As part of cancer care, many hospitals fund additional, non-medical care, such as aromatherapy, reflexology and shiatsu massage, these therapies help cancer patients to cope better with the demands of chemotherapy and radiotherapy. The consultation with a local wig provider, who is paid to come into the hospital and advise on wigs and scarves: that's not a 'treatment' either, so no doubt, that will end too.
The NHS is not a widget factory, banging out an end product with a set process. The NHS does so much more than just "treat patients". It is a National Health Service, not a National Treatment Service. The 'outcome' of a hospital is not always providing a cure, often it is preventing the need for treatment in the first place. What does 'payment for treatment' mean for nursing homes and hospices? What are their "results"?
Economics cannot always be the driving force in public services. Care for the elderly for example, is never economical, to try to make it so will lead to a huge failure in quality of care and availability of provision.
All Philip Hammond has achieved today is to further demonstrate why the Conservative Party cannot be trusted with health-care and our NHS.