Armchair politics

I’ve still got most of a large jar of Robertsons mincemeat left and am considering going once more to the breach and using it up rather than saving it for next December. Muffin times beckon but not quite yet.

And then Hot Cross Buns. :heart_eyes:

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Another batch coming to a kitchen near me soon as well :yum:

Then in a couple of weeks we’ll switch to hot cross buns, for the rest of the year if I have my way :grin:

In time for next Saturday? Most of the AAMPAC will be there (Audio Abattoir Mince Pie Appreciation Club) :smiley:

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Now there’s a society guaranteed to eat you alive

So, our Government would tell you that spending is at its highest in real terms which is sort of true. Here is a graph of expenditure in real terms and lo and behold it is hard to disagree (based on this graph) that spending has been higher in real terms.

image

However, what that graphic ignores is that we have had almost zero price growth in a decade, so normalising using the CPI or RPI is going to be almost meaningless. More to the point, I as am NHS user am only interested in the quantity and quality of services available to me. As it is free at the point of service, the price should be irrelevant to me. What about the amount the Nation has spent on the NHS, as a proportion of National Expenditure? This measure encompasses both price, quantity and composition elements and is unit free:

Read about it here. As a proportion of GDP we now spend 8.5% of GDP on healthcare, down from 8.8% of GDP, or a cool £14 Billion.

This may be why Mr Hunt has largely disappeared from view and Mrs May is on the Telly today apologising to patients and praising Doctors and Nurses.

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We also spend less as a proportion of our national income compared to most advanced countries, IIRC

This is true. The OECD publishes data on this. I believe the UK is in the bottom tercile of the countries that are surveyed.

I like graphs.

Me too. I really like tables of data also. :nerd_face:

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me too

[devilsadvocate] Statement of the obvious: if you want to change a fraction, e.g. NHS Spending divided by the GDP then there are two ways of doing that. You can change the numerator or you can change the denominator. I fear the reason that the graph goes up so ‘pleasingly’ just before the grey section is because the country’s GDP (the denominator) tanked as a consequence of the global financial crisis

It’s true that the increasing demands of an ageing population mean that your curve needs to keep rising if standards are not to fall. So the flat/falling ‘greyed’ part does represent a real fall in standards. But we shouldn’t forget that the percentage graph is the result of several things changing. [/devilsadvocate]

VB

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[obvs tl;dr fodder]

It looks like real term funding growth until you have to net off the in year and cumulative affect of other pressures and NHS inflation including

  • wages (yes even though there is a pay freeze increments go up and people get rebanded etc)
  • drugs and medications
  • medical technology
  • demographic growth, specifically more older people using more services

In real terms these amount to an in year cut in funding of c 4-6%. To put this into perspective, in a system like say Nottingham (city and south counties) the total alllocated funding is c £1.6bn and in 18/19 the effect of these unfunded pressures will be c £70m.

So what’s not having £70m mean? - we’ll for Notts its probably something like halving all community services, or reducing spend on continuing healthcare (elderly care/ nursing home & domicilary care) by 75%, or shutting about 50 acute hospital wards/ about 1500 beds, or only writing 60% of prescriptions etc etc. So practically speaking, not possible.

It’s exactly the same for every health system up and down the country. Most have avoided wholesale cuts to services so far by spending all of their reserves, contingencies and money for investment in services, and/ or going into debt (which they’ll never be able to payback due to compound pressures as above).

I say so far because now all the budgets have been raided and every other financial wriggle has been exploited, the only choice left now for 18/19 is going to be rationing, limitations and cuts, with the worst affected being the most vulnerable as usual. Think it’s bad now, just wait and see.

There is scope for efficiency and integration but the kind of changes and the scale required have long lead times and require cross system co-operation that the stupid artificial ‘market’ that was created and failed (except to help prop up acute hospitals via tariff) not only undermines but actively disincentives.

I’m afraid to say it’s been so shockingly mismanaged for such a sustained period of time, and worsened over the last 8-10 years, that the only choice left for any government is to throw money at it in the short term to try to prop it up, and nothing like the piecemeal offerings we see when the DH gets cornered, I mean cash injections in the order of £7-10bn in the coming financial year and available now.

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Yep, it is a normalisation, and as such depends intrinsically on the point of reference. However, NHS spend as a % of GDP is unit free so it is free from a move from (e.g. CPI to RPI) one price index to another as the method for calculation of GNP and/or GDP is fixed across nations. This is important because if you want to make valid international comparison you need to avoid issues with a numeraire currency.

Also, despite the sample period being different in the two graphs, there is a trend with a mean shift at 2008:4 (roughly), in the GDP series, but the trend in the series is recovered after roughly 4 quarters. The NHS share series suffers a break in trend at 2010 and experiences a sustained decline.

Anyhoo, the point is that this is clearly the deepest and most sustained cut to NHS since modern record keeping began. Now where is that £350 million/week we were promised?

I heard her ‘apology’ on the radio earlier. She couldn’t have sounded less apologetic and disinterested if she tried. Not a trace of empathy or humanity in her voice.

The only time her voice has displayed a trace of humanity was when it disappeared during her speech at the Tory Party Annual Conference.

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44% Tories are aged 65 or older. They score highest on
“Schools should teach children to obey authority”.

So the gangbanging generation of the swinging sixties failed to decently raise their own children.
And 2 degenerations later they complain about it. :joy:

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FXT

I don’t know much about Business Insider or the agenda it runs, but they are doing a lovely line in character assassination, or in BoJo’s case, lack of character assassination:

Might explain why in waded in behind Toby Young when anybody sensible would have left it alone, or it might not, in which case pointing out Boris is an arse is a useful thing to do if you are amusing when doing it.

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tank-topped bumboy

A new action man figure for the 21st century?

I’ll let the more entrepreneurial among you take that one to the Dragons’ Den.