Where has the money for the NHS and schools gone?

[EmmaGrundyForPM]

I'm not an economist so please cam someone explain this in lay terms to me?

The NHS and schools need far more funding. Along with other public services. But why is this? Taxes have risen, some costs have gone down, and yet there's not as much funding as,say, 20 years ago.

I work in local government. We've had wage stagnation for at least 10 years. In real terms, my pay is about 20% less. That's the same in a lot of other public services. I appreciate that other costs, especially building ones, have gone up.

Given that, as far as I can see, taxes haven't gone down, why is there now far less money to pay for public services?

But you can make sure it isn't going I to the hands of private company shareholders. You can make sure it isn't wasted on inadequate providers or frankly unworkable/ill thought out schemes like Stockholm Bibby and Ruanda. You can spend it efficiently and effectively. You can see the problems of increasing people's workload so far and so overwhelmingly that they give up (teachers nurses) - you may save money in the short term but in the long thern everything crumbles.

I think there are better and more effective ways of spending the budget. I also think that there should be higher taxation of the very rich and a change of policy to reduce tax avoidance issues.

@sleepyscientist I honestly don't understand it either 😕 kids are given a list of required equipment yet half of them don't seem to be ablento bring in a pen. We aren't allowed to seen to discriminate so have to provide it if they haven't got it (where in my day you would have had to borrow a mates), then most of these pens get destroyed. We go through 100's of the dam things and don't start me on glue sticks. They would never forget their phones 🤔.

Laptops is a bit of a more difficult one as school computers have a lot of blocking software on them. I think that would be harder to setup and we don't have many IT staff.

Oh and trust are a huge wasted money, they do seem to add in a lot of high end management on rolls over 6 figures who have no student contract and aren't adding much value for the schools.

Can you substantiate the total of their expenses and wage increases please?

How do you plan to reform GP surgeries then, because they are run by share holders funded by the NHS.

In this order

Staff
Estate (buildings)
Tech equipment

The total cost of Covid, was between £300-400bn which the Government had to borrow. Now we need to both service the interest and try and pay it down a bit.

https://commonslibrary.parliament.uk/research-briefings/cbp-9309/

Thanks for your replies everyone. I'm aware of some issues such as greater demand for social care, as we have an ageing population, but I know that doesn't apply to everything.

I appreciate the population has grown due to immigration rather than birth rates, but that means more tax payers, surely?

And I know there was the impact of Covid, but there were issues pre Covid. It just feels as though there should be more money than there is

Yes immigration does mean more tax payers, but a large proportion of those tax payers will be poorly paid (such as those in care work, cleaning, the service industry, agriculture, all of which have high levels of migrant workers) and their tax will not cover the additional cost of e.g. the levels of elderly care required.

The majority of people in the UK are not met contributors. Most of us will take out far more from the system than we pay in.

Don't forget that we bring in a lot of immigrants for technology and healthcare roles (like doctors and nurses), because that way we don't have to fund their educations (even subsidised with tuition top-up). We can just import them fully qualified and collect taxes from them without investing in the training.

As ever, people love to blame immigrants but I think only those living under a rock have failed to notice that the immigrants are WORKING in the NHS and schools, not taking up places!

@RayonSunrise exactly!

It's the myriad of treatments now available in the NHS - I don't think I know many in their 60s who haven't had some treatment - kidney stones, broken wrist, scans of various parts (they were only really in use in the 80s), any type of cancer, heart by passes (10 a penny now), hip replacements. In the 50s my DGM got cancer and died, only being admitted in the last week or so. That doesn't happen now.

Gove made the curriculum ridiculously harder, including at early years/ reception level.
This means that a higher number of kids can't keep up with expectations from a very early age and automatically you get higher "SEN" and higher levels of student anxiety because of the pressure they are under

There's a knock on effect as school staff are also under pressure to attain these ridiculous results in an over packed, over difficult curriculum. They are then less resilient in dealing with students who are finding life difficult in one way or another. Ofsted then compounds all this as schools get very little kudos for being supportive, nurturing and inclusive but are easily marked down on attainment. Plus schools where everything is OK, that used to be graded satisfactory, are now graded at "requires improvement", which is a psychologically damaging term for something that is basically, nothing much wrong.

So, hard over packed curriculum, anxious students and failing students then leads to increase in anxiety based school avoidance and requests for ehcps. This all compounded by COVID school closures and subsequent focus on "catch up" instead of the soft skills that underpin learning - attention, attunement, listening, turn taking etc.

Basically, most of it boils down to government policy. Effing Tories.

We were still paying off the costs of the financial crisis when Covid hit. We (taxpayer) still own parts of the banks that were nationalised then to stop them collapsing. Real wages haven't returned to where they were in 2007 yet. The economy's growing very slowly so that means our debts (from the financial crisis, Covid and general borrowing) weigh more heavily. We also have higher rates of economic inactivity (working age people not participating in the workforce) than comparable countries. And we can't have a pro growth policy because Liz Truss totally poisoned that type of approach and made the money markets nervous (long term growth means borrowing for investment).

So all that plus the growing population (2011-12 baby boom hitting secondary schools around now), burden of ill health and collapsing education buildings and high levels of hcp and teaching vacancies.

Plus we had some of the highest inflation in the OECD and it's come down more slowly than in similar countries.

So really quite a few problems, some shared by many other countries and some more UK specific (Brexit, Truss, whatever's keeping the over 50s out of work).

Just to clarify, the total budgets for the NHS and education are the highest they've ever been in money terms. It's what they need to cover that's the issue.

In even fewer words: backlog maintenance.

What nonsense. Honestly, I really do wonder about the intelligence of some people on here. There are 650 MPs, each with a salary of just over £91k after this year's pay rise.
That's a TOTAL of around £59m. If my maths is correct, this year's 5.5% payrise totalled around £3.25m. And you think that will pay for the shortfalls in all public services and NHS?
For Goodness sake

Totally agree with Dr Ruth!

I know. It’s a tired, ridiculous refrain at this point, which diverts from addressing the actual issues

Shit wages mean lower amounts of tax paid per capita. If the money is all syphoned off at the top, it goes into offshore tax dodges. The more the workers are paid, the stronger the economy as we'd all pay more in taxes and spend more on everyday items. But no, the shareholders must come first!

Liz Truss blasted through a lot of it. Tory MPs mates got a share. They don't tax the rich. There is a public debt of 100% , up from 35% 15 years ago. They (we) are still paying for the financial crisis and the incompetence of the financial sector, and of course we have wars we apparently need to support and gas /energy prices through the roof to subsidise.

www.reuters.com/world/uk/next-uk-government-faces-toughest-challenge-since-1950s-debt-ifs-2024-01-25/

They can when it’s stiff the government want to fund.

Its all choices. Austerity was a choice.

Staff leave for better paid jobs, which are then covered by agency workers for more money.

Staff take on too much extra work and burn out taking more sick days, needing covering by agency staff.

People realize that the staff are being worked too hard and don’t want to apply for roles.

Private sectors offering more money in some cases 10-15K more for steady hours - paid over time and more holidays.

Thats where the money is going and increased gas and electricity bills.

I think a lot of public sector money is mis managed. For example I don't know if it's true but a hospital Dr friend said if we buy generic paracetamol it costs pennies for the cheapest packet on the high street. However if it's prescribed in hospital it costs something ridiculous like £9.

I work in Banking and spend considerable time looking at the finances of care home owners. There are many doing extremely well because the local authorities they deal with are so terrible at negotiating fees. For example one client said they pretended they were going to close the home which has over 100 rooms. The local authority panicked and increased the fees they will pay him by 40%. The panic driven by not enough homes with an aging demograohic. This particular client is a multi millionaire and had absolutely no intention of closing the home. I could give many many more examples.

So I do think poor management is a huge contributing factor for this problem.

This is an interesting point. The NHS is trying to fund sooooo many more things for 'free'. So waits are long. But more paid staff would reduce waits.. but no money to pay them

And profiteering by the likes of the care home owner.