To want fact not a rose-tinted view of the NHS under Labour?

[iseenodust]

Can we just be clear that privatisation of the NHS was started under Blair? Virgin started providing NHS services in 2006.

This does not detract from the much needed debate around priorities, staffing issues, resources, ageing demographics, postcode lottery etc. Can we please just have the discussion without the hypocrisy? Why Labour should stop crying privitisation.

reawakening Why did I not know this? Why are we not told this? Why does my newspaper not explain this to me?

There are a number of reasons. The first is that modern journalists, on the whole, aren't very good with figures (usually because they are humanities or arts bods) nor do they tend to research issues deeply, usually because there is no budget for any kind of investigative research or reporting.

Public finances are also deeply unsexy. In a tabloid, a story about taxation can't really compete with the eyeballs attrached to a piece about, I dunno, Kim Kardashian. For a broadsheet, stories on child poverty, terrorism, Donald Trump, the EU, teenage hackers etc ... attrach far more interest.

And when it comes to broadsheets with a specific political bent, reporting properly on public finances can be extremely awkward because they expose failures on all sides of the political divide. The reality also destroys a lot of very politically convenient, historical memes that still carry a lot of currency today.

I have to say, however, that the one journalist that is extremely good on all this is Larry Elliot in the Guardian, but, to my mind, he's very much kept under wraps, probably for the above reasons.

The interesting thing about the NHS is that adequate funding is not a particularly new subject. Below I'll give you a link to a pathe news reel from 1957 shows there were issues less than ten years after the NHS was founded.

Note this response from a GP in the film.

".... if this situation is to continue we are going to have to limit the development in the way of extra staff, equipment, improving our premises which has been going on steadily since the Health Service began.

And in addition many of the particularly younger general practitioners are beginning to think about emigrating to other countries and I think this process if continued with is bound to effect the Service."

Now where have we heard that recently?

The NHS in Wales is not 'in a shambles' as far as I can see, it responds to local priorities in areas with a high level of long term ill health, focuses on prevention and rehabilitation and provides a good service despite the challenges of rural logistics and valleys poverty. There are problems, but it hasn't wasted money on the re-organisation and privatisation nonsense in England.

Tax credits weren't ideal- they are bureaucratic, overcomplicated and support low wage employers- but they lifted a lot of families out of poverty, made work pay and allowed a lot of parents to work part time to support family life, a huge improvement on family credit, if anyone remembers that. They were supposed to be integrated into PAYE but employers kicked up a fuss, and it went back to HMRC to pay them.

It would be very politically difficult to cut that pensions figure, though wouldn't it?
Especially since the proportion of pensioners vs working age people is likely to increase even more (especially if the immigration controls are successful). So there will be more money leaving the system, and much less tax being paid in as the number of those working and paying taxes shrinks.
I suspect the triple lock will go soon, though.

Giving more money into the NHS is pointless if we don't do something about social care. Properly funded suicidal care keeps people in their homes for longer, keeps them out of hospital, and if they do need to be in hospital it gets them out quicker.

In fact all community based support needs more funding. Another thing that the Tories did was close down the old asylums (good, absolutely needed to be done) and then tried to do care in the community on the cheap, and that does not work.

Properly funded suicidal care

Crikey, mirime, that's a bit harsh.

In my local area it is blatantly obvious that the NHS improved under Labour and is now in decline. The reason is simple -
it's being starved of funds. www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally

PFI has certainly been a mistake. It was started by the Tories, of course.

The economy is in a mess because the last thing you want is to take money from the poor and give it to the rich the poor spent their pittance in their local economy. the rich spent it on foreign holidays and spent more on imported goods. Trickle down does not work. The Tories are not paying down the deficit. They have blown the money loaned to the banks, which should have been recouped when they were sold and the money used to pay back the debts, on tax cuts fr the rich.

Five more years of Tory government and suicidal care is all that will be left.

Fully ageee with OP. Really irritates me that almost no one acknowledges this.

I also went to secondary school under Labour which was a PFI comp funded by a private company - Labour under Blair were obsessed with privately funding public services.

And my other favorite left wing hypocrisy is how everyone bangs on about TM being "unelected" (err that's not how the U.K. political system works since we vote for an MP not a PM but anyway) is that Gordon Brown got into power in exactly the same way!! Worse in fact since his rise to leadership was effectively a coronation by Blair. So I hope all those banging on about TM were equally vocal about Brown.

Werkz I swear I changed that back to social care! What is it with autocorrect??

Thank you Flowering and Werk I will follow up in the morning after the unavoidable body-tax that is Pilates.

Sugar Gordon Brown was accused of being unelected. I don't remember it but apparently so was John Major.

All sides are capable of hypocrisy, it's not a purely left wing failing.

Werkz bloody brilliant posts. Thank you.

The Tories are not paying down the deficit.

I think you have the deficit and the national debt confused here. The Tories have been correcting the deficit (the difference between annual revenue and spend), it currently stands at about £63bn to £70bn from the high of £160bn in 2010.

The national debt has not been reduced (or paid down) because in an environment of deficit, you are still borrowing your shortfall. These borrowing requirements add to the overall national debt that, as a result, increases.

The reason is simple. It's being starved of funds.

You always need to be careful with figures that compare rates of spending to GDP (as in the article you cite) because GDP is a measure of an entire economy. Your economy shrinks or is small, your healthcare spend can look high, and visa versa.

To some extent, you could raise the % GDP for healthcare spend in the UK by just removing money from the economy by whacking up the interest rate. It wouldn't mean the actual NHS spend was higher or better; it would just mean your GDP shrank.

According to the world bank, British spending on public healthcare is currently 7.6% of GDP. What does this actually tell us? Well, considering public health spend in Lesotho is 8.1% of GDP, not very much. Are we really suggesting that public healthcare in Lesotho is better than the UK?

What gives us more of an idea is to look at public health expenditure as a percentage of government expenditure: ie. how much of our annual budget goes towards public healthcare.

Here, the UK spends 16.2%, Spain 15.3%, Italy 14.2%, Ireland 12.1%, France 15.6%, Austria 16.2%, Portugal 13.4%, Belgium 14.9% ... but it becomes complicated to compare because similar principles apply. Private healthcare may make up more of total healthcare expenditure in another country; there may be a mechanism for private top-ups to public health provision that do not show up in the public expenditure stats; such private care maybe cheap; different budget priorities may mean the cost of public healthcare appears high etc.

For example, take Portugal at 13.4% on this measure ... public healthcare expenditure in Papua New Guinea is 13.2% on the same measure. The idea that Portuguese public healthcare is comparable to that in Papua New Guinea is somewhat bizarre.

Interestingly, on this measure, the overall public healthcare spend as a percentage of government expenditure for the EU area is 15.9%. So Britain spends a greater percentage of its public funds on public healthcare than the EU average.

These are all world bank figures by the way. >> World Bank figures for health expenditure, public (% of government expenditure)

The thing is you can work stats to create whatever narrative you want, which is why you need to be so careful about them. Take the US ... they spend an extortionate amount of government expenditure on public healthcare. It's about 19.5%. But that doesn't mean that US medicaid and medicare provides a better and more comprehensive service to US citizens that qualify for those services than the NHS does to a similar segment of the population in the UK.

@Werkzallhourz

Well, haven't your posts been an education!

Reading that post back, it sounded sarcastic. It wasn't supposed to be.

I knew lots of what you wrote, but you certainly clarified a lot too and it's good to see some figures in there.

Thanks

Really interesting thread. So nice to have discussion without it resorting to name calling.

Thanks again flowering.

"Gross spending on pensions for former public sector employees will approach £36 billion this year. Despite some reforms, these pensions, and those being accrued by current public sector workers, are hugely more generous than almost anything in the private sector."

My husband is on a university career earnings scheme. (It used to be final salary until this year). It's called the Universities Superannuation scheme.

I am self employed and paying into a private scheme that often doesn't seem worthwhile.

Is my husband in the USS part of that £36billion accrual/spend mentioned in the article?

Are GPs in that £36b despite being self-employed?

"Giving more money into the NHS is pointless if we don't do something about social care."

Yes there seems to be widespread agreement on this.

How do we manage to spend £4.2b on broadcasting?!?!

Final question for now, can someone tell/remind me what being Keynesian is in Werk's posts? Is it something to do with whether you will borrow?

Keynesianism is the term for the economic principles of John Maynard Keynes, a political economist who, in the 30s, revolutionised thinking about economics, in particular how to run state and transnational finances.

He was part of the left wing intelligentsia in Britain at the time.

Basically, Keynes believed that governments should run a surplus during a boom, and then use that money to offset lower tax receipts during a recession, thus providing stability in state finances across the economic cycle.

The Labour party superficially upholds Keynesianism as its model for public expenditure because, roughly, it is seen as the alternative to monetarism (which is perceived as the back bone of Thatcher's economic policies, and focuses more on tweaking economies through manipulating the money supply). In practice, what this tends to mean is twisting Keynes to support whatever fiscal policy they are currently promoting, often in ways that make absolutely no sense.

However, what needs remembering about Keynes is that he was formulating his ideas before the birth of the welfare state (ie. the NHS, postwar nationalisation, and the welfare system) but after the introduction of national insurance. Britain was also still on the gold standard, which suppressed the money supply.

Sorry, maybe that's a bit unclear.

When I say "run a surplus during a boom", I mean a budget surplus. During a boom, tax receipts will rise because there is more economic activity. So the idea is that governments don't spend this extra money they receive, they save it. Then when there is a downturn in the economy and tax receipts fall, the governments then use this saved money to avoid having to cut public spending.

The idea is to ensure stability in state spend because cuts in public spending have negative repercussive effects across the economy, which you simply do not need at a time of recession.

"Sugar Gordon Brown was accused of being unelected. I don't remember it but apparently so was John Major.

All sides are capable of hypocrisy, it's not a purely left wing failing."

Yes, both were accused of being unelected. Theresa May herself told Gordon Brown he had no mandate!

@Werkzallhourz, thank you for your helpful posts. Has given me much to think about.

Two points though I would like to raise. You say 'The idea that Portuguese public healthcare is comparable to that in Papua New Guinea is somewhat bizarre". I take it though that PNG's GDP is a lot smaller so whilst they may spend the same proportion on healthcare as Portugal the actual spend will be lower, though? So not so bizarre?

Also I only just today gave that link about Labour borrowing less in the last 70 years than conservative. You breaking it down has definitely been helpful and made me want to reevaluate my initial reading of it. However, your u refer to Tories having to spend more in the 1980's to pay off the high costs of the 1970's. Do you know whether Labour borrowed less than conservative govts between end of the 2WW to the 1970's? Thank you.

Ps Google tells me only two Labour governments between 2WW and 1970's.

Thinking more about this. Couldn't the answer be to still try and reduce the deficit but not as quick and deep as Osborne did?