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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

120 replies

iseenodust · 21/04/2017 12:36

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.

OP posts:
squishysquirmy · 24/04/2017 19:14

That's my opinion sleepy. I agreed that cuts needed to be made, but the extent of them was counter productive; cut the fat - fine. Cut into flesh - cause pain. Cut into bone - cause issues which will cause economic problems in the long term. Sorry for the gross analogy, but I do think that the level of austerity under the last government went so far as to be counter productive, and was not evenly applied.

Certain areas of society, and certain regions, bore the brunt of austerity whilst others (cynically, I'd say the demographics most likely to vote Tory) got off relatively lightly. The massive cuts to councils, for example (which is related to the NHS because it is interconnected with services like social care) led to decisions which will cost far more in the future to reverse than they ever saved. But the council gets the blame, not the government. Never mind the scandal of Conservative councils like Surrey receiving "sweetheart" deals not available to other areas.

And after all the pain of austerity, the target for reducing the deficit has now been scrapped by Hammond anyway.

reawakeningambition · 24/04/2017 21:06
Werkzallhourz · 25/04/2017 16:10

sleepyowl

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?

That measure was the percentage of government expenditure spent on public healthcare, rather than the percentage of GDP. But yes, you are right. I was including that example to illustrate why such comparative measures (% of this and % of that) do not really tell us very much about the reality of healthcare on the ground.

Do you know whether Labour borrowed less than conservative govts between end of the 2WW to the 1970's?

Oh crikey. To give you a proper answer, I'd need to write a small lecture series. Grin So this will be very rough.

The situation between 1945 and 1976 was rather complicated. Basically, the entire public expenditure paradigm was very different, and was much more about the instability of the overall economy and money supply.

You have to start from the point that Britain's national debt in 1945 was 238% of GDP (this is beyond horrendous). In order to deal with the fallout from the war, Britain saw the "Austerity Britain" period, was essentially forced to save many areas of industry through nationalisation, taxes were pretty crippling etc. As an anecdotal example, my DGM was paying superannuation tax on her job packing soap in a factory in the late 40s.

The real killer, though, was the 1970s period, particularly when Harold Wilson (Labour) resigned over the failure of the Public Expenditure White Paper in 1976. The prior circumstances around this are varied, but basically there was an oil crisis (petrol prices doubled), Bretton Woods had ended, currencies were free floating, energy and commodity prices went through the roof, credit had been deregulated, and Britain entered a period of stagflation (recession and inflation). This was not helped by a prior policy of printing money to cover costs.

Wilson's government was elected in 1974 with no overall majority and the campaign was driven with this notion of "going German", i.e. trying to get unions to work with employers in the German style, plus a commitment to public spending. This created a loss in confidence in sterling and the pound devalued, as pretty much the unions took this as an opportunity to seize control of whatever they could.

Then Denis Healey (Labour Chancellor) comes along and tries to stabilise the situation by decreasing the deficit by raising taxes and decreasing spend and restricting the supply of money ... and all hell breaks loose. They end up needing to borrow £9bn (which was a record at the time). Eventually, in 1975, the Cabinet agrees to Healey's limits on public expenditure, which go into the White Paper, which the left wing of the Labour party then defeats.

The pound then continues to lose value and needs a loan to support the currency. The IBS gives a loan of $5.3bn but wants it repaid six months later. It becomes obvious Britain can't do that, so it ends up going to the IMF.

Yes, the IMF. Britain requests $3.9bn, the largest loan ever requested from the IMF. So big, in fact, that the IMF has to go to the US and Germany to ask for more funds to cover it.

The conditions for this loan were harsh (Greek-style harsh) : massive cuts in public expenditure and the budget deficit. Things get very nasty and we end up with the Winter of Discontent.

It is into this economic disaster zone that Thatcher is elected in 1979, and basically starts to tackle the underlying issues, which then gets her labelled as the most demonic creature ever to have existed in Britain, despite the fact that "her" economic policies have been circulating through government since Harold Wilson, but neither Heath, Callaghan or Wilson could politically go anywhere near them.

I say all this because every government between 1945 and 1979 inherited a pretty stinky economic and financial situation on a range of measures. Yes, Wilson wasn't great (and very hobbled by the left wing of his party), but neither was Heath. Healey did what he could, but, again, he was battered by the leftwing of his own party.

#Disclaimer: I have a very soft spot for the late Denis Healey Blush

So when it comes to borrowing, deficits or public expenditure decisions from Labour in this period (and Conservative), I kinda think you have to recognise they were stuck in-between the devil and the deep blue sea, plus central government ministers had no control over local government expenditure, which, in some areas, was just potty and added to the PSBR.

What makes 1997 to 2010 different is that Labour wasn't caught between a rock and a hard place, and that's why I can't forgive them for their spending decisions during this period.

All that is very rough, and I've missed loads of important bits out, but my position is that the borrowing of Labour and Conservative governments prior to Thatcher tend to be a matter of necessity, rather than political gain.

lucydogz · 25/04/2017 16:33

Who are you werkz? Do you do a blog or a column elsewhere, because your posts are the most lucid and intelligent I've read anywhere. Is it possible to give us a hint without totally outing yourself?

lucydogz · 25/04/2017 16:35

....and can I ask you how you'll vote?

RachelRagged · 25/04/2017 17:00

I wish we could get rid of the parties altogether at the moment. Will no one think of the good of the country, not their own power / pockets?

Damn Right .. Totally agree with you .

reawakeningambition · 25/04/2017 19:37

No no!

We can't ask who Werks is!

Crumbs1 · 25/04/2017 19:39

Fact

To want fact not a rose-tinted view of the NHS under Labour?
Crumbs1 · 25/04/2017 19:41

Fact

To want fact not a rose-tinted view of the NHS under Labour?
reawakeningambition · 25/04/2017 19:49

Werkz should work for the new WikiTribune

PerkingFaintly · 26/04/2017 07:15

Pretty prose, werkzallhours, but your figures are wrong.

From HM Treasury Public Expenditure Statistical Analyses 2016
www.gov.uk/government/uploads/system/uploads/attachment_data/file/539465/PESA_2016_Publication.pdf

pp74-5 Table 5.2
Police expenditure in the UK in 2015/16 was £16.645 billion
Broadcasting and publishing services: £3.945 billion

So no, we don't spend more on broadcasting than on policing. Or anywhere near.

p74
Fire-protection: 2.821 billion
Law courts: 5.691 billion
Prisons: 4.092 billion

Total approx 12.6 billion. Not £26 billion.

And so on.

reawakeningambition · 26/04/2017 10:37
ShotsFired · 26/04/2017 10:57

I would like to join the pp thanking @Werks for their clear and helpful explanations. Their non-partisanship is just the icing on the cake of lucid writing.

PerkingFaintly · 26/04/2017 14:06

Yep.

Beautiful eloquence; factually wrong.

This site has some nice, easy-to-read graphs which seem to be using the Treasury data.
www.statista.com/statistics/298637/united-kingdom-uk-public-sector-expenditure-police-services/

PerkingFaintly · 26/04/2017 14:08

And I'm Grin at werkzallhours warning people off comparing healthcare as a percentage of GDP because GDP can change (correct), only to plunge merrily into a shower of figures comparing healthcare as... a percentage of public spending (even easier to change than GDP).

What's actually spot on, is that percentages alone don't tell us enough. As demonstrated, it's easy to find a Lesotho which has the same percentage as the UK for... something.

That doesn't mean figures have no value at all, of course.

If anyone does want international comparison figures - including actual expenditures not just percentages - here's a table from the same WorldBank site. wdi.worldbank.org/table/2.12

It has more up-to-date figures (2014) than werkzallhours's WorldBank link.

For the UK, total healthcare spending in 2014 was

9.1 % of GDP
83.1 % of that healthcare spend was publicly funded
9.7 % of that healthcare spend was out of pocket (direct outlay by households)
$3,935 is the UK's expenditure per capita on healthcare, at current US dollar value
$3,377 is the UK's expenditure per capita on healthcare, valued in international dollars converted using 2011 purchasing power parity (PPP) rates.

PerkingFaintly · 26/04/2017 14:26

By the way YANBU, OP, to remind people that the last Labour government aimed to privatise the NHS (regardless of niggles about which bits were private already).

They skinned it, the Coalition cooked it.

I don't agree with your New Statesman article from 2015, that Labour "can't escape its past". It escaped its past enough to embrace the privatisation in the first place, and is now having to reinvent itself yet again.

But it's annoyed me in the last few years when people haven't pressed the Labour party on this issue, and just assumed it'll be anti-privatisation. I'll be reading the detail of what the parties are offering, not making assumptions.

ilovegin112 · 26/04/2017 14:52

Thanks Werkz those posts were very informative

reawakeningambition · 26/04/2017 15:48

I want an economist-off!

PerkingFaintly · 26/04/2017 15:53

Also completely agree with mirime and reawakeningambition et al on this:

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

The huge cuts to social care under Austerity weren't just a backdoor cut to NHS funding, they're hugely expensive to the combined social care and medical care system. Good social care keeps people healthier and out of hospital in the first place; lack of it means they can't leave hospital.

Between 2013 and 2015, bed-blocking rose by 31% to 1.15m bed days lost. www.bbc.co.uk/news/uk-36466409

PerkingFaintly · 26/04/2017 15:56

And actually it's generally true of the Austerity cuts, that they simply moved costs around - eg off a local council's budget sheet onto the DWP's or vice versa.

Often increasing the cost in the process.

PerkingFaintly · 26/04/2017 15:58

Sorry, that was badly written.

generally frequently true of the Austerity cuts across many fields

EC22 · 26/04/2017 16:08

I watched this today and found it really informative.
juniordoctorblog.com/2017/04/26/the-nhs-a-visual-essay-from-juniordoctorblog-com/

ilovegin112 · 26/04/2017 16:23

You could pour billions and billions into the NHS and nothing would change, the whole thing needs an overhaul

ForalltheSaints · 26/04/2017 16:34

The point the OP makes about the Blair years is a valid one. Hence my referring to the last Labour government ending on 4 May 1979.

However, I am confident that the NHS will get worse when the Tories are returned on 8 June. Things were better under the Blair government, when there were fewer obese and overweight people, very few winters (at least in the south of England) and a population that was younger on average.

blaeberry · 26/04/2017 16:52

I think a lot of the problems with the NHS are due to the way it was set up in the first place; pulling together lots of private doctors and hospitals with vested interests not wanting to give up their independence or level of private income. It has never been the logical cohesive public service of myth. Also the fact that you don't pay (directly) to use it means the public are horrified at any discussion around cost and limitations to the service, often very unrealistically. Everything must be provided and free on the NHS.