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Insufficient by what measure? You're comparing against - it appears - the second highest spender in the world. There have been no cuts in NHS service. Sometime

Insufficient by what measure? You're comparing against - it appears - the second highest spender in the world. There have been no cuts in NHS service. Sometimes I think I need to assign this to a keyboard macro because it's such a frequently repeated myth. The NHS has more funding now than it's ever had, it has been explicitly protected from budget reductions when every other government department has seen massive real cuts, and just last year has been given enormous spending boosts. NHS "cuts" are a bit like the gender pay gap - they exist only when statistics are abused to meet political and ideological agendas. Or, you could equally ask why Germany and the USA seem to spend so much on healthcare. After all the UK spends about average for the OECD. And the USA spends the most of all by far so it should barely notice COVID-19 compared to other countries? I guess we'll see.

elyobo 7y ago
I can't find stats to back this up either way; funding seems to have grown in real terms over time, but I can't see real funding per capita which is probably the more relevant factor.
- pmyteh 7y ago
  It has grown in real terms, but not as fast as either demand or costs. Healthcare inflation is very high, and greatly outpaces the CPI index that we use for 'real-terms' comparisons. Basically, the same funding in 'real-terms' doesn't buy you the same level of care as last year in any country. Plus Britain is getting somewhat older, and somewhat sicker (partly because of medical advances meaning that previously-fatal conditions are now chronic and need ongoing treatment). And we can treat more now, so there is more demand. Bluntly, the proportion of GDP which needs to be allocated to healthcare to maintain a good quality service is rising unsustainably in all countries. The NHS is beating CPI inflation (and in doing so doing way better than other parts of government: local government has seen >25% real terms cuts, which has trashed the social care system amongst other things) but not nearly enough to keep up.
rkangel 7y ago
NHS spending has not dropped, but it has not grown at the appropriate rate. There are various discussions that we could have about nursing numbers and junior doctor hours, but instead I'd like to provide one hard data point: Addenbrookes Hospital in Cambridge (technically Addenbrookes Hospital Trust, comprised of several hospitals on one site) is the largest hospital in the UK. For the tax year 2019/2020, the available budget for capital expenditure (building, large equipment like MRIs etc.) was £0. (accurate prior to Covid-19) Occasionally as a result of political manoeuvering (General Election campaigning) pots of money for very narrow purposes with a limited time window on them appeared, but in general things like ward refurbishments have been funded by charitable donations. Most worthwhile capital investments take more than a year, so a predictable capital budget is necessary to implement programs. Having no money for CapEx is not how you maintain a health service long term.
- Zenst 7y ago
  Yeah, let's look at where hospital money goes: https://www.mirror.co.uk/news/uk-news/hospital-bosses-face-1million-bill-10413015 https://www.mirror.co.uk/news/uk-news/hospital-bosses-face-1...
  - Zenst 7y ago
    Sorry for those who don't like facts that go against their political agendas :(
- thu2111 7y ago
  NHS spending has not dropped, but it has not grown at the appropriate rate Yes, this is how such threads always go. It's a simple three step process: 1. Someone claims the NHS funding has been cut 2. I point out that's a lie, no such cuts have ever happened and in fact the budget has always gone up 3. Somebody else replies with: but it should have grown even faster. The point I'm making is not about the correct level of healthcare spending, which is arbitrary and values-based as healthcare systems will consume however much money is given to them. Rather the persistent level of outright lying that accompanies any discussion of the NHS in Britain. It's absurd and quite obviously linked to a belief that misleading people is fine if it's for a 'good cause'. But this behaviour has to stop. It isn't OK to lie even if the outcome might appear to be desirable (more political pressure for higher healthcare spending). People learn that they're being manipulated and support for the desired cause can collapse. Having no money for CapEx is not how you maintain a health service long term. I'll repeat this until I'm blue in the face. The NHS has more money now than it's ever had. Not only does the NHS have money for capex but it's been repeatedly allocated money specifically and only for capex, because NHS managers have a long history of preferring to divert spending on upgrades to other forms of spending - frequently salary increases. It's bad management. The government attempts to combat this lack of forward thinking by earmarking of money specifically for upgrades (what you criticise here as "pots of money for very narrow purposes"). One of the first things Boris Johnson did is allocate a billion pounds to the NHS only for capex. Unfortunately it doesn't work: https://www.hsj.co.uk/technology-and-innovation/exclusive-quarter-of-a-billion-marked-for-nhs-tech-goes-unspent/7021476.article https://www.hsj.co.uk/technology-and-innovation/exclusive-qu... "Capital spending was particularly tight with only £150.3m spent from £354.1m of allocated funding ... funding to help NHS trusts to become more digitally advanced accounted for most of this capital underspend. The DH planned to spend £116.2m of capital on these trusts in 2016-17 – instead it spent nothing." The idea the NHS doesn't have money for capex is just another piece of misdirection. It refuses to spend on upgrades even when central government is trying to force its hand, because it knows that the result is No 10 will blink and give up, which is what happens: "The money was not allocated elsewhere but “as with all Department underspends, was available to offset pressures in other parts of the system”, she said."

elyobo 7y ago

I can't find stats to back this up either way; funding seems to have grown in real terms over time, but I can't see real funding per capita which is probably the more relevant factor.

pmyteh 7y ago
It has grown in real terms, but not as fast as either demand or costs. Healthcare inflation is very high, and greatly outpaces the CPI index that we use for 'real-terms' comparisons. Basically, the same funding in 'real-terms' doesn't buy you the same level of care as last year in any country. Plus Britain is getting somewhat older, and somewhat sicker (partly because of medical advances meaning that previously-fatal conditions are now chronic and need ongoing treatment). And we can treat more now, so there is more demand. Bluntly, the proportion of GDP which needs to be allocated to healthcare to maintain a good quality service is rising unsustainably in all countries. The NHS is beating CPI inflation (and in doing so doing way better than other parts of government: local government has seen >25% real terms cuts, which has trashed the social care system amongst other things) but not nearly enough to keep up.

rkangel 7y ago

NHS spending has not dropped, but it has not grown at the appropriate rate. There are various discussions that we could have about nursing numbers and junior doctor hours, but instead I'd like to provide one hard data point: Addenbrookes Hospital in Cambridge (technically Addenbrookes Hospital Trust, comprised of several hospitals on one site) is the largest hospital in the UK. For the tax year 2019/2020, the available budget for capital expenditure (building, large equipment like MRIs etc.) was £0. (accurate prior to Covid-19) Occasionally as a result of political manoeuvering (General Election campaigning) pots of money for very narrow purposes with a limited time window on them appeared, but in general things like ward refurbishments have been funded by charitable donations. Most worthwhile capital investments take more than a year, so a predictable capital budget is necessary to implement programs. Having no money for CapEx is not how you maintain a health service long term.

Zenst 7y ago
Yeah, let's look at where hospital money goes: https://www.mirror.co.uk/news/uk-news/hospital-bosses-face-1million-bill-10413015 https://www.mirror.co.uk/news/uk-news/hospital-bosses-face-1...
- Zenst 7y ago
  Sorry for those who don't like facts that go against their political agendas :(
thu2111 7y ago
NHS spending has not dropped, but it has not grown at the appropriate rate Yes, this is how such threads always go. It's a simple three step process: 1. Someone claims the NHS funding has been cut 2. I point out that's a lie, no such cuts have ever happened and in fact the budget has always gone up 3. Somebody else replies with: but it should have grown even faster. The point I'm making is not about the correct level of healthcare spending, which is arbitrary and values-based as healthcare systems will consume however much money is given to them. Rather the persistent level of outright lying that accompanies any discussion of the NHS in Britain. It's absurd and quite obviously linked to a belief that misleading people is fine if it's for a 'good cause'. But this behaviour has to stop. It isn't OK to lie even if the outcome might appear to be desirable (more political pressure for higher healthcare spending). People learn that they're being manipulated and support for the desired cause can collapse. Having no money for CapEx is not how you maintain a health service long term. I'll repeat this until I'm blue in the face. The NHS has more money now than it's ever had. Not only does the NHS have money for capex but it's been repeatedly allocated money specifically and only for capex, because NHS managers have a long history of preferring to divert spending on upgrades to other forms of spending - frequently salary increases. It's bad management. The government attempts to combat this lack of forward thinking by earmarking of money specifically for upgrades (what you criticise here as "pots of money for very narrow purposes"). One of the first things Boris Johnson did is allocate a billion pounds to the NHS only for capex. Unfortunately it doesn't work: https://www.hsj.co.uk/technology-and-innovation/exclusive-quarter-of-a-billion-marked-for-nhs-tech-goes-unspent/7021476.article https://www.hsj.co.uk/technology-and-innovation/exclusive-qu... "Capital spending was particularly tight with only £150.3m spent from £354.1m of allocated funding ... funding to help NHS trusts to become more digitally advanced accounted for most of this capital underspend. The DH planned to spend £116.2m of capital on these trusts in 2016-17 – instead it spent nothing." The idea the NHS doesn't have money for capex is just another piece of misdirection. It refuses to spend on upgrades even when central government is trying to force its hand, because it knows that the result is No 10 will blink and give up, which is what happens: "The money was not allocated elsewhere but “as with all Department underspends, was available to offset pressures in other parts of the system”, she said."