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> Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. If this were the t

> Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. If this were the true issue, the excess deaths would have been starting at peak Covid hospitalization. In fact the opposite is true… That said, particularly on any bureaucracy- more money doesn’t solve issues. In fact, more money often makes more bureaucracy. Obviously that’s not only the case, but it’s one I’d seriously consider here.

heurisko 4y ago
The UK has been spending less on healthcare as a percentage of GDP than comparable European countries, Germany and France. I agree more money doesn't solve the issue, especially as so much money was wasted on Covid testing and private beds that were never used. However in my lifetime the difference in healthcare spending between New Labour and Conservative has been noticeable. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2019&locations=DE-FR-GB&start=2000&view=chart https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2...
- makomk 4y ago
  I'm not convinced that the UK has been all that comparable to Germany and France for years. GDP is of course an imperfect measure of the real size and capacity of the economy - Ireland has about twice the GDP per capita of all of those countries, but there's not really any way for their government to capture that economic activity as funding for stuff - and certain other metrics are not so great. For example, the average UK household is apparently £8,800 a year worse off than in Germany or France (median income, adjusted for purchasing power) and that gap's been there since about 2008: https://www.theguardian.com/business/2022/jul/13/average-uk-household-8800-a-year-worse-off-than-those-in-france-or-germany https://www.theguardian.com/business/2022/jul/13/average-uk-... In some sense, the UK became poorer than the other European countries it'd normally be compared to at the end of the previous New Labour government when the financial crisis hit and just never really recovered from that. It's possible there is no obvious way out anymore - everyone being poorer means less means less money for them to spend on consumer products and services and less tax revenue the government to spend on things like healthcare and infrastructure, and all of that means less businesses interested in setting up in the country (for reasons other than low taxes anyway) and less tax revenue, less well paying jobs... it's a vicious circle to be stuck in. Even before that happened, the New Labour-era spending was obviously unsustainable at the level of tax they were willing to charge. Despite the economy booming and a bunch of NHS infrastructure spending being moved off government books via expensive PFI programs the national debt went up consistently as a proportion of GDP year after year. Afterwards the Tories made a big fancy show of austerity and cutting back on government spending (and to be fair it did eliminate the deficit like they promised, for a while anyway) but even their big scary austerity program only froze the proportion of GDP spent on healthcare for a while.
  - jotm 4y ago
    On the bright side, there's more opportunity and mobility in the UK. Just have to get off your ass and hustle. But that's something most people don't use or even like. A stable job and better safety nets are preferred, and here DE/FR/etc excel.
  - pcrh 4y ago
    I'm impressed by how you managed to blame the current situation on Labour, despite the Conservatives being in power for 12 yrs.
- inglor_cz 4y ago
  As a counterpoint, this is the same graph, but with the Netherlands, Belgium, Denmark and Norway chosen instead of Germany and France. All nice developed rich northern European countries with reasonable life expectancy and life quality. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2019&locations=GB-NL-BE-DK-NO&start=2000&view=chart https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2... Their difference from the UK is negligible.
  - jotm 4y ago
    Belgium's system works way better than the Netherlands (or Germany's, both are very similar) btw. It's pretty good.
sprawld 4y ago
The historic squeeze in NHS funding has shown up in all sorts of metrics: most notably waiting list times - which have exploded over the last decade. Health prioritisation means the doctors can try to reduce the immediate deaths - the major costs being pushed into pain and suffering of people waiting for operations (but not dying, or being rushed in if they go downhill). All of this just kicks the can, and left the NHS at breaking point - ready for covid to break it. On bureaucracy - a health service requires administration, so any health funding can be described as "more money for a bureaucracy". The evidence shows that I direct public service like the NHS - concentrating on building hospitals, hiring doctors and nurses and making people well - involves somewhat less administrative costs than using an indirect insurance system (like most European countries, Canada etc) and much less than the dysfunctional private system in America https://www.healthaffairs.org/doi/10.1377/hlthaff.2013.1327 https://www.healthaffairs.org/doi/10.1377/hlthaff.2013.1327
RobotToaster 4y ago
Not necessarily, many life saving operations for things like cancer were postponed during that time, we could be seeing the result of that now.
cassepipe 4y ago
I feel like we always end up having the same debate. On side says "Not enough money" The other side says "But money don't solve problems, there's an effciency problem" Both are true. Maybe we can now admit that yes bureaucracies are generally inefficient (by design. Why would seek efficiency when it can provide safe jobs for a part of your population that you can now get out of your unemployment stats) and yes public healthcare system have been massively underfunded, probably for ideological reasons, in order to open up the market to private healthcare like European Union wants to open anything to market. (Look up what happened when they "opened up" the electricity market in France, what a joke)

heurisko 4y ago

The UK has been spending less on healthcare as a percentage of GDP than comparable European countries, Germany and France. I agree more money doesn't solve the issue, especially as so much money was wasted on Covid testing and private beds that were never used. However in my lifetime the difference in healthcare spending between New Labour and Conservative has been noticeable. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2019&locations=DE-FR-GB&start=2000&view=chart https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2...

makomk 4y ago
I'm not convinced that the UK has been all that comparable to Germany and France for years. GDP is of course an imperfect measure of the real size and capacity of the economy - Ireland has about twice the GDP per capita of all of those countries, but there's not really any way for their government to capture that economic activity as funding for stuff - and certain other metrics are not so great. For example, the average UK household is apparently £8,800 a year worse off than in Germany or France (median income, adjusted for purchasing power) and that gap's been there since about 2008: https://www.theguardian.com/business/2022/jul/13/average-uk-household-8800-a-year-worse-off-than-those-in-france-or-germany https://www.theguardian.com/business/2022/jul/13/average-uk-... In some sense, the UK became poorer than the other European countries it'd normally be compared to at the end of the previous New Labour government when the financial crisis hit and just never really recovered from that. It's possible there is no obvious way out anymore - everyone being poorer means less means less money for them to spend on consumer products and services and less tax revenue the government to spend on things like healthcare and infrastructure, and all of that means less businesses interested in setting up in the country (for reasons other than low taxes anyway) and less tax revenue, less well paying jobs... it's a vicious circle to be stuck in. Even before that happened, the New Labour-era spending was obviously unsustainable at the level of tax they were willing to charge. Despite the economy booming and a bunch of NHS infrastructure spending being moved off government books via expensive PFI programs the national debt went up consistently as a proportion of GDP year after year. Afterwards the Tories made a big fancy show of austerity and cutting back on government spending (and to be fair it did eliminate the deficit like they promised, for a while anyway) but even their big scary austerity program only froze the proportion of GDP spent on healthcare for a while.
- jotm 4y ago
  On the bright side, there's more opportunity and mobility in the UK. Just have to get off your ass and hustle. But that's something most people don't use or even like. A stable job and better safety nets are preferred, and here DE/FR/etc excel.
- pcrh 4y ago
  I'm impressed by how you managed to blame the current situation on Labour, despite the Conservatives being in power for 12 yrs.
inglor_cz 4y ago
As a counterpoint, this is the same graph, but with the Netherlands, Belgium, Denmark and Norway chosen instead of Germany and France. All nice developed rich northern European countries with reasonable life expectancy and life quality. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2019&locations=GB-NL-BE-DK-NO&start=2000&view=chart https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2... Their difference from the UK is negligible.
- jotm 4y ago
  Belgium's system works way better than the Netherlands (or Germany's, both are very similar) btw. It's pretty good.

sprawld 4y ago

The historic squeeze in NHS funding has shown up in all sorts of metrics: most notably waiting list times - which have exploded over the last decade. Health prioritisation means the doctors can try to reduce the immediate deaths - the major costs being pushed into pain and suffering of people waiting for operations (but not dying, or being rushed in if they go downhill). All of this just kicks the can, and left the NHS at breaking point - ready for covid to break it. On bureaucracy - a health service requires administration, so any health funding can be described as "more money for a bureaucracy". The evidence shows that I direct public service like the NHS - concentrating on building hospitals, hiring doctors and nurses and making people well - involves somewhat less administrative costs than using an indirect insurance system (like most European countries, Canada etc) and much less than the dysfunctional private system in America https://www.healthaffairs.org/doi/10.1377/hlthaff.2013.1327 https://www.healthaffairs.org/doi/10.1377/hlthaff.2013.1327

RobotToaster 4y ago

Not necessarily, many life saving operations for things like cancer were postponed during that time, we could be seeing the result of that now.

cassepipe 4y ago

I feel like we always end up having the same debate. On side says "Not enough money" The other side says "But money don't solve problems, there's an effciency problem" Both are true. Maybe we can now admit that yes bureaucracies are generally inefficient (by design. Why would seek efficiency when it can provide safe jobs for a part of your population that you can now get out of your unemployment stats) and yes public healthcare system have been massively underfunded, probably for ideological reasons, in order to open up the market to private healthcare like European Union wants to open anything to market. (Look up what happened when they "opened up" the electricity market in France, what a joke)