4 ms·

The nhs also has a shedload of funding. Let’s not overlook the aging population in the UK please. There are many more factors than simply “the Tories are to bl

The nhs also has a shedload of funding. Let’s not overlook the aging population in the UK please. There are many more factors than simply “the Tories are to blame”

X0Refraction 4y ago
This is the actual issue, spending isn't keeping up with the demand. I'd agree that "the Tories are to blame" doesn't capture it, but I don't think they're equipped to deal with the problem. Real terms spending per age adjusted capita appears to have been on a downwards trend [0] since they took power. I think this has gone up since the pandemic, but I think it's likely too little too late and will probably be a short term increase. I'm also skeptical the IFS have managed to accurately estimate the required increase in funding. They don't go into their workings from what I can see, but I doubt they've accurately included the effect of the lifetime allowance on pensions causing doctors to avoid overtime or the £100k tax bracket where you lose your personal allowance not moving since 2009 which more and more doctors will fall into. I'd imagine they've underestimated it, but would be happy to hear evidence to the contrary. That's not to say that I think any other party has a solution or is properly holding the Tories to account on this. I'll admit I haven't thought too hard about the problem, but I think the fairest solution would be to make pensioners pay national insurance on their income. It wouldn't affect the poorest pensioners and since national insurance is no longer ring fenced for pensions/healthcare I'm not sure what the justification for a tax break based on age even is anymore. As someone who intends to subsist on more in retirement that change would negatively affect me, but I still think it's fair. I know that this would be deeply unpopular though, so I don't hold out much hope of it happening anytime soon. Maybe that isn't the best solution, but I really wish we'd start to have real discourse on how we need to restructure our society as the demographic of the country continues to skew older. [0] https://ifs.org.uk/publications/9186 https://ifs.org.uk/publications/9186 (figure 5)
- simonswords82 4y ago
  Interesting - nice to have a sensible debate on it. I think your idea is worth pursuing even if it's not perfect. Young people should not be subsidising old people who no longer work - especially those same young people who don't own house or have savings or a pension.
swores 4y ago
It would get a lot more value from that funding if the Tories (and to be fair, also the last Labour gov a decade and a half ago, though not as much) hadn't been pushing so much of it towards embedding privatisation through the NHS such that profits are pointlessly being taken out at all stages. (Well, obviously not pointless for the shareholders, who happen to often coincidentally be tory party donors.) A hospital having a 20% bigger budget for their janitorial staff isn't in a better position if it's also been required to move from hiring full time cleaners in-house to contracting an approved cleaning company that has 30% profit margin baked in. An NHS patient isn't helped knowing that 50% more funding goes into paying consultants for the problem they have, if gradually more and more of those consultants are moving to private health companies and having to be rented back to the NHS at a markup that pays both the doctor and the company's shareholders. Etc etc. Sure, the population demographics are related, but even if we had the exact same population as 20 years ago we'd be in a much worse situation; plus it's the government's job to pay attention to things like demo changes in their population, and to listen to the warnings that have been coming from the medical community for many years, and should have been proactively funding better social care (instead of completely abandoning it to local councils while also lowering their funding) AND making the NHS even better (rather than gradually turning it into an umbrella for private companies who eat up any budget increases).

The nhs also has a shedload of funding. Let’s not overlook the aging population in the UK please. There are many more factors than simply “the Tories are to blame”

X0Refraction 4y ago

This is the actual issue, spending isn't keeping up with the demand. I'd agree that "the Tories are to blame" doesn't capture it, but I don't think they're equipped to deal with the problem. Real terms spending per age adjusted capita appears to have been on a downwards trend [0] since they took power. I think this has gone up since the pandemic, but I think it's likely too little too late and will probably be a short term increase. I'm also skeptical the IFS have managed to accurately estimate the required increase in funding. They don't go into their workings from what I can see, but I doubt they've accurately included the effect of the lifetime allowance on pensions causing doctors to avoid overtime or the £100k tax bracket where you lose your personal allowance not moving since 2009 which more and more doctors will fall into. I'd imagine they've underestimated it, but would be happy to hear evidence to the contrary. That's not to say that I think any other party has a solution or is properly holding the Tories to account on this. I'll admit I haven't thought too hard about the problem, but I think the fairest solution would be to make pensioners pay national insurance on their income. It wouldn't affect the poorest pensioners and since national insurance is no longer ring fenced for pensions/healthcare I'm not sure what the justification for a tax break based on age even is anymore. As someone who intends to subsist on more in retirement that change would negatively affect me, but I still think it's fair. I know that this would be deeply unpopular though, so I don't hold out much hope of it happening anytime soon. Maybe that isn't the best solution, but I really wish we'd start to have real discourse on how we need to restructure our society as the demographic of the country continues to skew older. [0] https://ifs.org.uk/publications/9186 https://ifs.org.uk/publications/9186 (figure 5)

simonswords82 4y ago
Interesting - nice to have a sensible debate on it. I think your idea is worth pursuing even if it's not perfect. Young people should not be subsidising old people who no longer work - especially those same young people who don't own house or have savings or a pension.

swores 4y ago

It would get a lot more value from that funding if the Tories (and to be fair, also the last Labour gov a decade and a half ago, though not as much) hadn't been pushing so much of it towards embedding privatisation through the NHS such that profits are pointlessly being taken out at all stages. (Well, obviously not pointless for the shareholders, who happen to often coincidentally be tory party donors.) A hospital having a 20% bigger budget for their janitorial staff isn't in a better position if it's also been required to move from hiring full time cleaners in-house to contracting an approved cleaning company that has 30% profit margin baked in. An NHS patient isn't helped knowing that 50% more funding goes into paying consultants for the problem they have, if gradually more and more of those consultants are moving to private health companies and having to be rented back to the NHS at a markup that pays both the doctor and the company's shareholders. Etc etc. Sure, the population demographics are related, but even if we had the exact same population as 20 years ago we'd be in a much worse situation; plus it's the government's job to pay attention to things like demo changes in their population, and to listen to the warnings that have been coming from the medical community for many years, and should have been proactively funding better social care (instead of completely abandoning it to local councils while also lowering their funding) AND making the NHS even better (rather than gradually turning it into an umbrella for private companies who eat up any budget increases).