The Notebook: Reforming the NHS, how the world got rich, and tax breaks for the over-50s
The notebook is a place for interesting people to say interesting things. Today, it’s the turn of John O’Connell, Chief Executive of the TaxPayers’ Alliance
Reforming the NHS no longer so unsayable?
As the NHS endures its annual winter crisis – before it moves into its inevitable summer crisis – thousands of doctors are reportedly heading off to work in Australia. Pay and conditions are better Down Under, according to those who’ve had enough of the pressures of working in the NHS. Patient outcomes are superior, too.
Surely then we should be asking ourselves: how does the Australian system work, and should we try to emulate it? Of course, with the NHS it’s never that straightforward; traditionally, any notion that it could possibly be reformed is unsayable.
But that seems to be changing. Just yesterday, Sir Keir Starmer said that the NHS must “reform or die”. He said that “well-meaning reverence” for the health service has “supplanted reality”; it must not be “off limits” for criticism. Talking about reform doesn’t seem so taboo.
Unfortunately, British public services seem to be failing across the board. Indeed, we all have our own tales of woe: long delays booking a driving test; the new passport delayed; a burglary not investigated by the Police.
More taxpayers’ money needed, you say? According to the OBR the government will spend £1.2 trillion this year, equivalent to around £42,000 per household. Public spending is predicted to be 47.3 per cent of national income. That means the tax burden is at its highest in more than 70 years.
Reforming public services is good in and of itself – we pay for world class, 21st century services and should get them. But it is also the only way to break the doom loop of throwing good taxpayers’ money after bad.
Step one? Stop deferring to Twitter noise as a measure of support or otherwise for an idea – a virus that has infected the private sector, too. Debating ideas openly will weed out the bad ones and polish the good ones.
Tax breaks for the over-50s? Beware unintended consequences
HMT is considering giving the over-50s tax breaks to return to work. This will go down like a lead balloon with younger cohorts, already feeling hard done by. It feels unnecessarily complicated, too. Would we see comfortably off bosses coming back to work for a bumper payday, then retiring again without paying tax? What about Premier League football managers – would Sam Allardyce count if he came back around? Surely that’s not what is intended, so how would it be prevented? With more complex rules, presumably.
Bin vans in need of a charge?
York Council has come under fire after spending £8 million on electric bin vans that can’t be used. They purchased the vehicles to replace their diesel fleet, although a local councillor claims they are standing idle as there aren’t enough electric charging points to get them going. His broader beef is that the process has been badly managed but the council has hit back, claiming that it was wiser to buy the vehicles early due to inflation. Fab forecasting, or slick spinning?
A must-read with a message
The economy grew in November, to the surprise of economists and forecasters. December’s figures might be equally difficult to predict, with strong Christmas sales reported by many retailers likely to be checked by the impact of strikes.
Growth, and how to get it, has been the underlying theme to the political turmoil of the last few months. But to get growth in the future, it’s important to understand how we got it in the past. Koyoma and Rubin have produced a masterly must-read – especially for our political class – on how and why economic growth occurred when and where it did.
One theme that the authors explore is the importance of culture in achieving sustained growth and declining poverty. It’s something we must learn from – moving with the times is one thing, but allowing Western values to be chipped away at could leave us all poorer in the long run.