Things that are not true about the NHS

Here’s an interesting - and entirely incorrect - claim:

The cumulative NHS funding gap since 2010 is more than £200bn. What this means, as the recent book NHS Under Siege by John Lister and Jacky Davis explains, is the difference between the money the service would have received if funding levels prior to 2010 had been sustained, and the money it has received since.

That’s not true, not in the slightest. As the next sentence goes on to explain:

For all New Labour’s flaws, it followed the globally accepted rule that to keep pace with an ageing population and technological change a modern health system requires an annual 4% real terms increase in funding.

The level of funding in 2010 is, well, it’s the level. Then the next claim is that this level must increase by 4% a year in real terms. Which is not the level, it’s an increase in it. The £200 billion is therefore spurious bull… - well, we’ll not use that word but think cowpats.

We can go on - think what happens if we do have a 4% real terms increase per year in an economy which doesn’t grow at 4% a year. Soon enough we hit that event horizon where there is nothing in the British economy other than the NHS. At which point we’ve still not solved the problem as the insistence is that the NHS would still require 4% increases even though it is already larger than GDP.

One step more. If the NHS does require 4% real increases then that shows us that there’s something wrong with the structure of the NHS. Productivity is not increasing, at least not as fast as in other areas of the economy. Which is weird, as part of the claim is that new tech requires that greater funding. But the adoption of new tech is productivity enhancing - that’s why we adopt it. It cannot be true, not unless we’ve a seriously absurd system, that we both gain that productivity enhancing tech but don’t enhance productivity. The dual claim would be a nonsense.

Our final step is that OK, so the NHS doesn’t increase productivity over time. That is the underlying claim there, which is why the continued increase in funding is required. So, what do we know about increasing productivity? Yes, it’s more difficult in services than it is in manufactures (from Baumol) and also that markets increase productivity more than planning does (also Baumol).

So, precisely because of this claim of a necessary 4% increase in the real NHS budget each year we now know that we need to have more markets in the NHS so as to increase productivity in the NHS. For it’s the lack of those competitive pressures which is failing to lead to the productivity increases and thus the demand for the 4% real budget increase.

QED.

Which is good, having examined the untruth we now have the plan. All we need to do is get on with it.

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