We do wonder where Polly Toynbee gets her information from

Polly Toynbee tells us that:

In the last decade, the NHS budget per capita fell in a rapidly ageing population.

That doesn’t, particularly, seem to be true.

In this edition of the UK Health Accounts, healthcare expenditure consistent with the definitions of the System of Health Accounts 2011 (SHA 2011) has been estimated back to 1997 for the first time (Figure 1). Health spending between 1997 and 2018, in nominal terms, trebled, with the average annual rate of growth being 5.8%.

Controlling for inflation, healthcare expenditure more than doubled over the same period, experiencing an average annual rate of growth of 3.8%. Breaking this down into healthcare spending before and after the impact of the 2008 economic downturn, healthcare spending grew by an average rate of 5.3% per year between 1997 and 2009, slowing to an average of 1.9% between 2009 and 2018.

Estimated healthcare spending per person, in real terms, almost doubled between 1997 and 2018, rising from £1,672 per person in 1997 to £3,227 in 2018, as healthcare expenditure growth greatly exceeded population growth.

Agreed, that doesn’t include the last couple of years but we think we’d have heard about it if “the cuts” had reversed that previous 8 years of growth to give us that decade Polly claims.

There’s also a political problem here:

Voters might ignore the fiendishly complex history of NHS restructuring, but they will grasp one simple, sinister point: the government is seizing control of the everyday running of the NHS, in what the Health Service Journal calls “an audacious power grab”.

This is a corollary to Hayek’s point in The Road To Serfdom. His main one being that if government provides health care then we, the population, will be managed to benefit the health care system. Like, you know, cowering in place in order to save the NHS.

The corollary here is that Polly does insist that government be that healthcare provider. Both in financing and in providing the workforce and facilities, the treatments. And yet she seems to think that government isn’t then going to try to control what is done with that £200 billion a year and more.

That’s really not the way politics works now, is it?

We even have a logical problem here:

The then NHS CEO, David Nicholson, himself called that upheaval so colossal “it can be seen from space” as it broke the NHS into fragments, putting every service out to tender to anyone, public or private, enforced by competition law. Every part of the NHS had to bid and compete against others for any service: co-operation was illegally anti-competitive.

This is to grossly misunderstand how markets work.

Yes, there is competition, yes, competition is beneficial. But the competition isn’t between the different layers or links in the chain of provision. That always remains as cooperation. It’s between the different people - organisations - that can be any specific link in that chain.

The supermarket and I are cooperating when I buy a banana. More than that, so is everyone in the supply chain. The folks who make the refrigerated ships that carry the fruit (actually, an herb) across the ocean, the sailors upon said ship, the guy who dug the hole to put the clone of the Cavendish into it 10 years before, the people who make the fungicides, the supply chain is a masterpiece of coordination and cooperation.

Competition is between the varied alternative folks who could provide any one or more of these goods and services in that supply chain.

The cooperation makes a market work, the competition is how I get to buy the banana at 99 pence per kg.

Markets, that is, are a method of organising cooperation. Competition is just the decision about who to cooperate with. And why would we be against that?

Factual errors, illogic and an ignorance of politics. Well, it is a Polly column, isn’t it?