Why government's a lousy way to do things

A standard argument in favour of government doin’ stuff is that government is eternal - therefore they’re the only people able to take a long term view of matters. To be able to deal with those decades long, even generational, matters that individual lifespans, or corporate ones, simply won’t bring to salience.

Well, OK, it’s a theory, Like all theories - or at this stage of the scientific game, hypothesis - this needs to be tested. The way science works is that we deliberately look around for the evidence which disproves the contention. If we find such evidence - we need only the one piece - then the hypothesis fails. Repeated attempts to disprove that do not disprove gradually move the hypothesis over to being a theory at which point it becomes a useful working assumption for how we deal with the world. Until, if ever, that disproof does arrive.

So, doctor training:

Ministers have dramatically stalled plans to double the number of doctors being trained in England by 2031 in a move that has caused dismay across the NHS, as well in medical schools and universities, the Observer can reveal.

In June last year, ministers backed a long-term plan to expand the NHS workforce and pledged, amid great fanfare, to “double medical school places by 2031 from 7,500 today to 15,000, with more medical school places in areas with the greatest shortages to level up training and help address geographic inequity”. Labour is also committed to raising the number of doctors to 15,000 by 2031.

But a leaked letter written jointly by health minister Andrew Stephenson and the minister for skills, apprenticeships and higher education, Robert Halfon, to the independent regulator the Office for Students, says they will fund only 350 additional places for trainee doctors in 2025-26.

Now, we have noted this before around here. That glorious - and yes, it is glorious - economic liberation of women has led to some run on problems. Female entry into the professions - part of that glorious economic freedom - then runs into things like maternity leave and a predeliction for part time working while the snot-machines are awaiting primary school. Now, because we’re all in with the economic liberation part this isn’t something to bemoan, it’s simply something to deal with.

Over recent decades doctoring has become a majority female occupation - economic liberation again. Huzzah!

Government also takes to itself the power to determine how many doctors are trained each year - or even each decade given the time it takes to train.

An average doctoring working life is some 30 years - out of training at around 30, hitting the pensions cap and retiring at 60. Say, about. Add maternity and part time working to give a decade of less than full time work over that three decades and what’s the result? Other than the wholly welcome result of that economic liberation?

The answer is that we need to be training more doctors. More more doctors than an ageing population requires, more more doctors than a growing population requires. We gain fewer doctoring working hours out of each doctor trained therefore we require more doctors trained. As we say, this is not a problem it’s simply an effect and one that has to be dealt with.

This all became obvious some 30 years back. Government did not increase the number of doctor training places 30 years back. Government’s not a good manner of doing those long term things.

Then it gets worse. Obviously, finally, they agreed that more training places needed to be financed. But now it’s being limited for whatever short term - we assume financial - reason. Which is the whole point of passing those long term problems over to government, that long term things get dealt with in a long term manner, not subject to the short term buffeting of events Dear Boy, events.

We’ve just found our disproof of the contention - hypothesis - that government deals well with long term issues. Therefore the hypothesis fails.

A beautiful theory killed by ugly facts. Again.

Now note how science works here. Repeated assertions that sometimes the hypothesis holds don’t matter. All we need is the one disproof. As science doesn’t actually say but does mean after all even the blind squirrel sometimes finds a nut. Government is good at dealing with long term problems fails as an assertion if we find the one example of government not being good at dealing with a long term problem.

Which does, of course, mean that Mazzonomics is tosh but then we all knew that anyway.