Category Archives: politics

Martin’s law of meetings, and the ‘national conversation’

I’m slightly amused by all the news reports this week that the government wants a ‘national conversation’ on the future of the NHS. While this is a laudable idea which will appeal to the punters, I doubt it’s actually very practical.  

My late friend Martin King used to say that the ease of making any decision is inversely proportional to the number of people involved in making it.  So trying to have a committee of 70 million people might be counterproductive?  Anyway, Martin’s theory was that you shouldn’t, in general, try to make any decisions in meetings; you should only use them to ratify decisions you have already made!

A wise man, in many ways.

My own view of how to fix the NHS, for what it’s worth (and I admit it’s not worth very much, probably!) is as follows:

Firstly, it needs to be more tightly integrated with social care (so people can get out of hospitals quickly), secondly, it needs much better ways of rewarding efficient and effective workers and getting rid of others (because of the often amazing administrative inefficiency and incompetence of many otherwise lovely and well-meaning people), and thirdly, of course, it always needs more funding.  (Oh, and fourthly, we should re-join the EU, but I’m not holding out much hope there…)

So let’s talk about funding. We should be completely open with the public about how much more funding is needed. My guess, based on the cost of private healthcare plans, is about £1-2k more per person per year.  We currently spend just under £4k/person/year on healthcare.

I wrote more about this topic a couple of years ago.  Note that, despite much common rhetoric, the NHS has never actually had any cuts in funding, except once, when the increased spending during Covid returned to its normal levels after the pandemic.  But the rate of growth in spending has varied under different governments. This interesting page from the BMA suggests that, under the Conservative government, there has been an cumulative ‘underspend’ of £446bn, which they base on the fact that the longer-term historical rate of growth (a pretty substantial 3.8% in real terms) hasn’t been maintained at the same rate in the last decade and a half.  If it had, they would have had that much more.  

It sounds like a terrifying figure, but it’s only £6K per person, or £400 for each of those years, to recover all of it.  Another interesting observation is that we spend the same proportion of GDP on healthcare as most other comparable countries.  It’s just that our GDP hasn’t been doing very well lately!  (So I guess the counter-argument would be that we get the NHS we can reasonably afford, and we need to fix the economy to get a better one.) But let’s assume, for the purposes of argument, that we want to fix the NHS and we can’t immediately fix the economy.  

We should then simply propose adding whatever amount is really needed to income tax or NI.   There are far too many people who complain that the NHS is underfunded but assume that the funding is going to come from somebody other than themselves!  

For people to accept this, these funds should be ring-fenced, so they really can’t be spent on anything else.   Then we should just make people vote on whether they really want it, based on the extra x% of tax it’s going to cost them, either through a referendum or as a manifesto at the next general election.  (Count me in, for all reasonable values of x!)

Actually, a referendum would allow the extraction of real numbers for x.  Imagine going to your polling station and being presented with just one multiple choice question; something like this:

How much should the government raise the current standard rates of income tax for the exclusive purpose of further funding the NHS and Social Care systems? (choose one answer)

  • Not at all
  • 1%
  • 2%
  • 3%
  • 4%
  • 5%

Then you do the maths and give people the NHS they’re willing to pay for. The ballot box, I would suggest, may be the only way to make a decision when the participants in your ‘conversation’ are truly ‘national’ in their numbers!  

Otherwise, Martin’s law applies.

P.S. I do know that some of the above is over-simplistic. Historically, raising overall tax rates hasn’t usually actually raised overall revenues for any length of time, for example, but I think raising them for this explicit purpose, and then cutting them elsewhere if you want to, would prove popular.  However, I’m not an economist, and you should feel free not to vote for any government proposing to appoint me as Chancellor or Health Secretary,

 

 

 

 

Conspiracy

John Naughton quoted this on his blog, but it’s so good I had to repeat it here.

Two Donald Trump supporters die and go to heaven. God meets them at the Pearly Gates.

“Tell us,” they say, “what were the real results of the 2020 election, and who was behind the fraud?”

God answers: “My children, there was no fraud.”

After a few seconds of stunned silence, one turns to the other, whispering: “this goes higher up than we thought.”

Was Boris Johnson undemocratically removed from Parliament?

My friend Mark Elliott is a very busy man, and these days he only occasionally posts on his site ‘Public Law for Everyone’. This is a pity, because it’s always worth reading, even if you might not naturally assume that thoughtful articles by a Law professor are the natural choice to accompany your cornflakes.

From his latest post:

Johnson himself said that he was ‘being forced out of Parliament by a tiny handful of people, with no evidence to back up their assertions, and without the approval even of Conservative party members, let alone the wider electorate’. He went on to contend that ‘a dangerous and unsettling precedent is being set’, describing the Committee as a ‘kangaroo court’ and the process adopted by it as part of a ‘witch hunt’…

Was he right? Read on…

Truth, Social or otherwise

Today I did something I never thought I would do. I went and had a look at ‘Truth Social’, Donald Trump’s own social media platform. This was for a reason that I’ll explain in a minute, but it’s interesting to note that the front page looks quite attractive.

“Truth Social is America’s ‘Big Tent’ social media platform that encourages an open, free, and honest global conversation without discriminating on the basis of political ideology”, it says. Mmm. It sounds quite a nice place to be. There’s a big button encouraging you to create an account. “Let’s get started!”, it suggests, offering, “Social Media Without Discrimination”.

Well, I had no intention of creating an account, or even allowing it to create any cookies on my machine, but I was interested to see that, if you came across the site without knowing the background, there wasn’t much on the front page that might put a normal person off.

However, I knew the software they were using and so was able to guess the URLs I could use to see the content without signing up. And it was revealing.

You see, somebody on Twitter had posted, side by side, a Christmas tweet from Joe Biden and a Christmas ‘Truth’, as they call it, from Donald Trump. The contrast was so vivid that I thought the Trump one had to be a spoof, and I wanted to see if I could track them down to check.

But no, it was genuine, so I thought I’d share with you the Christmas messages from these two men:

Sources here and here.

Of course, it would be easy to be selective and deliberately pick unfavourable posts from one side. So, to be fair, I also include the next post from each of them so you can make a more informed decision:

Sources here and here.

I do not wish to engage in any political debate here, especially not at this time of year, so having presented these Yuletide messages, I will leave you entirely free to come to your own conclusions, at this season of peace and good will to all men.

But I will offer the following benediction to all my readers:

May your festive period, and the coming year for all of us, be filled with one of these philosophies rather more than the other!

The dangers of a headline figure

If you believe my Twitter stream, there are a lot of people out there who think that the UK government has capped the energy bills so they can’t pay more than £2,500 this year. This is not at all true. But it’s been reinforced by the Prime Minister’s interviews on various radio stations this morning when she said things like “making sure that nobody is paying fuel bills of more than £2,500”. Either she doesn’t understand it, or she’s not very good at explaining things clearly.

The problem is that the media are so keen to feed people a single, simple number, that for weeks we’ve been hearing about what’s happening to the energy costs for the average household and referring to that as a capped number, when in fact, of course, it’s the price per kWh that’s been capped. (More info here.) If, say, you use twice as much as the average household, your bill could be £5000. Some not-very-smart people even think they can use as much as they like, because, hey, it’s been capped now, and they’re going to get a nasty surprise! And similarly, of course, if you use half as much, you can worry a bit less about that headline figure.

This desire to reduce things to one number causes problems in many situations. Remember when the only way most people had to assess the PC they wanted to buy was based on its CPU’s GHz? (Or MHz for those with longer memories?)

Now, the headline figure for every electric car is the number of miles it can do on a charge, when lots of other factors will affect how easy it is to use in reality, like how fast it charges, or its drag coefficient (which affects how its energy use varies with speed). For many people, long journeys are relatively rare, and the important question when embarking on one will actually be something like, “How fast will this be able to recharge at the type of chargers available about 150-200 miles from my house?” And even that question is much less important if the chargers happen to have a nice cafe or restaurant next to them!

The kind of gamification that reduces things to a simple score is always appealing. But whenever you see things being compared with just one number, remember Ben Goldacre’s warning: “I think you’ll find it’s a bit more complicated than that.”

Playing fast and loose…

Subjects like the Northern Ireland Protocol, and Boris Johnson’s plans to disregard the bits he find awkward, are not the kind of thing I’d normally cover in this blog.

But a good friend, Prof. Mark Elliott, has just made a nice video explaining the situation on the University’s YouTube channel. Worth 9 minutes of your time if you want to avoid the banter and bluster from other sources.

Direct link.

© Copyright Quentin Stafford-Fraser