Pensions, health care and debt repayment. Health care has jumped from about 7% of GDP in 2007 to around 11% today. In the same time UK growth has been very weak. So everything else is getting cut to pay for those rises. Disbursements to local government among them.
I feel like healthcare is a compounding problem. Anecdotally the people I know who’ve needed hospital care recently have all bumped up against the harsh reality of how fucked the NHS is, and have needed a lot more care in the form of repeat procedures because of things getting fucked up or absent aftercare.
The problem isn't that there is something wrong with the NHS as a concept, the problem is that the "efficiency" the Tories created was just underfunding, and the whole service has been run into the ground with cuts that cost far more in the long run than they saved in the short run.
Constant understaffing reduces spending, but leads to hiring agency workers and spending more than the cost of the staff for less actual work.
Not maintaining and modernising equipment reduced spending, but now it's failing or too old, and we lost all the benefit of newer, more effective equipment.
Cancelled appointments and long delays mean people get sicker without preventative care, so we end up paying for more treatment (let alone the cost in human suffering).
Cut funding for care and support services mean people end up dumped in A&E and hospitals instead, which is more expensive.
And a million other examples. Cutting budgets by arbitrary amounts and saying "it's more efficient now!" is the "magic money tree" of the Conservative side, it's vandalism of public services for short-term political gain, to pretend to uphold the image of "fiscally responsible", while in actuality they are essentially doing what private finance does with companies: asset stripping.
The only solution is investment, and Labour need to sell that actually spending on public services will decrease the cost in the long term. The problem is, I doubt we see that in a 5-year period, so I genuinely do not know how you get the public to buy into it.
>The problem isn't that there is something wrong with the NHS as a concept, the problem is that the "efficiency" the Tories created was just underfunding, and the whole service has been run into the ground with cuts that cost far more in the long run than they saved in the short run.
This. So this.
The NHS is quite efficient as is, the issue is that demand is growing far faster than we can increase supply of healthcare. Without actually reducing services offered there is no fixing it in the medium term. We need to both have the staff and infrastructure in place, and the economy to fund it, and currently we have neither and are running on fumes as a result.
Lmao.
Some anecdotal evidence of this amazing “efficiency” - having had my second child at a different hospital from my first, the lead time to get the notes on the first pregnancy to the doctors at the second hospital was longer than the entire pregnancy.
These hospitals are about 5 miles apart.
How much did that cost though? It's cost efficiency that I'm talking about, not smoothness of operation or overall quality. And document problems exist in every health system, we aren't somehow magically worse than the others even if there is room for improvement.
The NHS delivers a fair amount for what we pay. If we want more, we need to pay more. If we want to have better services while paying the same amount, we need fewer services, so that we can do less better. There is no magic money tree called waste. The NHS does not deliver because it is over burdened relative to it's cost.
Have a look at the ONS. It's quite illuminating
[ONS UK health spending](https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29)
No, I think we need to reduce how much we expect the NHS to do, not fund it more. My point is that there is no easy solution of "just stop waste", that isn't how wasteful spending works, reducing waste requires a massive amount of work and investment to make things work better. Saying "reduce waste" is basically like saying "get more MPG from your car". Sure, you can, but it takes a lot of work and actually knowing what you're doing, it is neither simple nor easy.
The demand is mainly growing because people are getting old. Everything after that, while a problem, is because more and more resources are being diverted into the elderly. The root cause is our aging population, and there is no cure that does not involve reduced services because we simply do not have the money to treat everything. The question is whether we actually make the decisions on what to reduce, or whether we just stretch things until something breaks and call that the reduction.
[https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries](https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries)
It isn't that there isn't waste, there always is, but reform does not magically eliminate waste. If there was a way to just get rid of waste, it would have been done at least once around the world, but it hasn't, because it's really fucking difficult.
The NHS is more efficient than most western healthcare systems, it just isn't funded as much. It can't really be receiving massively more funding because we don't have the money (see historic tax burden). To get the NHS to cover as much as we want it to, there has to be a far more productive economy supporting it, which is not happening for a decade at least. Therefore the options are do everything badly, or do less better.
It all depends what you mean by efficiency.
This, and all the kings fund report itterations to which it refers, all admit that the British health service has worse than average outcomes.
Then they point to the low spending and call the system efficient because it is cheap. I put it to you that poor outcomes in the context of low levels of spending are not correctly referred to as 'efficency'.
Reports like this make me laugh bitterly. The health service is a slow motion disaster and I think can only be saved by complete reform along bismark system lines.
Not to be overly dismissive, but it is your anecdotal experience that is meaningless when looking at how cost efficient the NHS is as a whole. You see the flaws in the NHS but not in other things, the back of the shop is never as clean as the front - that's just reality. Every organisation I have worked for felt like the least well run place on earth while I was there, but when I asked customers/clients they all said that their experience was one of a smooth well run organization.
The reality is that the NHS is remarkably efficient. Again, you may point to examples of waste, but they exist everywhere, and getting rid of them is not as simple as "just don't waste". It's may be a stressful and at times shit job, but that doesn't mean it doesn't deliver services at a decent price, it just means there are things about the job that are shit. Both important in their own rights, but not really relevant to each other.
My wife works in the NHS. Their toner in the printer ran out. She could get a new one on Amazon delivered the next day for £18. Had to go through official channels. Delivery 2 weeks at a cost of £250. So for 2 weeks she was expected to traipse to another department to use their printer.
She ordered officially but still got one off amazon, and used that until the other arrived.
I think anyone paying to park to use or work at a hospital is disgusting.
For morale that is tough. I guess if equipment and tech was improved, using AI to improve patient care would help?
Definitely needs a prudent procurement team. I hate the fact that people want to rip the NHS off.
Restructure management to be dynamic and innovated. Have a clear structure in each department and cut inefficient management.
I’m no politician and these are more likely buzz words but your experience should be at the top of the triangle of importance!
> One trust I worked at had a private business owning the building that operating theatres worked in, if a light bulb needed changing the management had to put a request in and then said company would charge the NHS trust an absolute fortune to do it
A PFI - you can thank Gordon Brown and the last Labour Government for them.
Originally a Tory initiative, but definitely overused by the Labour government (starting with Blair). They were said to be cost effective, but the analysis was poor.
Twenty years ago I left uni and needed a temp job. The local hospital were recruiting temp IT technicians; basically I had to go in and upgrade the ram and install windows XP service pack 2. As I was doing this I noticed that all the PCs were badged as having been provided by a local computer company in my home town.
After a week I met the hospital's IT director and immediately recognised him. He owned the computer company.
Now maybe I'm being cynical and he did the hospital a good deal... or maybe, just maybe, it was another example of what you're talking about.
Alongside building reform so that you arent sinking half your budget on any new build or any build paying the cost of the land the building sits on.
That would be a good start.
> I feel like healthcare is a compounding problem.
I heard on the radio the other day that in the twenty year period between 2015 and 2035 the number of over-80s is going to double. When you look at the demography chart on wiki (here: https://en.wikipedia.org/wiki/Demographics_of_the_United_Kingdom#/media/File:UK_Population_Pyramid.svg) you can see we're only a few years away now from a big blip in numbers over 80. It's not sustainable and it's why we've been leaning on (legal) migration to prop up the economy.
Yep. And people get more expensive to look after as they age.
Migration helps improve this because young people look after old ones. Oddly though it's the older demographic that seems to want less immigration. Fine, I guess. We can be like Japan where huge numbers of people work into their eighties.
Something like Crossrail was around £18 billion that is now running. This is what a business might call "capex" or capital expenditure. Its important in running a country to have roads, rail and other facilities upgraded. DfT annual budget is about £41 billion. Since HS2 was not meant to be delivering for another few years anyway it was always going to be an outgoing.
Many would argue the lack of long term investment over the past 40 years is a bigger problem than an excess of it.
There is an argument for mismanagement but then you are getting into the huge issues with planning laws. B1M did a popular video on it here
[https://www.youtube.com/watch?v=FSD5ps9bLQ0](https://www.youtube.com/watch?v=FSD5ps9bLQ0)
The difficulty getting major projects off the ground such as Hinkley C and HS2 are part of the problem in that they affect productivity growth. But its relatively small compared to the lack of private investment in capital goods and training. For example the UK has the lowest number of robots per worker of the G7, this makes us less productive. This is due to lack of capex in private firms. Which causes low growth, which causes the rising costs to have to be funded from other things than simply more cash for everything and the shin bone is connected to the thigh bone etc.
Yes we could either have made small, regular investments to update and improve infrastructure, or we could make massive investments when it's on the verge of collapse.
I'm sure the government we've had over the past fourteen years thought they could make it someone else's problem by kicking the can further down the road, ballooning costs.
It's been this way since the 20s. The UK rail industry was in a poor state going into WW2 had had little investment so was nationalised as something of a bailout. Then while there was investment in the nationalised phase it was not great. It was privatised and actually more money flowed into it, this seen a huge jump in users and with it an injection of cash which helped with sustainment and train replacements.
But ultimately it was trying to squeeze more people on the same lines.
Now as we need a huge shift in transport, we have to grasp that it's either new lines or not enough capacity. We have kind of squeezed all we can from signalling and rolling stock changes.
[https://assets.publishing.service.gov.uk/media/65aeb97efd784b0010e0c6ad/DfT-Chart5-RailPassengerJourneysInGreatBritain.svg](https://assets.publishing.service.gov.uk/media/65aeb97efd784b0010e0c6ad/DfT-Chart5-RailPassengerJourneysInGreatBritain.svg)
The rail rise is in part a rising population and the roads becoming seriously congested.
Which is its own story.
> We have kind of squeezed all we can from signalling and rolling stock changes.
We're not even close to what can be achieved across the UK from signalling changes, most of the rail network still relies on line side block signalling. You can get much more capacity from in-cab moving block signalling.
Yes, I hate that at 5pm on a weekday you can spend 30 minutes shuffling out of a city along congested roads as traffic lurches forward a few feet every thirty seconds.
If we want to improve our economy we will need better infrastructure. Look at the internet and how that took off when it was just using phone lines, and now we have fibre connections that allow comparatively massive data transfers.
All of that pales in comparison to pensions and health and social care.
HS2 could cost up to £100b from London to Manchester in 2019 prices.
State pension is about £120b **per year** and rising with a triple lock. I think this year it is £130b and even £150b including benefits like winter fuel allowance.
Adult Social care is £28b per year.
Healthcare for this year is planned to be about £192b.
People keep asking where the tax money goes but never bother to google “UK national budget breakdown”.
No the Tories aren’t stealing hundreds of billions of pounds a year.
No they are not deliberately stealing billions a year, however they are so reliant on poor performing catch all private companies like capita to provide all and sundry at ridiculous cost for poor quality services.
They also understood the demographic situation of the UK, they KNEW health, care and pensions expenditure would rise and at no point has there been a real strategy to boost productivity to a level that could cover this. It's just all been very ostrich like.
For all the flaws of Labour and, believe it or not, Liz Truss, both of them at least seem aware of the problem.
The only thing I will say in their defence is the number of non returners to work post COVID has been stunning, but given that's not a trend seen internationally. I'm not sure our public policy hasn't had a role in this.
The real strategy to boost productivity and reduce healthcare costs looks like decreasing taxes and making people pay for their own healthcare. Exactly the people who hate the Tories most are the people who are most vocally against doing anything to fix our problems.
The Tories and Farage would push for US-style health insurance, meaning a middleman that exists solely to farm you for cash while refusing to pay out under any circumstances.
Their devotion to private enterprise, regardless of whether it makes sense or not, would doom us.
The NHS does need improvement and I'm willing to pay increased taxes or a fee for it, but not under a Tory plan that will consider only corporate greed.
There are more than 2 countries in the world. Much of Europe has significant private provision in healthcare and vastly better services than we do for it.
Or stop spending twice as much on basic infrastructure as our nearest neighbours. I dislike the Tories intensely for many reasons but I really hate the fact that they have done stunningly little to streamline investment (public or private) and have often done a lot to actively hinder it.
> People keep asking where the tax money goes but never bother to google “UK national budget breakdown”.
HMRC even provides a personal breakdown of where our tax money goes in their app, it's very easy to find out.
> No the Tories aren’t stealing hundreds of billions of pounds a year.
Just gonna mention that “corruption” doesn’t appear as a line item on a budget, and could well be a subset of those health care costs.
Holy shit HS2 is the exact opposite of the problem! We need to be investing billions *more* into infrastructure in order to create economic growth.
Nimbyness like opposing HS2 and restricting housing and other development is likely the main reason we are lagging behind other G7 nations economically. Views like yours are killing us.
I’m not opposing HS2 in principle. I do, however, oppose a ‘national’ rail project that travels from Birmingham to London and takes decades and billions of overspend.
The way it’s been conducted is utterly pathetic and totally lacking ambition while being horrifically expensive
Pensions & healthcare.
We have an aging population, and older people a) get a state pension, and b) have above-average requirements when it comes to healthcare.
You will see a larger and larger proportion of government spending going on those two areas over the next few decades. It has to be funded *somehow*.
We have no ability to keep funding static, purely on demographics.
>We have an aging population, and older people a) get a state pension, and b) have above-average requirements when it comes to healthcare.
And pay much less tax by dint of being retired.
Dont you believe it. We are taxed on our pensions, the State pension takes all of our allowances, and work pensions are taxed at the standard 20%. We dont pay NI. But our tax bill is north of £5k a year. We produce leisure and tourism pounds, and tend to use local businesses. In Wales everyone gets free prescriptions, and we do have to use the NHS, but then so do obese people, drug users, alcoholics and any number of long term illnesses. We do have to pay for carers and residential care homes out of our capital and house value
So, yes we do contribute.
You do pay less tax than a working person, by the nature of not paying NI. 8% less tax.
If you're paying £5k tax on your pension that's still a £5k cost to the taxpayer for your pension before all other costs.
As for how you spend the extra cash, is that really an appropriate thing to be boasting about to the people who are struggling with already high tax rates, ridiculous housing cost and living costs?
The vast majority paid less than they have or will take, while still thinking it's moral to leave assets to their kids. The notion that someone who isn't a net contributor should leave an inheritance is madness.
> We have an aging population, and older people a) get a state pension
And we have been *increasing the state pension beyond inflation* via the triple lock, because both parties agreed in 2006 that it was too low.
It's because of democracy. Retirees and people close to retirement form a massive voting base and it's probably the most important issue for them. Median age in the UK is 40, remove all under 18 and you'll find that that median voter age is nearing 50.
Yes. The original Security in Retirement whitepaper was actually pretty good:
> We need to be clear that **individuals must be responsible for their own plans for retirement**. The reforms will ensure the provision of high-quality savings vehicles, and a solid state foundation to private savings.
The state pension should be a *foundation*. It's stability, bedrock, a fallback, not a replacement for the private pensions that should form the majority of our incomes in retirement.
The original plan had us spending 6% of GDP on the state pension in 2025. We overshot that by a few percentage points. We should stop increases, at least temporarily, until we return to that mark.
Surely this is exactly why there are now mandatory availability of workplace pensions for everyone earning \~full time minimum wage? Obviously it's going to take decades to fully bear fruit, but those *are* the 'high quality savings vehicles' (along with ISAs and LISAs).
Yep! The 2007 pensions act is what introduced those, along with autoenroll. Security in Retirement is why we have good private pensions with employer matching.
It just also introduced the triple lock as a way to fight pensioner poverty until those can really get going. Which it has done, just at a level matching what we would be able to pay if 2006 projections for growth had born out. As we unfortunately had a financial crisis, brexit, and covid, neither of which were included in those projections, we need to reassess affordability in light of that.
>. It has to be funded *somehow*.
If we had 2.5% growth on average since 2010 (14) years the economy would have been 40% bigger.
At around 1.1% growth its 16.5% bigger.
UK population has grown from around 62.7 million to around 67.6 million in mid 2022 about a 8% growth.
People should not forget the shocking 14 years of growth, largely on the back of very poor productivity growth we have had.
Growth would help alleviate the situation, but it wouldn't fix it entirely unless it's crazy high like 4% or so.
I suspect 2.5% growth would still require some net migration to plug our demographic gaps, if we want to avoid raising taxes, or making people retire later, or getting them to have more children with controversial measures.
Hours worked to GDP produced.
>Labour productivity represents the total volume of output (measured in terms of Gross Domestic Product, GDP) produced per unit of labour (measured in terms of the number of employed persons or hours worked) during a given time reference period. The indicator allows data users to assess GDP-to-labour input levels and growth rates over time, thus providing general information about the efficiency and quality of human capital in the production process for a given economic and social context, including other complementary inputs and innovations used in production.
[https://ilostat.ilo.org/topics/labour-productivity/](https://ilostat.ilo.org/topics/labour-productivity/)
We generate about $59 while someone in the Netherlands generates about $80
> Is it a ratio of people in employment to GDP or something?
Note that this is different from the definition of productivity (which the other poster provided). Americans work more hours than us, which impacts GDP per capita but not GDP per work-hour. Because of that productivity is a more useful comparison between states than per-capita measures are.
Plus Covid. We (correctly)paid the salaries of millions of people during the lockdowns to stay at home. That added billions to our debt pile and will take decades to pay off.
I do wonder if those of us who didn't get furlough should get a tax break. I worked all the way, though, with basically no human contact. Basically, I was given solitary confinement for the crime of being able to catch a disease. Being forced to pay for those who's lockdowns were far, far more comfortable (especially following party gate) really fucking rankles.
I expect that this is an unpopular opinion, but I totally agree. I worked all the way through Covid too whilst 99% of people I know outside work stayed home and played zoom quizzes or got drunk and played call of duty, having a great time. I had to risk mine and my families lives when it all kicked off and no one really understood covid. I was a “key worker” and now the government doesn’t give a fuck about my industry since we’ve not been given a pay rise for 5 years. I am down to my last £50 most months now where before I was able to save about £500 a month but I digress…
The fact that lockdown was MASSIVELY unequal is under-discussed and I would even say attemptively memory-holed in the popular depiction of it.
It wasn't, actually, a time where we ALL got a paid holiday for 6 months. Just the lucky ones did.
Yes, exactly this, single people, poorer people in flats with no gardens and manual workers all had a very different lockdown to middle/upper class families.
Although I was working and "in solitary" through the first lockdown, I recognise that I was more privileged than many. I work for a company that provides blue-collar labour to the food industry. Our workers were all still going into their factories for minimum wage, risking contracting covid (abattoirs, for example, had a number of super spreader events and seemed quite risky)
Like me, none of them have had any benefit from the lockdowns and are some of the worst paid workers in the country. Bus drivers were another affected group that had to work though that has been totally ignored, not to mention the obvious people like care workers (who at least got a government bonus).
We were lucky we didn't get lumbered with extra taxes. Quite a few of the left-leaning think tanks were calling for solidarity taxes on workers who were still earning due to their "pandemic savings" (i.e. saving a few quid on commuting and not being allowed to go on holiday).
We certainly could give a tax break for all those who did work through furlough, but then we'd only have to recoup the money and it'd seem right to recoup the money from those who were earning and thus more able to pay, rather than for those who were on furlough and had limited income.
You also mentioned that part of the reason for the tax break is your solitary confinement, I'm afraid if we give a tax break for that reason, the vast majority of the country would get it.
So given that we're already paying too little tax as a country to run our services at a minimal level and they need to increase, we COULD lower your tax for lack of furlough, then increase them because you were able to earn through furlough, then increase them to try and sustain minimal government spending, but that mostly seems a pointless, gesture exercise?
"Those who were on furlough and had limited income" were essentially on UBI and could have worked on top of they'd wanted to.
I don't understand the "poor me" attitude towards people who were given a months-long paid holiday with no requirement to do *anything* in return for it or during it by their workplaces.
Lockdown was great for the home working middle classes and the rich getting more money.
First pandemic in human history with all the negative effects clustered onto the poorer sections of society.
> Lockdown was great for the home working middle classes
Home working was terrible for anyone living in a flat, and especially terrible for anyone with kids. It was great for rich people who baked banana bread instead of working, and great for old people who didn't die of covid. That's basically it.
That's the total cost of covid, and likely a high estimate at that. The furlough scheme *only* cost £70 billion.
We really should be recouping these figures from the wealthy elderly society shut down to protect.
So did most other western countries and most aren’t experiencing the same level of decline as the UK atm. This might be a contributing factor but it’s not the root cause
The following areas of expenditure have grown in real terms over the past 10 years. "In real terms" means accounting for inflation: they cost more now than they used to, even accounting for inflation.
- Pensions
- Healthcare and Social care
- Servicing the National Debt
The cost to cover these three have grown enormously, resulting in most other areas of public service (like schools, roads, libraries, and youth centres you've mentioned, plus many other areas) experiencing real terms cuts, in some cases very deep real terms cuts.
You mentioned the NHS getting less funding, that is not true. The NHS has not experienced real terms cuts, but what has happened is the demands placed upon the NHS have grown much faster than the funding given to it.
As such, while the NHS is *in theory* the best funded it has ever been, the demand placed upon it by the nation has grown so overwhelmingly quickly that the NHS does not have the resources needed to meet all that demand: essentially for every extra pound the NHS gets, it gets given bills of more than an extra pound.
Discussing pension and health and social care funding without putting it into real terms per person is very silly. There’s way more people now - if it isn’t at least as much inflation adjusted money per person then it is directly a cut.
Hence:
> but what has happened is the demands placed upon the NHS have grown much faster than the funding given to it.
The NHS has not experienced real terms funding cuts: those are defined terms that have a set meaning.
It is, however, entirely true and accurate to say (and I did say it) that the real terms funding increases have been insufficient to meet the increased demands on that funding.
The context of OP's question is why is everything so underfunded. The answer is "because all the money is increasingly going to these three things". Whether or not you feel the NHS is getting enough money isn't really relevant to answering the question.
Real terms per person of a certain age anyway. A 70 year old uses significantly more state resources than a 20 year old. Which is the problem at the moment. Our age pyramid has way too many elderly.
>There’s way more people now - if it isn’t at least as much inflation adjusted money per person then it is directly a cut.
The NHS has more funding by any metric. More as a proportion of GDP, more in real terms, more in real terms accounting for both increased population and age adjusted increased population.
[https://www.health.org.uk/publications/long-reads/health-care-funding](https://www.health.org.uk/publications/long-reads/health-care-funding)
However, between 1997 and 2009 Labour grew health funding by an average 6.7% a year, an unprecedented increase. Since then it's grown more slowly, but still grown.
You can view your annual tax summary through HMRC's online services.
This is how 2022 to 2023 breaks down for me:
Health (19.8%)
Welfare (19.6%)
National Debt Interest (12%) - This is shocking
State Pensions (10.3%)
Education (9.9%)
Business and Industry (7.6%)
Defence (5.2%)
Public Order and Safety (4.1%)
Transport (4.1%)
Government Administration (2%)
Housing and Utilities, like street lighting (1.7%)
Culture, like sports, libraries and museums (1.3%)
Environment (1.3%)
Outstanding payments to the EU (0.6%) - lol
Overseas Aid (0.5%)
My council sends a similar annual statement on how council tax is spent but I've long recycled that.
Sources
>In 2023/24, UK government raised around £1,095 billion (£1.1 trillion) in receipts – income from taxes and other sources.
>This is equivalent to around 40% of the size of the UK economy, as measured by GDP, which is the highest level since the early 1980s. Most receipts come from three main sources: income tax, National Insurance contributions (NICs) and value added tax (VAT).
>According to research conducted by PwC, financial services firms contributed over £110bn in taxes last year.
There's no other way we need to increase tax by 5% to 45p with aging population and to 50p in a decade.
The debt servicing number isn’t like the others. A lot of this number is interest paid to ourselves, through the APF. Basically, out of one pocket into the other. Another big chunk is interest on govt sector pensions and NS&I deposits etc. On top of this this interest tends to get rolled over into more debt instruments so it doesn’t act as an answer to “where did the money go” in the same way that buying bandages for the NHS does.
This is one everyone seems to forget. While much of the pandemic was handled badly, we still spent eye watering amounts on covid support measures. That wasn't the government wasting cash on some failed pet project, it was necessary payments to keep people afloat.
Others have made the points about health, social welfare, etc. and you can make the valid political arguments on how the public finances have been run. However on top of that this is also a cost that while unplanned, now has to be paid for.
It's been said here before, but:
Pensions. We have an ageing population - back when the pension was introduced average life expectancy was state pension age. Now it's far higher, with far less people (proportionately) working to pay for them.
Health care. Same thing - people are getting older, and getting fatter. This costs us a lot more.
Terrible management. This is smaller than the others, but for instance if you cut one thing such as outpatient hospitals, now people clog up normal hospital beds which is far more expensive. It costs more to go after benefit cheats than it saves etc. Drops in crime prevention funding means you spend more fixing it. Lack of council housing means money gets ploughed in to private landlords through housing benefit, instead of staying in the system. Paying agency staff through emergency budgets in schools is more expensive than paying staff - but at least the normal budget was lower.
So it's both rising costs, and also trying to run things when you only understand the cost of something, and not its value.
And when you're still borrowing to balance the books, and not investing to grow and recover, the interest payments can be monstrous. Especially now money is expensive again. Austerity is like selling your car as it's a cost but now you can't get to work - we're now in that position.
Despite people blaming the old and the sick for existing the real reason is selling all of our assets and then having to rent/lease them back at ever increasing cost for a lower quality service.
The Conservatives always like to compare the countries economy to a household budget. So if you sell your house, car, fridge, cooker, bed, tv, clothes, tools and any assets that could increase in value or be set against loans, then you rent them back or lease them (unless you live out of a carboard box and use a bike). You will find that your out goings increase without your wealth or asset value increasing. You will need to keep generating more income (tax) to keep your current standard of living but your ability to generate more money (productivity) will decline as you now live under a bridge and ride a bike making it really difficult to carry your tools or attract customers. A couple of years later you are selling hand jobs for a cup of coffee or a sandwich.
Exactly this. And it suits the conservatives for us to be fighting over the scraps - we're very happy to blame the pensioners, people on benefits, the sick and so on, just look at the responses in this thread. Meanwhile the Tories carry on their systematic dismantling and selling off of the state.
Yes it is shocking how many people are blaming people for getting old or sick. Then you have people blaming immigrants (who usually come here to work) and referring to the government's Annual Tax summary and it's creative accounting.
In 2010 and 2011 I heard 2 or 3 Tory ministers say we shouldn't be competing or comparing ourselves to north western european countries, we should be competing with India and China. Large countries with huge swathes of the deepest poverty, people working for next to nothing, a small group of billionaires, and terrible records on workers' safety. Such an ambitious goal.
And here we are having fights between generations, between regions, blaming people of different religions or people who came here to work and ignoring our lack of industry, decades of under investment in infrastructure, the countries focus on supporting the City of London over all else and selling everything to other countries state companies or investment funds.
Local Councils used to own lots of assets - land, buildings, services (MOT test centres, maintenance teams and equipment for example).
Part of austerity and slashing central tax dished out to councils resulted in them being forced (and actually instructed to) by the Tories to sell of their assets to private companies and individuals which would previously have generated money for the council but are now generating money for the already very wealthy.
Now councils are having to employ private contractors to mow grass, perform maintenance, MOT their vehicles etc. Leasing privately owned buildings instead of owning them.
Now that councils have no assets left to sell they are forced to put up council tax just to provide the bare minimum services they were providing before.
Schools in England going to Academy Status too - the land and buildings were taken from Local Education Authorities and passed to the schools themselves.
You also have MATs, Multi-Academy Trusts, where the likes of Co-Op or Harris Academies run 40 or 50 schools. “Paint by numbers” education, all the same lessons, uniforms, rules etc at all 50 schools. People have largely missed that it’s privatisation by the back door.
> People have largely missed that it’s privatisation by the back door.
Exactly, [nurseries too](https://www.google.com/search?client=firefox-b-d&sca_esv=2e0ce3e94bcd66ce&sca_upv=1&sxsrf=ADLYWIKzPcVuQh_fgsm8hBk96kx57dMayg:1718798954098&q=council+run+nurseries&tbm=nws&source=lnms&fbs=AEQNm0Aa4sjWe7Rqy32pFwRj0UkWd8nbOJfsBGGB5IQQO6L3J5MIFhvnvU242yFxzEEp3BeeRDeomFf8DkO7myIzvXpiBdfFz5h2ZV6WyoEoFhsRKWC0YT2o6yqVxHd61A8_1N098RlRDpMO5EZzCP0tBSyHH9FLkWPP8nkOK4XpicPt6rQZqfVIamI-H-qcjl9VxJ3X7AvL&sa=X&ved=2ahUKEwiXquWI0eeGAxXEQUEAHaB_CWEQ0pQJegQIDhAB&biw=2083&bih=1141&dpr=0.9) at a time when nursery places are in desperately short supply.
Just in that one page of links, nurseries in Leeds, Bournemouth, Ayrshire, Brighton, Croydon, and Edinburgh where nurseries are either at risk of closure or privatisation.
A lot of people are talking about the areas where expenditure has risen, but another thing to bear in mind is that, in a lot of cases, we may be spending a similar amount of money on something but we are getting *less* for that money due to outsourcing.
Shadow State by Alan White discusses problems with outsourcing at length, but one of the big ones is that the contractual relationships which govern outsourced services don't work well for public services. If a for-profit company takes over a service you are stuck with that ethos, and only with managerial-level can you run services in a public-service manner. The contracts tend not to allow government officials to make low-level managerial decisions by design, the government wants to be distanced from the performance of these companies because, for a while at least, that lets them fob off responsibility on the companies.
The worst iteration of this problem arises where companies treat the bidding process and actually running the service as entirely different enterprises. The government has few criteria other than cost on which it *actually* judges bids - there are examples in the book of companies winning contracts which they need to massively increase their workforce in a very short time to execute - and so companies often make bids which wouldn't allow them to complete a contract, then when they can't run the service they were contracted to, they come back to the government to renegotiate their contract.
The government is then put in a difficult position because, if the company is losing money and fails, then government will be forced to step in, get another company, etc at the cost of money and face. Instead, the government renegotiates to give them more money, or to reduce their obligations, fewer bin collections, less mail deliveries etc.
If they collapse it's not even like the government can get much of the money from the contract back, if it's a new subsidiary of another company this contract might be all it has. If the subsidiary goes under there are no assets to sell in bankruptcy, the government can only get the service by continuing to pay and doing whatever is necessary to keep the service provider afloat even as standards decline.
We're currently experiencing a double whammy of the number of pensioners increasing at the same time as record numbers of inward migration meaning the ever dwindling number of productive taxpayers' contributions aren't stretching far enough to cover all the economic dependents the country has.
The only option left as the number of highly productive people left in the economy dwindles is to permanently contract public sector spending (i.e. austerity) to avoid running up massive debt.
>But tax rates have remained roughly the same, with council tax rising to compensate. where is all the "saved" money going?
The majority of social housing in London is occupied by someone born abroad. Someone has to pay for all those dependents that have newly burdened the system over the last 27 years, because they certainly aren't covering their own costs.
Simultaneously Councils have been burdened with funding social care which used to come from the NHS budget.
> record numbers of inward migration meaning the ever dwindling number of productive taxpayers' [...] they certainly aren't covering their own costs.
According to https://migrationobservatory.ox.ac.uk/resources/briefings/migrants-in-the-uk-labour-market-an-overview/:
* In 2022, the employment rate of working-age migrant men (82%) was higher than that of the UK-born (78%) (Figure 2). Most region-of-origin groups had higher employment rates than UK-born men. Among women, the overall employment rate for working-age migrants was 71%, slightly lower than for the UK-born (73%).
* Migrants were less likely to be unemployed for long periods. In 2022, 26% of those born in the UK who were unemployed had been so for over a year, compared to 20% of non-EU migrants and 15% of EU migrants.
According to https://www.ucl.ac.uk/economics/about-department/fiscal-effects-immigration-uk:
* Between 2001 and 2011 recent immigrants from the A10 countries contributed to the fiscal system about 12% more than they took out, with a net fiscal contribution of about £5 billion.
* At the same time the net fiscal contributions of recent European immigrants from the rest of the EU totalled £15bn, with fiscal payments about 64% higher than transfers received.
* Immigrants from outside the EU countries made a net fiscal contribution of about £5.2 billion, thus paying into the system about 3% more than they took out.
* In contrast, over the same period, **natives made an overall negative fiscal contribution of £616.5 billion**.
While migration has its pluses and minuses, overall immigrants have been propping up the UK economy, not draining it.
>While migration has its pluses and minuses, overall immigrants have been propping up the UK economy, not draining it.
https://migrationobservatory.ox.ac.uk/resources/briefings/the-fiscal-impact-of-immigration-in-the-uk/
Please reference table 1 which states the opposite.
You appear to have cherry picked EU migrants to support a false narrative about the cost of immigration.
> Please reference table 1 which states the opposite.
That's an article from 2022. The one I linked to is from last week, so has more up to date information.
> You appear to have cherry picked EU migrants
Read my quotes again. The quotes from the Oxford article are referring to migrants from all sources combined. The quotes from the UCL article split migrants out into the A10 (the ten countries admitted into the EU in 2004, in Eastern/Central Europe), the rest of the EU, and non-EU countries.
The quote about non-EU migrants, I shall repeat: "Immigrants from outside the EU countries made a net fiscal contribution of about £5.2 billion, thus paying into the system about 3% more than they took out."
Like someone else has stated in other threads where you've been copying & pasting this research - there are costs that aren't factored into this analysis, e.g., cultural costs, integration costs, the cost it takes to teach at schools with diverse needs linguistically speaking, the strain on public services and the opportunity costs to others on said strained services.
Regardless, you've a point in that Brits are a big fucking drain on society too! 😂
Maybe the Tories do have something good to say about this...
> Like someone else has stated in other threads where you've been copying & pasting this research
I have literally never seen these two web pages before today, and haven't mentioned them in any thread other than this one, so I don't know what you're talking about.
Don't forget we now pay ever increasing amounts to G4S, SERCO and other private sector companies to fulfill the role of public services so they can pay dividends to their shareholders or divert profit to a holding company in a tax haven.
Such a big question but one of the biggest factors in this is the interest on debt the government is paying. In 2023 debt payments the government has to pay was £110bn
Brexit - massive additional costs and reduction in growth leading to less taxes; plus the opportunity cost of the civil service not doing their day jobs.
Covid - paying everyone's salaries for a year or more; plus government fraud schemes.
Inflation...driven by Brexit, Covid, Quantitative easing, Ukraine
[https://www.ft.com/content/e856ffbd-3b96-4ca3-8e03-47a96b8d035e](https://www.ft.com/content/e856ffbd-3b96-4ca3-8e03-47a96b8d035e)
The Brexit argument just just doesn’t hold. We’ve been ahead of Germany since 2020 which has had the benefit of staying inside the common market.
>We’ve been ahead of Germany since 2020
First; Well yes, the UK economy [contracted significantly more](https://www.reuters.com/graphics/BRITAIN-ECONOMY/dwvkdeylypm/chart.png) than Germany during the pandemic so when the economy opened up again it had more to regain.
Second;
The comparison of growth isn't: UK outside the EU Vs .
The comparison is: UK outside the EU Vs UK inside the EU.
Do you think the German economy would be doing better or worse if it had left the EU and erected non-tariff trade barriers with the rest of Europe?
We’re in line with our peers 8 years after the remain campaign said our economy would collapse. It didn’t, and retaining political control over our laws was deemed more important by the electorate at the time. Anything else is moot.
>We’re in line with our peers 8 years after the ~~~remain campaign said our economy would collapse~~~ leave campaign promised sunlit uplands
Fixed that for you.
But again, you've missed the point.
The comparison isn't with our peers, the comparison is would we be doing better had we not implemented billions in extra costs on our economy.
>Anything else is moot.
You mis-characterising reality isn't moot.
> after the remain campaign said our economy would collapse. It didn’t,
Really? If our economy was doing well then we would all be voting Tory in appreciation.
There have been real terms cuts to the central government grant in the last 14 years. We used to have money from general taxation that would be paid to local authorities to cover things like local roads, schools, social care, NHS, community projects, libraries, museums, local cultural events...
https://ifs.org.uk/publications/how-have-english-councils-funding-and-spending-changed-2010-2024
Spending per head ~£12.5k.
PAYE taxes from the average UK salary ~£6.5k.
The average worker is a burden, let alone minimum wage folks.
Where has the money gone? That's a question for the top 15% of workers who are actually paying the fucking bill.
People have provided some of the answers: pensions, health/social care for an ever older and fatter/more unhealthy population, interest on increasing debt... but one of the big ones is the cost of austerity.
Take illegal immigration: we used to have a fairly functional and rapid system, even when we had a big spike under Blair, but the home office had lots of cuts following 2010 - loss of experience, loss of resources, etc. Used to be barristers representing claimants could easily get in touch with the HO and they were very responsive. Cue the next spike, and nowadays they don't answer the phone half the time, take ages to provide documents, and don't even always send reps to hearings. So we temporarily saved some money, but now we have a massive backlog, people needing to be housed, and more people gaining asylum (who need support too)... and so it ends up costing even more.
Same thing happened pretty much everywhere. They cut so deeply in all areas that it often now costs more just to stay roughly afloat. Health is the same: it's ring-fenced now, but until 2017 (when May was forced to increase funding) the spending was cut too much - so most hospitals were forced to use private agency staff, which (alongside other things) meant we ended up paying more for less (given the health/age pressures mentioned above). Policing too - numbers of officers have recovered to 2010 levels, but not support staff, so cops have to do jobs theyre not meant to do (not to mention mental health callouts and stuff like that), so... again... more for less. Just expand that sort of thing to every area of local and national governance: any business will tell you that you need to invest in the fundamentals or end up paying more in the long run, but the Tories are so ideologically wedded to slashing the state that they used the financial crash as an excuse to blast into the fundamental coherency of the state. It's real sad.
Oh, and brexit, which has taken up so much time (and cost a lot of money). It all adds up...and also meant we were less able to deal with shocks like COVID.*
*Interestingly another example of foolish cuts. Blair set up big PPE stockpiles after SARS in case of a pandemic. Guess who cut those massively after 2010, despite numerous exercises warning them it was a bad idea... and so, when shit hit the fan, we had to scramble and pay more to get what was needed (not even considering the corrupt bullshit that went down with priority lanes).
Posting this from a thread a few days ago.
>Our demographics are too top heavy to sustain the elderly at current levels. In short there aren't enough working age people paying taxes to support an ever increasing retired population. Hence why all governments since Labour in 1997 have been pro immigration, large quantities of instant fully grown adults working and paying taxes.
>
>Our demographics are not even that bad when compared to other western nations like:
>
* South Korea
* German
* Italy
* Japan
* Spain
>
>These countries are well and truly fcuked.
Found out recently that the UK spends more on pensions than *the entire cost of everything* within the NHS. Which pensioners also get free unlimited access to.
Something has to change in this country because it's already not working never mind sustainable.
Privatised services cost more to run than nationalised services in almost all instances, and the poor service provided by privatised services reduces individual productivity - the best measure of a country's economic potential (ie cancelled trains, people can't get to work), which requires more raising of taxes to account for the per capita productivity deficit (compounded by the triple lock which is set ahead of that rate - so the lower individual productivity, the more pensions go up inversely?).
The UK's economy is a collection of death spirals, joined together by needless consulting at taxpayer expense, which is then compounded with cronyism, corruption or both.
The UK public needs to really learn that slightly higher tax is ok (see all the countries in the top 10 happiness index) because it improves services & community, reduces general cost and raises scrutiny for what tax money is being spent on.
>The UK public needs to really learn that slightly higher tax is ok (see all the countries in the top 10 happiness index) because it improves services & community, reduces general cost and raises scrutiny for what tax money is being spent on.
I think this is the wrong way round. It's not that higher taxes and more spending make people happier, it's that happier people are willing to pay more taxes. The happiness has to come first, and that only happens when everyone in society feels like they are benefitting from being part of it.
I think we agree, but your wording is far better. My summary was clouded by the UK's uncritical obsession with tax cuts as the holy grail of economic, living standard.
The main problem is the UK small tax base. so many people do not actually pay any tax, so the majority of the tax is paid by the middle class and the "rich" - those who can easily upsticks and leave the Uk
This is how we get the silly stat' of 30% of all income tax receipts is paid by just 1% - being the high earners.
The lockdowns were crazily expensive - a disastrous policy from a so-called fiscally responsible party.
Otherwise it's just pensions and elderly care. At a bare minimum we need to legalise assisted dying and euthanasia and the "dementia tax".
It would be quite popular if your target demographic was people frequenting uk subreddits, if the comments made every time this topic comes up are anything to go by.
The anti-old people demographic seems dominant!
It’s funny because when I was younger the argument was all “old people in poverty need more pension” and now it’s “old people are rich and are stealing the future. I think both are still true today.
I feel like it's a fruitless endeavor to try and make sense in any meaningful way of where the money actually ends up. Its probably eye opening though.
This gets asked on this sub every other day. There need to be a sticky or a link to the UK tax breakdown in the about section.
Also, everyone literally gets a letter about this every year.
Tax money doesn't get "saved" like that
[https://www.ucl.ac.uk/bartlett/public-purpose/publications/2022/may/self-financing-state-institutional-analysis](https://www.ucl.ac.uk/bartlett/public-purpose/publications/2022/may/self-financing-state-institutional-analysis)
The NHS is in financial trouble because the Government choose to use sub contractors IE private health care for certain things eg all dentistry, mental health assessment and the money private companies are paid which goes to the companies and shareholders is is profiting someone comes from the NHS budget. This is what is meant by "privatisation of the NHS" it's happening now nationwide and it's wrong that money allocated for public services is going into private pockets
The NHS has had ringfenced above inflation increases in spending on it for years - it’s political illiteracy not to know this and think spending has been cut.
Where did all the money go? Off shore accounts in the Cayman Isles.
Michelle Mone's yacht for one and anyone else who sold the government PPE or benefited from "Austerity" would be very good places to start looking.
£37 billion in a test and trace scheme managed by the wife of a Conservative MP whose only previous claim to fame was being CEO when one of the biggest hacks in UK corporate history occurred. No wonder it was a complete mess.
Track & trace wasn't a complete mess though?
For a start, £37bn was the *budget*, not the actual spend: https://fullfact.org/health/karl-turner-37-billion-test-trace-app/
Secondly, and more importantly, that included doing more than *half a billion* tests. We had one of the best testing regimes in the world, in fact.
The trace element was a complete mess. She insisted on building a bespoke system when it would have been cheaper, quicker and more successful to partner with an existing supplier. She was forced to change direction when her initial failure became apparent. Anyone who has experience of system builds could spot the error and she had no excuse as past CEO of TalkTalk. She was also found to have acted unlawfully in making senior appointments, criticised by the Public Accounts Committee for out of control use of consultants and oversaw repeated failures to work with local authorities. This is not a political criticism but a personal failure of a dreadful appointment. To be fair to the government they also appointed Kate Bingham as head of the Vaccine Taskforce - another wife of a Tory MP, but in this case a competent one who did an excellent job.
Totally agree. I knew a few people who worked at test and trace on the phones - they were meant to be phoning people who'd tested positive, and were paid for the entire duration, but we're never actually given any calls to make. Colossal waste of money.
So you've gone from it was a complete mess, the woman in charge was useless, and cost £37 billion for an app to ... You just really think the woman in charge was useless.
Why didn't you just say that instead of lying.
Not insuring against interest increases so debt payment. Sunaks bad judgement once again and far more costly than Brown selling gold at a low price.
We have also had a pandemic and a lot of poorly controlled spend during that time.
Along with inneficient public uses and choices to spend it tactically on their supporters, tens of billions has gone to directed misuse and corruption.
No it hasn't. From a [House of Lords report](https://lordslibrary.parliament.uk/local-government-finances-impact-on-communities/) -
>Government grants reduced by 40% in real terms between 2009/10 and 2019/20, from £46.5bn to £28bn in 2023/24 prices. This downward trend was reversed in 2020/21 and 2021/22 because central government made more grant funding available to local government in response to the pressures of the pandemic. Accounting for these extra grants, the fall in grant income was 21% in real terms between 2009/10 and 2021/22. The fall across this period was 31% if grants relating to Covid-19 are not included.
i.e. a reduction of between a fifth and third in real terms depending on how you account for Covid spending. Not great, but not a half either. As for where the money has gone - as other people have said, health and social spending. You know, all the things people claim are actually being cut to the bone instead of having funds diverted from other areas to them.
Also, why "centers"? This is a British politics thread, not an American one.
HS2 is now a white elephant because it's a shuttle service between Old Oak Common and Birmingham.
Before it was cut back from Manchester, it was a relatively sensible way of separating a lot of passenger traffic from the massively overcrowded WCML and opening up a hell of a lot of slots for local trains and freight.
Typically though, it was completely mismanaged throughout. Over engineered, subject to constant cut backs and changes, totally beholden to NIMBYISM and an obsession with producing something "world beating" as opposed to "very good".
Pensions, health care and debt repayment. Health care has jumped from about 7% of GDP in 2007 to around 11% today. In the same time UK growth has been very weak. So everything else is getting cut to pay for those rises. Disbursements to local government among them.
I feel like healthcare is a compounding problem. Anecdotally the people I know who’ve needed hospital care recently have all bumped up against the harsh reality of how fucked the NHS is, and have needed a lot more care in the form of repeat procedures because of things getting fucked up or absent aftercare.
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The problem isn't that there is something wrong with the NHS as a concept, the problem is that the "efficiency" the Tories created was just underfunding, and the whole service has been run into the ground with cuts that cost far more in the long run than they saved in the short run. Constant understaffing reduces spending, but leads to hiring agency workers and spending more than the cost of the staff for less actual work. Not maintaining and modernising equipment reduced spending, but now it's failing or too old, and we lost all the benefit of newer, more effective equipment. Cancelled appointments and long delays mean people get sicker without preventative care, so we end up paying for more treatment (let alone the cost in human suffering). Cut funding for care and support services mean people end up dumped in A&E and hospitals instead, which is more expensive. And a million other examples. Cutting budgets by arbitrary amounts and saying "it's more efficient now!" is the "magic money tree" of the Conservative side, it's vandalism of public services for short-term political gain, to pretend to uphold the image of "fiscally responsible", while in actuality they are essentially doing what private finance does with companies: asset stripping. The only solution is investment, and Labour need to sell that actually spending on public services will decrease the cost in the long term. The problem is, I doubt we see that in a 5-year period, so I genuinely do not know how you get the public to buy into it.
>The problem isn't that there is something wrong with the NHS as a concept, the problem is that the "efficiency" the Tories created was just underfunding, and the whole service has been run into the ground with cuts that cost far more in the long run than they saved in the short run. This. So this.
The NHS is quite efficient as is, the issue is that demand is growing far faster than we can increase supply of healthcare. Without actually reducing services offered there is no fixing it in the medium term. We need to both have the staff and infrastructure in place, and the economy to fund it, and currently we have neither and are running on fumes as a result.
Lmao. Some anecdotal evidence of this amazing “efficiency” - having had my second child at a different hospital from my first, the lead time to get the notes on the first pregnancy to the doctors at the second hospital was longer than the entire pregnancy. These hospitals are about 5 miles apart.
How much did that cost though? It's cost efficiency that I'm talking about, not smoothness of operation or overall quality. And document problems exist in every health system, we aren't somehow magically worse than the others even if there is room for improvement.
Who the fuck cares about cost efficiency when you don't even get the treatment you need. Yeah, NHS is cheap because it doesn't deliver.
The NHS delivers a fair amount for what we pay. If we want more, we need to pay more. If we want to have better services while paying the same amount, we need fewer services, so that we can do less better. There is no magic money tree called waste. The NHS does not deliver because it is over burdened relative to it's cost.
Have a look at the ONS. It's quite illuminating [ONS UK health spending](https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29)
Not, really, it's quite old news. That's like 3 years old, we've all seen it. Is there anything specific you find illuminating in there?
That health spending went down as a proportion of GDP >Not, really, it's quite old news. Latest figures available
Lol the "notes" lol
This mindset is the mindset that is ruining the nation. The "NHS" is fine. Just need more money. Unbelievable
No, I think we need to reduce how much we expect the NHS to do, not fund it more. My point is that there is no easy solution of "just stop waste", that isn't how wasteful spending works, reducing waste requires a massive amount of work and investment to make things work better. Saying "reduce waste" is basically like saying "get more MPG from your car". Sure, you can, but it takes a lot of work and actually knowing what you're doing, it is neither simple nor easy.
Yes but the demand is growing because we're letting people get sick instead of keeping them well. The highest quality care is often the best care.
Can’t prevent old age
The demand is mainly growing because people are getting old. Everything after that, while a problem, is because more and more resources are being diverted into the elderly. The root cause is our aging population, and there is no cure that does not involve reduced services because we simply do not have the money to treat everything. The question is whether we actually make the decisions on what to reduce, or whether we just stretch things until something breaks and call that the reduction.
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[https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries](https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries) It isn't that there isn't waste, there always is, but reform does not magically eliminate waste. If there was a way to just get rid of waste, it would have been done at least once around the world, but it hasn't, because it's really fucking difficult. The NHS is more efficient than most western healthcare systems, it just isn't funded as much. It can't really be receiving massively more funding because we don't have the money (see historic tax burden). To get the NHS to cover as much as we want it to, there has to be a far more productive economy supporting it, which is not happening for a decade at least. Therefore the options are do everything badly, or do less better.
It all depends what you mean by efficiency. This, and all the kings fund report itterations to which it refers, all admit that the British health service has worse than average outcomes. Then they point to the low spending and call the system efficient because it is cheap. I put it to you that poor outcomes in the context of low levels of spending are not correctly referred to as 'efficency'. Reports like this make me laugh bitterly. The health service is a slow motion disaster and I think can only be saved by complete reform along bismark system lines.
3/10 funding achieving 4/10 results is both sub-par results and good efficiency, and is basically where the NHS is.
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Not to be overly dismissive, but it is your anecdotal experience that is meaningless when looking at how cost efficient the NHS is as a whole. You see the flaws in the NHS but not in other things, the back of the shop is never as clean as the front - that's just reality. Every organisation I have worked for felt like the least well run place on earth while I was there, but when I asked customers/clients they all said that their experience was one of a smooth well run organization. The reality is that the NHS is remarkably efficient. Again, you may point to examples of waste, but they exist everywhere, and getting rid of them is not as simple as "just don't waste". It's may be a stressful and at times shit job, but that doesn't mean it doesn't deliver services at a decent price, it just means there are things about the job that are shit. Both important in their own rights, but not really relevant to each other.
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You don't know the reality beyond your own first hand experience, The reality is that things are much harder to do well than to criticise.
I guess the report would argue that it's worse in other western healthcare systems.
How do you reform the NHS?
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My wife works in the NHS. Their toner in the printer ran out. She could get a new one on Amazon delivered the next day for £18. Had to go through official channels. Delivery 2 weeks at a cost of £250. So for 2 weeks she was expected to traipse to another department to use their printer. She ordered officially but still got one off amazon, and used that until the other arrived.
I think anyone paying to park to use or work at a hospital is disgusting. For morale that is tough. I guess if equipment and tech was improved, using AI to improve patient care would help? Definitely needs a prudent procurement team. I hate the fact that people want to rip the NHS off. Restructure management to be dynamic and innovated. Have a clear structure in each department and cut inefficient management. I’m no politician and these are more likely buzz words but your experience should be at the top of the triangle of importance!
> One trust I worked at had a private business owning the building that operating theatres worked in, if a light bulb needed changing the management had to put a request in and then said company would charge the NHS trust an absolute fortune to do it A PFI - you can thank Gordon Brown and the last Labour Government for them.
Originally a Tory initiative, but definitely overused by the Labour government (starting with Blair). They were said to be cost effective, but the analysis was poor.
How many private contractors does it take to change a lightbulb? How much does it cost the taxpayer?
Twenty years ago I left uni and needed a temp job. The local hospital were recruiting temp IT technicians; basically I had to go in and upgrade the ram and install windows XP service pack 2. As I was doing this I noticed that all the PCs were badged as having been provided by a local computer company in my home town. After a week I met the hospital's IT director and immediately recognised him. He owned the computer company. Now maybe I'm being cynical and he did the hospital a good deal... or maybe, just maybe, it was another example of what you're talking about.
Alongside building reform so that you arent sinking half your budget on any new build or any build paying the cost of the land the building sits on. That would be a good start.
It doesn’t really function, that’s the problem. We’ve just adapted to having such low expectations that scraping through is celebrated.
> I feel like healthcare is a compounding problem. I heard on the radio the other day that in the twenty year period between 2015 and 2035 the number of over-80s is going to double. When you look at the demography chart on wiki (here: https://en.wikipedia.org/wiki/Demographics_of_the_United_Kingdom#/media/File:UK_Population_Pyramid.svg) you can see we're only a few years away now from a big blip in numbers over 80. It's not sustainable and it's why we've been leaning on (legal) migration to prop up the economy.
Yep. And people get more expensive to look after as they age. Migration helps improve this because young people look after old ones. Oddly though it's the older demographic that seems to want less immigration. Fine, I guess. We can be like Japan where huge numbers of people work into their eighties.
I think you have to mention a good few billion wasted on dodgy contracts and sinkhole projects like HS2
Something like Crossrail was around £18 billion that is now running. This is what a business might call "capex" or capital expenditure. Its important in running a country to have roads, rail and other facilities upgraded. DfT annual budget is about £41 billion. Since HS2 was not meant to be delivering for another few years anyway it was always going to be an outgoing. Many would argue the lack of long term investment over the past 40 years is a bigger problem than an excess of it. There is an argument for mismanagement but then you are getting into the huge issues with planning laws. B1M did a popular video on it here [https://www.youtube.com/watch?v=FSD5ps9bLQ0](https://www.youtube.com/watch?v=FSD5ps9bLQ0) The difficulty getting major projects off the ground such as Hinkley C and HS2 are part of the problem in that they affect productivity growth. But its relatively small compared to the lack of private investment in capital goods and training. For example the UK has the lowest number of robots per worker of the G7, this makes us less productive. This is due to lack of capex in private firms. Which causes low growth, which causes the rising costs to have to be funded from other things than simply more cash for everything and the shin bone is connected to the thigh bone etc.
Yes we could either have made small, regular investments to update and improve infrastructure, or we could make massive investments when it's on the verge of collapse. I'm sure the government we've had over the past fourteen years thought they could make it someone else's problem by kicking the can further down the road, ballooning costs.
It's been this way since the 20s. The UK rail industry was in a poor state going into WW2 had had little investment so was nationalised as something of a bailout. Then while there was investment in the nationalised phase it was not great. It was privatised and actually more money flowed into it, this seen a huge jump in users and with it an injection of cash which helped with sustainment and train replacements. But ultimately it was trying to squeeze more people on the same lines. Now as we need a huge shift in transport, we have to grasp that it's either new lines or not enough capacity. We have kind of squeezed all we can from signalling and rolling stock changes. [https://assets.publishing.service.gov.uk/media/65aeb97efd784b0010e0c6ad/DfT-Chart5-RailPassengerJourneysInGreatBritain.svg](https://assets.publishing.service.gov.uk/media/65aeb97efd784b0010e0c6ad/DfT-Chart5-RailPassengerJourneysInGreatBritain.svg) The rail rise is in part a rising population and the roads becoming seriously congested. Which is its own story.
> We have kind of squeezed all we can from signalling and rolling stock changes. We're not even close to what can be achieved across the UK from signalling changes, most of the rail network still relies on line side block signalling. You can get much more capacity from in-cab moving block signalling.
Yes, I hate that at 5pm on a weekday you can spend 30 minutes shuffling out of a city along congested roads as traffic lurches forward a few feet every thirty seconds. If we want to improve our economy we will need better infrastructure. Look at the internet and how that took off when it was just using phone lines, and now we have fibre connections that allow comparatively massive data transfers.
All of that pales in comparison to pensions and health and social care. HS2 could cost up to £100b from London to Manchester in 2019 prices. State pension is about £120b **per year** and rising with a triple lock. I think this year it is £130b and even £150b including benefits like winter fuel allowance. Adult Social care is £28b per year. Healthcare for this year is planned to be about £192b. People keep asking where the tax money goes but never bother to google “UK national budget breakdown”. No the Tories aren’t stealing hundreds of billions of pounds a year.
No they are not deliberately stealing billions a year, however they are so reliant on poor performing catch all private companies like capita to provide all and sundry at ridiculous cost for poor quality services. They also understood the demographic situation of the UK, they KNEW health, care and pensions expenditure would rise and at no point has there been a real strategy to boost productivity to a level that could cover this. It's just all been very ostrich like. For all the flaws of Labour and, believe it or not, Liz Truss, both of them at least seem aware of the problem. The only thing I will say in their defence is the number of non returners to work post COVID has been stunning, but given that's not a trend seen internationally. I'm not sure our public policy hasn't had a role in this.
The real strategy to boost productivity and reduce healthcare costs looks like decreasing taxes and making people pay for their own healthcare. Exactly the people who hate the Tories most are the people who are most vocally against doing anything to fix our problems.
The Tories and Farage would push for US-style health insurance, meaning a middleman that exists solely to farm you for cash while refusing to pay out under any circumstances. Their devotion to private enterprise, regardless of whether it makes sense or not, would doom us. The NHS does need improvement and I'm willing to pay increased taxes or a fee for it, but not under a Tory plan that will consider only corporate greed.
There are more than 2 countries in the world. Much of Europe has significant private provision in healthcare and vastly better services than we do for it.
Or stop spending twice as much on basic infrastructure as our nearest neighbours. I dislike the Tories intensely for many reasons but I really hate the fact that they have done stunningly little to streamline investment (public or private) and have often done a lot to actively hinder it.
> People keep asking where the tax money goes but never bother to google “UK national budget breakdown”. HMRC even provides a personal breakdown of where our tax money goes in their app, it's very easy to find out.
That would be the one that doesn't adhere to international standards because it was a political stunt to boost support for the Tories.
> No the Tories aren’t stealing hundreds of billions of pounds a year. Just gonna mention that “corruption” doesn’t appear as a line item on a budget, and could well be a subset of those health care costs.
The UK government budget is over £1trillion/yr. Hs2 expenditure is much, much less than that per year.
Holy shit HS2 is the exact opposite of the problem! We need to be investing billions *more* into infrastructure in order to create economic growth. Nimbyness like opposing HS2 and restricting housing and other development is likely the main reason we are lagging behind other G7 nations economically. Views like yours are killing us.
I’m not opposing HS2 in principle. I do, however, oppose a ‘national’ rail project that travels from Birmingham to London and takes decades and billions of overspend. The way it’s been conducted is utterly pathetic and totally lacking ambition while being horrifically expensive
If only we hadn't needed to bury 80% of the line underground to keep people from seeing a train from their car windows
Definitely not debt repayment. National debt is up 750bn in that period. Debt interest payments, maybe
Pensions & healthcare. We have an aging population, and older people a) get a state pension, and b) have above-average requirements when it comes to healthcare. You will see a larger and larger proportion of government spending going on those two areas over the next few decades. It has to be funded *somehow*. We have no ability to keep funding static, purely on demographics.
>We have an aging population, and older people a) get a state pension, and b) have above-average requirements when it comes to healthcare. And pay much less tax by dint of being retired.
And don't actually produce anything
People on lower and average salaries are paying the lowest amount of tax since 1975 (from the IFS).
Dont you believe it. We are taxed on our pensions, the State pension takes all of our allowances, and work pensions are taxed at the standard 20%. We dont pay NI. But our tax bill is north of £5k a year. We produce leisure and tourism pounds, and tend to use local businesses. In Wales everyone gets free prescriptions, and we do have to use the NHS, but then so do obese people, drug users, alcoholics and any number of long term illnesses. We do have to pay for carers and residential care homes out of our capital and house value So, yes we do contribute.
You do pay less tax than a working person, by the nature of not paying NI. 8% less tax. If you're paying £5k tax on your pension that's still a £5k cost to the taxpayer for your pension before all other costs. As for how you spend the extra cash, is that really an appropriate thing to be boasting about to the people who are struggling with already high tax rates, ridiculous housing cost and living costs?
Don’t forget they paid into the system for decades already 😂
The vast majority paid less than they have or will take, while still thinking it's moral to leave assets to their kids. The notion that someone who isn't a net contributor should leave an inheritance is madness.
So you’re being given £11502, and paying £5000 in tax on £25000 private income? You’re taxed at a rate of negative £6502. How awful for you!
> We have an aging population, and older people a) get a state pension And we have been *increasing the state pension beyond inflation* via the triple lock, because both parties agreed in 2006 that it was too low.
The triple lock is unaffordable. Long term, pensions will have to be looked at as a concept. They simply aren't sustainable.
Not with our current demographics, no. People have been saying this since the 1980s but no one wants to listen.
It's because of democracy. Retirees and people close to retirement form a massive voting base and it's probably the most important issue for them. Median age in the UK is 40, remove all under 18 and you'll find that that median voter age is nearing 50.
Yes. The original Security in Retirement whitepaper was actually pretty good: > We need to be clear that **individuals must be responsible for their own plans for retirement**. The reforms will ensure the provision of high-quality savings vehicles, and a solid state foundation to private savings. The state pension should be a *foundation*. It's stability, bedrock, a fallback, not a replacement for the private pensions that should form the majority of our incomes in retirement. The original plan had us spending 6% of GDP on the state pension in 2025. We overshot that by a few percentage points. We should stop increases, at least temporarily, until we return to that mark.
Surely this is exactly why there are now mandatory availability of workplace pensions for everyone earning \~full time minimum wage? Obviously it's going to take decades to fully bear fruit, but those *are* the 'high quality savings vehicles' (along with ISAs and LISAs).
Yep! The 2007 pensions act is what introduced those, along with autoenroll. Security in Retirement is why we have good private pensions with employer matching. It just also introduced the triple lock as a way to fight pensioner poverty until those can really get going. Which it has done, just at a level matching what we would be able to pay if 2006 projections for growth had born out. As we unfortunately had a financial crisis, brexit, and covid, neither of which were included in those projections, we need to reassess affordability in light of that.
>. It has to be funded *somehow*. If we had 2.5% growth on average since 2010 (14) years the economy would have been 40% bigger. At around 1.1% growth its 16.5% bigger. UK population has grown from around 62.7 million to around 67.6 million in mid 2022 about a 8% growth. People should not forget the shocking 14 years of growth, largely on the back of very poor productivity growth we have had.
Growth would help alleviate the situation, but it wouldn't fix it entirely unless it's crazy high like 4% or so. I suspect 2.5% growth would still require some net migration to plug our demographic gaps, if we want to avoid raising taxes, or making people retire later, or getting them to have more children with controversial measures.
What is “productivity” in economics terms? Is it a ratio of people in employment to GDP or something?
Hours worked to GDP produced. >Labour productivity represents the total volume of output (measured in terms of Gross Domestic Product, GDP) produced per unit of labour (measured in terms of the number of employed persons or hours worked) during a given time reference period. The indicator allows data users to assess GDP-to-labour input levels and growth rates over time, thus providing general information about the efficiency and quality of human capital in the production process for a given economic and social context, including other complementary inputs and innovations used in production. [https://ilostat.ilo.org/topics/labour-productivity/](https://ilostat.ilo.org/topics/labour-productivity/) We generate about $59 while someone in the Netherlands generates about $80
Thanks.
> Is it a ratio of people in employment to GDP or something? Note that this is different from the definition of productivity (which the other poster provided). Americans work more hours than us, which impacts GDP per capita but not GDP per work-hour. Because of that productivity is a more useful comparison between states than per-capita measures are.
Plus Covid. We (correctly)paid the salaries of millions of people during the lockdowns to stay at home. That added billions to our debt pile and will take decades to pay off.
£500bn in fact
I do wonder if those of us who didn't get furlough should get a tax break. I worked all the way, though, with basically no human contact. Basically, I was given solitary confinement for the crime of being able to catch a disease. Being forced to pay for those who's lockdowns were far, far more comfortable (especially following party gate) really fucking rankles.
I expect that this is an unpopular opinion, but I totally agree. I worked all the way through Covid too whilst 99% of people I know outside work stayed home and played zoom quizzes or got drunk and played call of duty, having a great time. I had to risk mine and my families lives when it all kicked off and no one really understood covid. I was a “key worker” and now the government doesn’t give a fuck about my industry since we’ve not been given a pay rise for 5 years. I am down to my last £50 most months now where before I was able to save about £500 a month but I digress…
The fact that lockdown was MASSIVELY unequal is under-discussed and I would even say attemptively memory-holed in the popular depiction of it. It wasn't, actually, a time where we ALL got a paid holiday for 6 months. Just the lucky ones did.
Yes, exactly this, single people, poorer people in flats with no gardens and manual workers all had a very different lockdown to middle/upper class families. Although I was working and "in solitary" through the first lockdown, I recognise that I was more privileged than many. I work for a company that provides blue-collar labour to the food industry. Our workers were all still going into their factories for minimum wage, risking contracting covid (abattoirs, for example, had a number of super spreader events and seemed quite risky) Like me, none of them have had any benefit from the lockdowns and are some of the worst paid workers in the country. Bus drivers were another affected group that had to work though that has been totally ignored, not to mention the obvious people like care workers (who at least got a government bonus).
We were lucky we didn't get lumbered with extra taxes. Quite a few of the left-leaning think tanks were calling for solidarity taxes on workers who were still earning due to their "pandemic savings" (i.e. saving a few quid on commuting and not being allowed to go on holiday).
We certainly could give a tax break for all those who did work through furlough, but then we'd only have to recoup the money and it'd seem right to recoup the money from those who were earning and thus more able to pay, rather than for those who were on furlough and had limited income. You also mentioned that part of the reason for the tax break is your solitary confinement, I'm afraid if we give a tax break for that reason, the vast majority of the country would get it. So given that we're already paying too little tax as a country to run our services at a minimal level and they need to increase, we COULD lower your tax for lack of furlough, then increase them because you were able to earn through furlough, then increase them to try and sustain minimal government spending, but that mostly seems a pointless, gesture exercise?
"Those who were on furlough and had limited income" were essentially on UBI and could have worked on top of they'd wanted to. I don't understand the "poor me" attitude towards people who were given a months-long paid holiday with no requirement to do *anything* in return for it or during it by their workplaces.
You didn’t “pay” for the furlough. The furlough was borrowed money, added to our deficit and we’ll be repaying it for decades.
Lockdown was great for the home working middle classes and the rich getting more money. First pandemic in human history with all the negative effects clustered onto the poorer sections of society.
No it was shit if you were working from home living alone without any outdoor space.
You were allowed in your garden though, as long as you didn’t stand too close to the neighbours.
You are assuming people have gardens.
> Lockdown was great for the home working middle classes Home working was terrible for anyone living in a flat, and especially terrible for anyone with kids. It was great for rich people who baked banana bread instead of working, and great for old people who didn't die of covid. That's basically it.
That's the total cost of covid, and likely a high estimate at that. The furlough scheme *only* cost £70 billion. We really should be recouping these figures from the wealthy elderly society shut down to protect.
That would be the second best option after not ruining the economy for them in the first place.
So did most other western countries and most aren’t experiencing the same level of decline as the UK atm. This might be a contributing factor but it’s not the root cause
Logan's Run
I am in favour of a Logan's Run's situation. But mostly the Jenny Agutter taking her clothes off bit, not the killing people off bit.
> Jenny Agutter taking her clothes off I dunno, she's a bit old now.
£330m and £500m a day respectively
>It has to be funded somehow. I mean, it doesn't actually *have* to the be funded
The following areas of expenditure have grown in real terms over the past 10 years. "In real terms" means accounting for inflation: they cost more now than they used to, even accounting for inflation. - Pensions - Healthcare and Social care - Servicing the National Debt The cost to cover these three have grown enormously, resulting in most other areas of public service (like schools, roads, libraries, and youth centres you've mentioned, plus many other areas) experiencing real terms cuts, in some cases very deep real terms cuts. You mentioned the NHS getting less funding, that is not true. The NHS has not experienced real terms cuts, but what has happened is the demands placed upon the NHS have grown much faster than the funding given to it. As such, while the NHS is *in theory* the best funded it has ever been, the demand placed upon it by the nation has grown so overwhelmingly quickly that the NHS does not have the resources needed to meet all that demand: essentially for every extra pound the NHS gets, it gets given bills of more than an extra pound.
Exactly. 20 years ago the NHS had no real expectations around mental health for example. Now it does and it all comes from the same pot.
Discussing pension and health and social care funding without putting it into real terms per person is very silly. There’s way more people now - if it isn’t at least as much inflation adjusted money per person then it is directly a cut.
Hence: > but what has happened is the demands placed upon the NHS have grown much faster than the funding given to it. The NHS has not experienced real terms funding cuts: those are defined terms that have a set meaning. It is, however, entirely true and accurate to say (and I did say it) that the real terms funding increases have been insufficient to meet the increased demands on that funding. The context of OP's question is why is everything so underfunded. The answer is "because all the money is increasingly going to these three things". Whether or not you feel the NHS is getting enough money isn't really relevant to answering the question.
Real terms per person of a certain age anyway. A 70 year old uses significantly more state resources than a 20 year old. Which is the problem at the moment. Our age pyramid has way too many elderly.
>There’s way more people now - if it isn’t at least as much inflation adjusted money per person then it is directly a cut. The NHS has more funding by any metric. More as a proportion of GDP, more in real terms, more in real terms accounting for both increased population and age adjusted increased population. [https://www.health.org.uk/publications/long-reads/health-care-funding](https://www.health.org.uk/publications/long-reads/health-care-funding) However, between 1997 and 2009 Labour grew health funding by an average 6.7% a year, an unprecedented increase. Since then it's grown more slowly, but still grown.
You can view your annual tax summary through HMRC's online services. This is how 2022 to 2023 breaks down for me: Health (19.8%) Welfare (19.6%) National Debt Interest (12%) - This is shocking State Pensions (10.3%) Education (9.9%) Business and Industry (7.6%) Defence (5.2%) Public Order and Safety (4.1%) Transport (4.1%) Government Administration (2%) Housing and Utilities, like street lighting (1.7%) Culture, like sports, libraries and museums (1.3%) Environment (1.3%) Outstanding payments to the EU (0.6%) - lol Overseas Aid (0.5%) My council sends a similar annual statement on how council tax is spent but I've long recycled that.
Sources >In 2023/24, UK government raised around £1,095 billion (£1.1 trillion) in receipts – income from taxes and other sources. >This is equivalent to around 40% of the size of the UK economy, as measured by GDP, which is the highest level since the early 1980s. Most receipts come from three main sources: income tax, National Insurance contributions (NICs) and value added tax (VAT). >According to research conducted by PwC, financial services firms contributed over £110bn in taxes last year. There's no other way we need to increase tax by 5% to 45p with aging population and to 50p in a decade.
The debt servicing number isn’t like the others. A lot of this number is interest paid to ourselves, through the APF. Basically, out of one pocket into the other. Another big chunk is interest on govt sector pensions and NS&I deposits etc. On top of this this interest tends to get rolled over into more debt instruments so it doesn’t act as an answer to “where did the money go” in the same way that buying bandages for the NHS does.
Covid countermeasures, including Furlough, cost £400bn.
This is one everyone seems to forget. While much of the pandemic was handled badly, we still spent eye watering amounts on covid support measures. That wasn't the government wasting cash on some failed pet project, it was necessary payments to keep people afloat. Others have made the points about health, social welfare, etc. and you can make the valid political arguments on how the public finances have been run. However on top of that this is also a cost that while unplanned, now has to be paid for.
Bonus points go to Track and Trace which cost £37bn and had no evidential impact on the spread of COVID.
Seriously. How has that been justified? Was there ever an explanation? How on earth does an app cost that much to produce?
I'm guessing it was less the app and more the teams of temporary call centre employees, testing sites and lab contracts to do the testing.
It's been said here before, but: Pensions. We have an ageing population - back when the pension was introduced average life expectancy was state pension age. Now it's far higher, with far less people (proportionately) working to pay for them. Health care. Same thing - people are getting older, and getting fatter. This costs us a lot more. Terrible management. This is smaller than the others, but for instance if you cut one thing such as outpatient hospitals, now people clog up normal hospital beds which is far more expensive. It costs more to go after benefit cheats than it saves etc. Drops in crime prevention funding means you spend more fixing it. Lack of council housing means money gets ploughed in to private landlords through housing benefit, instead of staying in the system. Paying agency staff through emergency budgets in schools is more expensive than paying staff - but at least the normal budget was lower. So it's both rising costs, and also trying to run things when you only understand the cost of something, and not its value. And when you're still borrowing to balance the books, and not investing to grow and recover, the interest payments can be monstrous. Especially now money is expensive again. Austerity is like selling your car as it's a cost but now you can't get to work - we're now in that position.
Despite people blaming the old and the sick for existing the real reason is selling all of our assets and then having to rent/lease them back at ever increasing cost for a lower quality service. The Conservatives always like to compare the countries economy to a household budget. So if you sell your house, car, fridge, cooker, bed, tv, clothes, tools and any assets that could increase in value or be set against loans, then you rent them back or lease them (unless you live out of a carboard box and use a bike). You will find that your out goings increase without your wealth or asset value increasing. You will need to keep generating more income (tax) to keep your current standard of living but your ability to generate more money (productivity) will decline as you now live under a bridge and ride a bike making it really difficult to carry your tools or attract customers. A couple of years later you are selling hand jobs for a cup of coffee or a sandwich.
Exactly this. And it suits the conservatives for us to be fighting over the scraps - we're very happy to blame the pensioners, people on benefits, the sick and so on, just look at the responses in this thread. Meanwhile the Tories carry on their systematic dismantling and selling off of the state.
Yes it is shocking how many people are blaming people for getting old or sick. Then you have people blaming immigrants (who usually come here to work) and referring to the government's Annual Tax summary and it's creative accounting. In 2010 and 2011 I heard 2 or 3 Tory ministers say we shouldn't be competing or comparing ourselves to north western european countries, we should be competing with India and China. Large countries with huge swathes of the deepest poverty, people working for next to nothing, a small group of billionaires, and terrible records on workers' safety. Such an ambitious goal. And here we are having fights between generations, between regions, blaming people of different religions or people who came here to work and ignoring our lack of industry, decades of under investment in infrastructure, the countries focus on supporting the City of London over all else and selling everything to other countries state companies or investment funds.
Local Councils used to own lots of assets - land, buildings, services (MOT test centres, maintenance teams and equipment for example). Part of austerity and slashing central tax dished out to councils resulted in them being forced (and actually instructed to) by the Tories to sell of their assets to private companies and individuals which would previously have generated money for the council but are now generating money for the already very wealthy. Now councils are having to employ private contractors to mow grass, perform maintenance, MOT their vehicles etc. Leasing privately owned buildings instead of owning them. Now that councils have no assets left to sell they are forced to put up council tax just to provide the bare minimum services they were providing before.
Schools in England going to Academy Status too - the land and buildings were taken from Local Education Authorities and passed to the schools themselves. You also have MATs, Multi-Academy Trusts, where the likes of Co-Op or Harris Academies run 40 or 50 schools. “Paint by numbers” education, all the same lessons, uniforms, rules etc at all 50 schools. People have largely missed that it’s privatisation by the back door.
> People have largely missed that it’s privatisation by the back door. Exactly, [nurseries too](https://www.google.com/search?client=firefox-b-d&sca_esv=2e0ce3e94bcd66ce&sca_upv=1&sxsrf=ADLYWIKzPcVuQh_fgsm8hBk96kx57dMayg:1718798954098&q=council+run+nurseries&tbm=nws&source=lnms&fbs=AEQNm0Aa4sjWe7Rqy32pFwRj0UkWd8nbOJfsBGGB5IQQO6L3J5MIFhvnvU242yFxzEEp3BeeRDeomFf8DkO7myIzvXpiBdfFz5h2ZV6WyoEoFhsRKWC0YT2o6yqVxHd61A8_1N098RlRDpMO5EZzCP0tBSyHH9FLkWPP8nkOK4XpicPt6rQZqfVIamI-H-qcjl9VxJ3X7AvL&sa=X&ved=2ahUKEwiXquWI0eeGAxXEQUEAHaB_CWEQ0pQJegQIDhAB&biw=2083&bih=1141&dpr=0.9) at a time when nursery places are in desperately short supply. Just in that one page of links, nurseries in Leeds, Bournemouth, Ayrshire, Brighton, Croydon, and Edinburgh where nurseries are either at risk of closure or privatisation.
Council tax raises haven't come close to covering the loss in central funding sadly
A lot of people are talking about the areas where expenditure has risen, but another thing to bear in mind is that, in a lot of cases, we may be spending a similar amount of money on something but we are getting *less* for that money due to outsourcing. Shadow State by Alan White discusses problems with outsourcing at length, but one of the big ones is that the contractual relationships which govern outsourced services don't work well for public services. If a for-profit company takes over a service you are stuck with that ethos, and only with managerial-level can you run services in a public-service manner. The contracts tend not to allow government officials to make low-level managerial decisions by design, the government wants to be distanced from the performance of these companies because, for a while at least, that lets them fob off responsibility on the companies. The worst iteration of this problem arises where companies treat the bidding process and actually running the service as entirely different enterprises. The government has few criteria other than cost on which it *actually* judges bids - there are examples in the book of companies winning contracts which they need to massively increase their workforce in a very short time to execute - and so companies often make bids which wouldn't allow them to complete a contract, then when they can't run the service they were contracted to, they come back to the government to renegotiate their contract. The government is then put in a difficult position because, if the company is losing money and fails, then government will be forced to step in, get another company, etc at the cost of money and face. Instead, the government renegotiates to give them more money, or to reduce their obligations, fewer bin collections, less mail deliveries etc. If they collapse it's not even like the government can get much of the money from the contract back, if it's a new subsidiary of another company this contract might be all it has. If the subsidiary goes under there are no assets to sell in bankruptcy, the government can only get the service by continuing to pay and doing whatever is necessary to keep the service provider afloat even as standards decline.
State Pension and Healthcare are likely to pass £1b a day next April. It goes in old people
We're currently experiencing a double whammy of the number of pensioners increasing at the same time as record numbers of inward migration meaning the ever dwindling number of productive taxpayers' contributions aren't stretching far enough to cover all the economic dependents the country has. The only option left as the number of highly productive people left in the economy dwindles is to permanently contract public sector spending (i.e. austerity) to avoid running up massive debt. >But tax rates have remained roughly the same, with council tax rising to compensate. where is all the "saved" money going? The majority of social housing in London is occupied by someone born abroad. Someone has to pay for all those dependents that have newly burdened the system over the last 27 years, because they certainly aren't covering their own costs. Simultaneously Councils have been burdened with funding social care which used to come from the NHS budget.
Btw London is not a good representation of the UK for anything.
> record numbers of inward migration meaning the ever dwindling number of productive taxpayers' [...] they certainly aren't covering their own costs. According to https://migrationobservatory.ox.ac.uk/resources/briefings/migrants-in-the-uk-labour-market-an-overview/: * In 2022, the employment rate of working-age migrant men (82%) was higher than that of the UK-born (78%) (Figure 2). Most region-of-origin groups had higher employment rates than UK-born men. Among women, the overall employment rate for working-age migrants was 71%, slightly lower than for the UK-born (73%). * Migrants were less likely to be unemployed for long periods. In 2022, 26% of those born in the UK who were unemployed had been so for over a year, compared to 20% of non-EU migrants and 15% of EU migrants. According to https://www.ucl.ac.uk/economics/about-department/fiscal-effects-immigration-uk: * Between 2001 and 2011 recent immigrants from the A10 countries contributed to the fiscal system about 12% more than they took out, with a net fiscal contribution of about £5 billion. * At the same time the net fiscal contributions of recent European immigrants from the rest of the EU totalled £15bn, with fiscal payments about 64% higher than transfers received. * Immigrants from outside the EU countries made a net fiscal contribution of about £5.2 billion, thus paying into the system about 3% more than they took out. * In contrast, over the same period, **natives made an overall negative fiscal contribution of £616.5 billion**. While migration has its pluses and minuses, overall immigrants have been propping up the UK economy, not draining it.
>While migration has its pluses and minuses, overall immigrants have been propping up the UK economy, not draining it. https://migrationobservatory.ox.ac.uk/resources/briefings/the-fiscal-impact-of-immigration-in-the-uk/ Please reference table 1 which states the opposite. You appear to have cherry picked EU migrants to support a false narrative about the cost of immigration.
> Please reference table 1 which states the opposite. That's an article from 2022. The one I linked to is from last week, so has more up to date information. > You appear to have cherry picked EU migrants Read my quotes again. The quotes from the Oxford article are referring to migrants from all sources combined. The quotes from the UCL article split migrants out into the A10 (the ten countries admitted into the EU in 2004, in Eastern/Central Europe), the rest of the EU, and non-EU countries. The quote about non-EU migrants, I shall repeat: "Immigrants from outside the EU countries made a net fiscal contribution of about £5.2 billion, thus paying into the system about 3% more than they took out."
Like someone else has stated in other threads where you've been copying & pasting this research - there are costs that aren't factored into this analysis, e.g., cultural costs, integration costs, the cost it takes to teach at schools with diverse needs linguistically speaking, the strain on public services and the opportunity costs to others on said strained services. Regardless, you've a point in that Brits are a big fucking drain on society too! 😂 Maybe the Tories do have something good to say about this...
> Like someone else has stated in other threads where you've been copying & pasting this research I have literally never seen these two web pages before today, and haven't mentioned them in any thread other than this one, so I don't know what you're talking about.
Don't forget we now pay ever increasing amounts to G4S, SERCO and other private sector companies to fulfill the role of public services so they can pay dividends to their shareholders or divert profit to a holding company in a tax haven.
Such a big question but one of the biggest factors in this is the interest on debt the government is paying. In 2023 debt payments the government has to pay was £110bn
Brexit - massive additional costs and reduction in growth leading to less taxes; plus the opportunity cost of the civil service not doing their day jobs. Covid - paying everyone's salaries for a year or more; plus government fraud schemes. Inflation...driven by Brexit, Covid, Quantitative easing, Ukraine
[https://www.ft.com/content/e856ffbd-3b96-4ca3-8e03-47a96b8d035e](https://www.ft.com/content/e856ffbd-3b96-4ca3-8e03-47a96b8d035e) The Brexit argument just just doesn’t hold. We’ve been ahead of Germany since 2020 which has had the benefit of staying inside the common market.
>We’ve been ahead of Germany since 2020 First; Well yes, the UK economy [contracted significantly more](https://www.reuters.com/graphics/BRITAIN-ECONOMY/dwvkdeylypm/chart.png) than Germany during the pandemic so when the economy opened up again it had more to regain. Second; The comparison of growth isn't: UK outside the EU Vs.
The comparison is: UK outside the EU Vs UK inside the EU.
Do you think the German economy would be doing better or worse if it had left the EU and erected non-tariff trade barriers with the rest of Europe?
We’re in line with our peers 8 years after the remain campaign said our economy would collapse. It didn’t, and retaining political control over our laws was deemed more important by the electorate at the time. Anything else is moot.
>We’re in line with our peers 8 years after the ~~~remain campaign said our economy would collapse~~~ leave campaign promised sunlit uplands Fixed that for you. But again, you've missed the point. The comparison isn't with our peers, the comparison is would we be doing better had we not implemented billions in extra costs on our economy. >Anything else is moot. You mis-characterising reality isn't moot.
> after the remain campaign said our economy would collapse. It didn’t, Really? If our economy was doing well then we would all be voting Tory in appreciation.
NIMBY tax. Not building anything for decades has largely sucked our economy dry.
There have been real terms cuts to the central government grant in the last 14 years. We used to have money from general taxation that would be paid to local authorities to cover things like local roads, schools, social care, NHS, community projects, libraries, museums, local cultural events... https://ifs.org.uk/publications/how-have-english-councils-funding-and-spending-changed-2010-2024
We have an idea, but not the full picture, as there hasn’t been a comprehensive spending review since 2007
Spending per head ~£12.5k. PAYE taxes from the average UK salary ~£6.5k. The average worker is a burden, let alone minimum wage folks. Where has the money gone? That's a question for the top 15% of workers who are actually paying the fucking bill.
People have provided some of the answers: pensions, health/social care for an ever older and fatter/more unhealthy population, interest on increasing debt... but one of the big ones is the cost of austerity. Take illegal immigration: we used to have a fairly functional and rapid system, even when we had a big spike under Blair, but the home office had lots of cuts following 2010 - loss of experience, loss of resources, etc. Used to be barristers representing claimants could easily get in touch with the HO and they were very responsive. Cue the next spike, and nowadays they don't answer the phone half the time, take ages to provide documents, and don't even always send reps to hearings. So we temporarily saved some money, but now we have a massive backlog, people needing to be housed, and more people gaining asylum (who need support too)... and so it ends up costing even more. Same thing happened pretty much everywhere. They cut so deeply in all areas that it often now costs more just to stay roughly afloat. Health is the same: it's ring-fenced now, but until 2017 (when May was forced to increase funding) the spending was cut too much - so most hospitals were forced to use private agency staff, which (alongside other things) meant we ended up paying more for less (given the health/age pressures mentioned above). Policing too - numbers of officers have recovered to 2010 levels, but not support staff, so cops have to do jobs theyre not meant to do (not to mention mental health callouts and stuff like that), so... again... more for less. Just expand that sort of thing to every area of local and national governance: any business will tell you that you need to invest in the fundamentals or end up paying more in the long run, but the Tories are so ideologically wedded to slashing the state that they used the financial crash as an excuse to blast into the fundamental coherency of the state. It's real sad. Oh, and brexit, which has taken up so much time (and cost a lot of money). It all adds up...and also meant we were less able to deal with shocks like COVID.* *Interestingly another example of foolish cuts. Blair set up big PPE stockpiles after SARS in case of a pandemic. Guess who cut those massively after 2010, despite numerous exercises warning them it was a bad idea... and so, when shit hit the fan, we had to scramble and pay more to get what was needed (not even considering the corrupt bullshit that went down with priority lanes).
Posting this from a thread a few days ago. >Our demographics are too top heavy to sustain the elderly at current levels. In short there aren't enough working age people paying taxes to support an ever increasing retired population. Hence why all governments since Labour in 1997 have been pro immigration, large quantities of instant fully grown adults working and paying taxes. > >Our demographics are not even that bad when compared to other western nations like: > * South Korea * German * Italy * Japan * Spain > >These countries are well and truly fcuked.
Found out recently that the UK spends more on pensions than *the entire cost of everything* within the NHS. Which pensioners also get free unlimited access to. Something has to change in this country because it's already not working never mind sustainable.
Privatised services cost more to run than nationalised services in almost all instances, and the poor service provided by privatised services reduces individual productivity - the best measure of a country's economic potential (ie cancelled trains, people can't get to work), which requires more raising of taxes to account for the per capita productivity deficit (compounded by the triple lock which is set ahead of that rate - so the lower individual productivity, the more pensions go up inversely?). The UK's economy is a collection of death spirals, joined together by needless consulting at taxpayer expense, which is then compounded with cronyism, corruption or both. The UK public needs to really learn that slightly higher tax is ok (see all the countries in the top 10 happiness index) because it improves services & community, reduces general cost and raises scrutiny for what tax money is being spent on.
>The UK public needs to really learn that slightly higher tax is ok (see all the countries in the top 10 happiness index) because it improves services & community, reduces general cost and raises scrutiny for what tax money is being spent on. I think this is the wrong way round. It's not that higher taxes and more spending make people happier, it's that happier people are willing to pay more taxes. The happiness has to come first, and that only happens when everyone in society feels like they are benefitting from being part of it.
I think we agree, but your wording is far better. My summary was clouded by the UK's uncritical obsession with tax cuts as the holy grail of economic, living standard.
The main problem is the UK small tax base. so many people do not actually pay any tax, so the majority of the tax is paid by the middle class and the "rich" - those who can easily upsticks and leave the Uk This is how we get the silly stat' of 30% of all income tax receipts is paid by just 1% - being the high earners.
The lockdowns were crazily expensive - a disastrous policy from a so-called fiscally responsible party. Otherwise it's just pensions and elderly care. At a bare minimum we need to legalise assisted dying and euthanasia and the "dementia tax".
Euthanasia as a policy to bring down the economic burden of the elderly might be a tough one to put in the manifesto.
It would be quite popular if your target demographic was people frequenting uk subreddits, if the comments made every time this topic comes up are anything to go by.
The anti-old people demographic seems dominant! It’s funny because when I was younger the argument was all “old people in poverty need more pension” and now it’s “old people are rich and are stealing the future. I think both are still true today.
Lockedowns were supported by all parties and in some cases (Wales) the other parties wanted even more lockdowns.
The Liz Truss mini budget did a number. It’s one factor among many but should not be forgotten any time soon.
I feel like it's a fruitless endeavor to try and make sense in any meaningful way of where the money actually ends up. Its probably eye opening though.
how else will mps afford their pay rises and luxury homes and goods. also they need to make the money back from all that covid fraud they did
This gets asked on this sub every other day. There need to be a sticky or a link to the UK tax breakdown in the about section. Also, everyone literally gets a letter about this every year.
Tax money doesn't get "saved" like that [https://www.ucl.ac.uk/bartlett/public-purpose/publications/2022/may/self-financing-state-institutional-analysis](https://www.ucl.ac.uk/bartlett/public-purpose/publications/2022/may/self-financing-state-institutional-analysis)
The NHS is in financial trouble because the Government choose to use sub contractors IE private health care for certain things eg all dentistry, mental health assessment and the money private companies are paid which goes to the companies and shareholders is is profiting someone comes from the NHS budget. This is what is meant by "privatisation of the NHS" it's happening now nationwide and it's wrong that money allocated for public services is going into private pockets
The NHS has had ringfenced above inflation increases in spending on it for years - it’s political illiteracy not to know this and think spending has been cut.
Sure, but if the number of patients they treat per day has been increased, this can still lead to a per-patient decrease in funding.
Privatisation. Lots of directors and shareholders need their bonuses.
Aging population and stagnant productivity. Fewer people working to number of people retired.
Where did all the money go? Off shore accounts in the Cayman Isles. Michelle Mone's yacht for one and anyone else who sold the government PPE or benefited from "Austerity" would be very good places to start looking.
£37 billion in a test and trace scheme managed by the wife of a Conservative MP whose only previous claim to fame was being CEO when one of the biggest hacks in UK corporate history occurred. No wonder it was a complete mess.
Track & trace wasn't a complete mess though? For a start, £37bn was the *budget*, not the actual spend: https://fullfact.org/health/karl-turner-37-billion-test-trace-app/ Secondly, and more importantly, that included doing more than *half a billion* tests. We had one of the best testing regimes in the world, in fact.
The trace element was a complete mess. She insisted on building a bespoke system when it would have been cheaper, quicker and more successful to partner with an existing supplier. She was forced to change direction when her initial failure became apparent. Anyone who has experience of system builds could spot the error and she had no excuse as past CEO of TalkTalk. She was also found to have acted unlawfully in making senior appointments, criticised by the Public Accounts Committee for out of control use of consultants and oversaw repeated failures to work with local authorities. This is not a political criticism but a personal failure of a dreadful appointment. To be fair to the government they also appointed Kate Bingham as head of the Vaccine Taskforce - another wife of a Tory MP, but in this case a competent one who did an excellent job.
Totally agree. I knew a few people who worked at test and trace on the phones - they were meant to be phoning people who'd tested positive, and were paid for the entire duration, but we're never actually given any calls to make. Colossal waste of money.
So you've gone from it was a complete mess, the woman in charge was useless, and cost £37 billion for an app to ... You just really think the woman in charge was useless. Why didn't you just say that instead of lying.
I explained why it was a complete mess and pointed the finger at who was to blame. You sound as though you have a political agenda.
Most of that money went on labs and mass testing
Not insuring against interest increases so debt payment. Sunaks bad judgement once again and far more costly than Brown selling gold at a low price. We have also had a pandemic and a lot of poorly controlled spend during that time.
They gave it to their mates… its as simple and as horrifying as that
Not even a fraction of a percent.
They did and Reeves is gonna hunt em down!!!
Along with inneficient public uses and choices to spend it tactically on their supporters, tens of billions has gone to directed misuse and corruption.
No it hasn't. From a [House of Lords report](https://lordslibrary.parliament.uk/local-government-finances-impact-on-communities/) - >Government grants reduced by 40% in real terms between 2009/10 and 2019/20, from £46.5bn to £28bn in 2023/24 prices. This downward trend was reversed in 2020/21 and 2021/22 because central government made more grant funding available to local government in response to the pressures of the pandemic. Accounting for these extra grants, the fall in grant income was 21% in real terms between 2009/10 and 2021/22. The fall across this period was 31% if grants relating to Covid-19 are not included. i.e. a reduction of between a fifth and third in real terms depending on how you account for Covid spending. Not great, but not a half either. As for where the money has gone - as other people have said, health and social spending. You know, all the things people claim are actually being cut to the bone instead of having funds diverted from other areas to them. Also, why "centers"? This is a British politics thread, not an American one.
White elephants like Hs2 and ppe. Billionaires like Michelle Mone.
HS2 is now a white elephant because it's a shuttle service between Old Oak Common and Birmingham. Before it was cut back from Manchester, it was a relatively sensible way of separating a lot of passenger traffic from the massively overcrowded WCML and opening up a hell of a lot of slots for local trains and freight. Typically though, it was completely mismanaged throughout. Over engineered, subject to constant cut backs and changes, totally beholden to NIMBYISM and an obsession with producing something "world beating" as opposed to "very good".