Yet more resources are no substitute for healthcare reform
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The Kingdom of Prussia was once described as “not a country with an army, but an army with a country.” If the NHS Long Term Workforce Plan is to be implemented in full, then by the middle of the next decade, Britain could become a health service with a country attached. According to the Institute for Fiscal Studies ([link removed]) , the NHS could then employ almost half of the public sector workforce, and almost a tenth of the overall workforce.
Most of the media commentary has concentrated on the questions of whether this plan is fiscally sustainable, how it should be financed, or whether it is going to deliver good value for money. What nobody seems to have noticed is what an unusual situation it is, in a market economy, that the state should directly employ such a large proportion of the workforce, and engage in detailed workforce planning. Imagine we had a Long Term Brewing Workforce Plan, outlining how many master brewers, how many hop growers and how many beer delivery drivers there should be in 2036.
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I have written for the Spectator ([link removed]) , and spoken to Epoch Times ([link removed]) , about the plan and its economic implications. Meanwhile, the Labour Party has released figures showing that more than 120,000 people died while waiting for NHS treatment last year.
These figures look dramatic, but they are a bit misleading. If somebody dies while they are on an NHS waiting list for a knee operation, then their bad knee is probably not what killed them.
Given that almost everyone seems to be on an NHS waiting list of some sort these days, I am, if anything, surprised that the figure is not even higher than that. Nonetheless – we do have elevated excess mortality rates, which refuse to fall back to pre-Covid levels, and it would be strange if the explosion in NHS waiting times had nothing to do with this. I have written for CapX ([link removed]) this week discussing the issue.
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Kristian Niemietz
IEA Head of Political Economy
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A socialist direction… Kristian appeared on talkTV to discuss his piece in The Spectator ([link removed]) , arguing that throwing more resources at the NHS is unlikely to solve its problems without systematic reform.
** ULEZ: A step towards road pricing or a punitive TfL bailout?
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This week, Sadiq Khan’s controversial expansion of the Ultra-Low Emissions Zone (ULEZ) across all London boroughs, came into effect. Much like London itself, we at the IEA have a range of views on the issue.
On the one hand, free marketers have little objection to shifting the cost of road use and environmental externalities onto road users. But is ULEZ really a step towards that goal? Questions linger as to whether the environmental benefits justify the extra daily cost of £12.50 imposed on road users. Perhaps the scheme has more to do with bailing out Transport for London that it does with saving Londoners’ lungs.
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In the green corner… Research Assistant Daniel Freeman argued the free market case for ULEZ against Energy Analyst Andy Mayer for the IEA’s YouTube channel. Daniel argued that London’s roads are over-congested and under-priced, while Andy contended that the negligible environmental benefits cannot justify the regressive costs.
Milton’s paradise… Daniel wrote for The Evening Standard ([link removed]) this week arguing that free marketers like Milton Friedman would have welcomed ULEZ as a tax on dirty air.
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A tax on the poor… When the ULEZ expansion was first announced last year, Andy wrote in Spiked ([link removed]) that ‘White Van Man’ and ‘School-Run Mum’ were being forced to pay the price for environmental posturing.
A timeless idea… While they disagreed about ULEZ, Daniel and Andy were unified in supporting a move towards road pricing. In 2004, the IEA published Pricing Our Roads: Vision and Reality ([link removed]) , which outlined a wide range of pricing models the government could pursue.
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IEA Latest.
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** Brex and Mortar ([link removed])
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Director of Public Policy and Communications, Matthew Lesh, The Sun ([link removed]) , City AM ([link removed]) , and The Times ([link removed])
Get cutting, get building… The announcement that ‘nutrient neutrality’ regulations are to be relaxed is a welcome step towards building more homes. But there is still a long way to go towards solving the housing crisis.
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** Is printing too much money the real cause of inflation? ([link removed])
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Economics Fellow, Julian Jessop, The Spectator
Always and everywhere… As the Bank of England continues its fight against inflation, analysts may be neglecting its key input: the money supply itself.
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** Demand for tax cuts hits fever pitch as UK economy recovers ([link removed])
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Economics Fellow, Julian Jessop, The Daily Express
Tax cut appetite… Higher wages, profits, and prices will boost tax revenues for the government. Rather than being absorbed by the Treasury, this unexpected windfall could be used to fund tax cuts.
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** When will the Scottish government get a grip on alcohol deaths? ([link removed])
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Head of Lifestyle Economics Christopher Snowdon, The Spectator
When will we learn?… The Scottish government has quietly rolled back its claim that minimum pricing has directly saved lives. Will the tide finally turn against ineffective nanny statism?
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** The trans threat to freedom ([link removed])
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Head of Cultural Affairs Marc Glendening, Spiked
We must beware… As Marc’s latest paper ([link removed]) demonstrated last week, extremists within the transgender movement are becoming a threat to liberal values. Failure to tackle their illiberalism will only push us down an authoritarian rabbit hole.
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** The BMA has left the Government little choice. Should it now ban NHS strikes? ([link removed])
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Editorial and Research Fellow, Len Shackleton, The Daily Telegraph
Held to ransom… With both junior doctors and consultants coordinating strike action next month, the government may need to step in to prevent dangerous NHS shortfalls.
IEA Insider.
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** Budget Challenge 2024 ([link removed])
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Calling all teachers and students… The IEA’s 2024 Budget Challenge is now open. Teams of four students submit entries outlining the key challenges facing the UK’s economy and proposing a budget to solve them. Top entries will be invited to the Budget Challenge semi-final at the University of Buckingham’s Vinson Centre in February, followed by the final at the IEA’s offices in March.
The deadline for entries is 11:59pm on 26th January and should be no longer than 5,000 words.
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