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Dear Resident,

“If democracy means anything, it means deciding – for a change – to pay some attention to the expressed preference of the majority, to what people themselves want, not what we think they ought to want”. (JM Richards, The Anatomy of Suburbia, 1973)

This is one of the most important quotations that shapes my political philosophy, and bears oft repetition.

At the end of a busy November, I thought I would just share a few reflections on some of the government policy announcements we have seen in the past fortnight.

The Economy

These have been tumultuous times in British politics in recent months – far too much, in my view – so I welcome the fact we have entered calmer waters. Policy making has become more prudent and careful – even if some may think the contents are not as good as they might like them to be.

The key point I would make about the Chancellor’s statement is that the measures will limit the depth of any recession – which most countries look likely to face - rather than unleash the sugar-rush of an immediate boom that we all pay a higher price for at a later date. I am sure some of you (but not me) will remember the Barber Boom of the early seventies which ended in inflation over 20% and a sterling crisis.

There is a careful balance strike between avoiding or minimising tax rises, but also ensuring the confidence of the markets so interest rates don’t rise, adding even more to mortgages that would cost even more than any extra tax might, as well as reduce people’s spending power in the midst of a recession. The dash for tax cuts we saw also has a consequence for the stability of people’s pensions, because our system of pension funds is simply not designed to cope with.

Since the Autumn Statement, government borrowing has fallen and the pound has strengthened. Interest rates are steadily falling, with more and cheaper mortgages reappearing on the market. It’s still not ideal, but a damn sight better than I thought it might be.

But we still have inflation.

According to Milton Friedman, “nothing undermines the stability of our economy, community and families more than inflation. It inevitably hits the poorest in society hardest, and it is therefore a moral as well as an economic hazard … inflation is taxation without legislation, except that no one wins, including the Treasury”. Yet apart from the Prime Minister himself, few in the party in recent months seem to have put squeezing out inflation high on their agenda – despite it being top of Mrs Thatcher’s at all times.

The other dog that doesn’t bark in public debate besides inflation is the actual cost of food overall – but I bet we all notice day to day. No issue has more divided the Conservative Party throughout its history more often and more deeply than the cry for ‘cheap food’, acting as a proxy for the argument between protectionism and free trade, Little England versus globalisation. “Beef or Liberty” has been the cry. Britain always relied on importing Danish bacon and Dutch eggs back to the 19th century. We now import 23% of cucumbers, 15% of our tomatoes but are self-sufficient in milk, lamb, poultry, carrots and 86% self-sufficient beef. Yet we have to import seasonal fruits as we can find no-one to pick them. All these competing flows mean food is exposed to greater inflation fluctuations than any other sector of our economy.

Perversely, the cheap food that these voters want to see is more likely secured through global supply chains than a domestic, protected and subsidised UK agricultural sector – yet many of us still have a nostalgic learning for a green and pleasant land.

As a Conservative, I want to see lower taxes, but I also want sound money. I want the pound in your pocket to be worth something, and not undermined by inflation. But I also understand that people have legitimate expectations of public services which they fund through their taxes. So we’re caught in a bind. The prices of the services welfare states provide, such as health care and education, grow faster than the economy because of their high labour intensity and low rates of productivity increase.

And lowering tax means reducing demand for what the government provides. And people are wanting more from government right now, not less.

The simple truth is that when facing a choice between sound money and tax cuts, sound money must come first. Otherwise we cannot then fund the quality of public services people expect.
The Chancellor has done what is necessary to create the stable basis for future action, but in doing so is trying to be fair by taking measures like increasing the national living wage and protecting the pensions triple lock. He has also demonstrated that we can do so whilst still supporting growth and our public services.

The NHS

But the NHS is an excellent example of how headline funding is not the whole story, and that we need to make sure that extra health spending is spent wisely.

With an ageing population with more complex health challenges, spending on the NHS has gone from £123.7bn pre-pandemic to £151 bn now and will have to keep on rising. We have 13% more doctors, 10% more consultants, 11% more nurses. Yet the NHS is treating fewer from the waiting list than it was before the pandemic – so something else is happening that isn’t just about money or even bed numbers.

We now spend 44p in every £1 the Government spends on healthcare now – up from 25p in 2010. But we rarely ask whether the outcomes are better to the same extent – or why countries such as Australia and Italy get better survival rates for major diseases but spend less per capita.

Why is it cancer deaths are some 53% higher in deprived areas like the centre of Blackpool than elsewhere? Why are there such variations between trusts over issues like cancer and ambulance waiting times? Why do just 43% of NHS Trusts meet the target of rehabilitation services to the 90% of eligible patients who have suffered heart failure – what are the other 57% doing right?

I recently spent a day in A&E for myself to see the scale of the challenge facing the NHS Trust, and to better understand the challenges in discharging into social care, as well as a patient myself. I am under no illusion as to the scale of the challenge, and the need for systematic change in how we deliver healthcare.

If I could make one change it would be to put more focus on enabling weekend discharges of patients into social care settings so as to avoid a stop/start phenomenon in the availability of beds, the consequences of which amplify down the patient journey to the A&E front door at the busiest times.

Yours faithfully,

Paul Maynard MP
Conservative
01253 473071

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