Only two things in life are certain: death and taxes. There’s the nation’s ‘health provider’, and there’s the Autumn budget which the unfortunate Chancellor of the Exchequer will have to present on the 27th of this month. In the run-up to that date the first ‘warning’ has reached the MSM. So far, they aren’t connecting the dots even though they have published, side by side as it were, articles on the analysis by the IFS and Citibank on the need for more taxes for Social Care and the NHS, and on the impact of zoom GPs.
Looking at that grim but inevitable demand for more money to be taken out of our wallets, we learn that the NI rise to 2.5% form April 2022 won’t be sufficient, that it needs to rise from 2025 onwards. The Times has details, quoting from the IFS report which claims that the rise in NI contributions will only be “sufficient for the short term and would not address the deepening health and social care crisis.” (link, paywalled). The projection by the IFS and Citibank into the near future is horrifying:
“Health spending will rise to 44 per cent of all spending on public services by 2024-25, up from 27 per cent in 2000, the IFS estimates. It warned that government departments faced severe cuts over the coming years even though the size of the state has swollen to its highest share of national income since the mid-1980s.” (link, paywalled)
“Health spending” isn’t just money going to the NHS. It includes spending for Social Care which addresses the needs not just of the elderly but of disabled people and is distributed by Local Councils. There’s more:
“Last year government spending amounted to more than 50 per cent of GDP for the first time since 1945-46 as ministers poured billions into schemes to support households and businesses through the pandemic. Although that figure has since come down, the IFS said spending pressures would keep it high, as was the case after the world wars.” (link, paywalled)
Apparently, this is due to the ‘demographic pressure’, due to the ‘ageing population’ – the beloved scapegoat for every rise in ‘Health Spending’. It won’t come as a surprise to anyone outside Whitehall and the charmed Westminster bubble that there will be more ‘ageing’ people thanks to uncontrolled immigration, but never mind that! There’s more:
“The IFS said that there would still be “little or no scope to increase spending on things like local government, the justice system and further education, after a decade of sharp cuts”. These areas face cuts amounting to £2 billion, or 2.5 per cent, a year over the coming two years. Unprotected government departments face a difficult few years even though funding for public services is set to increase at an even faster rate than after Labour’s 2007 spending review.” (link, paywalled)
‘Unprotected government departments’ are all those which aren’t the DHSC – from the MoD and the Foreign Office to the Home Office. Prepare yourselves for the howls of ‘Toree Cuts’ coming from the Labour benches and of course from all those “sources” inside Whitehall. Amazingly, the IFS and the opinion piece writers in the MSM seem to have accepted the inevitability of tax rises because all those government departments, national and local, are apparently driven by a ‘gimme-gimme’ attitude.
The current government Party has been scared into being seen as the ‘Party of the NHS’ that they will happily sacrifice our national security by leaving the big offices of state ‘unprotected’. Let’s look at a detail of this huge spending spree, the 50% of GPD, most of which went to yon sacred cow. Let’s look at the ‘gatekeepers’ of the NHS, the GPs. They’re not paid out of the actual NHS budget, but their pay does come from government, from our taxes, via the DHSC.
Let’s ask: where’s the value for our money when we have no access those gatekeepers, when they don’t see us face-to-face? There were innumerable reports on this situation, always ‘well-balanced’ by statements from GP’s ‘trade unions’, the BMA and the Royal college of GPs. Their argument was and is that GPs work extremely hard because there’s a ‘shortage’ of GPs. Never mind that most of them worked only half-time, even before the Covid crisis.
We were told officially that they’ve increased their ‘face time’ with us plebs so what’s the problem? Well, here is one which makes me question anything coming from that quarter:
“Telephone consultations with GPs are being incorrectly classed as “face-to-face” appointments in official statistics, NHS chiefs have admitted, following an investigation by The Telegraph.” (paywalled link)
Oh dear! It seems the official NHS number of 58% face-to-face consultations which hasn’t changed since ‘officials vowed in May to give everybody the right to such consultations – is wrong:
“The Telegraph can reveal that even this figure exaggerates the number of consultations which are actually taking place in person. NHS officials said that because of the way some local systems were set up, some appointments were automatically being logged as face-to-face slots, regardless of how they were actually delivered. NHS Digital, which publishes national data on GP appointments every month, suggested this pattern could occur far more widely, because of the way data has been recorded.” (paywalled link)
The official weasel words are beyond belief – you have to read them to appreciate their squirming:
““We do acknowledge that there may be data quality issues with the data and instances where the data may not be a true representation of what may be happening in all practices. From March 2020, face-to-face appointment mode data may not be entirely reflective of what happens in the practices, as appointment types have been assigned to appointment modes prior to the pandemic. Thus, even if the appointment was carried out through a different mode, the appointment registers as a face-to-face appointment on the system.” (paywalled link)
Good grief: ‘data quality issues’, ‘data not entirely reflective …’ just some little unavoidable glitch in the system – nothing to see here! Just let one of us peasants use that excuse’ when HMRC come down like a ton of bricks on us … Anyway, going back to pre-covid times and normal face-to-face consultations isn’t what the GPs are prepared to do:
“The head of the Royal College of General Practitioners told MPs there was no point making such promises when GPs did not have the capacity to meet them.” (paywalled link)
Why is that? Have GPs retired en masse? Have there been no exams, are there no budding GPs ready to go into practice since 2020? Home visits by GPs, already as rare as hens’ teeth, have also declined:
“NHS figures show that while pre-Covid roughly one per cent of all GP appointments were home visits, in July and August they amounted to 0.6 per cent. [,,,] According to NHS figures for August, there were 151,627 home visits paid in England, down from 157,998 in July.” (paywalled link)
Let me ask politely: what are we paying them for? Why must we shell out even more in taxation to keep this ‘Health and Social Care’ edifice going when more and more of them do not even get a minimal return, i.e. seeing their GP? Do we really need more and bigger GP partnerships, with more GPs ‘specialising’ (link)? What would be the use of that when people still cannot see a doctor? Why not scrap the whole thing anyway and just plonk more A & E units across the towns and cities? Isn’t this where most of us now have to go because we either can’t see a doctor or their triage system tells us to?
I ask again: why do we need to pay more and more for a system that doesn’t work, for a system whose data collection is suspect, a system which we cannot trust to even get right a simple thing like recording a consultation correctly?
Money and health is a fatal combination. The one thing however of which we can be absolutely certain is that there’ll always be more taxes and there will be death at the end.