It’s like someone pressed a button.
Switched a switch.
Where they came from I have no idea but…
… there are daffodils in the park! Hurrah!
Sunny, eager, golden faces that are impossible look at without smiling.
They are supposed to be triggered by warmer temperatures but there they were, in the park, with everyone else bundled-up, leaning against a wind so cold, it could cut you to the bone.
It’s a bit early for their trumpeting, but they’re very welcome.
Unlike, I suspect, the ‘Spring Budget’, expected next week.
The financial pages are full of speculation.
It’s a confusing picture.
We are supposed to be in a recession, but January’s tax receipts are at a record high.
What do we know already?
• Public sector receipts are expected to rise from 40.3% of GDP this year to 41.6% by 2028/29, which means a rise of some £35bn.
• There’s a 25% increase in corporation tax.
• Freezing the income-tax personal allowance and the higher rate threshold
• Vehicle excise duties for electric cars
• Reversing the increase in stamp-duty thresholds.
…real income per household will fall by 3.5% this year compared to pre-pandemic levels
So-called fiscal headroom?
The government has a self-imposed fiscal rule (nonsense really but that’s economics for you)… public debt must be on the way down in the 4th and 5th year of forecasts. There might be wriggle room in this budget of between £15bn and £23bn.
So, what’s he Tinker Man gonna do…
My guess it’ll be something on income tax. Symbolic but expensive. Cutting National Insurance is more sensible but not as glamorous and he did that.
Probably tax-free shopping for tourists. Something on fuel-duty and something on saving… nicely prudent.
Meantime; three local authorities have announced they are skint.
To get local authorities back to pre-pandemic levels you’re looking at stumping up nearly £2bn… don’t hold yer breath. Meaning, social care will stay in a mess.
More Councils will be heading for Hooky Street.
The Tories won’t be around for much longer. An incoming administration will have their own agenda… so all this palavering about probably isn’t worth the energy, or the paper.
What about the NHS?
It’ll struggle to contain overspend to a record £700m. HMT will have to find a way to cover this… or do nothing and watch waiting-lists get even longer.
The OBR forecast; planned, total-healthcare spending 23/4 will be 3.2% less in real terms, than last year… -£6bn. NHSE’s revenue, this year, is £3.5bn less than last year. If plans are followed, in 24/5 it’ll fall by another £1bn.
Yup, I know… don’t say it. I will… £@$%##.
The Health Foundation have a very good approach to all this and to make matters worse, estimate if we adjust for population size and age, it reduces real terms revenues in the system, even more. (See Fig 4)
HMG can claim there’s more money in the NHS that at any time since Florence came to work on her bike… but, more does not necessarily mean enough.
We all know the NHS is hobbled by George Osborne’s ten years of hand-to-mouth funding following the banking crisis.
Covid covered up the damage, the lack of recruiting and investing and building and all the rest. Now the chickens are frightening the daffodils… making the sky dark, as they come home to roost.
The NHS is nowhere near as efficient as it could be. To change that means investment. Without investment the service will continue to be hollowed out.
The complexity of the NHS makes it possible that someone somewhere can always cut a bit more, shave this, stop that.
There’s nothing that can’t be done worse or cheaper or moved or done differently in the pretence it is better.
No accounting that can’t be re-engineered, no long-division that can’t be short measured and no strategy that can’t be polished to pretend its glitter is a proper shine.
If you do that you will, one day…
… find yourself laying on a second-hand operating table, cared for by the cheapest surgeon, with the shortest training, equipped with a cut-priced knife. You’ll recover with dime-a-dozen pills, and bargain-basement-bandages. Casually cared for by a domiciliary company who bid the least to do the job.
Good luck with that.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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