A wooden puppet with a long nose, large eyes, and a pointed yellow hat is set against a background reminiscent of a doctor's office—symbolizing the journey of learning and training, just as primary care professionals hone their skills over time.

Intend to

The Donald is back in the White House.

How did that happen?

The Democrats ran a confused campaign, the Republicans didn’t. 

The Democrats dithered with Biden and didn’t have enough time to get traction. 

The Republicans focussed and hammered home their messages.

Trump is a salesman and the Democrats, aren’t.

Trump pointed to his former successes as President…

…most of which wasn’t true or at best doubtful and nobody noticed or cared.

He claimed he oversaw the greatest economic growth in U.S. history.

While the economy did grow prior to the pandemic, it wasn’t at an unprecedented rate. The post-pandemic pick-up was largely due to recovery after the severe economic downturn from Covid.

Trump asserts he created more jobs than any other President.

In reality, job growth during his first three years was slower than under Obama’s last three years. The job market recovered partially under his administration after the pandemic, but the pre-Covid trend showed a steady decrease in job creation.

Trump has often said his tariffs on Chinese goods benefited the U.S. economy.

Actually, the tariffs increased costs for U.S. businesses and consumers. The trade deficit with China remained largely unchanged.

Trump claimed his administration handled the pandemic effectively.

The U.S. saw one of the highest Covid infection and death rates in the developed world. His downplaying the virus worsened the impact.

Trump said he completed hundreds of miles of new southern border wall.

In reality, most of the construction replaced existing barriers. Only a small portion was actually new.

Trump was responsible for a trail of terminological inexactitudes.  

Before we all get on our high horse about The Donald and point the finger at the dim American electorate… it’s happened here.

We were told;

Brexit would be good for us. 

It wasn’t.

Ms Truss would be a great Prime Minister. She wasn’t.

Boris Johnson was an honest politician. Yeah, right…

Individually, we can be clever and bright. Collectively, we seem gullible and dim.

It’s happening again.

Labour pledged not to increase taxes on ‘working people’ by holding off NI, VAT, and income tax increases. In the budget NI contributions were raise for employers and capital gains tax increased, which will indirectly impact workers by increasing business costs.

If it wasn’t a big-fat-black-lie, it was a slither and wriggle. 

Starmer promised squeaky clean politics and got another bloke to buy his wife’s frocks.


Labour committed to a ‘Green Prosperity Fund’ with an annual £28bn. Since postponed.

During his campaign for leadership, Keir Starmer promised to abolish tuition fees. He’s just put them up.

Labour’s manifesto included a promise to reduce energy bills by around £300 per household. This appears to have been dropped as has the Winter Fuel Allowance for pensioners…

… all justified by the claim that they didn’t know the state of the economy.

I find it hard to believe there is no one in the Labour Party with a calculator.

Closer to home Starmer has promised to cut NHS waiting lists and get them back to the 18 week target by the end of this Parliament.

To create that level of consistent flow through the system, waiting-lists can be no longer than 3.5m.

If you read the PM’s op-ed in last weekend’s FT you will see that he has already reduced the waiting list by 1.6m, from over 7.6m to 6m. 

See the screenshot below.

He’s done a Donald. 

It is true the core waiting list might be 6m but it turns into 7.6m because people are waiting for more than one thing.

That means the NHS must tackle 7.6m episodes of care and will need the time and the resource to do it.

As for the original promise… I doubt it is doable.

Based on current NHS data, roughly 375,000 people join the NHS waiting lists each week. Calculated from monthly referral estimates of 1.35 to 1.5 million people.

During the 2021-22 period, there were approximately 19.6 million finished consultant episodes… a hospital-stay under the direction of a consultant.

That’s 376,923 a week, which creates headroom of about 1,000 a week.

Add to that, over 2.3 million A&E visits this March alone, of which roughly, 20% might need a period of inpatient care and you can see Starmer has a fat chance of keeping his promise…

… 40,000 more ‘overtime’ appointments a week won’t do it, neither will £20bn pay for it.

I find it hard to believe there is no one in the Labour Party with a calculator.

The NHS doesn’t have the capacity and neither does the private sector, currently full with premium, self-pay patients.

So what have we learned?

To bear-in-mind, politicians are the same everywhere…

… they keep all the promises they intent to.

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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