[TobyD]

...I could ask why hasn’t the NHS started getting its promised £350million/wk extra yet?

Why? Hasn't it? 

This from Theresa May's speech as Prime Minister on the NHS: 18 June 2018

...As the NHS approaches its 70th birthday, it is the right moment to look again at how we secure the future of the NHS: now and for generations to come... Let me start with funding... we will do more than simply give the NHS a one-off injection of cash.

Under our plan, NHS funding will grow on average by 3.4 per cent in real terms each year from 2019/20 to 2023/24. We will also provide an additional £1.25 billion each year to cover a specific pensions pressure.

By 2023/24 the NHS England budget will increase by £20.5 billion in real terms compared with today. That means it will be £394 million a week higher in real terms.

Additionally, in August 2019, Prime Minister Boris Johnson announced an extra £1.8 billion for NHS frontline services

The £1.8 billion funding is in addition to the extra £33.9 billion, in cash terms, the NHS is set to receive every year by 2023/24 through the Long Term Plan agreed last year.

    

No, it hasn't.  Most of this is covered by the inflation and the standard necessary increase in funding. 

But anyway, rational economic arguments for or against leaving the EU are rather irrelevant now I think. Leave won in 2016 by making a primarily emotional argument and I think that this remains the case today.  I just hope that we can leave in the least damaging way possible

[nik at work]

Not followed this thread especially closely but the suggestion that the NHS now has it’s extra £350 million based on the above quotes is not accurate.

It is actually below the average annual increase in funding for the NHS since it’s inception to 2008 (which is about 3.7% pa from memory...) but still, being positive, it is above the 2008-2018 average funding increase of about 1.8% annually (again from memory, might be slightly out...). So we’re still drifting away from the “average” albeit at a slower rate than the last 10 years.

My understanding (and given the lack of “fact” around the whole brexit debate I use the word understanding in the very loosest sense...) is that the £350 million a week was going to be above and beyond these standard annual funding increases as it was “free money” that we no longer had to hand over to the EU, hmmmm.....

Anyway I agree with Toby that facts and rational thought seem to have very little to do with this whole shambles so this is all largely irrelevant...

(Figures from slightly hazily remembered Kings Fund report, feel free to google....)

[A Jooser]

I made no such suggestion Nik, I only posed the questions. Perhaps I should have taken a stab at an answer myself for avoidance of doubt on my position on this:... Yes, it hasn't.    No, it has!

My understanding (and given the lack of “fact” around the whole brexit debate I use the word understanding in the very loosest sense...) is that the £350 million a week was going to be above and beyond these standard annual funding increases as it was “free money” that we no longer had to hand over to the EU, hmmmm.....

I fear you may be reading a bit too much into what was little more than a campaign slogan painted on the side of a bus, but then again you're probably not the first. 

(Another question: when Mrs May said "£394 million a week higher in real terms" she was quoting a figure which took inflation into account, was she not?)

[ali k]

Regardless of the accuracy of the increased NHS funding figures you cite, or the semantics over whether that is money including/excluding the promised extra £350million/wk, you (and Pete) have both missed the point.

Pete was arguing that, despite the fact that we are still in the transition period and there has been no change in trading arrangements or immigration restrictions (or other factors which might impact the economy), because we are not in recession TODAY that somehow proves the economists’ predictions of a weakened economy following Brexit wrong.

So by the same logic we should be getting an extra £350million/wk TODAY which is not happening, even by those figures.

Either way, this thread isn’t really about Brexit. It’s done now, and I’m not sure why Pete decided to bring it back round to that.

[A Jooser]

Wait! There's a point to all this?! In that case you are right; I have missed it!

One of my personal favourite false Brexit predictions was that of George Osborne when he said if the UK voted to leave the EU it would trigger an 'immediate economic shock' which would cause an 18% reduction in house prices. The then chancellor seemingly oblivious to the possibility that an 18% reduction in the cost of buying a house might be seen as a positive by millions of people in the country struggling to get a foot on the housing ladder. I'm sure, in 2016, no one actually cast a ballot one way or the other with that in mind, but it illustrates well how out of touch much of the political class really is.

[Johnny Brown]

Like I said plenty of time for one yet, but it was supposed to be on leaving the EU. I'll wait to see, if we don't enter recession in 2020, if any one of those forecasters revisits their 2016 forecasts and has the humility to admit they were wrong.

Speaking as a business owner, I would point out that 'nothing has changed'. We are in the transition period.. yet more kicking the can down the road... the crunch will not arrive until 1st Jan 2021. Lots of firms are using this peroid to relocate all or essential service into the EU before that date. I see lot of firms are also hastily pushing spending through now having sat on their hands for the last two years. And yet growth remains well below the long term average.

All our business planning currently is on making hay while we can while preparing for a massive recession kicking in sometime in 2021. That would be tempered by a good deal but all the wrong noises are being made at the moment.

[Stabbsy]

Thought this was worth a repost in light of some of the discussions up-thread. I'll leave you to decide who's who.



I'd replace religious logic with political/Brexit logic if I had the appropriate technical skills, but I only do spreadsheets, so if you could just imagine that I've done that....

[Offwidth]

With improvements in medicine and an NHS to look after all... here is some news we should never have seen this decade:

https://www.theguardian.com/society/2020/feb/24/austerity-blamed-for-life-expectancy-stalling-for-first-time-in-century

In the meantime the Boris cull of inconvenient voices continues:

https://www.theguardian.com/politics/2020/feb/25/inside-boris-johnsons-whitehall-a-poisonous-horrible-atmosphere

[Stabbsy]

With improvements in medicine and an NHS to look after all... here is some news we should never have seen this decade:

https://www.theguardian.com/society/2020/feb/24/austerity-blamed-for-life-expectancy-stalling-for-first-time-in-century

I'm normally all for a bit of Tory/austerity bashing, but I think this article is making the classic correlation vs causation mistake. I think it's more instructive to look at the source of the past mortality/longevity improvements and see why they've not continued. We've been discussing this drop off in life expectancy in the pensions/insurance industry for a couple of years and there has been some causal analysis of improvements. From memory, the slow down is a drop off in improvements attributed to cardiac disease. I'll try and find a decent summary of it when I get a few minutes.

I don't doubt that there's some effect of austerity, but I'd question whether you would see it coming through the data that quickly.

[tomtom]

With improvements in medicine and an NHS to look after all... here is some news we should never have seen this decade:

https://www.theguardian.com/society/2020/feb/24/austerity-blamed-for-life-expectancy-stalling-for-first-time-in-century

I'm normally all for a bit of Tory/austerity bashing, but I think this article is making the classic correlation vs causation mistake. I think it's more instructive to look at the source of the past mortality/longevity improvements and see why they've not continued. We've been discussing this drop off in life expectancy in the pensions/insurance industry for a couple of years and there has been some causal analysis of improvements. From memory, the slow down is a drop off in improvements attributed to cardiac disease. I'll try and find a decent summary of it when I get a few minutes.

I don't doubt that there's some effect of austerity, but I'd question whether you would see it coming through the data that quickly.

From what I read the key findings were the notable regional differences in drops in LE - and how these were regions most affected by austerity policies.

[Oldmanmatt]

With improvements in medicine and an NHS to look after all... here is some news we should never have seen this decade:

https://www.theguardian.com/society/2020/feb/24/austerity-blamed-for-life-expectancy-stalling-for-first-time-in-century

I'm normally all for a bit of Tory/austerity bashing, but I think this article is making the classic correlation vs causation mistake. I think it's more instructive to look at the source of the past mortality/longevity improvements and see why they've not continued. We've been discussing this drop off in life expectancy in the pensions/insurance industry for a couple of years and there has been some causal analysis of improvements. From memory, the slow down is a drop off in improvements attributed to cardiac disease. I'll try and find a decent summary of it when I get a few minutes.

I don't doubt that there's some effect of austerity, but I'd question whether you would see it coming through the data that quickly.

If austerity was directly affecting the quality of critical care, that wouldn’t that produce immediate changes to data?

[Stabbsy]

With improvements in medicine and an NHS to look after all... here is some news we should never have seen this decade:

https://www.theguardian.com/society/2020/feb/24/austerity-blamed-for-life-expectancy-stalling-for-first-time-in-century

I'm normally all for a bit of Tory/austerity bashing, but I think this article is making the classic correlation vs causation mistake. I think it's more instructive to look at the source of the past mortality/longevity improvements and see why they've not continued. We've been discussing this drop off in life expectancy in the pensions/insurance industry for a couple of years and there has been some causal analysis of improvements. From memory, the slow down is a drop off in improvements attributed to cardiac disease. I'll try and find a decent summary of it when I get a few minutes.

I don't doubt that there's some effect of austerity, but I'd question whether you would see it coming through the data that quickly.

If austerity was directly affecting the quality of critical care, that wouldn’t that produce immediate changes to data?

Yes, but I’d expect it to be quite slow to impact LE. LE takes quite a lot to move it significantly and critical care would only affect a small portion of deaths. Like I said, I think austerity has an impact and will continue to have one, but writing an article suggesting the entire drop off in LE is due to austerity is a bit disingenuous in my opinion.

[Stabbsy]

From what I read the key findings were the notable regional differences in drops in LE - and how these were regions most affected by austerity policies.

Yes, but is that correlation or causation? The deprived areas are also those that have the most to gain from cardiac disease mortality improvement, which is now slowing.

[mrjonathanr]

The article is just that; the issue is Marmot’s review. He was on Today this am, pretty unequivocal in his views about the impact of austerity.

From the foreword:

From rising child poverty and the closure of children’s centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to food banks in large numbers, to ignored communities with poor conditions and little reason for hope … Austerity will cast a long shadow over the lives of the children born and growing up under its effects.”
[/quite].

Do you think he is wrong/extrapolating too far from the available evidence?

[tomtom]

From what I read the key findings were the notable regional differences in drops in LE - and how these were regions most affected by austerity policies.

Yes, but is that correlation or causation? The deprived areas are also those that have the most to gain from cardiac disease mortality improvement, which is now slowing.

Isn't it all correlation??? Not trying to be an arse but unless you look at the actual mortality causes - and then drill each one down to the lifestyle/treatment/austerity (or not) 'cause' then it has to be??

[Stabbsy]

From what I read the key findings were the notable regional differences in drops in LE - and how these were regions most affected by austerity policies.

Yes, but is that correlation or causation? The deprived areas are also those that have the most to gain from cardiac disease mortality improvement, which is now slowing.

Isn't it all correlation??? Not trying to be an arse but unless you look at the actual mortality causes - and then drill each one down to the lifestyle/treatment/austerity (or not) 'cause' then it has to be??

Yes, it is and that’s exactly my point. “Austerity blamed for life expectancy stalling” implies causality to me when the truth is likely to be way more nuanced than that.

[Will Hunt]

Personally I find myself very conflicted by this news. I want to blame it on austerity but I also want to blame it on Brexit or Brexiters. Would it be too much to hope that it could be blamed on both?

[TobyD]

From what I read the key findings were the notable regional differences in drops in LE - and how these were regions most affected by austerity policies.

Yes, but is that correlation or causation? The deprived areas are also those that have the most to gain from cardiac disease mortality improvement, which is now slowing.

Isn't it all correlation??? Not trying to be an arse but unless you look at the actual mortality causes - and then drill each one down to the lifestyle/treatment/austerity (or not) 'cause' then it has to be??

Yes, it is and that’s exactly my point. “Austerity blamed for life expectancy stalling” implies causality to me when the truth is likely to be way more nuanced than that.

I totally agree. The Guardian is too ready here to leap up and down shouting austerity when a responsible journalistic approach would have reported the news rather more neutrally.

[mrjonathanr]

I totally agree. The Guardian is too ready here to leap up and down shouting austerity when a responsible journalistic approach would have reported the news rather more neutrally.

Bit puzzled by this desire to shoot the messenger. Marmot said

Austerity has taken a significant toll on equity and health, and it is likely to continue to do so. If you ask me if that is the reason for the worsening health picture, I’d say it is highly likely that is responsible for the life expectancy flat-lining, people’s health deteriorating and the widening of health inequalities.

How would you have them report this? With the caveat that they don’t believe the report’s findings? Or do what they have done, which is report the conclusions Marmot has drawn?

[Stabbsy]

The article is just that; the issue is Marmot’s review. He was on Today this am, pretty unequivocal in his views about the impact of austerity.

From the foreword:

From rising child poverty and the closure of children’s centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to food banks in large numbers, to ignored communities with poor conditions and little reason for hope … Austerity will cast a long shadow over the lives of the children born and growing up under its effects.”

.

Do you think he is wrong/extrapolating too far from the available evidence?

Simple answer would be yes - LE projections require a degree of extrapolation and there’s different ways to go about it which can give different results. I’ve just read the exec summary of the report and there’s not enough detail to see how it’s been done for this study (childcare day today and full report wouldn’t download onto my phone). My preferred way of looking at these things is to show a range of projected outcomes with the assumptions that underpin them. Too easy to bring in bias (intentional or otherwise) with a single view.

Having now read the exec summary, Guardian reporting seems fine. Just surprises me that the IHE report isn’t more nuanced.

[tomtom]

Yes, it is and that’s exactly my point. “Austerity blamed for life expectancy stalling” implies causality to me when the truth is likely to be way more nuanced than that.

My point was more nuanced I meant to communicate that ALL LE data is based on correlation... not just this work.

[TobyD]

I totally agree. The Guardian is too ready here to leap up and down shouting austerity when a responsible journalistic approach would have reported the news rather more neutrally.

Bit puzzled by this desire to shoot the messenger. Marmot said

Austerity has taken a significant toll on equity and health, and it is likely to continue to do so. If you ask me if that is the reason for the worsening health picture, I’d say it is highly likely that is responsible for the life expectancy flat-lining, people’s health deteriorating and the widening of health inequalities.

How would you have them report this? With the caveat that they don’t believe the report’s findings? Or do what they have done, which is report the conclusions Marmot has drawn?

That's a fair point,  I hadn't read it very carefully, it's reasonable reporting.  If there was an open government,  dedicated to transparency, then there would have been a minister commenting on this, or being interviewed on the today programme about it. However,  they're all too busy trying to sack civil servants who tell them things they don't want to hear. 

[A Jooser]

Toby, may I respectfully suggest you return to the above-linked article and scroll down, almost to the very bottom, where you may find Secretary of State for Health Matt Hancock's comments in response.

With regard to the Today Programme: I used to tune in each morning but in recent years have found it un-listenable. I saw its recent output best described as 'Blue Peter for adults'. Why would any serious politician bother? I think there has been a change of editor now so maybe it will improve.

[TobyD]

Toby, may I respectfully suggest you return to the above-linked article and scroll down, almost to the very bottom, where you may find Secretary of State for Health Matt Hancock's comments in response.

With regard to the Today Programme: I used to tune in each morning but in recent years have found it un-listenable. I saw its recent output best described as 'Blue Peter for adults'. Why would any serious politician bother? I think there has been a change of editor now so maybe it will improve.

It's basically a departmental press release though isn't it, rather than a minister having to answer difficult questions.

[A Jooser]

Geeze Louise, Toby, has the Guardian's Health Editor done something to offend you or something?

I had looked at the Department of Health's press releases but couldn't find anything about this story. So no, it doesn't seem to be 'basically a departmental press release' as far as I can tell. After checking the gov.uk site I then did a web-search of news items and this piece seemed to be the first and only one to come up with comments from Matt Hancock.

Give the poor Guardian journalist some credit for pity's sake. It does seem like she may have actually contacted the department and requested a statement from the Health Secretary before no doubt editing it down and burying it at the bottom of the article.

Difficult questions?... Worth watching the below in full...



(As an aside, how nice it is when an interviewee is given time to answer without constant interrupting.)