Pothole Britain and the Health of the Nation

     

Potholes in our roads symbolise Britain today. The fifth richest country in the world as measured by GDP but with third world roads. When I drive over a pothole I always think of George Osborne and his illiterate Austerity policy. He is not an economist but an English Lit graduate, now an excellent journalist.

 

We know that filling in potholes is a waste of money because they soon break up again. The most cost effective solution is to resurface the whole road. Short term fix but long term pain. This symbolises the underlying problem with British government: ideology, cuts and short-sightedness. The failure to look forward and tackle fundamental challenges such as creating a new sustainable economy for the whole nation.

 

Economic Consequences

The past twelve years have been a disaster. For most people there has been no improvement in their real income or living standards. The prospects for young people have declined. There is a lot more insecurity in a gig economy. Britain is in the midst of a severe and prolonged household debt crisis. Household debt, not including mortgages, is on the rise again. It has increased 20% in the past 2 years and is now £239bn, higher than just before the crash in 2008. Jubilee Debt Campaign. There’s zero good about Brexit for vulnerable workers. 3.2 m in insecure work, 11% of women in insecure jobs, 810,000 in zero-hours contracts, 75% part-time workers are women. In the North East of England insecure jobs 67% of all new roles.

Austerity has had adverse consequences in almost every sector of our economy and society. For instance, the causes of knife crime are complicated but in part are attributed to cuts in services for young potentially alienated youths and policing. The same is true of the Grenfell disaster – a cost cutting mentality led to fatal flaws in the building.  Also there was an underlying attitude towards the inhabitants some of whom thought they were regarded as less than human. Cuts have contributed to high levels of violence, drug taking, depression, self-harm, suicide and failure to rehabilitate inmates in many prisons.

 

Austerity has resulted in a slower recovery from recession and lower productivity than our main European neighbours. The underlying flaw is a lack of long-term strategic economic planning and a failure to invest. Nor are our banks adequately fulfilling their role in supporting enterprise, as is the case in Germany. We need banks that support enterprise.

We did have a Green Investment Bank designed to create prosperity out of refurbishing our “leaky housing” and support a growing sustainable energy industry. But it was starved of funds and recently sold off. Quantitative easing was pumped into the banks, rather than where investment was needed.

 

Add Brexit, an own goal, predicted to lead to poorer economic performance for ten years. That is apart from all the alienation of enterprising people from other countries who enrich our economy and culture. This has created staffing problems in many public services and other economic sectors including fruit and vegetables. The Home Office has created staff shortages in the NHS by denying entry to trainee Doctors from other countries. Of course we failed to invest in training our own people. The Brexit vote to a significant extent resulted from the failure to address more than a generation of economic decline and deprivation in areas where old industries were not replaced by new.  Government was content with a prosperous south east as opposed to enabling the whole country to prosper. It all adds up to incompetent, not joined up government.

 

As to Brexit, I said in an earlier blog post: We’re allowing ourselves to be ruled by knaves and charlatans, more concerned with their political ambitions than what is best for the nation and democratic decision making.

 

The nation’s health depends on an economy that serves everyone and a political system in which everyone feels represented and engaged. Instead we have a deeply divided nation.

See my article Re-imagining Politics – A Collaborative Democracy . In particular young people are disadvantaged: difficulties in finding good work, high levels of debt, if they went to university, and difficulty affording to rent or buy a home. There is a link between income levels and mental health.

 

Above all Britain needs a long-term economic strategy. The UK could learn a lot from Germany . As a share of its economy, Germany’s manufacturing sector is twice the size of Britain’s – 23% of national GDP, compared with 11%, according to the World Bank. Unlike Britain, it runs a large surplus on trade in goods.

It has a good banking system and collaborative relationships with trades unions. Mark you, it may be argued that the Euro currency has enabled Germany to extract wealth form other European countries, particularly those in the south. See The problem with Europe is the euro.

Health

 The latest crisis is in the NHS NHS trusts in England have reported a combined financial deficit that was nearly twice the amount planned. There was a deficit of £960m in the last financial year compared with the £496m they had planned for, the regulator NHS Improvement said. The NHS in England has nearly 100,000 jobs unfilled, a situation described as “dangerously” understaffed.

Taxes are going to have to rise to pay for the NHS if the UK is to avoid “a decade of misery” in which the old, sick and vulnerable are let down, say experts. The Institute for Fiscal Studies and Health Foundation said the NHS would need an extra 4% a year – or £2,000 per UK household – for the next 15 years. It said the only realistic way this could be paid for was by tax rises.

However I shall argue in this article that taxpayers should not be required to pay considerably more tax.

Prevention is better than Cure

Much of the NHS crisis has been caused by lack of emphasis on prevention. Health education should begin early in a child’s education and would be parents should be offered the same.

The government failed to invest sufficiently in the NHS. They tried surreptitiously to privatise it– see How to Dismantle the NHS 10 Easy Steps. They imposed essentially ideological reorganisations that did not involve the people “on the ground”. They have been doing the same in school education, alienating teachers, causing extra stress and thus losing experienced staff. Mental health until now has been a low priority, particularly for the young, and access to reasonably local services have not been provided. Many local 24 hour A&E emergency services have been closed.

 

UK has relatively low health spend The UK is ranked 6^th out of the seven countries that form the G7 (a group of large developed economies) for healthcare expenditure as a proportion of Gross Domestic Product (GDP)

Crimes against Humanity?

 The proportion of overweight and obese people is enormous. The WHO report predicted that 74% of men and 64% of women in UK to be overweight by 2030.  Worldwide obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. Much Ill health can be attributed to lack of health education from an early age, unhealthy life styles including lack of exercise and poor posture.

Child obesity is alarming. A growing number of children are becoming obese as young as four or five years old, is sparking renewed concern about the obesity crisis although this is starting to decline. Almost 60% more children in their last year of primary school are classified as “severely obese” than in their first year, according to Public Health England figures for England and Wales. Childhood obesity at primary school age twice as likely in poor areas. Food producers should reduce fat, salt and sugar content, with taxes levied on junk food, say campaigners.

The Local Government Association (LGA) said this shows children are becoming fatter as they go through school . One in 25 children aged 10 or 11 ‘severely obese’. UK anti-obesity drive are at risk from new US trade deal, doctors warn.

According to the World Health Organisation, there are 1.1 billion smokers and tobacco kills up to half of its users. Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890 000 are the result of non-smokers being exposed to second-hand smoke.. A Tobacco tax could lead to ‘a cigarette-free world by 2040’.

In my view this is wholly inadequate and should be introduced rapidly.

Similarly those corporations causing air pollution, responsible for 40,000 deaths per year in UK and much ill-health, should pay. The World Health Organisation estimates that 7 million premature deaths annually are linked to air pollution.

 

All of this is harmful commerce.  Ultimately causing these harms should be regarded as harmful commerce and crimes against humanity – leading to a new UN Crime against Humanity.

 

Should the burden fall on the taxpayer when we are being ripped off?

Meanwhile, surely the businesses responsible for ill health, premature deaths and rising costs should be held responsible and required to contribute substantially to the NHS. We need to go upstream and charge a hypothecated Corporate Ill Heath Tax specifically for the NHS. This includes the production and promotion of unhealthy food containing excessive sugar, promoting alcohol consumption and tobacco. Ultimately causing these harms should be regarded as crimes against humanity – leading to a new UN Crime against Humanity.

 

The Taxpayer is ripped off by the Pharmaceutical Industry. According to Global Justice Now, the UK spent £2.3 billion on health research and development (R&D) in 2015.1 About a third of new medicines originate in public research institutions and even medicines discovered by drug companies are often built on a large body of scientific work done in the public sector. Some estimate that the public pays for up to two-thirds of all drug R&D. In spite of this, there is no guarantee that these medicines will be accessible to patients in the UK or worldwide. Instead, the commercialisation of these discoveries by pharmaceutical companies has generated huge private profits out of public funds. Pharmaceutical companies claim that high prices are needed to recoup R&D costs. However, evidence suggests that pharmaceutical companies often spend more on either marketing and/or buying back their own shares to artificially boost their shareholder value than on R&D for new drugs. In many cases, the UK taxpayer effectively pays twice for medicines: first, through investing in R&D, and again, by paying high prices to pharmaceutical companies for the resulting medicines. The NHS spent more than £1 billion last year alone on drugs whose development substantially relied on UK public research funding, while two of the five drugs with the highest costs for the NHS were developed in large part through UK publicly funded research.

It is beginning to be recognised that an independent cross party long-term strategy is needed for the NHS .

 

Resources for Action

• The Kings Fund – Ideas that Change Health Care
• The Institute for Public Policy Research
• IPPR Commission on Economic Justice https://www.ippr.org/cej
• Time for Change: A New Vision for the British Economy https://www.ippr.org/research/publications/cej-time-for-change
• New Economics Foundation – The people-powered think tank http://neweconomics.org/
• Ecocide Law and Polly Higgins the Earth’s lawyer

 

Bruce Nixon, author, writer and speaker. His latest book is The 21^st Century Revolution – A Call to Greatness