Let’s start with a straightforward chart and an uncontroversial statement.
British government spending and investment have declined in recent years, both as a share of GDP and relative to peer countries.
But this chart is a little drab, isn’t it. Let’s add some colour...
Here’s that same chart, but now highlighting which party was in power at which point.
The eagle-eyed among you may have noticed something.
When Labour were in power, spending and investment went up 📈
When the Conservatives came in, it went down 📉
Some will say the Tories’ hand was forced in 2010, that most countries had to tighten their belts as they faced off against the global financial crisis.
But the Tory belt-tightening was tighter than what other governments did in any of the UK’s peer countries.
Technically speaking, the NHS budget was protected from the cuts, but with a rapidly ageing and ailing population, merely maintaining health spend has been proven insufficient.
Where Britain’s peers continued to grow health spending as a share of GDP, here it steadily declined.
One very immediate result has been the squeeze on NHS staff pay.
Here’s what happened to nurses’ pay under Labour and Tory governments since 1997.
Nurses’ real-terms pay is now 12% below what it was on the eve of the 2010 election.
It’s also worth taking a closer look at those remarkably deep cuts to healthcare capital investment in the early years of austerity.
That dearth of investment in infrastructure and technology means that despite nominally having more doctors than ever before and more funding than ever before, the NHS finds itself hamstrung by acute shortages of beds and the equipment that gets people out of beds faster.
It’s also worth pausing to note that the assumption implicit in the ring-fencing of the health budget — that the only spending that protects and promotes health is NHS spending — has proved a false economy.
Cuts to housing and communities budgets have left Britain’s dwellings in such a dire state that they are now causing deaths among children theguardian.com/uk-news/2022/n…
So, that gives us:
• Prolonged cuts to overall spending
• Especially deep cuts to capital investment
• A health budget that was protected in name only and which now looks more like a gradual squeeze
What has been the impact?
Let’s start with the most striking: the astonishingly clear association between the governing party, health spending and the functioning of the NHS.
Waiting lists swelled under Major, shrunk under Labour as health funding soared, before climbing again under Tory austerity.
Those mounting NHS pressures and the wider deterioration of public health show up in data on avoidable deaths — deaths that should not occur with timely and effective healthcare — which under austerity flattened off and then began rising after years of steady decline.
It’s a very similar picture with life expectancy.
Although progress here has slowed in many countries over the last decade, under austerity the the UK’s trajectory has flattened off much more quickly than most.
And of course the impacts of a conscious erosion of state capacity extend well beyond health.
Real wages are below where they were 18 years ago. There has not been a single year since austerity began when the average wage has matched the peak under the last Labour government.
You might appear to "get away with" austerity for a few years if you’re lucky, but when your luck runs out you’re going to be in a world of trouble.
In conclusion, Cameron and Osborne are lucky to have escaped the fate of Truss and Kwarteng.
Like Trussonomics, austerity was ideology-over-evidence. Unlike Trussonomics, it was not quickly reversed, and so has gone on to cause enormous, lasting damage.
My wish for the next election is that poll trackers look like the one on the right 👉 not the left
This was yet another election where the polling showed it could easily go either way, but most of the charts just showed two nice clean lines, one leading and one trailing. Bad!
Pollsters and poll aggregators have gone to great lengths to emphasise the amount of uncertainty in the polls in recent weeks...
But have generally still put out charts and polling toplines that encourage people to ignore the uncertainty and focus on who’s one point ahead. Bad!
The thing about human psychology is, once you give people a nice clean number, it doesn’t matter how many times you say "but there’s an error margin of +/- x points, anything is possible".
People are going to anchor on that central number. We shouldn’t enable this behaviour!
We’re going to hear lots of stories about which people, policies and rhetoric are to blame for the Democrats’ defeat.
Some of those stories may even be true!
But an underrated factor is that 2024 was an absolutely horrendous year for incumbents around the world 👇
Harris lost votes, Sunak lost votes, Macron lost votes, Modi (!) lost votes, as did the Japanese, Belgian, Croatian, Bulgarian and Lithuanian governments in elections this year.
Any explanation that fails to take account for this is incomplete.
Many of the NHS’s difficulties can be traced back to the deep cuts in manager numbers.
Fixing this doesn’t just unblock waiting lists, it also gives doctors more time to be doctors, and alleviates the stress and poor morale that come from having to do things that aren’t your job
Here’s another fun NHS low hanging fruit example:
A trial last year found that by running two operating theatres side by side, they cut the time between operations from 40 minutes to 2, and were able to do a week’s worth of surgeries in one day thetimes.com/uk/article/lon…
In what might be one of the most significant trends I have ever charted, the US obesity rate fell last year.
My column this week is about this landmark data point, and what might be behind it ft.com/content/21bd0b…
We already know from clinical trials that Ozempic and other GLP-1 drugs produce sustained reductions in body weight, but with mass public usage taking off — one in eight US adults have used the drugs — the results may now be showing up at population level.
It’s really striking how the Corbynite left has migrated to the Greens.
The result is a curious coalition between the older and more Nimby environmentalist base, and the new hard left/progressive influx.
These are quite different people with quite different politics!
In 2019, one in ten Green voters was from the most progressive/left segment of voters; now that’s one in four.
Big difference in policy preferences, priorities and pressure on the leadership, as we’ve seen in e.g reaction to Denyer’s Biden statement.
The most glaring tension between these two types of Green is on decarbonisation, where the older Nimby base doesn’t want pylons *or even onshore wind farms* but many of the new progressive Green vote do.
Greens are actually less keen on wind farms than Labour and Lib Dem voters!