Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
On that basis, one person* having five kids is the Ponzi-est scheme of all time.
If a society had no kids, and imported a bunch of 18 years olds every year, how would that be different from one where there were a bunch of kids born and there was no immigration?
@Leon there are many reasons why people may want to significantly limit immigration but it is far from the cause of all our ills. It would also cause a few problems in of itself which would need to be tackled. Not sure I have heard Farage discuss them.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
The could help themselves a bit (the NHS, that is) by not admitting elderly dementia patients for 11 days when they come in for an x-ray. Using up a bed and actively harming the patient at the same time.
OK, we don't want more scandals, but more procedures to follow don't seem to stop them.
We definitely aren't making best use of what facilities we do have.
Totally agree 100x.
I have various similar tales from close family in recent years.
Getting the sods to discharge someone elderly is a bloody nightmare and yet they scream 'beds, beds, beds, money, money, money' all the time.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Control immigration and use social insurance not income tax to fund healthcare like most OECD nations and require the top 10% of earners to have private health insurance like Australia
You mean, impose extra taxes on the people who already pay the most taxes?
BMG's Rob Struthers says: "Some polls make you do a double-take. This is one of them."
We are witnessing something pretty extraordinary here. This is potentially a quiet revolution. A Very British Tipping Point
Gives Reform a majority of 124 with FPTP on just under a third of the vote.
At the moment it seems PR might be the only way to stop Farage becoming PM with an outright majority
PR for parliamentary elections is a Reform UK policy (after a referendum on it).
Or perhaps it used to be given the potential advantage FPTP might offer them...
Indeed, ironically the Tories now need PR far more than Reform and Starmer is far more likely to stay PM with PR while at the moment Farage is odds on to become PM with FPTP.
Indeed under the BMG poll only the Greens would be worse off under FPTP than the Tories in terms of MPs won relative to voteshare, FPTP also now gives the LDs a solid base of around 70 MPs while the BPG poll would give the Tories less than 50 MPs when PR would give them over 100 seats on 19%.
One Nation Tories like Grieve in the Guardian are now openly pro PR
Assisted dying could go along way to solving the health and care issue, allowing for lower taxes, and making the UK a more attractive place for high earners.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Hasn't France had mass immigration and their health service is not collapsing?
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
Very large parts of the NHS drug budget are for managing chronic conditions, and simply grow with age.
Right, so a small increase in chronic condition rates, age profile held constant, costs far more than a changing demographic profile because they affect people for decades and are exceptionally costly.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
The could help themselves a bit (the NHS, that is) by not admitting elderly dementia patients for 11 days when they come in for an x-ray. Using up a bed and actively harming the patient at the same time.
OK, we don't want more scandals, but more procedures to follow don't seem to stop them.
We definitely aren't making best use of what facilities we do have.
yet they scream 'beds, beds, beds, money, money, money' all the time.
Ah, chronic repetitive outburst syndrome, a persistent and harmful condition indeed.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Hm, looks like 3% per year between 2010-2020, then flat (page 7):
Thanks! I'll take a look. I wonder if there have been any studies into why emergency admission growth was running a couple times higher until the pandemic.
When you cant get a gp appointment for 3 weeks you end up going to a&e.
Huh, good point.
"When you cant get a gp appointment for 3 weeks you end up going to a&e."
Hence Wes and Darsi trying to shift funding to GP and away from hospitals.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Well, immigrants are part of the reason why demographics do not explain the massive increase in per capita spending, because they tend to not be old and not be babies. As such, the UK's demographic profile isn't bad like S.Korea and Japan.
I think it's true that ethnic minorities have higher admissions rates, after accounting for a different age profile. But isn't that entirely explained by higher rates of poverty? Dr Foxy may know.
There are other factors that are also important.
1. Vitamin D deficiency. Most of us in the UK are deemed vitamin D deficient to an extent, and this is associated with diabetes, heart disease, auto-immune conditions and cancer. Those with darker skins are at greater risk, because their skin absorbs less from the sun. Those who add modest dressing must be considered at even greater risk. 2. First cousin marriage. The medical and developmental problems associated with being the child of first cousin marriage can be serious. https://www.bbc.co.uk/news/articles/c241pn09qqjo
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Control immigration and use social insurance not income tax to fund healthcare like most OECD nations and require the top 10% of earners to have private health insurance like Australia
You mean, impose extra taxes on the people who already pay the most taxes?
Not a tax, an insurance so they use private health insurance and private hospitals and cut NHS waiting lists
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once,
Then this title is a lie! (it was also just not a very good book)
@Leon there are many reasons why people may want to significantly limit immigration but it is far from the cause of all our ills. It would also cause a few problems in of itself which would need to be tackled. Not sure I have heard Farage discuss them.
Did I ever say it was the cause of all our ills?
No
We have:
An ageing society
Decreasing IQ
Low birthrates
A process state which inhibits innovation and development for various reasons (Net Zero, Woke, etc)
Increasing sectarian/religious divides
And so forth
Mass immigration deeply worsens some of these, and only somewhat and temporarily ameliorates others. It's a bad idea. Let's stop it and try something else
You may say "Leon stop banging on about migration" but I suggest that is ill-advised on the day a poll shows Reform as the leading party, and ten points ahead of the governing party
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Control immigration and use social insurance not income tax to fund healthcare like most OECD nations and require the top 10% of earners to have private health insurance like Australia
You mean, impose extra taxes on the people who already pay the most taxes?
Not a tax, an insurance so they use private health insurance and private hospitals and cut NHS waiting lists
Insurance that is compulsory only for the well off.
The only comparator for this is the short but amazing rise of the SDP in the early 80s, right?
Then Thatch got saved by Galtieri and they fell away. IIRC. It was a looooooong time ago
Maybe Starmer can persuade Putin to invade Gibraltar, badly
The SDP/Alliance polled 50% but the Tories were leading in some polls before the invasion of The Malvinas.
Was it as high as 50%??! That's even more spectacular than I remember
However there are major differences between Reform and the SDP, and the most important is the one that tells me this might be a new permanent change, not a fleeting weirdness like the Alliance: Reform are just part of a wider vibeshift to the populist right across the West - from Le Pen to Meloni, from Trump to the AfD to the Danish social democrats adopting hard right migration policies, and many other examples: some hopeful some depressing
This is a secular change in mood across the western world, not a uniquely British blip
In a fortnight where hard right leaders have lost national elections in Canada and Australia to the Liberals and Labor a bit out of date.
The AfD also failed to win Germany's election in February either and are now opposition to the CDU and SPD government
Those are simply delays. Has the election of Starmer stopped Reform in its tracks? Hardly. It's been exactly the rocket fuel Nigel needed. Carney will be the same. He's utterly useless.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Hasn't France had mass immigration and their health service is not collapsing?
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
If Reform don’t win a majority at the next election, which most people, the betting odds, and all instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
Of course we would. When biggest supporters talk about a Reform win being near inevitable, even if Farage himself is presumably more cautious than that, a 'failure' to win outright would be contrasted with that over optimism.
But if they significantly increase their current MP count no one will really notice that much.
If Reform don’t win a majority at the next election, which most people, the betting odds, and all instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
If Reform do lose the next election, I suspect it will be because Labour, the LibDems and the Greens have an informal agreement over which seats each will be the primary challenger in.
Paper campaigns will become much more explicitly so, so that Labour voters in -say- the Isle of Wight East seats know that they should be voting Green.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
There's not much leeway in running council finances, and despite the low regard most are held in staff will do as good a job as they can to support the newly formed Reform run councils. With an election only several years away it really should be easy to avoid complete disaster whilst getting some positive headlines for their audience for the few areas they can have a direct impact on.
They might disappoint some people if they cannot immediately freeze or reduce council tax, but I wouldn't think that would doom them immediately, and in some areas if bold enough on what to stop doing they could even manage a freeze and get a PR win.
The only comparator for this is the short but amazing rise of the SDP in the early 80s, right?
Then Thatch got saved by Galtieri and they fell away. IIRC. It was a looooooong time ago
Maybe Starmer can persuade Putin to invade Gibraltar, badly
The SDP/Alliance polled 50% but the Tories were leading in some polls before the invasion of The Malvinas.
Was it as high as 50%??! That's even more spectacular than I remember
However there are major differences between Reform and the SDP, and the most important is the one that tells me this might be a new permanent change, not a fleeting weirdness like the Alliance: Reform are just part of a wider vibeshift to the populist right across the West - from Le Pen to Meloni, from Trump to the AfD to the Danish social democrats adopting hard right migration policies, and many other examples: some hopeful some depressing
This is a secular change in mood across the western world, not a uniquely British blip
In a fortnight where hard right leaders have lost national elections in Canada and Australia to the Liberals and Labor a bit out of date.
The AfD also failed to win Germany's election in February either and are now opposition to the CDU and SPD government
Those are simply delays. Has the election of Starmer stopped Reform in its tracks? Hardly. It's been exactly the rocket fuel Nigel needed. Carney will be the same. He's utterly useless.
We will see, on swing of the pendulum after 14 years out of power you would expect the right in Canada to win finally next time and the Canadian Conservatives did gain seats just not enough to win.
Albanase and Labor though are likely to win a third term after handing Dutton and the Coalition their worst ever post war defeat.
The AfD are also still well short of the 40%+ or so they would need to be polling to have any chance of ousting the CDU and SPD government next time as well
This week I start a very cheap medication with a 10% chance of complete success and 35% of any remisson at all, and some chance of damaging my liver, because the NHS will not pay the £10000 for a course of the fancy new drug with a 65% chance of success unless I fail on this one (and another crap one afterward) first. Now, this is a chronic condition so it's completely understandable. But I await the weekly blood test results with trepidation.
By contrast, in the healthcare situation in the US is pretty dire. But they would jump straight to the good stuff...
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
There's not much leeway in running council finances, and despite the low regard most are held in staff will do as good a job as they can to support the newly formed Reform run councils. With an election only several years away it really should be easy to avoid complete disaster whilst getting some positive headlines for their audience for the few areas they can have a direct impact on.
They might disappoint some people if they cannot immediately freeze or reduce council tax, but I wouldn't think that would doom them immediately, and in some areas if bold enough on what to stop doing they could even manage a freeze and get a PR win.
Avoiding complete disaster whilst generating some positive headlines is more than our current Government has managed, so if Reform councils prove capable of that, we're fine.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
“If they manage to run councils OK”
🤣 I nearly wet myself when I read that. You mean you have doubts these Trump and Musk acolytes might not run them well?
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Control immigration and use social insurance not income tax to fund healthcare like most OECD nations and require the top 10% of earners to have private health insurance like Australia
You mean, impose extra taxes on the people who already pay the most taxes?
Not a tax, an insurance so they use private health insurance and private hospitals and cut NHS waiting lists
Insurance that is compulsory only for the well off.
Or, to put it another way, a ... errr ... tax.
Nope. a tax can be used to fund any government service, private health insurance and social insurance for public healthcare is hypothecated to only fund healthcare
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
Not an "assumption". PBers can decide if they want to go with your instincts or an OECD economic analysis.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
There's not much leeway in running council finances, and despite the low regard most are held in staff will do as good a job as they can to support the newly formed Reform run councils. With an election only several years away it really should be easy to avoid complete disaster whilst getting some positive headlines for their audience for the few areas they can have a direct impact on.
They might disappoint some people if they cannot immediately freeze or reduce council tax, but I wouldn't think that would doom them immediately, and in some areas if bold enough on what to stop doing they could even manage a freeze and get a PR win.
Avoiding complete disaster whilst generating some positive headlines is more than our current Government has managed, so if Reform councils prove capable of that, we're fine.
Add to that plenty of other councils may need emergency government funding to avoid going effectively bust (as has happened several times already, and is quite likely in many other areas), and if they are lucky in which councils they won (eg their finances are not too bad) and they could even look better than the other parties simply because it will be 'labour/tory run council goes bust' as a headline not 'reform council collapses'.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
“If they manage to run councils OK”
🤣 I nearly wet myself when I read that. You mean you have doubts these Trump and Musk acolytes might not run them well?
I'm sorry to hear that you're experiencing bladder control issues - best of luck.
Yes, I do have doubts that people who've never held public office might find it a challenge, as would newly elected Conservatives and Labour councils. However, their attitude to the job seems excellent and singularly lacking in the complacency and entitlement that oozes out of the legacy parties, so neither would I bet against them.
This week I start a very cheap medication with a 10% chance of complete success and 35% of any remisson at all, and some chance of damaging my liver, because the NHS will not pay the £10000 for a course of the fancy new drug with a 65% chance of success unless I fail on this one (and another crap one afterward) first. Now, this is a chronic condition so it's completely understandable. But I await the weekly blood test results with trepidation.
By contrast, in the healthcare situation in the US is pretty dire. But they would jump straight to the good stuff...
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
Not an "assumption". PBers can decide if they want to go with your instincts or an OECD economic analysis.
Flawed analysis is still flawed analysis.
rcs has shown you the data that matches what I'm saying, but you keep spouting out meaningless bits like "YODO" or "last 12 months" without realising that the NHS has become experts at dragging the last 12 months into a last 48, 72 or more months nowadays.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Control immigration and use social insurance not income tax to fund healthcare like most OECD nations and require the top 10% of earners to have private health insurance like Australia
You mean, impose extra taxes on the people who already pay the most taxes?
Not a tax, an insurance so they use private health insurance and private hospitals and cut NHS waiting lists
Insurance that is compulsory only for the well off.
Or, to put it another way, a ... errr ... tax.
Nope. a tax can be used to fund any government service, private health insurance and social insurance for public healthcare is hypothecated to only fund healthcare
I'll grant that finances and taxation policy appear to be beyond my grasp, but I really don't see how that makes for much of a distinction beyond claiming a tax for a specific purpose is not a tax. Is council tax not a tax because it is only to fund local government?
This week I start a very cheap medication with a 10% chance of complete success and 35% of any remisson at all, and some chance of damaging my liver, because the NHS will not pay the £10000 for a course of the fancy new drug with a 65% chance of success unless I fail on this one (and another crap one afterward) first. Now, this is a chronic condition so it's completely understandable. But I await the weekly blood test results with trepidation.
By contrast, in the healthcare situation in the US is pretty dire. But they would jump straight to the good stuff...
I've changed my mind, I suddenly think we should spend loads more on mitigating chronic conditions in a hospital setting.
This week I start a very cheap medication with a 10% chance of complete success and 35% of any remisson at all, and some chance of damaging my liver, because the NHS will not pay the £10000 for a course of the fancy new drug with a 65% chance of success unless I fail on this one (and another crap one afterward) first. Now, this is a chronic condition so it's completely understandable. But I await the weekly blood test results with trepidation.
By contrast, in the healthcare situation in the US is pretty dire. But they would jump straight to the good stuff...
Sorry to hear this. Although it is NICE who decide these things rather than NHS directly I believe.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
“If they manage to run councils OK”
🤣 I nearly wet myself when I read that. You mean you have doubts these Trump and Musk acolytes might not run them well?
I'm sorry to hear that you're experiencing bladder control issues - best of luck.
Yes, I do have doubts that people who've never held public office might find it a challenge, as would newly elected Conservatives and Labour councils. However, their attitude to the job seems excellent and singularly lacking in the complacency and entitlement that oozes out of the legacy parties, so neither would I bet against them.
I've never seen a figure on the average turnover for councils at an election. I'd guess it is something like 1/3 to 1/2, though some number will be people who have experience but had previously lost seats. In some areas that has definitely been exceeded this time around by a significant margin, which should make for some interesting experiences.
(more than half of MPs were newly elected in 2024 I beleive)
This week I start a very cheap medication with a 10% chance of complete success and 35% of any remisson at all, and some chance of damaging my liver, because the NHS will not pay the £10000 for a course of the fancy new drug with a 65% chance of success unless I fail on this one (and another crap one afterward) first. Now, this is a chronic condition so it's completely understandable. But I await the weekly blood test results with trepidation.
By contrast, in the healthcare situation in the US is pretty dire. But they would jump straight to the good stuff...
Sorry to hear this. Although it is NICE who decide these things rather than NHS directly I believe.
The fancy drug in question was, for many years, the NHS's largest single drug bill. So I understand NICE's position.
I think the 10% figure for increase in attendances / admissions is dubious. Would be interested in which Trust as the National figure is very different.
The challenge in health is on one side an aging population with increasingly complex health requirements (the alternative is we bring back smoking and lung cancer - a very quick and cheap death) vs clinical and technological improvements. (Eg ?DVT has moved from overnight admission to day case to managed in the community within 2-3 years).
The challenge is that productivity improvements (QALY / £Input) is not the same as cheaper
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
Not an "assumption". PBers can decide if they want to go with your instincts or an OECD economic analysis.
Flawed analysis is still flawed analysis.
rcs has shown you the data that matches what I'm saying, but you keep spouting out meaningless bits like "YODO" or "last 12 months" without realising that the NHS has become experts at dragging the last 12 months into a last 48, 72 or more months nowadays.
Could you explain why Japan's health spending has grown so much more slowly then? Their population has aged much faster than ours (and continues to do so).
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
Do you have a source for that 0.2 % figure @eahbal ?
I quite like the REAL centres analysis of trends but they are way of 0.2%
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
Do you have a source for that 0.2 % figure @eahbal ?
I quite like the REAL centres analysis of trends but they are way of 0.2%
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Hm, looks like 3% per year between 2010-2020, then flat (page 7):
Thanks! I'll take a look. I wonder if there have been any studies into why emergency admission growth was running a couple times higher until the pandemic.
When you cant get a gp appointment for 3 weeks you end up going to a&e.
There’s simply not enough workers to support pensioners and the extra demands on public services . The ratio is getting progressively worse. So either taxes go up or the retirement age is extended.
This unpalatable option for governments is kicked down the road as parties are busy trying to win elections so don’t want to admit the scale of the problem .
What we get is scapegoating of sections of the community as simplistic solutions are peddled .
Cutting immigration even to levels that the public might seem accepting of won’t solve the problem. I think most accept current levels are much too high . So when they come down which they will what happens then ?
Until parties accept the scale of the problem and a cross party consensus can be found the moving of the deckchairs on the Titanic will continue!
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
Not an "assumption". PBers can decide if they want to go with your instincts or an OECD economic analysis.
Flawed analysis is still flawed analysis.
rcs has shown you the data that matches what I'm saying, but you keep spouting out meaningless bits like "YODO" or "last 12 months" without realising that the NHS has become experts at dragging the last 12 months into a last 48, 72 or more months nowadays.
Could you explain why Japan's health spending has grown so much more slowly then? Their population has aged much faster than ours (and continues to do so).
That’s a cultural thing and children are expected to look after their parents in old age . This reduces the burden on public services .
There’s simply not enough workers to support pensioners and the extra demands on public services . The ratio is getting progressively worse. So either taxes go up or the retirement age is extended.
This unpalatable option for governments is kicked down the road as parties are busy trying to win elections so don’t want to admit the scale of the problem .
What we get is scapegoating of sections of the community as simplistic solutions are peddled .
Cutting immigration even to levels that the public might seem accepting of won’t solve the problem. I think most accept current levels are much too high . So when they come down which they will what happens then ?
Until parties accept the scale of the problem and a cross party consensus can be found the moving of the deckchairs on the Titanic will continue!
We've been doing pretty well on extending the retirement age. Public support for increased taxation not so much.
“the government said certification procedures and border checks would ensure hormone-reared beef would not enter the UK. "The rules on food standards have not changed and they will not change as a result of the deal," said Chief Secretary to the Treasury Darren Jones.
But it’s Labours inability to police it properly that’s the actual question, checks at the border have already fallen apart, before adding US beef imports to the mess. Are borders resourced enough to do all the checking the laws say must happen? in all the delays and switch to checking happening more now at destination rather than border, it’s a weak system. Do we really think the ban on personal imports from EU of all meat and cheese is policeable, when illegal imports were already on the rise before they brought this in?
Mark my words, something bad is coming thanks to this Labour governments failure to control meat and dairy imports into our country. something bad is going to happen.
There’s simply not enough workers to support pensioners and the extra demands on public services . The ratio is getting progressively worse. So either taxes go up or the retirement age is extended.
This unpalatable option for governments is kicked down the road as parties are busy trying to win elections so don’t want to admit the scale of the problem .
What we get is scapegoating of sections of the community as simplistic solutions are peddled .
Cutting immigration even to levels that the public might seem accepting of won’t solve the problem. I think most accept current levels are much too high . So when they come down which they will what happens then ?
Until parties accept the scale of the problem and a cross party consensus can be found the moving of the deckchairs on the Titanic will continue!
“the government said certification procedures and border checks would ensure hormone-reared beef would not enter the UK. "The rules on food standards have not changed and they will not change as a result of the deal," said Chief Secretary to the Treasury Darren Jones.
But it’s Labours inability to police it properly that’s the actual question, checks at the border have already fallen apart, before adding US beef imports to the mess. Are borders resourced enough to do all the checking the laws say must happen? in all the delays and switch to checking happening more now at destination rather than border, it’s a weak system. Do we really think the ban on personal imports from EU of all meat and cheese is policeable, when illegal imports were already on the rise before they brought this in?
Mark my words, something bad is coming thanks to this Labour governments failure to control meat and dairy imports into our country. something bad is going to happen.
When we were in the EU there were very few checks. We had to trust the greek border agents to test all meat coming in from Turkey, for example.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
We have invited to live here about 5-10 million people from cultures that are - often - stupider, shorter, and less healthy than ours. And the native Brits are already a pasty faced bunch of fat people who eat too much pizza
These incomers bring their dependants who will be even less healthy. I see them waddling around Camden - I waddle next to them. The only difference between us is that I have paid several trillion quid into the NHS as tax, so at least I've earned my treatment, they have often paid zero, and they and their families get the same free care. even though they will always be a net fiscal negative. And they make enormous demands on a free health system
Unsurprisingly, the NHS is now collapsing
We have a choice as a society. Either we severely restrict migration AND start sending people home, and keep our beloved NHS as it is - free at the point of care - or we continue with mass immigration but we accept that the NHS will start picking and choosing who it cares for, and if you haven't contributed you get near zero care
It's that basic. CHOOSE
This is no slight on migrants. They make very understandable and perfectly moral human choices, and western European welfare states are incredibly attractive to people from poorer countries. It's just that western European welfare systems cannot cope with the strain of so many incomers, and if we continue along this road, they will implode
Yet the NHS is actually breaking under the strain of the boomer generation demographic now hitting 70s and 80s and needing a lot of care, chronic illnesses, endless ambulances for falls, bed blockers, keeping extremely frail old people alive for one more month, social care crisis etc etc.
This generation is overwhelming white and 'native' for want of a better term surely?
Oh for sure. That is also part of it. But inviting in one social care worker from Nigeria, who then brings five dependants - who will often be old and ill or young and demanding - is the Ponziest of Ponzi schemes. We have compounded the very real problems of an ageing society with the absurdity of enormous mass immigration from poorer countries which, in the end, actually makes things worse
I have personally given up on the NHS. For years I've had all my dental care done privately in Thailand, and of late my physical care is also done there
I don't know what the solution is. But I know what makes it much worse: mass immigration. So, stopping that immediately would at least be a braking mechanism, however painful the lurch as we come to an abrupt halt
Control immigration and use social insurance not income tax to fund healthcare like most OECD nations and require the top 10% of earners to have private health insurance like Australia
You mean, impose extra taxes on the people who already pay the most taxes?
Not a tax, an insurance so they use private health insurance and private hospitals and cut NHS waiting lists
Insurance that is compulsory only for the well off.
Or, to put it another way, a ... errr ... tax.
Nope. a tax can be used to fund any government service, private health insurance and social insurance for public healthcare is hypothecated to only fund healthcare
I'll grant that finances and taxation policy appear to be beyond my grasp, but I really don't see how that makes for much of a distinction beyond claiming a tax for a specific purpose is not a tax. Is council tax not a tax because it is only to fund local government?
There’s simply not enough workers to support pensioners and the extra demands on public services . The ratio is getting progressively worse. So either taxes go up or the retirement age is extended.
This unpalatable option for governments is kicked down the road as parties are busy trying to win elections so don’t want to admit the scale of the problem .
What we get is scapegoating of sections of the community as simplistic solutions are peddled .
Cutting immigration even to levels that the public might seem accepting of won’t solve the problem. I think most accept current levels are much too high . So when they come down which they will what happens then ?
Until parties accept the scale of the problem and a cross party consensus can be found the moving of the deckchairs on the Titanic will continue!
We've been doing pretty well on extending the retirement age. Public support for increased taxation not so much.
Whatever happens needs to be cross party otherwise you’ll have one party promising the moon on a stick to get elected .
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
Not an "assumption". PBers can decide if they want to go with your instincts or an OECD economic analysis.
Flawed analysis is still flawed analysis.
rcs has shown you the data that matches what I'm saying, but you keep spouting out meaningless bits like "YODO" or "last 12 months" without realising that the NHS has become experts at dragging the last 12 months into a last 48, 72 or more months nowadays.
Could you explain why Japan's health spending has grown so much more slowly then? Their population has aged much faster than ours (and continues to do so).
That’s a cultural thing and children are expected to look after their parents in old age . This reduces the burden on public services .
Their overall health is much, much better. 5% obesity v 30% here. They have about the healthiest population in the world, despite being so old.
Didn't they get like a £20bn bung last year? I guess KPMG and their ilk will have swallowed a lot of it...
Yes, but I think that sum quoted was over several years, albeit somewhat frontloaded.
My own Trust ended the last financial year with a £100 million overspend, and we are far from the worst in the country, indeed better than most comparable sized Trusts. We have been told that the workforce will shrink this year at all grades and areas. Most of the increased funding goes to GPs and community services, probably a wise decision.
The problem is that emergency attendances and admissions are relentlessly up 10% or so year on year. It's clearly a core part of the hospital service, but our income for the extra work is capped, hence emergency services are running at a continuous loss.
10% is just insane. Getting increasingly fed up with people who just say "demographics" ad infinitum. There's a lot more going on.
Healthcare inflation has long run at a higher rate than regular inflation. This is, I guess, because we’re good at inventing new treatments, mainly new drugs. For a long time, we were also seeing steady increases in life expectancy as well, although that’s stalled more recently.
Its also a tale of Sisyphus. We might invent medicines to try to cheat death but it doesn't matter how much effort you put into rolling that boulder up the hill, its going to roll back down again, for eternity.
It is demographic change, but not only is our population growing but it is ageing too and cheating death with a medicine this year doesn't end disease, it means the person is going to return with even more ailments next year.
It's just not the case, sorry. I know we've argued about this before but demographics are only a small element of why health costs are going on. It's just become a bit of a podcast meme - and more importantly, gives politicians an easy excuse.
We're just in a doom loop of finding more and more ways to keep very unwell people alive, at the cost of not actually preventing them becoming unwell in the first place.
I'm sorry but you are wrong.
Once people get past the age of 75 then their health conditions increase dramatically as does the expense. Our over 75 population has increased from 3.9 million in 2000 to 5.4 million in 2020, a 1.5 million increase.
That is not insignificant, however much you wish to pretend it is.
Yes, but there are 70 million people in the UK. A 100% increase in obesity rates across that entire population over the last 30 years has a far bigger effect.
And YODO. Most age-related expenses come in the last 12 months or so of life. So the number of people at that age simply does not matter - it's whether they are healthy or not.
(I'm not pretending. I can spam links to the literature like a madman but that will never satisfy you.).
You only die once, but you can evade death many, many times.
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
I think you've half got it. You need to seperate the age-specific rate of having a health problems from the change in the number of people of that age.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
The 0.2% assumption is bollocks, the expensive portion of the population is also the portion of our population that has grown by nearly half, not fractions of a percentage point.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
Not an "assumption". PBers can decide if they want to go with your instincts or an OECD economic analysis.
Flawed analysis is still flawed analysis.
rcs has shown you the data that matches what I'm saying, but you keep spouting out meaningless bits like "YODO" or "last 12 months" without realising that the NHS has become experts at dragging the last 12 months into a last 48, 72 or more months nowadays.
Could you explain why Japan's health spending has grown so much more slowly then? Their population has aged much faster than ours (and continues to do so).
Japan doesn't have a free at the point of use healthcare system, though it has gone up significantly there too.
If Reform don’t win a majority at the next election, and most people, the betting odds, and instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
I hope they don't. I think they need the Tories in there. But we'll see. If they manage to run councils OK, that will give me more confidence.
A party going from five MPs to a majority in one parliament just doesn’t compute in my head.
There’s simply not enough workers to support pensioners and the extra demands on public services . The ratio is getting progressively worse. So either taxes go up or the retirement age is extended.
This unpalatable option for governments is kicked down the road as parties are busy trying to win elections so don’t want to admit the scale of the problem .
What we get is scapegoating of sections of the community as simplistic solutions are peddled .
Cutting immigration even to levels that the public might seem accepting of won’t solve the problem. I think most accept current levels are much too high . So when they come down which they will what happens then ?
Until parties accept the scale of the problem and a cross party consensus can be found the moving of the deckchairs on the Titanic will continue!
Cutting immigration would make the ratio worse.
Yes it doesn’t help but there’s a more manageable level that’s more likely to get public support . The issue has been exacerbated by Brexit because EU migration tended to be younger with less family members coming . Of course for the treasury people working here , paying taxes then retiring back to their home country was a win for them . The data shows that EU migrants were indeed a positive for the treasury v non EU migration which is a negative in terms of what they put in v benefits .
I'd totally forgotten that as recently as 2012 Euston Station didn't feature the upper deck of cafes. I thought it was put in a lot earlier. See the photo here.
If Reform don’t win a majority at the next election, which most people, the betting odds, and all instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
If Reform do lose the next election, I suspect it will be because Labour, the LibDems and the Greens have an informal agreement over which seats each will be the primary challenger in.
Paper campaigns will become much more explicitly so, so that Labour voters in -say- the Isle of Wight East seats know that they should be voting Green.
That was my big tip for the last election, a Green win in Wight East. It didn't happen though.
Could this finally break the Westminster consensus/Prove that we were right all along?
How do you measure migrant costs? The question the OBR can’t answer
There is growing concern in government, shared by Morgan McSweeney, the prime minister’s chief of staff, that the benefit of immigration is being overstated because OBR does not take into account the additional costs of immigration-fuelled population growth to public infrastructure and services in its official forecasts.
In October the OBR for the first time started publishing an estimate of the fiscal impact of migrants across their lifetime and broke it down into highly paid, average and low-wage migrants, but it cannot incorporate this into the official forecasts.
It also assumes that each additional person would require an increase in public spending of £20,000 to cover for the extra strain on public infrastructure and services.
Could this finally break the Westminster consensus/Prove that we were right all along?
How do you measure migrant costs? The question the OBR can’t answer
There is growing concern in government, shared by Morgan McSweeney, the prime minister’s chief of staff, that the benefit of immigration is being overstated because OBR does not take into account the additional costs of immigration-fuelled population growth to public infrastructure and services in its official forecasts.
In October the OBR for the first time started publishing an estimate of the fiscal impact of migrants across their lifetime and broke it down into highly paid, average and low-wage migrants, but it cannot incorporate this into the official forecasts.
It also assumes that each additional person would require an increase in public spending of £20,000 to cover for the extra strain on public infrastructure and services.
If Reform don’t win a majority at the next election, which most people, the betting odds, and all instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
If Reform do lose the next election, I suspect it will be because Labour, the LibDems and the Greens have an informal agreement over which seats each will be the primary challenger in.
Paper campaigns will become much more explicitly so, so that Labour voters in -say- the Isle of Wight East seats know that they should be voting Green.
That was my big tip for the last election, a Green win in Wight East. It didn't happen though.
I don't see why backers of other parties should easily transfer to the greens. They're quite extreme.
Joey Politano 🏳️🌈 @JosephPolitano · 56s I’m a broken record on this but the key to understanding Trump’s trade policy is that he just thinks the act of importing is itself an economic loss.
I'm having a look into whether now is a good time to switch again, maybe to electric. I love it, but I'm not sure that I still need my large (low mileage now) estate. It may be at the point where the value may be going to take a dive, so now could be a good time to0 swap.
What is a good smallish electric? Needs would be for local and county travel, with occasional extended distance.
I think someone mentioned a Fiat 500e recently, and the larger battery version of that looks like having potential. Any other suggestions would be welcome.
One question I need to understand - how long does a battery actually sensibly last? And what age is practical for buying a second hand electric?
Renault 5. I've got one so you know it's mint. Alpine A290 if you're flush and want a bit more pep.
Did you get the standard one or the GTS, if GTS assume you believe worth the difference
I got the R5 not the A290. I did test drive the A290 GTS though. It is absolutely brilliant and very much worth the money. I did nearly buy it but in a rare outbreak of sanity I realised I have currently another five very fast cars (993, 996 GT3 CS, Tributo, M6 and Granturismo) so the case for adding a performance EV to the stable is weak. However, if I could only have one car, then that car would be a white A290 GTS with blue calipers and the black 19" flocon de neige wheels.
On topic, loosely: Gordon Dickson's novel, Spacial Delivery, features a fight between an alien much like an intelligent Kodiak bear. The man wins -- by cheating -- but things similar to the weapon he uses could probably be found in most jungles. (The two are good friends by the end of the book.) https://en.wikipedia.org/wiki/Gordon_R._Dickson#Novels
As for combat between 100 men and a gorilla, I think the men would win easily if even a few of them were trained on martial arts. Especially if they had a quick course on gorilla vulnerabilities.
(for rcs1000) FPT: Your alternate universe may already have happened, according to physicists who believe in the many worlds interpretation of quantum mechanics. Here's the start of Larry Niven's short story, "All the Myriad Ways": "There were timelines branching and branching, a mega universe of universes, millions more every minute. Billions? Trillions? Trimble didn't understand the theory, though God knows he'd tried. The universe split every time someone made a decision."
(The story is in a collection by the same name.
For a better explanation of the "many worlds" theory, don't ask me, consult your local quantum mechanic.)
Could this finally break the Westminster consensus/Prove that we were right all along?
How do you measure migrant costs? The question the OBR can’t answer
There is growing concern in government, shared by Morgan McSweeney, the prime minister’s chief of staff, that the benefit of immigration is being overstated because OBR does not take into account the additional costs of immigration-fuelled population growth to public infrastructure and services in its official forecasts.
In October the OBR for the first time started publishing an estimate of the fiscal impact of migrants across their lifetime and broke it down into highly paid, average and low-wage migrants, but it cannot incorporate this into the official forecasts.
It also assumes that each additional person would require an increase in public spending of £20,000 to cover for the extra strain on public infrastructure and services.
Assisted dying could go along way to solving the health and care issue, allowing for lower taxes, and making the UK a more attractive place for high earners.
What we need is a Sandman. Perhaps we can repurpose James Bond.
If Reform don’t win a majority at the next election, which most people, the betting odds, and all instinct tells us they won’t… we’ll still be getting ‘Farage threw away a 13pt lead’ won’t we?
If Reform do lose the next election, I suspect it will be because Labour, the LibDems and the Greens have an informal agreement over which seats each will be the primary challenger in.
Paper campaigns will become much more explicitly so, so that Labour voters in -say- the Isle of Wight East seats know that they should be voting Green.
That was my big tip for the last election, a Green win in Wight East. It didn't happen though.
I don't see why backers of other parties should easily transfer to the greens. They're quite extreme.
The Greens were never going to form the next government, and won't be forming the next government, so in fact, it's very easy for left-of-centre voters to transfer to them. A few Greens MPs are not going to be deciding things like tax policy after the next election, but could be vital to stop Reform from forming the next government, if the numbers are very tight.
That's going to be the question for left-of-centre voters: do they prefer a potential Labour minority government, with Lib-Dem+Greens support, or do they prefer a Reform majority government ? I think, a very large percentage of centre-left voters would prefer the first option.
A federal judge ordered the immediate release of Rumeysa Öztürk, a Turkish Tufts University student who was arrested by masked federal agents over an op-ed she wrote.
“There has been no evidence introduced by the government other than the op-ed. That literally is the case.…There is absolutely no evidence that she has engaged in violence or advocated violence” said U.S. District Judge William Sessions. https://x.com/RpsAgainstTrump/status/1920920359140028730
The Trump admin’s position here is that they want a judge to halt her order granting a guy the right to self-deport — because they want to instead detain him, keep him in custody for weeks/months, and THEN deport him.
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
Amusingly most US commentators are saying the opposite, and MAGA are complaining that the US got the bad side of the deal.
The truth is probably somewhere in between - and it's only a provisional deal for now.
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
Amusingly most US commentators are saying the opposite, and MAGA are complaining that the US got the bad side of the deal.
The truth is probably somewhere in between - and it's only a provisional deal for now.
I don't think the US got much out of it. But a 'trade deal' that leaves a higher tariff on British goods than a few weeks ago doesn't warrant obsequious 'gratitude' from our silly PM. It's absurd and dishonest.
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
Amusingly most US commentators are saying the opposite, and MAGA are complaining that the US got the bad side of the deal.
The truth is probably somewhere in between - and it's only a provisional deal for now.
I don't think the US got much out of it. But a 'trade deal' that leaves a higher tariff on British goods than a few weeks ago doesn't warrant obsequious 'gratitude' from our silly PM. It's absurd and dishonest.
It's pretty silly.
But how much does it matter ? No one believes the flattery is sincere (with the possible exception of Trump).
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
Amusingly most US commentators are saying the opposite, and MAGA are complaining that the US got the bad side of the deal.
The truth is probably somewhere in between - and it's only a provisional deal for now.
I don't think the US got much out of it. But a 'trade deal' that leaves a higher tariff on British goods than a few weeks ago doesn't warrant obsequious 'gratitude' from our silly PM. It's absurd and dishonest.
It's pretty silly.
But how much does it matter ? No one believes the flattery is sincere (with the possible exception of Trump).
Looks like immigration 'benefits' may have been incorrectly calculated for years, and the Home Office has finally woken up to it:
"The Home Office fears that annual net migration is going to settle above the 340,000 level expected by the government unless radical policies are introduced.
Officials believe that as well as underestimating the levels of long-term immigration to the UK, government forecasts are also overstating its economic benefits.
They fear that from 2028 net migration will be closer to 525,000 — currently the high end of the Office for National Statistics (ONS) projections — because migrants are staying for longer than previously thought."
"Immigration and economic experts have also warned that the official economic forecasts only take into account the initial few years or so of a migrant’s life in the UK, which is often when foreign workers are contributing the most to the economy and the public purse because they are paying taxes but cannot claim benefits for at least five years. They are also unlikely to use the NHS as much as they will later on in their lives."
On the Header, I need to know what weapons I can have.
Unarmed.
Probably eight or nine could beat it, unarmed.
The assumption is that it's a 'naked rush' on the gorilla, in full-view. Or, like a Steven Seagal or Jean Claude Van-Damme film where each man approaches the gorilla individually, in turn, to 'have a go'.
In reality, humans would use their brains - even if naked and unarmed. Some men would provoke, entice or stalk the gorilla whilst luring it into a hole or trap curated by others. And then it'd be easy prey.
Looks like immigration 'benefits' may have been incorrectly calculated for years, and the Home Office has finally woken up to it:
"The Home Office fears that annual net migration is going to settle above the 340,000 level expected by the government unless radical policies are introduced.
Officials believe that as well as underestimating the levels of long-term immigration to the UK, government forecasts are also overstating its economic benefits.
They fear that from 2028 net migration will be closer to 525,000 — currently the high end of the Office for National Statistics (ONS) projections — because migrants are staying for longer than previously thought."
"Immigration and economic experts have also warned that the official economic forecasts only take into account the initial few years or so of a migrant’s life in the UK, which is often when foreign workers are contributing the most to the economy and the public purse because they are paying taxes but cannot claim benefits for at least five years. They are also unlikely to use the NHS as much as they will later on in their lives."
The problem with all of these analysis is that there are massive second and third order effects.
On the negative side: how are we measuring the impact on British people of there now being fewer GPs per citizen?
On the positive side: how do we measure if a business chose to set up in the UK rather than (say) France, because of how easy it is to get multilingual staff?
Measuring them all properly is incredibly difficult, because most people - however much they might claim otherwise - come to the question of immigration with their minds already made up. It's classic cognitive dissonance: they either see the right of people to live where they like as something that should be preserved and look for evidence that it is economically beneficial; or they come from a perspective of being perturbed by the changes to their local community, and look for evidence it is economically harmful.
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
Amusingly most US commentators are saying the opposite, and MAGA are complaining that the US got the bad side of the deal.
The truth is probably somewhere in between - and it's only a provisional deal for now.
I don't think the US got much out of it. But a 'trade deal' that leaves a higher tariff on British goods than a few weeks ago doesn't warrant obsequious 'gratitude' from our silly PM. It's absurd and dishonest.
I think you're right. The amount of money saved -if any -will not cover the reputational damage of whoring the country out for a pat on the bottom from Trump. And not even his bottom but Mandleson's.
Supporting Starmer because the other contenders are worse is getting increasingly difficult. His breathless trip to the car factory where he had his choreographed dial-in with Trump was unbearable. Mandelson's poodle act with Trump was even worse. Sometimes you just can't find the words
Looks like immigration 'benefits' may have been incorrectly calculated for years, and the Home Office has finally woken up to it:
"The Home Office fears that annual net migration is going to settle above the 340,000 level expected by the government unless radical policies are introduced.
Officials believe that as well as underestimating the levels of long-term immigration to the UK, government forecasts are also overstating its economic benefits.
They fear that from 2028 net migration will be closer to 525,000 — currently the high end of the Office for National Statistics (ONS) projections — because migrants are staying for longer than previously thought."
"Immigration and economic experts have also warned that the official economic forecasts only take into account the initial few years or so of a migrant’s life in the UK, which is often when foreign workers are contributing the most to the economy and the public purse because they are paying taxes but cannot claim benefits for at least five years. They are also unlikely to use the NHS as much as they will later on in their lives."
Reading through that, you seem to be flagging up there is actually two very different types, good migration and bad migration - what would be a good idea is some sort of freedom of movement scheme to attract young people and productive skilled people to work here, who then largely return or go elsewhere where demand for them is. Filling labour shortages like that will definitely boost UK productivity a lot, wouldn’t it?
Looks like immigration 'benefits' may have been incorrectly calculated for years, and the Home Office has finally woken up to it:
"The Home Office fears that annual net migration is going to settle above the 340,000 level expected by the government unless radical policies are introduced.
Officials believe that as well as underestimating the levels of long-term immigration to the UK, government forecasts are also overstating its economic benefits.
They fear that from 2028 net migration will be closer to 525,000 — currently the high end of the Office for National Statistics (ONS) projections — because migrants are staying for longer than previously thought."
"Immigration and economic experts have also warned that the official economic forecasts only take into account the initial few years or so of a migrant’s life in the UK, which is often when foreign workers are contributing the most to the economy and the public purse because they are paying taxes but cannot claim benefits for at least five years. They are also unlikely to use the NHS as much as they will later on in their lives."
The problem with all of these analysis is that there are massive second and third order effects.
On the negative side: how are we measuring the impact on British people of there now being fewer GPs per citizen?
On the positive side: how do we measure if a business chose to set up in the UK rather than (say) France, because of how easy it is to get multilingual staff?
Measuring them all properly is incredibly difficult, because most people - however much they might claim otherwise - come to the question of immigration with their minds already made up. It's classic cognitive dissonance: they either see the right of people to live where they like as something that should be preserved and look for evidence that it is economically beneficial; or they come from a perspective of being perturbed by the changes to their local community, and look for evidence it is economically harmful.
They are massive second and third order effects that need to be modelled, just as they are for domestic citizens. Because, guess what, immigration is not a one-way bet.
The rest is excuses, IMHO. This is a mainstream government department arguing for it, somewhat to my surprise, and HMT only seriously consider the next 5 years in their models.
You have to assume immigrants are coming here for life. The failure to do so is, err, causing political problems, like the total collapse of the Conservatives, and the triumph of Reform.
I've just seen Starmer's phone call to Trump where he praises Donald's leadership. Wtf? He sounds exactly like one of those cult members in Trump's cabinet. It must be possible to be polite without losing every trace of dignity and self-respect. And the 'trade deal' is crap. Labour should replace Starmer asap
Amusingly most US commentators are saying the opposite, and MAGA are complaining that the US got the bad side of the deal.
The truth is probably somewhere in between - and it's only a provisional deal for now.
I don't think the US got much out of it. But a 'trade deal' that leaves a higher tariff on British goods than a few weeks ago doesn't warrant obsequious 'gratitude' from our silly PM. It's absurd and dishonest.
I think you're right. The amount of money saved -if any -will not cover the reputational damage of whoring the country out for a pat on the bottom from Trump. And not even his bottom but Mandleson's.
Supporting Starmer because the other contenders are worse is getting increasingly difficult. His breathless trip to the car factory where he had his choreographed dial-in with Trump was unbearable. Mandelson's poodle act with Trump was even worse. Sometimes you just can't find the words
If I understood you, what matters to you most isn’t what they deliver, but how they do it.
It’s not what you do, it’s the way that you do it?
Comments
If a society had no kids, and imported a bunch of 18 years olds every year, how would that be different from one where there were a bunch of kids born and there was no immigration?
* I guess technically two
I have various similar tales from close family in recent years.
Getting the sods to discharge someone elderly is a bloody nightmare and yet they scream 'beds, beds, beds, money, money, money' all the time.
Indeed under the BMG poll only the Greens would be worse off under FPTP than the Tories in terms of MPs won relative to voteshare, FPTP also now gives the LDs a solid base of around 70 MPs while the BPG poll would give the Tories less than 50 MPs when PR would give them over 100 seats on 19%.
One Nation Tories like Grieve in the Guardian are now openly pro PR
Hence Wes and Darsi trying to shift funding to GP and away from hospitals.
1. Vitamin D deficiency. Most of us in the UK are deemed vitamin D deficient to an extent, and this is associated with diabetes, heart disease, auto-immune conditions and cancer. Those with darker skins are at greater risk, because their skin absorbs less from the sun. Those who add modest dressing must be considered at even greater risk.
2. First cousin marriage. The medical and developmental problems associated with being the child of first cousin marriage can be serious. https://www.bbc.co.uk/news/articles/c241pn09qqjo
That is what the NHS has become very good at - prolonging life, into a period of spending a fortune on managing chronic conditions.
You can spam as much incorrect literature as you want, you are wrong. The data is that the NHS spends far more money on the elderly, and we have far more elderly people now. That is the nub of it.
Boomers getting old and staying alive is expensive. That's it.
https://substack.com/home/post/p-163081519
No
We have:
An ageing society
Decreasing IQ
Low birthrates
A process state which inhibits innovation and development for various reasons (Net Zero, Woke, etc)
Increasing sectarian/religious divides
And so forth
Mass immigration deeply worsens some of these, and only somewhat and temporarily ameliorates others. It's a bad idea. Let's stop it and try something else
You may say "Leon stop banging on about migration" but I suggest that is ill-advised on the day a poll shows Reform as the leading party, and ten points ahead of the governing party
Or, to put it another way, a ... errr ... tax.
Real spending per capita increased by 4.6% per year between 1995 and 2009. Based on the change in our demographic profile, you'd have expected it to grow by 0.2% per year.
Much of the difference is income effect - you'd expect spending to increase as our economy increased in size. But there's a chunky, unexplained residual of 2.8%.
https://www.spectator.co.uk/article/medical-migration-is-crippling-frances-healthcare-system/
But if they significantly increase their current MP count no one will really notice that much.
Paper campaigns will become much more explicitly so, so that Labour voters in -say- the Isle of Wight East seats know that they should be voting Green.
There is a world of difference between dying of a short, sharp illness and being kept alive with a litany of chronic conditions. The NHS has become very good at keeping people alive with a litany of chronic conditions, but those conditions don't go away, they merely get managed and more keep getting added. The more successful you are at managing those conditions, the more you then need to manage on top.
They might disappoint some people if they cannot immediately freeze or reduce council tax, but I wouldn't think that would doom them immediately, and in some areas if bold enough on what to stop doing they could even manage a freeze and get a PR win.
Albanase and Labor though are likely to win a third term after handing Dutton and the Coalition their worst ever post war defeat.
The AfD are also still well short of the 40%+ or so they would need to be polling to have any chance of ousting the CDU and SPD government next time as well
By contrast, in the healthcare situation in the US is pretty dire. But they would jump straight to the good stuff...
🤣 I nearly wet myself when I read that. You mean you have doubts these Trump and Musk acolytes might not run them well?
Yes, I do have doubts that people who've never held public office might find it a challenge, as would newly elected Conservatives and Labour councils. However, their attitude to the job seems excellent and singularly lacking in the complacency and entitlement that oozes out of the legacy parties, so neither would I bet against them.
rcs has shown you the data that matches what I'm saying, but you keep spouting out meaningless bits like "YODO" or "last 12 months" without realising that the NHS has become experts at dragging the last 12 months into a last 48, 72 or more months nowadays.
(good luck)
(more than half of MPs were newly elected in 2024 I beleive)
Matthew Gertz
@MattGertz
Pirro is the 23rd former Fox employee Trump has named to his administration.
The challenge in health is on one side an aging population with increasingly complex health requirements (the alternative is we bring back smoking and lung cancer - a very quick and cheap death) vs clinical and technological improvements. (Eg ?DVT has moved from overnight admission to day case to managed in the community within 2-3 years).
The challenge is that productivity improvements (QALY / £Input) is not the same as cheaper
I quite like the REAL centres analysis of trends but they are way of 0.2%
https://www.health.org.uk/real-centre-publications-and-analysis
Table 2.1
https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/
But I agree either way you. See also people on zero hours contracts where time offf for a GP = sacked
This unpalatable option for governments is kicked down the road as parties are busy trying to win elections so don’t want to admit the scale of the problem .
What we get is scapegoating of sections of the community as simplistic solutions are peddled .
Cutting immigration even to levels that the public might seem accepting of won’t solve the problem. I think most accept current levels are much too high . So when they come down which they will what happens then ?
Until parties accept the scale of the problem and a cross party consensus can be found the moving of the deckchairs on the Titanic will continue!
"The rules on food standards have not changed and they will not change as a result of the deal," said Chief Secretary to the Treasury Darren Jones.
https://www.bbc.co.uk/news/articles/c89pw3j7z9zo
But it’s Labours inability to police it properly that’s the actual question, checks at the border have already fallen apart, before adding US beef imports to the mess. Are borders resourced enough to do all the checking the laws say must happen? in all the delays and switch to checking happening more now at destination rather than border, it’s a weak system.
Do we really think the ban on personal imports from EU of all meat and cheese is policeable, when illegal imports were already on the rise before they brought this in?
Mark my words, something bad is coming thanks to this Labour governments failure to control meat and dairy imports into our country. something bad is going to happen.
Under the new five or more way party FPTP election coming in 2029 - Reform win.
https://londonrail.uk/architecture/a-euston-station-era-ends/
How do you measure migrant costs? The question the OBR can’t answer
There is growing concern in government, shared by Morgan McSweeney, the prime minister’s chief of staff, that the benefit of immigration is being overstated because OBR does not take into account the additional costs of immigration-fuelled population growth to public infrastructure and services in its official forecasts.
In October the OBR for the first time started publishing an estimate of the fiscal impact of migrants across their lifetime and broke it down into highly paid, average and low-wage migrants, but it cannot incorporate this into the official forecasts.
It also assumes that each additional person would require an increase in public spending of £20,000 to cover for the extra strain on public infrastructure and services.
https://www.thetimes.com/article/b69aa91e-511a-4773-ba1d-e680306f3147?shareToken=bf40f23c1def5e142f6e2ed9e718c043
@JosephPolitano
·
56s
I’m a broken record on this but the key to understanding Trump’s trade policy is that he just thinks the act of importing is itself an economic loss.
https://x.com/JosephPolitano/status/1920985406356476133
The leader of Reform UK is an extraordinarily protean politician and more pragmatic than is generally understood.
By Jason Cowley"
https://www.newstatesman.com/politics/2025/05/farage-rising
https://en.wikipedia.org/wiki/Gordon_R._Dickson#Novels
As for combat between 100 men and a gorilla, I think the men would win easily if even a few of them were trained on martial arts. Especially if they had a quick course on gorilla vulnerabilities.
"There were timelines branching and branching, a mega universe of universes, millions more every minute. Billions? Trillions?
Trimble didn't understand the theory, though God knows he'd tried. The universe split every time someone made a decision."
(The story is in a collection by the same name.
For a better explanation of the "many worlds" theory, don't ask me, consult your local quantum mechanic.)
That's going to be the question for left-of-centre voters: do they prefer a potential Labour minority government, with Lib-Dem+Greens support, or do they prefer a Reform majority government ? I think, a very large percentage of centre-left voters would prefer the first option.
That was the data from the poll results in this thread: https://www1.politicalbetting.com/index.php/archives/2025/05/08/this-bodes-well-for-labour-to-receive-tactical-votes/
Around 77% of Lib-Dem voters preferred a Labour+Lib-Dem+Greens coalition & only 5% preferred a Reform-led government.
This is overt nuclear signaling btw
Pakistan pursued similar signaling during the 2019 skirmishes until the U.S. State Department stepped in to defuse the situation.
https://x.com/John_A_Ridge/status/1921031262891852166
“There has been no evidence introduced by the government other than the op-ed. That literally is the case.…There is absolutely no evidence that she has engaged in violence or advocated violence”
said U.S. District Judge William Sessions.
https://x.com/RpsAgainstTrump/status/1920920359140028730
The Trump admin’s position here is that they want a judge to halt her order granting a guy the right to self-deport — because they want to instead detain him, keep him in custody for weeks/months, and THEN deport him.
She ruled that ICE is trying to punish him, not deport him.
https://x.com/ReichlinMelnick/status/1920226500931932658
The men should win versus the silverback, but I wouldn't want to near the front of the order.
The truth is probably somewhere in between - and it's only a provisional deal for now.
https://en.m.wikipedia.org/wiki/Tortoise_Media
But how much does it matter ? No one believes the flattery is sincere (with the possible exception of Trump).
We must deal with the senile loon as best we can.
Destroy them with fire, destroy them now.
"The Home Office fears that annual net migration is going to settle above the 340,000 level expected by the government unless radical policies are introduced.
Officials believe that as well as underestimating the levels of long-term immigration to the UK, government forecasts are also overstating its economic benefits.
They fear that from 2028 net migration will be closer to 525,000 — currently the high end of the Office for National Statistics (ONS) projections — because migrants are staying for longer than previously thought."
"Immigration and economic experts have also warned that the official economic forecasts only take into account the initial few years or so of a migrant’s life in the UK, which is often when foreign workers are contributing the most to the economy and the public purse because they are paying taxes but cannot claim benefits for at least five years. They are also unlikely to use the NHS as much as they will later on in their lives."
https://www.thetimes.com/uk/politics/article/net-migration-forecasts-labour-89rm85fb8
The assumption is that it's a 'naked rush' on the gorilla, in full-view. Or, like a Steven Seagal or Jean Claude Van-Damme film where each man approaches the gorilla individually, in turn, to 'have a go'.
In reality, humans would use their brains - even if naked and unarmed. Some men would provoke, entice or stalk the gorilla whilst luring it into a hole or trap curated by others. And then it'd be easy prey.
On the negative side: how are we measuring the impact on British people of there now being fewer GPs per citizen?
On the positive side: how do we measure if a business chose to set up in the UK rather than (say) France, because of how easy it is to get multilingual staff?
Measuring them all properly is incredibly difficult, because most people - however much they might claim otherwise - come to the question of immigration with their minds already made up. It's classic cognitive dissonance: they either see the right of people to live where they like as something that should be preserved and look for evidence that it is economically beneficial; or they come from a perspective of being perturbed by the changes to their local community, and look for evidence it is economically harmful.
Supporting Starmer because the other contenders are worse is getting increasingly difficult. His breathless trip to the car factory where he had his choreographed dial-in with Trump was unbearable. Mandelson's poodle act with Trump was even worse. Sometimes you just can't find the words
The rest is excuses, IMHO. This is a mainstream government department arguing for it, somewhat to my surprise, and HMT only seriously consider the next 5 years in their models.
You have to assume immigrants are coming here for life. The failure to do so is, err, causing political problems, like the total collapse of the Conservatives, and the triumph of Reform.
It’s not what you do, it’s the way that you do it?