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We'll call him Bill; tall thin. Widowed. Once in business, now retired. Can't shake off the habit of wearing a pinstriped suit and a military tie.
Bill is now one of the 'usual suspects'. On the committee of the CAB, Tory councillor, fundraiser for the hospice, volunteer driver at the Trust and with an interest in anything that will fill the empty days between a game of golf and a hand of bridge. Local charities and local politics are the beneficiaries of the Bills of this world.
We had an earnest conversation about the future of the NHS. Bill is numerate and understands the big-blue-bit-of-death. He gets the fact that the party he canvasses for, drops leaflets for and defends until death have made a mess of the NHS. His community involvement lays bare a picture of health and social services, confusion and pressures that his neighbours and friends don't see. He is not keen to amplify.
In the middle of a conversation about NHS funding Bill said something that sounded odd... scripted. Like he had learned it. It came out by rote but I got the impression he was uncomfortable saying it.
'... we have to deal with the deficit first, a strong economy underpins everything...'
On the way home I thought about Bill and what he'd said. It is hard to argue with. Nevertheless, I was cross with myself; I should have challenged him. He was trotting out lines from a Tory Central Office briefing that will be used a million times on the doorstep, up and down the country over the next 90-odd days before the election.
Electors will be carpet-bombed with that phrase. Indefatigable, solid, around the kitchen-table logic. Really?
Bill's been conned. He's been brainwashed. There is a world of difference between debt and deficit. At its most basic, debt is how much the government owes. Deficit the difference between what the government takes in in taxes and what it spends. Get it right and there is a surplus; wrong and the government has to borrow to make up the difference and that adds to debt. The rest of us might call it an overdraft.
There are three ways to cut the overdraft. Screw government expenditure right down and don't add to the problem. Go hell-for-leather for growth and hope to harvest more taxes and pay it off, or the third; do both.
Here are a few random factoids:
- Before the financial crisis Labour was borrowing less than the Major government in 1997
- The world-wide recession, in 38 countries, was not caused because Labour spent too much on schools and hospitals.
- The present government, in the last 5 years, is responsible for �517bn of the trillion+ accumulated public debt compared to the �472bn accrued during 33 years of a Labour led Britain.
- There were two years of budget surplus under Mrs T and four under Mr Blair.
- UK debt grows at �5,170 per second.
- Both debt and borrowing are up.
- It is not correct for the Prime Minister to say we are paying down Britain's debt.
- The economy was growing at 2.6%pa. The latest figures reveal 0.5%.
- The turbulence in the Eurozone and elsewhere may make our goods more expensive and potential customers may have less money to buy from us.
These facts (and I have no doubt you could find facts to challenge the facts and facts to challenge them) are not recited merely to underline the economy still stands in jeopardy. They are more to demonstrate there is not much happening to sort it out. If austerity is supposed to be fixing the economy, it isn't.
The NHS commands about 9.3% of GDP and the EU-15 average is 9.9%. An average that includes countries facing austerity, just like us and some places worse. To ease the pressures Tarzan wants a gargantuan step change in NHS productivity to 3%. Historically we've managed 1.5%.
My guess is, if asked, even people like Bill would pay a bit more in taxes, hypothecated for use by the NHS exclusively, to give it some headroom; but not to pay down debt.
The problem is; no one is asking.
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'What is the point of a select committee' come and join me in conversation with Dr Sarah Wollaston MP, chair of the Health Select Committee.
Kings Fund 11th March - details here.
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roy.lilley@nhsmanagers.net
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