Graphs at a glance: Office for National Statistics shows people in the bottom 10% areas of deprivation can expect 18 fewer years of health than those in the top decile, and 9 fewer years of life.

It is not just money the poorest get the least of. It is also life itself. Office for National Statistics (ONS) figures show life expectancy drops dramatically in areas of greater deprivation. Perhaps that's not news for many of you.


However, even more dramatic is the drop in the number of healthy years people in the lower deciles of deprivation can expect. (The ONS measures "Healthy Life Expectancy" as the number of healthy years you expect to have over the course of your life, the rest presumably being not healthy).

A male child born between 2011 and 2013 from the top (least deprived) decile can expect:

a) to live 9 years longer than a child from the bottom (most deprived) decile  

b) to have an extra 18 years of good health than a child from the bottom (most deprived) decile

Figures for female children born in 2011-2013 show a smaller gap in Life Expectancy, but a slightly larger gap in Healthy Life Expectancy.

Doubtless there are many factors involved in the loss of 'healthy years' by those suffering greater deprivation. Many of the "Elementary Occupations" are harder and more hazardous on the body than a career behind a desk wielding a mouse. These Elementary Occupations include:

• Sales and services elementary occupations
• Agricultural, fishery and related labourers
• Labourers in mining, construction, manufacturing and transport 

 
MPs bleating for more pay claiming they sacrifice their lives for their jobs maintain a stubborn shameless ignorance of those who quite literally sacrifice years of their lives and more years of their health. MPs will still be collecting their parliamentary pay, pension and perks for years while many of their contemporaries in the bottom decile are getting flowers in hospital, or pushing them up in a cemetery.

Cheaper foods, affordable to those from the lower deciles of deprivation, are often more unhealthy. 'Lean' minced meat generally has much less gristle and fat than the cheaper stuff. European regulations define the qualities of mince:

As usual, the UK government courageously caved into the food industry lobby to open up a loophole to allow worse stuff to be sold in the UK:

• allow lower quality "cuts of meat in minced meat that may otherwise have been discarded" 

and

• allow "minced meat to be placed on the market with an excess of thirty percent fat for minced pork or, in the case of minced beef, over twenty percent fat."

The reality is even when austerity cuts are imposed equally on all, they do not impact all equally. Evident from the graphs above, those in the lower deprivation deciles will be hit more by ongoing cuts to healthcare. 

https://www.gov.uk/government/statistics/english-indices-of-deprivation-2010

The graph above shows the levels of deprivation in the various regions of England. (An "LSOA" is a small area, like a town, within a region - click here if you are interested to know more). A National Audit Office report on healthcare funding in England showed many deprived areas getting much less money than they should based on the government's own formula for target funding:

A child born between 2011-2013 in the lowest decile can expect a gob-smacking 18 fewer healthy years in its lifetime than its contemporary born in the top decile. This situation has developed over decades of successive governments of all complexions. 

Ultimately, political parties seeking election don't act in your interests but in their own interests. If they think they can get your vote, or at least you won't vote against them, for nothing then they will give nothing. 

For political parties to work in their own interests by working for your interests, make sure you vote for whoever will serve you best. If that means none of them, then go to the polling station and spoil your ballot (it will still be counted).

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Our NHS is short of £5bn a year. But comparable countries' public/private mix costs them even more

We're told we'd need to find an extra £5bn every year to be able to afford an NHS that maintains standards, free at the point of delivery.

We're told it's only possible if we allow the private sector to take on more of our healthcare delivery.

We're told that other countries, including the progressive lefty ones, use a mix of public and private to be able to afford modern healthcare.

But a look at the data from other countries shows...

• Our system is the most efficient and cost effective.
• We’re spending less than almost everyone else – i.e. not enough.
• If we spent more, it should be on the system that is the most efficient and cost effective. Ours.

First, here’s the graph from a report by NHS England, showing how funding is falling behind spending requirements.

Now take a look at the costs, per head, of all the OECD countries. You’ll see that every nation has a mix of public and private provision, to varying degrees. What it shows is that the UK spends less than almost any nation comparable to ours.

  

What else does it tell us? If we had almost any of the other comparable nations’ public-private mix, we’d be spending more than that £5bn extra already. 

• Any other system we choose that costs approximately $125/head (=£83/head) more than ours, will end up costing us more than that £5bn the NHS needs.
• 60m people in the UK
• 60m X £83 = £5bn

Let’s now dig a little deeper into the performance of each country: quality, accessibility, efficiency, and results. The Commonwealth Fund, a healthcare think tank based in the US, ranks a range of comparable countries, by different criteria. The UK came top in most, and overall.

You’ll note that the UK comes almost bottom in one, very important criteria: Healthy Lives.

Compared to these other nations, our overall mortality rates, infant mortality, and life expectancy figures are indeed among the worst. But isn’t that because we’re spending less than the others, rather than because we don’t have enough private provision?

There is no doubt one big advocate for spending that extra £83 per head: the private healthcare companies and their friends in government, on condition none of it is spent on the NHS.

Looking forward, our healthcare system will need to find extra billions not just for one year, but for every year due to ageing populations and more expensive yet better treatments. But so will every other nation, whatever their mix of public-private delivery.

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Increasing NHS spending makes good business sense

Fee and KJ pitch Chris with a brilliant idea it seems no one's thought about...

SOURCE GUARDIAN: NHS will need an extra £65bn by 2030, say analysts

The Health Foundation analysis identifies the sum as the extra amount of Treasury funding the NHS will need by then because it is unlikely to meet unrealistically optimistic productivity targets. It says the NHS will need its budget to rise by 2.9% a year above inflation each year between 2015-16 and 2030-31 if it is to maintain the standard of services and avoid having to ration access to treatment. That 2.9% is higher than the expected 2.3% annual rise over that period in gross domestic product, which means the government will have to boost NHS spending faster than the economy is growing. The £65bn will also be needed because the health service is likely to make only 1.5% annual gains in productivity and not the 2% and 3% envisaged in the Five Year Forward View, NHS England’s recent blueprint for securing the service’s uncertain future. The Health Foundation wants whoever forms the next government to make reaching “a public and political consensus” on the NHS’s long-term funding needs a priority, and also to give it further additional money from April as a “transformation fund”, so new ways of delivering healthcare can be created.

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Graphs at a glance: NAO report shows public spending cuts are pushing the NHS into a black hole of deficit

The Office of Budget Responsibility's "Economic and Fiscal Outlook 2014", published in December 2014, stated that by 2019-20 public spending as a share of GDP will fall back below its lowest level since the Second World War. 

When questioned about this on BBC Radio4's Today Programme George Osborne retorted "Has the World fallen in? No it has not!". If Osborne's measure of economic success is the World not "falling in", perhaps he isn't doing so badly. Others may use other measures.

We are in a 'low wage recovery', where the rewards of relatively strong GDP growth are being kept by the few. Lower wages for the many and lowering tax rates for the few (top rate income tax and corporation tax) means no increase in government receipts.

The OBR put this planned collapse in spending in pounds and pence:

"Between 2009-10 and 2019-20, spending on public services, administration and grants by central government is projected to fall from 21.2 per cent to 12.6 per cent of GDP and from £5,650 to £3,880 per head in 2014-15 prices."  

The politically non-aligned Institute for Fiscal Studies (IFS) warned of more "colossal" spending cuts to come if the government aims to eliminate the deficit by austerity alone: 

Colossal cuts to come, on top of the colossal cuts that have already happened. The NHS is evidence of what is happening. A report by the National Audit Office shows National Health Service providers are falling into deficit like a row of toppling dominoes. The report states:

"The total number of providers in deficit increased from 25 in 2012-13 (10% of all secondary providers) to 64 in 2013-14 (26% of all secondary providers).

There were 5 NHS trusts in deficit at the end of 2012-13 and 22 at the end of 2013-14 [plus one more trust that was dissolved in October 2013, making a total of 23 trusts in deficit during 2013‑14].

The number of foundation trusts in deficit doubled from 20 in 2012-13 to 41 in 2013‑14."

The graph below shows how the dominoes are falling. 18 trusts which had neither a surplus or deficit in 2012-13 went into deficit in 2013-14. The graph shows another 10 trusts in 2013-14 with neither surplus nor deficit, perhaps to be the next dominoes to fall?

Fuscia and green text in graph above added by us

In November 2014 Colchester Hospital declared a "major incident" in which the hospital implored people not to go to its Accident & Emergency (A&E) unless they really really needed to. A result of the appalling Department of Health "marginal rate rule for emergency admissions"? This rule states a hospital gets 70% cut from its payment for any patients above the number they admitted in 2008/09:

"The 30% marginal rate rule for emergency admissions - under which providers are paid less for admissions over a certain level - was introduced in 2010 following concerns over growing emergency admissions."

This rule was specifically designed as a penalty to make hospitals restrict their A&E services.

Are the Tories fighting a righteous fight to bring down the cost of an excessively expensive health service? Not according to figures from the World Bank they aren't. UK health spending as a percentage of GDP is below the US, France, Germany, and below average for the European Union overall.

World Bank Figures

George Osborne did his best to create a smokescreen until the 2015 election. Until then he lobs occasional wads of cash at the NHS to keep it ticking over. Such as the £300 million announced in November 2014 to help the NHS get through the winter.  Dr. Mark Porter, the British Medical Association committee chair, dismissed this £300 million as a 'sticking plaster' saying there is a £30 billion funding gap opening up in the NHS. 

The National Audit Office report in November 2014, before the £300 million mentioned above was announced, said in 2013-14 another £500 million was lobbed at the NHS to keep the creditors at bay and to pay staff:

"[The] report notes that financial risk is increasing in NHS trusts and foundation trusts, and those in severe financial difficulty continue to rely on in-year cash support from the Department of Health. In 2013-14, over £0.5 billion extra money was issued to 21 NHS trusts and 10 foundation trusts to ensure that organisations in difficulty have the cash they need to pay staff and creditors."

Tossing a few hundred million here and there to plaster over the cracks is evidently the government's short term strategy to stop the World "falling in" before the next election. Will Dave and George pull it off? It's up to us voters, and we'll find out in May 2015.

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Graphs at a glance: NAO report shows public spending cuts are pushing the NHS into a black hole of deficit

The Office of Budget Responsibility's "Economic and Fiscal Outlook 2014", published in December 2014, stated that by 2019-20 public spending as a share of GDP will fall back below its lowest level since the Second World War. 

When questioned about this on BBC Radio4's Today Programme George Osborne retorted "Has the World fallen in? No it has not!". If Osborne's measure of economic success is the World not "falling in", perhaps he isn't doing so badly. Others may use other measures.

We are in a 'low wage recovery', where the rewards of relatively strong GDP growth are being kept by the few. Lower wages for the many and lowering tax rates for the few (top rate income tax and corporation tax) means no increase in government receipts.

The OBR put this planned collapse in spending in pounds and pence:

"Between 2009-10 and 2019-20, spending on public services, administration and grants by central government is projected to fall from 21.2 per cent to 12.6 per cent of GDP and from £5,650 to £3,880 per head in 2014-15 prices."  

The politically non-aligned Institute for Fiscal Studies (IFS) warned of more "colossal" spending cuts to come if the government aims to eliminate the deficit by austerity alone: 

Colossal cuts to come, on top of the colossal cuts that have already happened. The NHS is evidence of what is happening. A report by the National Audit Office shows National Health Service providers are falling into deficit like a row of toppling dominoes. The report states:

"The total number of providers in deficit increased from 25 in 2012-13 (10% of all secondary providers) to 64 in 2013-14 (26% of all secondary providers).

There were 5 NHS trusts in deficit at the end of 2012-13 and 22 at the end of 2013-14 [plus one more trust that was dissolved in October 2013, making a total of 23 trusts in deficit during 2013‑14].

The number of foundation trusts in deficit doubled from 20 in 2012-13 to 41 in 2013‑14."

The graph below shows how the dominoes are falling. 18 trusts which had neither a surplus or deficit in 2012-13 went into deficit in 2013-14. The graph shows another 10 trusts in 2013-14 with neither surplus nor deficit, perhaps to be the next dominoes to fall?

Fuscia and green text in graph above added by us

In November 2014 Colchester Hospital declared a "major incident" in which the hospital implored people not to go to its Accident & Emergency (A&E) unless they really really needed to. A result of the appalling Department of Health "marginal rate rule for emergency admissions"? This rule states a hospital gets 70% cut from its payment for any patients above the number they admitted in 2008/09:

"The 30% marginal rate rule for emergency admissions - under which providers are paid less for admissions over a certain level - was introduced in 2010 following concerns over growing emergency admissions."

This rule was specifically designed as a penalty to make hospitals restrict their A&E services.

Are the Tories fighting a righteous fight to bring down the cost of an excessively expensive health service? Not according to figures from the World Bank they aren't. UK health spending as a percentage of GDP is below the US, France, Germany, and below average for the European Union overall.

World Bank Figures

George Osborne did his best to create a smokescreen until the 2015 election. Until then he lobs occasional wads of cash at the NHS to keep it ticking over. Such as the £300 million announced in November 2014 to help the NHS get through the winter.  Dr. Mark Porter, the British Medical Association committee chair, dismissed this £300 million as a 'sticking plaster' saying there is a £30 billion funding gap opening up in the NHS. 

The National Audit Office report in November 2014, before the £300 million mentioned above was announced, said in 2013-14 another £500 million was lobbed at the NHS to keep the creditors at bay and to pay staff:

"[The] report notes that financial risk is increasing in NHS trusts and foundation trusts, and those in severe financial difficulty continue to rely on in-year cash support from the Department of Health. In 2013-14, over £0.5 billion extra money was issued to 21 NHS trusts and 10 foundation trusts to ensure that organisations in difficulty have the cash they need to pay staff and creditors."

Tossing a few hundred million here and there to plaster over the cracks is evidently the government's short term strategy to stop the World "falling in" before the next election. Will Dave and George pull it off? It's up to us voters, and we'll find out in May 2015.

Read More

Graphs at a glance: Government reforms of Higher Education and Family Health created thousands more Administrator jobs, but no more teachers or nurses.

Some interesting graphs we stumbled across during our general research show how Administrators have been the big winners from reforms in both the Higher Education and the Family Health sectors.

It would be interesting to know if this is the case in other areas of the Public Sector. If you come across any more, please email them to us to graphs@rippedoffbritons.com

1) National Audit Office report, "Further education and skills sector: implementing the Simplification Plan", shows: 
Between 2010/11 and 2012/13 the total number of "Administration and central services" staff rose by 5%. Teaching and teaching support staff together fell by 8%.

2) Health & Social Care Information Centre report shows:
Between 2009 and 2013 the number of GPs remained about constant. However, "Admin & Clerical" rose by about 20%.

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Graphs at a glance: Oxford University study predicts nearly half of jobs will be replaced by computers in the next 10-20 years.

We Britons are an optimistic bunch. The graph below by Glassdoor, a recruitment company, shows we  consistently believe our work colleagues are much more likely to get fired than we are.

Graph by Glassdoor

Is it this native optimism that encourages politicians to cut public services and rip up safety nets for the unemployed and the disabled? Because we are so confident we ourselves won't need them?

If so, our confidence is sorely misplaced. Office for National Statistics figures show how the UK manufacturing industry collapsed between 1979 and 2013, with 60% of all manufacturing jobs disappearing:

If you are heaving a sigh of relief that you aren't employed in manufacturing, hold that sigh!


A study done at Oxford University states that nearly half of all jobs are at a high risk of disappearing over the next two decades due to computerisation.

The colours in the graph represent different occupations:

The graph shows the following occupations with a high (more than 70%) probability of being wiped out: 

• Office & Administrative Support
• Sales & Related
• Service

And shows the following with a high probability of surviving: 

• Healthcare, Practioners & Technical
• Education, Legal, Community Service, Arts, and Media
• Management, Business and Financial

Of course as some occupations are extinguished others are created. However, according to figures by the TUC in the period between 2010 and 2013 nearly eighty percent of net job creation "has taken place in industries where the average wage is less than £7.95 an hour". 
 
Like slowly boiling a frog in a pan of water, the government hopes to cut adrift those who rely on public services without them noticing it. 

The government knows that with growing inequality more and more people will need public support. Something they would rather cut away before the voters notice.

Most people don't need a hospital today. But most will need a hospital one day, for themselves or their loved ones. Most people don't need an income top-up today in the form of state benefits and pensions, but most will need it one day.

Beware of voting in governments who would give away your rights to public services and support. They are your inherited rights just as much as a landlord has the right to receive rent on his or her inherited properties. 

In a society of growing inequality, once these rights are gone all that will be left is the charity of the unequally wealthy. What you receive by right you will only get by going cap in hand.

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The most fearsome beast in the political jungle is you, the voter. Now is the time to wake up and roar!

A long game is being played on the British public by the political classes. It is a game aimed at reducing our personal expectations from life in Britain. It started with the Tories in 1979, and continued through Labour and Coalition governments since then. 

The game was played quite subtly until the banker induced crash in 2008, but since then all the delicacy has been dropped. Not because the banker crash created a crisis, but because it created a cover.


In recent years we have seen wage freezes, benefits cuts, and the erosion of our pensions. Our access to legal aid has been sliced. Employment protections and the right to strike are being attacked. Services from libraries and public parks to police officers and defence are being scrapped. We now get unqualified teachers in “free schools”; unqualified translators and under-qualified barristers in the legal aid system; paramedics doing what doctorsused to do; reservists doing what the professional army used to do. 

Even our expectations of being able to sit down are to be cut. The Department of Transport is buying new trains where only two in five passengers will have a seat on journeys exceeding an hour. Naturally we are told every time something is taken away it is done for our own good. A railway spokesman said about the seat reductions:

"[It] ensures people can get on and off in under 30 seconds in central London"

Apparently the inconvenience of standing for over an hour is a price well worth paying if you can get off in 30 seconds. Certainly it is worth it for the train companies, who can pack us tighter into a carriage with fewer seats and more standing room. 


Now our expectations of family health provision are being realigned. Rather than expecting to get care from our GPs, we are being retrained to go to the chemist when we are feeling poorly. 

Some justify this claiming there is a crisis recruiting GPs because the job is so dreadful. They assert it would be sensible for us to take the pressure off the stressed doctors, and go to a chemist instead. However, a report by the Health and Social Care Information Centre (a government body) shows that in the 10 years up to 2013 the number of GPs has more than kept up with growth in the population. The report states for 2013:

• There are 40,236 headcount General Practitioners, a decrease of 29 (0.1%) since 2012 and a rise of 6,672 (19.9%) since 2003 (an average annual increase of 1.8%).
• This represents 36,294 Full Time Equivalent (FTE) GPs, an increase of 423 (1.2%) since 2012 and an increase of 6,209 (20.6%) since 2003 (an average annual increase of 1.9%).

[According to the World Bank the UK population has grown by about 0.8% per year. Therefore the number of GPs has grown twice as fast as the population.]

The real reason for pushing us out of GP surgeries into the local chemist is cost. A study by the Royal Pharmaceutical Society, the professional body for pharmacists, stated the cost of treating 'common ailments' was:

• £29.30 per patient at a chemist
• £82.34 per patient at a GP surgery
• £147.09 per patient at a hospital A&E (who took the strain when GPs stopped out-of-hours work)

GPs are presumably too clever to think the objective here is to reduce their workload. Once their workload is reduced, the government will reduce them.

The Government comes up with all sorts of ruses to claim there is plenty of money in the system regardless of the cuts. The most hackneyed being unspecified 'efficiency savings'. At least Jeremy Hunt, Secretary of State for Health, showed a bit more imagination helpfully pointing to billions of pounds worth of extra health services that could be had without spending a penny more, by having fewer mishaps in hospital:

"I talked about how unsafe care is costing the NHS between £1bn and £2.5bn each year – money that could be invested in more front line staff, better training, better equipment and more time for you to care."

Hunt even provided a helpful poster one can print and stick up - click >>here<< - just in case the doctors and nurses felt like tripping over a misplaced patient.

The government asserts that cuts are needed to pay off the costs of rescuing the banks. However government protestations of austerity were undermined in October 2014 by their promised £7 billion tax giveaway so long as they won the next election, and by the EU's €2.1 billion surcharge imposed due to Britain's economy doing better than had been thought. Credit Suisse's annual Global Wealth Report for 2014 also shows the UK top of household wealth growth, and second only to the USA for national wealth growth. 

Credit Suisse

The reality is all these cuts are not a short term measure to get over a temporary problem with public debt. The cuts are a permanent removal of public services, with the objective of permanently reducing taxes. A graph from the Office of Budget Responsibility (OBR), a body created by the government to provide independent economic forecasts, shines a light on this. The graph shows George Osborne’s current economic strategy will bring government consumption to the smallest share of GDP since before 1948 when the NHS was founded. 

Office of Budget Responsibility "Economic and Fiscal Outlook December 2013"

Those who point out the top 1% of earners pay a third of all income tax (making up about 10% of all taxes) dodge a couple of key questions:

1) If the top 1% pay a disproportionate share of taxes, then tax cuts will disproportionately benefit the top 1%. Why should the other 99% vote for that?

2) Why does the top 1% get such a disproportionately large share of income in the first place, that they have to pay those disproportionate taxes? You could reduce the proportion of income tax paid by the top 1% by paying them less and paying everyone else more!

The answer to the second question is apparently that market forces set pay. The most powerful force in the market doesn't realise its strength: it is the voter.

Public policy should have as a prime objective social justice for the general public, from the highest to the lowest. This is what provides the balance that makes Capitalism into a true success. Successful Capitalism allows even excessive pay and prices but balances that with taxation and public services. 

Capitalism gives rewards to the strong. Voters are strong.

It is for the voter to take the advice of Adam Smith, that Capitalist icon: Don't depend on the benevolence of others. Our polarised political parties have neglected their voters, confident that they have nowhere else to go. With UKIP in the south and the SNP in the north, things are changing.

Let the political parties know that you will vote for the party that will look after you! And if they don't deliver what they promise, then make it evident you will punish them the next time you are at a ballot box.

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