The combination of inflation, a productivity collapse and higher interest rates means public spending is up by £350 bn this year compared to 2019.
No wonder taxes are so high. If the public services got their productivity back up to 2019 levels they would cost £30 bn less. Productivity was down 15.2% in 2020, up 7.3% in 2021 and up 1.7% last year.Overall public sector productivity 2019 to end 2022 is down 7.5%.
October 1, 2023
Good morning.
I fail to see what I get for my money ?
But then again, I am just a taxpayer working long hours and do not get my food, rent or hotel, plus bills paid for me.
I’m clearly in the wrong game.
October 1, 2023
+++
All I can think of is (local tax) rubbish collection of multi layered plastic packaging which ( as with everything) I never asked for nor voted for nor wanted!
As for what is extorted at national/govt. level what on earth DO we get for it?
JR and a few other sane ones I guess.
But with the amount we pay they should ALL be as wise as Solomon!
The PM seems to be turning a light shade of blue around the edges?
October 1, 2023
Pickles was going to make sure weekly collections were reinstated- never happened. Another Tory govt failure along with freezing community charge, it went up year on year! I suppose another tax to help local authorities with boat people!
October 1, 2023
+++
Imagine if the council blokes took a hat round door to door.
Which is, after all, the basis of taxation, Penny for the Guy, door to door selling, Soul cakes etc etc.
Wouldn’t get much would they?
“Good afternoon Madame. Just wondering if you’d like to make a contribution to the Hotel Residents’ Improved Luxury Fund? Now, now Madame…no need for that…”
SLAM!
October 1, 2023
Pu lic service productivity will drop even more if departments are allowed to keep up their recruitment blitz.
There’s over 100,000 more on the public payrolls since before the pandemic.
Just what do they do.
October 1, 2023
@Ian+wragg – they all work in newly created Discrimination Departments. We even have the Chairman of the Conservative Party lecturing the media on how the Party going forward has the aim of Discrimination first when choosing Candidates – the best Candidates for the job are logically to be excluded. That the New Uni-Party Conservative faction for you, completely out of touch and stroking personal ego’s
October 1, 2023
State sector productivity? So much of what they “produce” is worthless or even of negative value anyway such as road blocking, net zero, their mad expensive intermittent energy agenda, the work and diversity lunacy, the gross incompetence in defence procurements and at the BoE, the net harm vaccine programme, the lockdowns, test and trace, police who tackle hate crimes rather than real ones, over regulation of almost everything, landlord licensing, the attacks on the self employed, encouraging EV and heat pumps, the BoE QE inflation programme, the soft loans for fairly worthless degrees (about 75% of them are) QE, HS2…
October 1, 2023
+1
October 1, 2023
@Lifelogic +1
October 1, 2023
“Productivity was down 15.2% in 2020, up 7.3% in 2021 and up 1.7% last year. Overall public sector productivity 2019 to end 2022 is down 7.5%.”
What is the provenance for these figures? Where do they come from? It is obvious that much of the new money given to the NHS has been spent on more middle managers and not ore medics, but 7.5% overall public sector represents a huge sum when the government employs 23% of the workforce.
REPLY. ONS
October 1, 2023
JR: “ONS”
So inflation just dropped magically out of the sky!? It wasn’t the Tory party that expanded money supply by 500% in 2020/21 ? In my opinion that was exact and primary cause of inflation.
JR: “If the public services got their productivity back up to 2019 levels they would cost £30 bn less. ”
If this pseudo Tory administration stopped spending £billions in Ukraine, it might be able to pay for better services in the UK.
What criteria do you use to measure the ‘efficiency’ of the Houses of Parliament? How much more efficient is Parliament today that it was in 2019 ?
October 1, 2023
Ah, Cameron was going to cut the number of MPs- did not happen. Most politicians other than China! Bonfire of quangos was another Cameron promise, the number increased! Additional 131,000 civil servants this year, tax cuts not possible says Hunt and Snake!
Does anyone have any reasonable argument for the huge number of Lords on the public purse teet? Blaire created the Environment Agency, no cut in our community charge for the alleged work carried out. LA took back rivers for flood defence and charged us extra!! EA allowed areas to flood!! The EA is a left wing waste of space EU directive implementation outfit.
October 2, 2023
Most of the Quangos are EU Directive Implementation and Monitoring organisations. If we’d LEFT the EU we could start scrapping, or at the very least downsizing them. But we haven’t LEFT, we are only semi-detached.
October 2, 2023
Yes, Hope, Complete and utter disfunction.
The latest humiliation, it turns out that the Challenger 2 tank has a ‘notorious’ flaw!
Did we know about that when we were told that the C2 was going to be a ‘gamechanger’ in Ukraine?
But, the Challenger 2 is a thirty year old design. Why wasn’t that ‘flaw’ identified and fixed before another military humiliation ? The Business Insider article says the flaw is ‘notorious’, that at least means it was well know, yet we sent Challengers into Ukraine knowing this vehicle was vulnerable, Why?
That’s a reasonable question to John Redwood too.
I see our defence secretary Mr Shapps ( Nice English name suggestive of the Pennines ) wants British ‘boots’ ( a euphemism for British servicemen’s lives on the line ), in Ukraine. Well, you should damn well give them a fighting chance with the best equipment and a tank with a ‘notorious’ flaw isn’t such a vehicle.
I’ve said it once before and I’ll say it again. We should draft a battalion from the children of MPs and Civil servants, which would be the first in to combat in any Politicians war. Let’s see how enthusiastic these snakes would be to send their own kith and kin into war zones in unarmoured Land Rovers ?
October 2, 2023
On September 21, US Sen. Josh Hawley ( R-MO ) After a meeting with Ukraine’s President Zelensky, said:-
“what the meeting revealed to me is that in the words of President Zelensky the conflict is a total stalemate, totaly frozen, I think was his words …”
And then he went on to say:- “… the administration told us yesterday, they want to spend $100 billion more, in the hopes that it will remain a stalemate“.
Yet on the 1st of October, Ben Wallace writing in the Telegraph, says ‘Ukraine is winning … ‘ Presumably, Wallace is agitating for the UK to throw away a couple of £billion more down the same black hole ?
Which of them is telling the truth, Mr Redwood, Senator Josh Hawley or Ben Wallace? Is the conflict a stalemate or is Ukraine winning? If the US administration wants to spend $100billion more – just to maintain the stalemate. That doesn’t sound like winning to me.
How much will the UK be expected to spend ?
No in the context of the financial state of the UK; Where Birmingham local authority recently filed for bankruptcy, we learn that twenty five more local authorities maybe bankrupt.
Next, you cannot be unaware of this news article ?
I think you, and the administration you support have your priorities completely wrong. You should be attending to the manifest problems people are experiencing day to day in the United Kingdom, before you spend billions of pounds in foreign parts of the world.
October 1, 2023
So no austerity then scorn ?
Your link shows no reduction in Government spending.
October 1, 2023
Daniel Hannan today:-
“It may be too late, but it is heartening to see Sunak governing like a true Conservative”
Well hardy a tiny delay on the mad EV agenda and the 20mph zones – all hot air and zero action he still even supports ULEZ he could stop it if he wanted to. He is still failing on small boats, NHS queues, growth, state sector debts and inflation (inflation he and the BoE caused). Still hooked on the net zero insanity. Not even trying on his 5 priorities it seems to me.
Certainly nothing remotely Conservative about Sunak. Highest taxes for over 70 years and appalling public services too. The state sector and scroungers are robbing/taking the piss out of the 80% who work in the productive sector. Not really even worth working very often, so we go into a doom loop of ever higher tax rates and ever less incentives to work.
October 1, 2023
The boss of Iceland supermarkets, who had hoped to become a Conservative MP, has quit the party, labelling it “out of touch”. The attack from Richard Walker came on the eve of the annual Conservative conference, as delegates gathered in Manchester. Mr Walker told the BBC’s Laura Kuenssberg that the party was losing touch with business and consumers. “It’s become clear to me over recent months that the Conservative Party are drifting out of touch with the needs of business, of the environment and the everyday people my business touches and serves.”
He claimed he was warned by senior Conservative figures that his outspoken views on the environment and social issues weren’t welcome, but he had concluded: “I won’t wear a gag to bag a seat.
“I am not prepared to change my values and principles to suit a party that has itself lost its way.”
Mr Walker had previously been vocal in his criticism of some Tory policies – including the plan of then-Prime Minister Liz Truss to scrap the top rate of income tax.
Sir John have you been warned about your written criticisms?
7.58
October 1, 2023
Well the tories have been anti-small business and the voters Socialists ever since Cameron too power throwing his first election by ratting on his Cast Iron promise, pushing green crap and failing to promise sensible tax cuts or sensible EU policies – thirteen years back – hence the dire coalition fiasco we had to suffer.
Richard Walker has surely worked the Tories are very unlikely to win and he might benefit rather more from not being on their losing side. 10% chance of a Tory Majority it seems from the betting odds and this against the appalling Starmer alternative!
October 1, 2023
Well it depends if Sunak can convince the gullible in the next 12 months more so than Labour that they need to be a bit Conservative. They’re both a bag of worms best avoided as Richard Walker has worked out. Probably best to remove all interests possible from the UK and let Lammy and Co. destroy it to the point where the present generation wakes up and smells the coffee.
October 1, 2023
Sunak gave away N.Ireland! I thought it said on the tin conservative and Unionist party! Trade description when it knowingly gives away our fishing waters, gives away part of our country, allows EU court to impose laws and fines across UK when we left! Sunak gives EU €2.6 billion each year to Horizon for EU competition and growth projects hoping EU might give some of our money back! Before he tells everyone to do more maths perhaps he needs to pass key stage 2 ! Idiot.
October 1, 2023
@Micky Taking
I’m a big fan of certain Iceland frozen meals (true)
Mr Walker should stick to what he does best.
October 1, 2023
I can’t imagine he might do worse than most of the current MPs, and there are going to be a number of vacancies – many seats are not going to be contested by the incumbent. Rat, Ship, waterline ….
October 1, 2023
This is because the Party Machine compile the shortlist and reject anyone with a Conservative instinct. Those being the very people that the Associations are looking for but can’t have since they lost the power to SELECT freely.
October 1, 2023
Here we go again Hannan another so-called expert one time MEP who got himself safely into the Lords – although how and why he got there is a mystery but nice gig if you can get it – and now after playing his part in spreading the great lie of the century about the sunny uplands sets out to defend Sunak for governing like a true conservative – as if he ‘Hannan’ knows anything more than anyone else – expert that he is.
October 1, 2023
@Lifelogic – Strange delay on EV’s – if a car manufacturer sells what the consumer wants and it is not an EV from 2030 they will be slapped with a fine. That is Conservative Government Punishment and Cancellation writ LARGE.
Hypocrites out to sink the UK – 90+% of the Worlds Governments have not sort to punish their People in this manner, they have protected their industrial base and economies. It is only the UK with its wreaking Conservative Government that seeks to Punish
October 1, 2023
We are certainly paying for the fiscally incontinent Johnson years.
October 1, 2023
Correction “fiscally incontinent Johnson and Sunak years.” Sunak signed off on all of the lunatic policies and QE to fund them.
October 1, 2023
All the way from Cameron, Osborne, May, Hammond, Boris, Javid, Sunak, Hunt. All funded the mad HS2 lunacy, the net zero energy insanity, the duff degrees… vast waste everywhere you care to look.
October 1, 2023
Somehow, somebody, somewhere has to stop this rotting fron the fish head downwards…..
Will a worthy PM please step forward?
October 1, 2023
Excuse me, JRs party promised to balance the structural deficit by 2015 and start paying down debt!! Goal post moved to 2017,2019,2021 and then abandoned!
Sunak and Hunt hoped we forgot so they reproduce the promise made five times before!!
October 1, 2023
@Donna +1
October 1, 2023
The PM is ‘The First Lord of the Treasury’ – it’s on the door of Nr 10 and his official title. No Chancellor can do anything other than what the PM allows/demands.
Johnson was the most profligate PM in history.
October 1, 2023
@Lynn Atkinson +1
Paid and empowered to administer everything he throws Taxpayer money at. What’s that, a 70 Year high for the Tax take, then add in the massive borrowing, massive interest payment, that at some time the taxpayer has to pay. These guys will be long gone, to more favourable ‘climes’, leaving those left behind actually paying for their incompetence.
October 1, 2023
Chin up Sir John, the Public Sector is recruiting even more Equality, Diversity and Inclusion bean counters, adding thousands to the small army of Cultural Marxists we’re already forced to fund. They’ll soon be beavering away scrutinising people’s ethnicity, faith, sexual preferences and gender and seeking to ensure that their “services” are only given to the most deserving – ie anyone who isn’t white, straight, Christian or claiming to be one of 1000 “genders.”
So not every part of the grossly over-manned public sector is unproductive and inefficient, only the parts which are supposed to actually be delivering the service we pay for.
The Not-a-Conservative-Party has done, and intends to do, SFA about it (although Steve Barclay has made some completely ineffective comments). Otherwise, it would at the very least amend the Equality Act or better still, scrap it. But that wouldn’t “be nice” so it won’t happen.
October 1, 2023
+1
October 1, 2023
+1.All talk, no action.
October 1, 2023
@Donna +1
October 1, 2023
The public sector is an obvious drag on the economy as with the BBC and are long overdue radical reform. I am not thinking of the men who empty my dustbins, rather the over manned Whitehall end of the CS. There are too many of them, many with woke and anti government agendas, most overpaid and rewarded.
Your conference is make or break for a Conservative programme to take the UK forward. Entrees like £1Bn are meaningless stocking fillers. High Street businesses need a total reset of the playing field to tempt them back, of which free parking would be a good first step. They have to compete with the internet with all their offshore tax lite advantages.
I await results from Manchester. It had better be good or it is au revoir a bientot.
October 2, 2023
Hunt says he is aware of the shortcomings of the bloated CS and has plans to reduce them in size. My judgement in six months on that. For me it should go further. End WFH, make them pay for their own pensions, a blessing for rate payers, financially insentivise the CS where appropriate, end their monopoly of the honours list, introduce hire and fire. Judge this government by results.
October 1, 2023
A real government would have done something about this situation – instead they make things worse by overtaxing us at every possible occasion while pouring £billions away in local and international drains.
They know exactly what they are doing.
By bankrupting us, the country will be in a very poor state to withstand the coming banking crisis – That will give them the excuse to impose a digital currency.
The novel 1984 would be considered a walk in the park compared to what the establishment have actually got planned. Even Tory MPs should be able to extrapolate the future from the myriad of oppressive regulations in place, anti middle class actions and the woke state of the nation.
October 1, 2023
+++
Not keen on the talk of “army on standby” as in Sweden ( bombs and stabbing) and here ( armed police lay down arms). Plus talk of similar in US.
It is too much like all the long term predictions of martial law.
October 1, 2023
actually most of us fear we are on ‘The road to Wigan Pier’.
October 1, 2023
Far too much of the spending funds waste.
October 1, 2023
Public sector productivity.
Passport office renewed two passports online within a week. Their processes worked.
Last year HMRC re opened a tax credit overpayment case from 2008 which they had already resolved in 2015 and paid me compensation. To resolve once more I had to raise a complaint so was once again paid compensation this week.
It took over a year and there was one response to four letters. When I phoned no one could take responsibility. This has cost HMRC interest on compensation twice.
In the public sector when things work all is fine and indeed good. When something goes wrong there isn’t the intellect, desire, authority or process to put it right.
Give the minions power to to act and productivity will increase.
October 1, 2023
Narrow Shoulders: “Their processes worked.”
I have to say the Passport office didn’t do too bad when I applied for my renewal. There was one oddity, I applied for my renewal a full three days before my partner, yet that passport came back before mine, which took another week. Although, I’ve paid enough tax so why a Passport costs anything is a mystery.
The really annoying thing is, on my first trip out of the United Kingdom since COVID mania, on return, I see the Passport office has spent ( I won’ t say invested ) £millions on new automated passport machines. ( Why they bother when you can just roll up the the beach at Dover, without any documents at all, is anyone’s guess. ) Anyway, guess what, after three tries, my brand new passport couldn’t be read by the machine. So I had to go to the back of the other queue to get my passport reviewed.
October 1, 2023
Never mind productivity. That debate accepts the headings of the expenditure and just asks for the spending on them whatever they are to be more efficient.
Where the H… is the money being spent? If it continues to be spent on the present subjects and we just ask for it to be done better, our bankruptcy will become more and more obvious. Expenditure on some subjects must therefore be ABOLISHED immediately. That must mean the closure of some government departments, agencies, so called advisory bodies and regulators. The idea that everyone with a cause or claim has validation and should get money must be rejected and not cynically and selfishly thought of a source of votes.
October 1, 2023
It’s welfare welfare welfare (5.6 millions) and vast increases of people doing very little in the public sector in all there forms. For whatever reason the Tory’s refuse to tackle it. Witness Barclays call to stop more diversity people in the NHS…….. ignored.
October 1, 2023
This is completely unacceptable.
The government should institute three firm policies:
1. The government must operate balanced budgets – this should be written into the constitution.
2. The public sector payroll must be reduced by 10% annually for ten years, bringing the parasitic load down to around 30% of the current level. Legislation and regulation must be removed at the pace administrators are sacked.
3. Public sector workers get the state pension when retiring, no more, no less.
At the pace this is deteriorating, soon no people will be left in the country to pay these insane bills. Our family only has one company in this country now, and we’re considering moving out completely. We no longer want to pay for the catastrophic mismanagement of government after government.
October 1, 2023
How can public spending not be spiralling out of control when there are so many guests to house, clothe and feed?
£8 million a day is it?
October 1, 2023
That is just for accommodation. Thereafter there is health, schooling, housing and other infrastructure.
Immigration at this level just imports poverty which someone has to pay for.
October 1, 2023
All part of the plan to reduce the UK to a third world country. Tax heavily, spend wastefully and increase state employment with inefficiency and diversity to destroy meritocracy, job satisfaction and performance.
Pursue massive immigration to reduce wages, to overload our institutions and infrastructure and to bring in third world misogyny and intolerance cultures together with 100,000 undocumented illegals to make the country less safe and 120,000 Chinese spies in our universities to steal our IP and keep the educational establishment in bed with China.
Institute Net Zero to destroy the economy despite climate action only being #13 in the list of the UN’s Sustainable Development Goals, our contribution to global CO2 emissions of only 1% and the fact that CO2 has no effect on the climate as shown by the IPCC WG1’s latest report where table 12.12 on p1873 shows no noticeable changes to frost, mean precipitation, river flood, heavy precipitation and fluvial flood, landslide, acidity, hydrological drought, agricultural and ecological drought, fire weather (hot and windy), mean wind speed, severe wind storm, tropical cyclones (includes hurricanes and typhoons), sand and dust storms, snow, glacier and ice sheet, heavy snowfall and ice storms, hail, snow avalanche, relative sea level, coastal flood, coastal erosion, marine heatwave, ocean acidity, air pollution weather and radiation at surface.
October 1, 2023
The spend, spend spend and tax Conservative Party. 13 years of driving the UK into poverty.
Not a single inclination to get their own House in order, just destroy, cancel and control – then blame it on others.
October 1, 2023
Let’s face it , the Government are out of control . Only strong leadership with values that rate the productivity side of our economy can recreate our economic position . Sunak and Hunt do not have the trust of the country or of members of the Conservative Party ; each day that goes by means another day lost . Independent bodies have had more influence in our economic affairs than those who ought to be directing and managing ; this was and continues to be wrong . We badly need another Margaret Thatcher to turn things round ; our dignity and place in world affairs has to be restored .
October 1, 2023
No way that the current fake Tory or Labour MPs would elect a Thatcher type. They even kicked out the soft, middle of the road, Truss.
October 1, 2023
A day or so ago – Mr Sunak pledged to crack down on “anti-motorist policies”
Today – Councils will be free to expand or create more 20mph zones despite new Government guidance, Rishi Sunak has indicated.
So yet again all talk and no trousers its about being in the limelight not doing what he has been paid and empowered to do – manage the State. The exponential growth in the State with no return on all the money stolen from the Taxpayer. Its the Boris Johnson, Rishi Sunak continuation of broken promises and their dire need to cripple the UK still continuing. Removing BJ and keeping his Government in tact is one of the many big Conservative Party failures.
October 1, 2023
Ian B: “Mr Sunak pledged to crack down on “anti-motorist policies”
ULEZ the expansion of which, the Tories are blaming on Sadiq Khan, turns out as a quid pro quo for providing financial assistance during COVID to stop the London Underground from collapsing, the Tory government told Khan to expand ULEZ.
That’s the modern Tories, Liars and con men*. [* Masculine includes the feminine, and anyone on the spectrum in between. ]
October 1, 2023
“Public spending up” more control, more banning, more cancelling of freedoms, the suppression of the economy – that’s not Conservatism – that Socialism
Following the JRM piece in today’s Telegraph, where he tries in vain to talk up the idea of Conservativism – one of the comments to his suggestions stands out and sums upthe problem “I did not leave the Conservative Party, it left me, long ago”
I would suggest there are lot of people joining that sentiment.
Would Labour be worse, would even the Liberal Democrats be worse, its hard to see how. The Conservative Party has fraudulently miss represented its-self, it is an extreme left wing Authoritarian Party well to the Left in practice than any of the alternatives would dare to tread.
To get a Conservative Government, we need first to have a Conservative Party, a new Conservative Party. The meet up in Manchester should be reported to the Advertising Standards Authority for miss representation
October 1, 2023
The “Restore Conservatism” event at 10.30am on Tuesday in the Trafford Room of the Midland Hotel, will carry on the momentum of the party pushing for change.
More just talk, that will be ignored by the Socialist Uni-Party Overlords
October 1, 2023
So what is the OBR doing about this? Where are their protestations and admonishment? Is it that they were complicit in this gross overspend or that they ‘dare not bite the hand that feeds them’ – salaries and pensions? Come to think of it, aren’t we taxpayers their actual “feeders”?
That explalns it. The OBR is exactly like the Government, oblivious of our expectations because we do not matter. LOL. Until the next Election when they’ll produce another liar sheet called “The Party Manifesto”, only this time, we will not believe whatever any of them say. Each election manifesto should be treated as a contract with the electorate, so failure to abide by it, must raise a penalty.
October 1, 2023
I’ve been thinking about this ever since I saw Paul Embrey on GB News calling for more wealth taxes, a windfall tax on the banks, more public ownership (energy, rail and water) and for the government to pay struggling families energy bills.
Taking inflation into account how much is £350bn actually worth In ‘real terms’ that the left like to use to belittle any extra spending. Which services have been given the extra, which are performing worst?
We’ve had pupil premiums, taxi’s taking SEND kids to school, a raised school leaving age, more paid for infant hours, is all this appreciated? Is any of it acknowledged. If its not felt a benefit and the cost appreciated what would happen if it was cut. No one appreciates anything this government spends money on but they’d be screaming if you just cut it off. People need reminding of what you’re spending the money on and what we’re getting out of it.
October 1, 2023
To the siren voices whatever is being spent is not enough.
There are wealthy so they should pay. Paul Embury is an interesting speaker but he, like all socialists, missed the need to motivation and competition in improving our lives.
October 1, 2023
You must be wrong SirJ, there’s no way public spending could be up £350bn ….as we have a conservative government with historic policies of low tax and small government !
October 1, 2023
@glen cullen +1
It is part of the Debt Mountain, you could say others will pay that when the perpetrators have left the building. As Cleverly has just pronounced ‘Conservative’ get what his people are doing…
October 1, 2023
The figure of £350billion would have more impact if John Redwood put it into its horrifying context. Our country’s annual Gross Domestic Product is roughly£2,500 billion per year of which very roughly (I am not up to date with the precise figures) about £1,000billion is taken from us in taxation. So £350billion is about one third of governmental income and what isn’t obtained from tax is borrowed to be paid for in future years.
Or put another way public spending since 2019 has gone up by nearly £12,000 per household per year which is in itself more than the state pension for most pensioners. What are we getting for our money, our extra £12,000 per household? Nothing for most people except a more inefficient state.
Something very radical must be done. There seem to be 4 main options-
1) Tax much more (the civil servants who are paid out of taxation like this even though tax is now the highest in 70 years) but we are Taxed Enough (too much) Already and it is a disincentive to work and business
2) Print or borrow the money. That leads to inflation, devalues money and such extra debt is unsustainable
3) Reduce public expenditure considerably – I favour this as we do not -and I say cannot- get real value for money and anyhow for centuries states spent very little compared to now but a lot of interest groups will squeal at this
4) Go all out for growth to make public expenditure more affordable. That seems the easy, attractive option (except to Sunak and the civil service) but though something can be achieved it may not be enough to solve this big problem.
October 2, 2023
Whether public service productivity is good or not depends rather on how it is measured. I checked out the ONS methodology for the NHS. Basically output is measured by multiplying the unit cost of an activity, eg a consultant led urological consultation with a patient by the number of times it has taken place. So productivity rises if the unit cost increases but it is still the same number of consultations. Also this measure is unrelated to effectiveness of the consultation. If effectiveness is low more consultations are needed so again productivity increases but the health outcomes show no improvement.
One might say that increasing the number of consultations would cut the waiting lists which are a major public concern. But again the key measure is not the waiting time, which is an intermediate operational measure, but the health outcomes. Cutting waiting lists is good politically but not necessarily for health outcomes. the problem with the NHS is that waiting times are so long they do in many cases impact health outcomes. So it would be better to measure that impact – eg., how many patients have died as a result of delays to treatment?
The ONS explains that there is no adjustment for quality of service provision and surely that and effectiveness are the main problems with the NHS. The ONS does make some adjustment for quality in its measures of education productivity. But there we all know that the problem is the content of the education not just how many pupils pass their exams – a measure of supposed quality. And we all know about grade inflation which one might reasonably suspect occurs indirectly from efforts to raise productivty if adjusted for pass rates.
Productivity alone does not measure either effectiveness or quality. Since the services are provided free to the ‘customer’ neither does it measure value. In the market place of the private sector value is measured by the price people are prepared to pay, not by its cost to the supplier.
Another better way to measure productivity is by comparison with public services in other countries or with similar services in the private sector and concurrently measure effectiveness, quality and value.
October 2, 2023
PS. After readng other comments here I can see another way productivity in the NHS could be raised dramatically. Mandate that every consultant led urological consultation – my example above – is attended by a diversity and inclusion expert to ensure there is no discrimination. So measured in the way it is, the unit cost of the consultation would rise so output would also rise in direct proportion.
October 3, 2023
Are we to understand that unfunded tax cuts are a sacking offence whilst unfunded public expenditure increases are OK?