The Week

The GEek 7 June 2024

Charlotte Pickles
Director

Welcome to week two of the GEek!

Forget the MRPs, leaders debate, and national voting intention polls, this week’s most interesting poll came from the Financial Times, and it revealed something underappreciated — and I think underreported in this election campaign — about the British public…

The FT poll, published yesterday, looked at the public's view of public services. And it is fascinating – not because of what the FT reported it shows, high levels of dissatisfaction (predictable) — but because of what reading between the lines tells us.

They asked people to pick from words, both negative and positive, that describe public services. By far the most selected was “Under-funded”, with somewhere in the region of 67% (annoyingly they don’t give exact figures) picking this word. So far so familiar. Yet cast your eyes down the list and (again roughly) just 5% think public services are value for money.

So almost no one thinks the money we are spending is being spent well. Add to this the fact that the second most popular word (at 30- 35%) is “Bureaucratic”, around a quarter think services are ”Unaccountable” and “Unresponsive” and just a few percent think they are “Efficient” (or “Honest”), and it seems pretty clear that ‘underfunded’ is more a proxy for broken, or not working.

Which is just as well, as there is little appetite for increased taxes — in our State of the State report we found 51% of the public would rather spending stayed the same or decreased, versus 25% who wanted to see an increase based on higher taxes or borrowing —  and the two main parties are busy ruling out any tax rises.

So what does that leave? Spending public money better — and that means overhauling outdated models in order to do things very differently. Conveniently exactly what we at Reform are arguing for.

Sadly the campaign trail is sorely lacking in radical proposals to deliver more efficient, accountable, responsive and citizen-centric public services.

Check out of our two blogs this week, one from Florence on why NHS England’s decision to cut vaccine funding is incomprehensible, and one from Joe on why data sharing should be the norm in government and it’s time to call out the common excuses for not sharing as exactly that, excuses.

Policy spotlight...

We’ve had the usual pick and mix of policy pledges this week, but in each edition of the GEek we’re going to spotlight one key area of policy: today it’s health.

The Conservatives have announced 100 new GP surgeries, with upgrades promised to a further 150. That’s small fry in the context of the 6,000 plus surgeries currently in operation, and with the GP workforce pressures we also need to know how the new surgeries would be staffed. But the real elephant in the room is whether more GP surgeries is even the answer to our overburdened primary care or whether using that money to boost community services that divert demand would be more effective. Watch this space for a Reform view on this.

Which is why the Conservatives’ other recent health pledge, to further expand Pharmacy First, is very welcome. This would allow people to access more medicines and contraceptives without the need to visit a GP, freeing up, they say, 20 million GP appointments. And attending a local pharmacy is also way more convenient for most people.

The problem with all of this, however, is that they are pledging to pay for both of these by cutting NHS management. So, for the millionth time: THE NHS IS WOEFULLY UNDERMANAGED. See for example, our analysis on what’s really driving the A&E crisis.

On the Labour side, we have been promised 40,000 more hospital appointments per week or two million a year through out-of-hours working. Aside from the challenge of getting an already stretched workforce to do even more hours, last year there were 124.5 million outpatient appointments alone, again meaning it’s unlikely to move the dial.

However their pledge to double the number of MRI and CT scanners could really help with the productivity challenge. As we have pointed out, we’re a real outlier when it comes to this sort of equipment. We’d like to see a commitment to protecting capital investment.

Of course, as per my opening comment, neither party is putting forward the sort of radical ideas that will be necessary to ensure our health and care system is effective and sustainable. But if they find some courage from somewhere, here’s our bold plan for a devolved model.