Announcing our consumer agenda for government

I understand your concern, Gail, but I truly believe no government is going to privatise the NHS whether by stealth or by outright legislative intent as you have identified. The political consequences would be too damaging for any Party to contemplate.

But where does opening contracts to international competition come into the equation if we leave the EU and are no longer required to purchase within the single market? Should we deny ourselves American drugs or wound management formulations because of policy dogma? This is a very complex issue and I don’t believe the politicians have served us well in dealing with it almost entirely in sound-bites, except possibly, perhaps, by demonstrating through public approbation that the NHS is the most precious part of our national infrastructure and must be protected. I think the public focus on this has brought the Conservatives up with a jolt.

In practice it’s not so much the question of the products and materials required by the NHS that is at stake but the founding principles – of being free at the point of use with universal access irrespective of means – that many fear could be put at risk.

What I do think requires attention is that, despite the excellence of the NHS, and decades of health and safety legislation to improve working conditions, there are a lot of people who are in a poor state of health, possibly because they choose not to have treatment, or because they have a lifestyle that militates against a healthy condition, or because the system has not found a solution to their ailments. I think much more effort should be made to produce a much healthier society which would actually take a burden off the back of the health service.

John -“should we deny ourselves American drugs ” –you said , tell me which company in US Big Pharma sells its drugs cheaper than the EU can obtain them , as far as I know –not one and that is Donald,s complaint – “the Brits are getting their drugs too cheap” —they must be brought up to our level .
After years of studying the US Big Pharma industry and getting US .org organisations directing me to State and lists of Big Pharma prices prepare this country for “Americanisation ” of our health .
You all told me no US figures but if Donald’s America First Trade Deal with us takes place how can anybody here criticise me when I will say–told you so .
US drug prices are shocking and that Americans saying it .
Look at India had enough of US drug monopoly and started their own generic drug industry – Donald —we will sanction you ,didn’t bother India ,our poor are dying from lack of drugs so live with it.

There has been far too much unsubstantiated scaremongering, largely for political reasons, about the NHS for example – well, in my opinion. I do not believe we would allow general “privatisation” to happen although I expect parts that are appropriate will still be contracted to specialist suppliers. Nor do I believe our drugs bill will be allowed to increase in cost just because of “Donald”. This topic is rather like the end-of-cash scare stories.

Electioneering seems to bring with it lies, speculation, contrived stories, damaging leaks, unaffordable promises, bribes……… I stop watching news, question time, listening to interviews when such childish games are played.

I hope my faith is not misplaced and that the speculation from some others does not come about.

Duncan – The NHS procurement organisation is one of the best in the world for obtaining essential supplies on the most favourable terms, largely because no other country can place such large contracts though a centrally specified and organised system.

Since they will depend on the terms of our leaving the EU and future tariffs we do not know what the drugs prices from mainland Europe suppliers will be but we would be free to source from any manufacturers anywhere that can provide the products the NHS specifies and requires. NHS contracts are so lucrative that competition will be intense but I think, overall, home supplies and European sources are likely to be more favourable – partly because security of supply and easily assured compliance are as important as price. Generally speaking, once the NHS has negotiated the best price for a product, other manufacturers are allowed to supply on the same terms for parts of the overall requirement.

There is another issue which I was to some extent alluding to in my previous comment: some drugs and formulations are still in patent and although there are sometimes alternatives it would not be in patients’ interests to avoid American products just because they are American.

I am confident that the NHS can stand up to any bullying on price from American drugs companies because for most products there are UK- or EU-manufactured equivalents. It has already been made clear from both sides of the Atlantic that a trade agreement with the USA cannot be conditional on exclusive access to NHS procurement.

“Ready been made “clear ” – who by Boris Johnstone (redacted ) ? John look if he was leading the Labour party I still wouldn’t trust him an inch and you have his arrogant side kick who lounges on the Parliamentary Benches , at least I would know where he stood on subjects .
At least M. Thatcher put forward full blown Tory views with no embarrassment that’s more honest , its not the Party John its the perceived policies , I really hope you are right John as a matter of fact I Pray you are right for the sake of the poor ,sick,old in this country .
I know exactly what Donald wants as I have said I have seen his “proclamation ” in writing on US websites/email from the USA , his talks with big pharma/medical who are “dying ” to get into and take over the NHS .
I will come and go on most things John but never on the NHS .

I have never encountered anyone who understands macro economics or international macro economics. So putting things as you have is far too simplistic.

It’s not to be confused with the government deficit.

The deficit is the difference between the government’s income and government spending. It’s the amount the government has to borrow each year.

Debt is the total amount of money owed at one time, most of which is made up of gilts auctioned by the government. The owner of a gilt gets paid interest until the government pays the debt back.

Borrowing money to cover the deficit adds to the total stock of national debt.

When does it have to be paid back?

In one sense, it doesn’t. Government gilts are issued with a date when they have to be paid back, but at that point the government can just issue new gilts to pay for the old ones—as long as investors are happy to buy them.

What costs money is the interest payments the government has to make in the meantime. About 5% of the government budget goes towards paying interest on the national debt.

Who owns the debt?

Most UK government gilts are owned by British institutions, and some by UK households. They get the interest payments.

UK insurance companies and pension funds own almost a third: about 30%.

The Bank of England owns about a quarter.

Other UK financial institutions like banks own 17%, just over a sixth.

Another quarter of the government’s debts, about 27%, are owed to foreign institutions. That’s called the UK’s external debt, and the interest payments go outside the UK.
Debt-to-GDP ratios

It’s common to compare the value of a government’s debt with what’s called annual gross domestic product, or GDP. That’s the total value of goods and services made in the UK each year.

The government’s net debt was worth about 85% of GDP at the end of May 2018.

Looking back at the last century, 85% is a relatively low ratio, especially compared to the post-war periods.

But compared to the last two decades, it’s relatively high. The size of government debt increased greatly in proportion to GDP around the time of the last recession.

While the size of UK debt has continued to increase in the past few years, other factors have meant that it’s actually become cheaper for the UK government to borrow money. So size isn’t everything.

There’s a debate about what constitutes a sustainable level of debt for a developed country like the UK, and the economic significance of changes in the debt-to-GDP ratio.

And when highly trained economists all disagree, proving that none of them really understands macro economics, what hope for politicians? Very few politicians have any statistical or scientific background.

I read that there have been record winter temperatures in the far north of Scotland. I forget who, but one of our correspondents used to remind us how Scotland was blessed with abundant hydro-electric power which enabled the power companies to maintain a broadly comparable tariff across the country even to the highlands and islands.

East Anglia has been very cold caused by a blanket of thick cloud preventing any air circulation and the rays of the sun from getting through; indoor temperatures have been very low for a long time so I sympathise with others experiencing prolonged cold weather. Time for the Scottish government to raise the winter fuel payment for pensioners perhaps.

Not all Scottish islands are connected to the national grid, see:-https://www.scotsman.com/news/politics/plea-to-improve-grid-connections-to-scots-islands-1-3551210

Long ago, when I was involved with research on electrical power generation from sea waves, our financial modelling identified “small island communities” as ideal early adopters for wave energy. Even back then, we assumed that such communities could only generate their base load power from fuel-expensive diesel generators, as opposed to other sources with much lower marginal costs of generation.

Thank you for the link, Derek. It’s interesting that the report was five years ago and I wonder how much has happened since then.

I would have expected wind power and other renewable technology to offer an economical route to baseload power for off-grid remote communities on a per island/community basis without the need for interconnectors but that would probably be too inefficient. Some serious investment in physical infrastructure will be required in order to join places together.

Unfortunately, wind power on its own is probably not consistently reliable enough without some power storage system to provide sufficient reserve capacity but wave power could be a useful supplementary resource even during periods of low wind force.

It is indeed strange that attempts over the years to eliminate poverty and curb egregious riches, and close the gap between the richest and the poorest, have made little practical difference to their relative positions. Because of their international mobility the super-rich have access to dodges and mechanisms that defeat any government’s attempts to level the playing field as they can re-domicile themselves wherever it suits them. Previous attempts to super-tax the extra-wealthy have failed to make much headway, and direct hand-outs to the poor are a blunt instrument that again does not seem to work.

I suppose we need the ‘good rich’; they have a philanthropic outlook and are socially responsible members of society who do feed down some benefits to the remainder, but it is on their terms, might be discriminatory in its effects, and is an inefficient and unreliable method of redistribution.

While a certain amount of wealth is necessary to enable the country to be prosperous and to invest in successful enterprises, what I personally regard as obscene is the extraction of excessive profits from companies to fund personal indulgence rather than reinvestment. Excessive prices are also partly responsible for poverty and there is a direct connection between high prices and excess profits. We also have to be careful with our judgments in discussions like this because it is too easy for accusations of envy to be thrown at those who challenge the accumulation of wealth.

One can argue forever over absolute poverty and relative poverty, but there is no escaping the fact that poverty is a cancer in society and gives rise to many consequences that cost us all more in the long run. We can’t go back to the days of the workhouse, nor carry on indefinitely with a laissez faire approach which is not humane, but finding the sweet spot in between those extremes has eluded social reformers down the centuries.