Britain’s broken public services

{"text":[[{"start":null,"text":"

"}],[{"start":7.92,"text":"From overcrowded hospitals and prisons to crumbling school buildings, Britain’s public services are broken. "},{"start":13.724,"text":"Voters cite the state of the NHS and healthcare, in particular, as their second biggest concern after the cost of living. "},{"start":20.392,"text":"For any incoming government, fixing services will involve some of the trickiest trade-offs. "},{"start":25.171999999999997,"text":"Yet neither main party is being open about the scale of the task, and how much it is likely to cost. "}],[{"start":31.299999999999997,"text":"The pandemic took a toll, especially on the NHS. "},{"start":34.967,"text":"But it hit services already weakened by a decade of Conservative-imposed austerity. "},{"start":39.534,"text":"Most have not regained pre-pandemic performance levels, says the Institute for Government — but nearly all were already performing worse in 2019 than in 2010. "}],[{"start":49.4,"text":"The reasons are straightforward: erratic policymaking and ever-changing ministers; falling real-terms pay that has made it hard to recruit and retain staff and led to damaging strikes. "},{"start":58.992,"text":"Raiding capital spending to plug day-to-day funding gaps in the 2010s compounded decades of under-investment. "}],[{"start":65.94,"text":"Solving these problems will take years. "},{"start":68.507,"text":"Stability and strategy can help. "},{"start":70.599,"text":"Any new government must adopt long-term plans, appoint able ministers and give them time. "},{"start":75.604,"text":"There is still scope for reform, too, across many services. "}],[{"start":80.67999999999999,"text":"It is worth seeking to remove distortions in the welfare system that discourage able people from work, though the Conservatives’ claim of £12bn potential savings is doubtful. "},{"start":89.95899999999999,"text":"In the NHS, further reforms should aim to reduce bureaucracy and silos. "},{"start":94.464,"text":"To put it on a more sustainable long-term footing, a no-taboos review is needed of how health is organised and funded, and whether it should move closer to European models that use social insurance and co-payments. "}],[{"start":105.8,"text":"In health and elsewhere, however, reforms will have to run in tandem with higher investment in the IT, equipment and infrastructure needed to unlock greater efficiencies. "},{"start":114.87899999999999,"text":"The NHS has lower productivity despite having more staff and funding than pre-pandemic. "},{"start":119.997,"text":"Some of that is due to absences and post-Covid burnout. "},{"start":123.164,"text":"But doctors cannot operate in theatres where the roof is leaking. "}],[{"start":127.55,"text":"Spooked by the market crisis over Liz Truss’s debt-funded tax cuts in 2022, both main parties have striven to show restraint in their spending plans. "},{"start":136.004,"text":"Labour, until recently the party of Jeremy Corbyn, is particularly intent on establishing trust. "},{"start":141.722,"text":"Its manifesto promises to recruit more teachers and provide more NHS appointments, funded by taxing independent school fees and non-doms. "},{"start":149.577,"text":"But it has pledged no increases in the main tax rates and to respect “robust fiscal rules” on debt. "}],[{"start":155.19,"text":"Fiscal rules can usefully prevent runaway borrowing, but need to be flexible enough to allow essential investment. "},{"start":161.469,"text":"There is a sound case for borrowing to fund finite investments in technology and infrastructure that can reduce running costs. "},{"start":167.624,"text":"Many investors expect additional borrowing, and will tolerate it if it is seen to be growth-enhancing. "}],[{"start":173.44,"text":"Some increases in current spending will be needed, too. "},{"start":176.982,"text":"The erosion of public sector pay and conditions needs to be addressed to attract sufficient staff, especially if parties want to limit immigration. "},{"start":184.312,"text":"And a greater emphasis is required on “preventive” spending — rebuilding public health programmes, for example, to reduce NHS demand. "}],[{"start":192.86,"text":"Britain’s hope of enjoying European-level social welfare for American-level taxes is reaching its limit. "},{"start":198.614,"text":"Cutting taxes to stimulate growth is a worthwhile aim, but the toll of poor services — from skills shortages to inactivity due to sickness — is holding the economy back. "},{"start":207.632,"text":"Polling suggests more than half of Britons think public service spending should be raised, even if that means higher taxes or borrowing. "},{"start":214.437,"text":"The politics today point in the opposite direction. "},{"start":217.26700000000002,"text":"But by failing to be upfront about what may really be needed, the main parties are doing a disservice to voters, and themselves. "}],[{"start":223.69,"text":""}]],"url":"https://creatives.ftacademy.cn/album/159582-1718762822.mp3"}