NHS Staff - a special case?

Recently I got embroiled in a discussion, on social media about NHS staff and pay rises.
Well, I was discussing, others were simply yelling emotion-driven abuse.

You may not be aware of this but there seem to be people out there who genuinely believe the following things:

a) that if you work in the NHS you are a better person than those who don't;

b) that those of us who don't work in the NHS would not be prepared to do what they do; we’d be too scared or it would be too much like hard work;

c)  that, far from being equal, there are different classes of citizen in our country. There are those who work in the NHS (and some might be good enough to add Police, Fire & Ambulance Service as well), then there are other Public sector workers and finally, at the bottom of the worthiness list, all those that work in the Private sector. 

I KID YOU NOT, THERE ARE PEOPLE WHO ACTUALLY THINK THIS!

This is a quite remarkable, dangerous & worrying way to think.

Firstly, let’s remember how money flows in terms of the Public and Private sectors. Put simply, the Private sector generates taxation via corporation tax, worker income tax, and employer & employee National Insurance.
These revenues go to the Government. The Government uses this money to pay for the Public sector, including the salaries of all those that work in it.
Yes, I know that all of those Public sector workers pay tax & NI, but as the wages they get has come from the Private sector (via the Government), any tax they pay is merely returning a proportion of that back. It’s not NEW tax revenue.

The point is that the Public sector does not create wealth, rather it consumes the wealth generated by the Private sector & distributed by the Government.

Now this isn't a problem as long as we all remember that without the Private sector being successful (which is not just successful companies paying taxation but unemployment being low such that all the Private sector workers are paying tax not receiving benefits), there would be no money to pay the NHS staff or the Fire Service, the Police service or the Ambulance service or the people that come and take away your rubbish every week etc, etc. 

Once we allow ourselves to think of any part of the Public sector as uncriticisable, like a cult/religion, we have lost our objectivity.

We all need to agree that we will not pursue any idea that certain people doing certain jobs or working in certain parts of our society are more deserving, better people, than others.
That’s divisive, which we have enough of already at the moment!

Importantly, and I can only speak for myself here, I would have been perfectly happy to work in the NHS if that’s the way my life had gone.
Indeed my mother, an aunt, and several cousins did/do work in the NHS.
The risks of being on the front-line of patient care would probably not even have occurred to me.
Like joining the armed services, it’s a risk you are aware of and accept when you choose that career.
Anyway, I suspect that people choose to work in the NHS for positive reasons and are not constantly weighing-up any dangers there may be over and above other jobs.

Also, when you look at the groups most vulnerable, not to catching CV19, but to being really badly affected by it, very few will be working in the NHS.

By far the most vulnerable group, the over 70s, are retired, and those with long-term existing susceptible conditions are likewise less likely to be working in the NHS, and if they are, they should have been self-isolating.

So, while CV19 patient doctors & nurses in the NHS may be of greater risk of catching CV19, they were, in reality, at no greater risk of serious illness or dying from CV19 than anyone else in the low-risk groups.
Of course I feel very sorry for the exceptions but they are such a small number compared to the total that they prove the rule.

Remember also that only a certain proportion of NHS staff come into direct contact with CV19 patients; under half, by no means ALL NHS staff as is implied by many.

Additionally, not only is it impossible for everybody outside the Public sector to work within it, but neither is it desirable that they should; remember where the money comes from.

Without the Private sector there would be no NHS.

And it certainly isn’t the case that everyone should WANT to work in the Public sector in some bizarre attempt at symbolising what a ‘good’ person they are, which really appears to be the view of some strange people on social media.

So, while I am sure that we are all very grateful to those who do work in the NHS, that gratitude simply cannot overflow into cult status, hero worship & special treatment.  

When so many people in the Private sector have, and over the next 12 months even more will, lose their jobs; and when even more will receive no pay rise of any kind, it seems rather strange to be singling out people that work in the NHS as if they are the only people who have had a difficult time in the last 12 months. They are not; not by a long chalk.

What I suspect is that a lot of the fuss and noise around wanting to treat the NHS staff better than everybody else, is generated by the usual suspects: certain politicians, certain parts of the media, trade unions, those who generally favour the Public sector over the Private sector, and those who just never think about where the money comes from to give Public sector workers pay increases. 

I was going to say that I wonder, should there be an anonymous poll of NHS staff, how many of them would be happy to claim that they are better people and more deserving than their fellow citizens.
However, I am confident that the vast majority of people working within the NHS would NOT describe themselves in such an arrogant narcissistic and entitled way.

I agree with them.

They do a great job; they do a very necessary job, and we are grateful.
But they do benefit from almost 100% job security which is worth a lot at the moment, and I for one am not SO grateful that I'm prepared to pretend that they are literally better people and more deserving of special treatment than the rest of us.

The NHS

The NHS was conceived toward the end of the Churchill wartime government. It came into being in 1948.
The population of the United Kingdom in 1948 was 49.8 million. The average life expectancy for women was around 70; the average life expectancy for men was around 66.

The population of the United Kingdom now is approximately 68.2 million. The average life expectancy for women is 83; the average life expectancy for men is 79.

If those making the decisions in 1948 had been able to predict this level of growth in population combined with increase in life expectancy, they may have paused for thought before proceeding.

There is something which is very important in the context of the NHS's position within our society that doesn't get discussed.
Namely, that not only is our overall population much larger and growing but the proportion of our population that is elderly is far higher than in 1948 and very importantly, there has been a vast increase in the number of people being kept alive by modern medicine yet who are not very healthy.

Thus, not only is the total number of people using expensive NHS resources much higher than at its inception, but the proportion of the population needing to use expensive NHS resources on a regular or permanent ongoing basis has increased hugely.

So, the original decision to go ahead with the NHS all those years ago, which was always based more on social factors than a robust financial case, is rapidly becoming untenable.

Put simply, it's Pyramid Scheme. 

Not just a reducing proportion of healthy/young paying for the increasing proportion of unhealthy/old but Private sector paying for the increasingly costly Public sector.

It’s surely obvious to anyone with an even vaguely open mind on the subject that the Public sector in general and the NHS in particular is becoming, if it has not already become, unaffordable; unaffordable bearing in mind all the other things that are in the Public sector.
Unimportant things like education & law & order for example.

Even if we think we can get away with it for a few more decades, our children will find it a burden that is simply not sustainable by the time they get to my age, unless significant changes are made.

Let’s remember how money flows in terms of the Public and Private sectors. Put simply, the Private sector generates taxation via corporation tax, worker income tax, and employer & employee National Insurance.
These revenues go to the government. The government uses this money to pay for the Public sector, including the salaries of all those that work in it.

Yes, I know that all of those Public sector workers pay tax, but as the wages they get has come from the Private sector via the Government, any tax they pay is merely returning a proportion of that back.

It's not NEW or EXTRA money in the economy!

The point is that the Public sector does not create wealth, rather it consumes the wealth generated by the Private sector & distributed by the government.

I know that so many people don't want to hear this and don't want to even think about it.

90% of people alive today have known nothing else but the NHS.
They think of it as a ‘Right’.
The whys and wherefores of how it is run, organised and paid for are, to many, irrelevant.
They want it, they will always want it, and the only way in which they want it changed is for yet more money to be put into it so that it does exactly what it does now but faster, with more capacity and, yes, more staff.

The only way that we can stop the Public sector and specifically the NHS consuming more and more to the point of bankrupting the Nation is through innovation.

I strongly recommend Matt Ridley's book How innovation works. 

Innovation, far more often than not, is stifled by State intervention. Scientific innovation generally, but medical innovation in particular, is being slowed massively by bureaucracy and the desire for medicines and products that are 100% safe.
The length of time it takes to get new products to market is enormous.
So enormous, that it often puts companies off bothering to the detriment of many potential beneficiaries.

This is not how we will reduce cost while improving outcomes for all.

We see what can be done with the covid vaccines.
They have been created, essentially, from a standing start, and were ready to give people in around nine months. And the vast majority of people are more than happy to take it, even though they are aware that, simply by definition, they cannot possibly have gone through anything other than short term safety trials.
Indeed the clinical trials for the current vaccines are not officially due to end until well into 2023.

What this proves is that if State bureaucracies stopped the cult of ‘safteyism’ and adopted a light touch approach to innovations in medicine, the improvements we need on both the medical outcome and the cost sides can happen and can happen quite fast.

This does not mean a free for all with no testing & trials done for safety.
It does mean slimming the approval process down, so it doesn’t take 70 months to approve the use of a new pacemaker as it did in Europe recently.

The only way to stop the Public sector and particularly the NHS becoming a financial burden that cannot be overcome for our children and grandchildren is through innovation.

It’s through making it worthwhile for those in science generally and medical science particularly to put a lot of time and effort into new ideas and new concepts many of which will fail. But the ones that don't, can make a significant difference.

In simple terms we have to get out of the way of medical science & technology as much as is reasonably possible because we need them to find ways not just of keeping more and more people alive but keeping them alive and healthy.
The healthy for longer, thus requiring less NHS resources part, is how the NHS remains affordable long term while at the same time allowing more people to live longer in good health. 

It may not affect me too much, but it will certainly affect my children and their children if we don't realise this.