"be willing to use the massive fiscal capacity available to governments of sovereign, currency-issuing nations to deliver investment-led growth."
Fiscal capacity is one thing. Physical capacity is another. We have a systemic problem in the UK of lack of capital investment, terrible management that is incapable of using modern organisational methods, an addiction to "cost of living rises" in business pricing rather than competitive quantity adjustment and an amplification mechanism via the huge overhang of index-linked gilts that increase government spending at the RPI rate if prices change.
Unfortunately to deliver investment growth in the UK will require shutting down consumption in areas people would rather not. We have been eating our seed corn for far too long.
That requires an even more radical approach than abandoning the "we haven't any money" fallacy.
In healthcare, for example, it would require a new NHS act transferring the private medical system to the NHS - as we did with the cottage hospitals in 1948. We all know that it's the same consultants in private and public and the private system just allows you to "jump the queue" because you have money. And we know from the death of NHS dentistry where that slow burn ends up.
We can't spend our way out of the NHS problem. We have to physically take the resources from those who would reserve them for themselves and make them available to all - on the basis of need rather than ability to pay.
Unfortunately the blinkered hear the words "private health care" and need the smelling salts to recover. They think only of America when they hear those words. They don't think of numerous European countries who have a private system mixed with government subsidies. The Netherlands for example is usually in the World top 3 for health care and yes you pay to see the GP (shock horror) and the poor get it paid for them. The current NhS is a disaster. And who are the fools who think it's free?? It's an enormous tax burden.
It's more that those who cry "private health care" haven't thought it through very well.
Private health care in the UK, like the dentistry system, doesn't add any physical capacity. It simply leaches off the public system and smothers it. The private system trains no doctors or health care workers and builds nothing the state couldn't build itself.
In essence it is like the Fast Track queue at Alton Towers. It allows those with money to jump the queue to access the limited facilities that actually exist.
The European systems aren't anywhere near as marvellous as advocates insist. The results are a function of high level of investment over decades. In reality capacity is used up in the Netherlands - hence their recent report on the shortage of GPs, and the private funding mechanism wastes around 2-3% of health expenditure on pointless contract negotiations and insurance claims. All people that could be better employed doing something useful.
The problem we have here is lack of investment - all the way across the board
I disagree about private health care leeching off the system. Things could work more efficiently as with many instances of privatisation. I'm not saying it will provide all the answers necessarily and everything is a compromise but the current system is definitely not working in the UK. There is no queue jumping for the rich in the Netherlands. Check their health outcomes. They have a world class system by comparison. I'd like to see how much the UK wastes in a similar vein. Negotiating contracts may cost money but the resulting work could save millions. If you don't need to negotiate because you have a government behind you then more money will be wasted. You seem to imply that anything government run will be cheaper when in fact privatisation of numerous industries creates incentive and streamlining. The blob is a great example that anything government run sucks money in as no one is accountable for their performance.
Are you sure there's a shortage of GPs in The Netherlandsor is there an excess of people? Immigration into the Netherlands in recent years has surpassed that of the UK in terms of percentage of population and is growing rapidly. Especially in the south with ASML shipping tens of thousands of workers in from India. They are certainly not building infrastructure to match. Meanwhile in the UK, the government chooses to import already trained doctors from third world counties rather than pay to train more of our own (there's no shortage of people willing and capable) because it's cheaper to do so. The result is sub standard doctors in many cases and third world countries losing their talented people leaving them even worse off. The left always moan about colonisation and plundering the third world in the past yet here they are still doing it.
As I said the Netherlands health outcomes are a response to sustained investment over decades, which we haven't done in the UK. But now the cracks are starting to show due to the failure of the Eurozone to grow significantly. Hence the 2025 dutch report on GPs, which I'm sure you've read if you are commenting.
The rich queue jump in the UK by leaching off the public system. It's the same consultants in the public and private sphere. There is no mechanism by which competition can have any effect without excess capacity to supply, and there aren't enough doctors to go around.
There is no magic in market provision. It is more efficient if, and only if, there is excess capacity to supply and sufficient competitors. Otherwise it drifts rapidly to oligopoly and monopoly - as we have seen with the train operators.
The UK's capacity to train doctors is limited by the training places available in the system. To train people you have to do *less* doctoring and more training. Unfortunately we are now caught in a trap of having insufficient doctors to do the work let alone free up time to train anybody. Getting out of that requires rather more thought than shouting "private health care".
Remember that in the UK *all* GPs are already private businesses and always have been since the beginning of the NHS. And they are hardly a resounding advert for private markets.
Great article Paul and I share your misgivings on Burnham as do most thinking people I’d guess.
Your list of priorities are spot on but I lose confidence with public investment fiscally led projects leading the way. I would agree with large investments into a new nuclear power programme and something around defence expenditure around ships, tanks and drones but I’d guess Burnham thinks building a new Old Trafford will sort out Manchester. And it’s all very well saying he’ll stick with Reeves’ iron clad rules (which are killing us really) but we have to free up cash for corporate tax and investment tax (CGT) to really get moving again n
I'd like to make a suggestion for where he can get some "massive fiscal capacity"....get all illegals now out of accommodation (especially of the 4* kind) and put them in tents at some disused army base or wasteland somewhere. Scrap their free phones and bowling vouchers and pocket money and free NhS care. That should save at least £2bn a year. Then force all non-Brits to pay the full amount for their health care rather than subsidising it. I could go on.
And in terms of you expecting to see Burnham ride in on a donkey, remember he IS the donkey (along with the entire Labour cabinet and the majority of its backbenchers).
The saddest thing of all is that based on Makerfield the red wall voters seem to be flocking back to more of the same rather than sticking with Reform under whom, despite more right-leaning economic policies, this class will feel no worse off and likely a lot better off. Only a fool would vote for Labour in the next general election and those that do can suffer the consequences because I don't know what else can be said or done to make such voters realise that the Labour Party hates them - that's indoctrination for you. The middle classes meanwhile, and property, land or business owners are laughing all the way to the bank. Much as it goes against my principles, if the government offered to rent my house to fill it with 20 illegal immigrants I'd take them up on the offer. Just to rub the nimby noses of my immigration-loving neighbours in it. Refugees welcome here, oh but not on my street. Reform brilliantly called the bluff of such voters by announcing he'll send them all to those postcodes. First thing they did? Complain. It's so tiresome.
The pathetic Labour clown show is getting worse! Even Capt. Pugwash with his crew members, Seamen Stains and Master Bates had more credibility…..
That shower need taking out of their fart filled bubble and dropped smack bang in the middle of the physical mess they’ve created, let them get a taste of the rising fear and distrust the indigenous peoples are feeling.
This won’t end well and one things for sure, those cowards won’t be anywhere near what/where ever the front line develops.
I think Burnham is a lot smarter than people think. I have experience with his methods and off-camera personality from my time in Manchester, where I grew up. I can guarantee you that he will surprise everyone.
He's got a lot of integrity, he doesn't take any nonsense, and if he says he's going to do something, then he will do it to the best of his ability within the limits of his power. He will be much more limited as PM than he was as Mayor but he’s got a majority in parliament, he can make the necessary changes.
Politicians are overwhelmingly bad, but Andy understands it’s give and take and he gives as much as he takes.
Hi Paul 👋
What a wonderfully written piece, absolutely brilliant 👏
"A Blairite, brownite, milibander and starmerite walk into a bar ,
The barman says "what you drinking Andy ? "
Andy Burnham is basically Keir Starmer with personality, but he is still a weathercock.
Have a lovely week Paul and other readers 😀
Burnham is the Weathercock of the North.
Just "cock" will suffice.
"be willing to use the massive fiscal capacity available to governments of sovereign, currency-issuing nations to deliver investment-led growth."
Fiscal capacity is one thing. Physical capacity is another. We have a systemic problem in the UK of lack of capital investment, terrible management that is incapable of using modern organisational methods, an addiction to "cost of living rises" in business pricing rather than competitive quantity adjustment and an amplification mechanism via the huge overhang of index-linked gilts that increase government spending at the RPI rate if prices change.
Unfortunately to deliver investment growth in the UK will require shutting down consumption in areas people would rather not. We have been eating our seed corn for far too long.
That requires an even more radical approach than abandoning the "we haven't any money" fallacy.
In healthcare, for example, it would require a new NHS act transferring the private medical system to the NHS - as we did with the cottage hospitals in 1948. We all know that it's the same consultants in private and public and the private system just allows you to "jump the queue" because you have money. And we know from the death of NHS dentistry where that slow burn ends up.
We can't spend our way out of the NHS problem. We have to physically take the resources from those who would reserve them for themselves and make them available to all - on the basis of need rather than ability to pay.
Unfortunately the blinkered hear the words "private health care" and need the smelling salts to recover. They think only of America when they hear those words. They don't think of numerous European countries who have a private system mixed with government subsidies. The Netherlands for example is usually in the World top 3 for health care and yes you pay to see the GP (shock horror) and the poor get it paid for them. The current NhS is a disaster. And who are the fools who think it's free?? It's an enormous tax burden.
It's more that those who cry "private health care" haven't thought it through very well.
Private health care in the UK, like the dentistry system, doesn't add any physical capacity. It simply leaches off the public system and smothers it. The private system trains no doctors or health care workers and builds nothing the state couldn't build itself.
In essence it is like the Fast Track queue at Alton Towers. It allows those with money to jump the queue to access the limited facilities that actually exist.
The European systems aren't anywhere near as marvellous as advocates insist. The results are a function of high level of investment over decades. In reality capacity is used up in the Netherlands - hence their recent report on the shortage of GPs, and the private funding mechanism wastes around 2-3% of health expenditure on pointless contract negotiations and insurance claims. All people that could be better employed doing something useful.
The problem we have here is lack of investment - all the way across the board
I disagree about private health care leeching off the system. Things could work more efficiently as with many instances of privatisation. I'm not saying it will provide all the answers necessarily and everything is a compromise but the current system is definitely not working in the UK. There is no queue jumping for the rich in the Netherlands. Check their health outcomes. They have a world class system by comparison. I'd like to see how much the UK wastes in a similar vein. Negotiating contracts may cost money but the resulting work could save millions. If you don't need to negotiate because you have a government behind you then more money will be wasted. You seem to imply that anything government run will be cheaper when in fact privatisation of numerous industries creates incentive and streamlining. The blob is a great example that anything government run sucks money in as no one is accountable for their performance.
Are you sure there's a shortage of GPs in The Netherlandsor is there an excess of people? Immigration into the Netherlands in recent years has surpassed that of the UK in terms of percentage of population and is growing rapidly. Especially in the south with ASML shipping tens of thousands of workers in from India. They are certainly not building infrastructure to match. Meanwhile in the UK, the government chooses to import already trained doctors from third world counties rather than pay to train more of our own (there's no shortage of people willing and capable) because it's cheaper to do so. The result is sub standard doctors in many cases and third world countries losing their talented people leaving them even worse off. The left always moan about colonisation and plundering the third world in the past yet here they are still doing it.
As I said the Netherlands health outcomes are a response to sustained investment over decades, which we haven't done in the UK. But now the cracks are starting to show due to the failure of the Eurozone to grow significantly. Hence the 2025 dutch report on GPs, which I'm sure you've read if you are commenting.
The rich queue jump in the UK by leaching off the public system. It's the same consultants in the public and private sphere. There is no mechanism by which competition can have any effect without excess capacity to supply, and there aren't enough doctors to go around.
There is no magic in market provision. It is more efficient if, and only if, there is excess capacity to supply and sufficient competitors. Otherwise it drifts rapidly to oligopoly and monopoly - as we have seen with the train operators.
The UK's capacity to train doctors is limited by the training places available in the system. To train people you have to do *less* doctoring and more training. Unfortunately we are now caught in a trap of having insufficient doctors to do the work let alone free up time to train anybody. Getting out of that requires rather more thought than shouting "private health care".
Remember that in the UK *all* GPs are already private businesses and always have been since the beginning of the NHS. And they are hardly a resounding advert for private markets.
Great article Paul and I share your misgivings on Burnham as do most thinking people I’d guess.
Your list of priorities are spot on but I lose confidence with public investment fiscally led projects leading the way. I would agree with large investments into a new nuclear power programme and something around defence expenditure around ships, tanks and drones but I’d guess Burnham thinks building a new Old Trafford will sort out Manchester. And it’s all very well saying he’ll stick with Reeves’ iron clad rules (which are killing us really) but we have to free up cash for corporate tax and investment tax (CGT) to really get moving again n
I'd like to make a suggestion for where he can get some "massive fiscal capacity"....get all illegals now out of accommodation (especially of the 4* kind) and put them in tents at some disused army base or wasteland somewhere. Scrap their free phones and bowling vouchers and pocket money and free NhS care. That should save at least £2bn a year. Then force all non-Brits to pay the full amount for their health care rather than subsidising it. I could go on.
And in terms of you expecting to see Burnham ride in on a donkey, remember he IS the donkey (along with the entire Labour cabinet and the majority of its backbenchers).
The saddest thing of all is that based on Makerfield the red wall voters seem to be flocking back to more of the same rather than sticking with Reform under whom, despite more right-leaning economic policies, this class will feel no worse off and likely a lot better off. Only a fool would vote for Labour in the next general election and those that do can suffer the consequences because I don't know what else can be said or done to make such voters realise that the Labour Party hates them - that's indoctrination for you. The middle classes meanwhile, and property, land or business owners are laughing all the way to the bank. Much as it goes against my principles, if the government offered to rent my house to fill it with 20 illegal immigrants I'd take them up on the offer. Just to rub the nimby noses of my immigration-loving neighbours in it. Refugees welcome here, oh but not on my street. Reform brilliantly called the bluff of such voters by announcing he'll send them all to those postcodes. First thing they did? Complain. It's so tiresome.
The pathetic Labour clown show is getting worse! Even Capt. Pugwash with his crew members, Seamen Stains and Master Bates had more credibility…..
That shower need taking out of their fart filled bubble and dropped smack bang in the middle of the physical mess they’ve created, let them get a taste of the rising fear and distrust the indigenous peoples are feeling.
This won’t end well and one things for sure, those cowards won’t be anywhere near what/where ever the front line develops.
Pucker up folks, Burpham is not the solution!
I think Burnham is a lot smarter than people think. I have experience with his methods and off-camera personality from my time in Manchester, where I grew up. I can guarantee you that he will surprise everyone.
He's got a lot of integrity, he doesn't take any nonsense, and if he says he's going to do something, then he will do it to the best of his ability within the limits of his power. He will be much more limited as PM than he was as Mayor but he’s got a majority in parliament, he can make the necessary changes.
Politicians are overwhelmingly bad, but Andy understands it’s give and take and he gives as much as he takes.
Watch and see.