On being the right size
In the early 20th century, big companies were synonymous with efficiency. In the late 20th century they were synonymous with inefficiency.
Paul Graham, The Refragmentation, 2016
Student loans (again)
The latest estimates on the loan system from London Economics suggest that 53.9 per cent of the money loaned out will be written off, 88.2 per cent of graduates will still be paying when the 30-year write off kicks in, and 33 per cent of graduates will never make any repayment. With several years of sluggish growth now forecasted, and a long road ahead for the post-Covid recovery, graduate repayments are likely to fall further in coming years, giving the Treasury even more reason to worry about the unique way it funds higher education — particularly as demand for universities continues to increase while the costs per student are rising.
Primary care (GPs and other practice staff—notably nurses) does around 90% of NHS patient contacts for about 10% of the budget and an annual budget of around £155 (€179; $217) per patient on the practice list. A 2019 study in The BMJ compared 11 high-income countries and found that UK GPs saw patients at twice the speed of those in the other nations. Surveys show an average of 41 patient contacts a day, and 10% of GPs see 60 or more.4
The number of GPs barely grew during 2010-15, and the Nuffield Trust has reported nearly 2000 fewer permanent, qualified GPs in 2020 than in 2015 despite a growing population and demand. Community nurse numbers have also fallen, and social care and local government budgets have been cut. The UK has some of the lowest numbers of hospital beds per capita in the world, and ever increasing activity means ever faster patient transfers into the community and more pressure to keep patients at home.
It will get worse before it gets better. Scrub that. Not in my lifetime. Scrub that. Perhaps it will not get better. (This is before you add in all the ‘professional’ and ‘technical’ debt the NHS has accrued over the last thirty years.)
Scientists at the University of Liverpool face being made redundant based on research grant income and citation impact scores, a union has claimed.
The institution is poised to cut 47 research jobs from its Faculty of Health and Life Sciences, with compulsory redundancies due to be made after voluntary severance packages were rejected.
The cuts are being made as part of Project Shape, which aims to realign the Faculty of Health and Life Sciences “in order to help tackle the extreme health inequalities and unmet health needs in the Liverpool city region”.[emphasis added].
A truly fluent narrative.
True, the [Global Britain] plans include some eye-catching proposals for new military technologies in the spheres of cyber, drones and space. These are largely chaff. Whitehall insiders say that overall, the document offers a fluent narrative largely detached from real strategic purpose [emphasis added].
Neat phrase. Cock-up, as usual.