Saturday 27 August 2016

Why Frederick Forsyth is talking rubbish about NHS investment

One of my favourite columnists is Federick Forsyth in the Daily Express every Friday. Unlike the inane babble spouted by most tabloid celebrity columnists, who have dull lives and merely peddle tittle tattle, Fred has lead an interesting life and has plenty to say. I don't agree with most of his politics, but he makes interesting and well argued points and can bring a wealth of experience and anecdotes to support his views. This week however he demonstated that he really doesn't understand government or running a business. In his column, under the title "Doublespeak Politicians just love to 'invest' " he betrays a fundamental failure to appreciate what the govt is supposed to do with our money. He says

HAVE you noticed that politicians and most especially Left-wingers never mention the word “spending” when they unveil their economic plans? Thus Jeremy Corbyn, in a long, recent list of proposals, managed to blow several hundred billion pounds on the “investments” he would like to make if, heaven forbid, he ever actually got into power. 
Let’s be frank. If you really invest, the money remains yours and you can retrieve it when you want unless you have been daft enough to sign away your right to do that. And invested money provides a “yield” or “return on investment” – the ROI – which is the point of wise investment. But when it is spent, it’s gone. 
Thus, you cannot “invest” in the NHS. So billions are spent on it. OK, it’s a good expenditure to provide a nationwide healthcare service free at the point of delivery. But it is not an investment. We are never going to see it back or get an annual dividend dropping on to the doormat. 
Mind you, we live in a world of euphemisms, platitudes and smarmy untruths. 
Perhaps someone should create a parallel dictionary: what big business, advertisers, officialdom and politicians tell you and what it really means in plain English. It would be quite a big lexicon because what is said and what it really means is very rarely the same nowadays.

Mr Forsyth states "You cannot invest in the NHS" on the grounds "invested money provides a yield or return on investment". Sadly Fred really hasn't thought this through. There are three ways in which his statement is factually incorrect. First, there are many opportunities for investment in the NHS which will produce a yield for the taxpayer. Mr Forsyth should know better than anyone that technology is always offering investment opportunities, to increase efficiency in the way we do things. I will give one example. Fifty years ago the process of taking X-Rays was done by large departments. All of the results were stored on film and there was a huge requirement for a library system for the prints. These had to be kept for decades so comparisons etc could be performed. Modern technology means they are now digitised. This frees up land, reduces the number of staff required to run X Ray departments and means they cost far less to run. As the government funds this process, the investment in new equipment has produced a very real and tangible return for the taxpayer as the they have to levy less tax to pay for X rays. This process has been repeated in every part of the NHS. Had the governement not invested in this modernisation and we still used the 1950's way of doing things the NHS would cost many billions more to run.

The second way in which the NHS delivers a return for the government is when investment in new treatments mean that people who were previously unable to work are able to be treated and return to contributing to the economy. The NHS is just one strand of the UK economy, the government is responsible for the whole thing. It is true that the NHS is largely a cost centre, but it is a necessary one as it keeps the population fit and in good shape for work. This lowers the bill for disability benefits. I am a living example of how this works. Since 2011, I've been under the care of the NHS for cancer. In January I had a new treatment for prostate cancer, which has only been available for 4 years. The treatment is non invasive and thus far the results are good. By investing in screening and development of such treatments, people like me don't get ill with cancer and have to live on benefits at huge cost to the taxpayer. I have a friend who recently had stents for a chrnic heart condition. Twenty years ago he'd be living on cardiac drugs or even dead. If he was dead, the taxpayer would be picking up the bill for his family. Lowering the tax bill by having lower levels of chronic illness is a great example. Perhaps the greatest return on investment has been for immunisation programs that have eliminated diseases such as polio, measles and mumps. Improvements in osbstetrics have also massively reduced the number of problems with births. These have contributed massively to reducing the cost of running the nation. If this is not a wise investment, I've no idea what is.

The third way in which investment in the NHS produces a dividend is perhaps the most obvious, even for someone like Fred, who clearly doesn't get business. The NHS is continually developing and pioneering new treatments. Once these have been perfected, they are then licensed and sold around the world. The UK is a centre of excellence and doctors come from all over the world to learn about the innovations we provide. This generates huge amounts of money for the GDP.

Fred Forsyth says that because we won't get a dividend check through the door, it is wrong to define it as an investment. I couldn't disagree more. The dividend check is paid in the way the NHS is continually using technology to develop new treatments, to make more people well again and that citizens of the UK pay less money than any other developed nation for first class medical care. 

There are all manner of reasons someone will invest. Some people invest to recieve a big dividend check. Some people invest in companies, because they know that there won't be dividends for years (even decades) but the company is developing producst that will make the share value rocket (early google investors are an example of this). Then there are people who invest in shares to get a shareholder benefit. For years I held shares in The Restaurant Group. They gave every shareholder 12 vouchers a year that gave them 30% off the full price of a meal for up to 12 people. As the restarants like Frankie and Bennys, Chiquito and Blubeckers were favourites of my family and kids, my £1000 investment was recovered in 2 years of savings on family nights out. For me the best "shareholder benefit" of the NHS is that I am still alive and you really can't get a better benefit than that!

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