As I suggested was likely in our last seminar together, longstanding Conservatives grassroots darling Liz Truss became the Conservative and Unionist Party’s new leader, and thus our new prime minister. The NHS was listed after the energy crisis and the economy as one of her top three priorities.
So, how’s it going on the economy?
Well… that escalated quickly.
But then, Team Truss did promise “we’re going to hit the ground” in their leadership campaign. It’s good to see a politician really deliver on a commitment.
KamiKwasi economics
In a delightful echo of former chancellor Norman Lamont’s "Non, Je Ne Regrette Rien" heroics on Black Wednesday back in 1992, chancellor Kwasi Kwarteng proved that his solution to the energy crisis was to set fire to the Conservatives’ reputation for economic and fiscal competence.
Kwarteng’s "Growth Plan" hugely cut taxes in ways that heavily favour the wealthiest, while massively increasing borrowing in the pursuit of economic growth.
Market reaction
Conservatives are traditionally fans of free markets. How did the not-traditionally-left-wing bond and currency markets respond to Team Truss’s tax-slashing, borrowing-heavy, "not-a-budget-honest-guv" budget?
It would be safe to say that the markets proved less than keen.
It would, indeed, be fair to say that they think the new government’s economic policy is dangerously incompetent, and vice versa. The value of sterling has tanked, and gilt prices have soared.
Trussonomics: higher inflation = growth?
This will force the Bank of England to raise interest rates higher than it would otherwise have, further fuelling already-rocketing UK inflation.
Inflation is already a big problem for public services in general, and the NHS in particular, as John Appleby and Sally Gainsbury of the Nuffield Trust pointed out in this detailed analysis.
Mr Kwarteng’s people have chosen The Times as their leak-receptacle of choice, and briefed the paper that the Spending Review settlement will not be re-opened in the light of the inflation the chancellor has just avoidably caused (promising more pay squeezes for civil and other public servants). The chancellor is to have Office for Budget Responsibility forecasts published on 23 November, alongside his medium-term fuscal plan (his delivery instructions for "the Growth Plan").
Underwhelming new Plan For Patients
We got a new health and social care secretary, in the shape of Dr Therese "Tiz" Coffey. Dr Coffey’s new "Plan For Patients" left health experts profoundly underwhelmed.
It found a "new" £500m for social care that is not actually new; promised an extra million GP appointments a year, without making clear where the GPs to deliver them will be found; and made no meaningful preparations for the forthcoming winter, when we know that an economic crisis will add to the usual NHS demand-vs-supply crisis once respiratory diseases and falls fractures are joined by the next seasonal wave of Covid-19.
Yet again, the government’s habit of strong briefings to the media (this time, that GPs MUST see patients within two days) turned out in the rather more mundane real world to be merely an "expectation".
The proposals overall represent what NHS England's Pope Amanda Pritchard’s introduction describes as "ambitions".
Nor was there anything on workforce growth or retention. The pensions taper tax and annual allowance issues (much discussed in these columns past) continue to contribute to the Great Resignation. The NHS now has over 130,000 full-time vacancies.
Promoting the launch of her plan, Dr Tiz was also bidding to get people to believe that GP numbers have been "stable".
This is untrue.
The most recent GP workforce data, also published by NHS Digital last month, showed that the number of fully-qualified full-time equivalent GPs continues to fall.
There were 27,507 fully-qualified FTE GPs in July, down from 27,558 the previous month and 27,750 in July last year.
Oh, and the Covid-19 vaccination volunteers will be encouraged to re-enlist in this "national endeavour". It's a missed opportunity that Team Truss and Dr Tiz have not promised to re-open the Nightingales.
Comma police
Dr Coffey’s real priorities seem to be making sure that communications about the NHS are positive, and that DHSC staff do not use Oxford commas. I’ll buy a pint for whichever cunning civil servant slipped an Oxford comma into Dr Tiz’s ministerial introduction to the Plan For Patients.
Andy Cowper is the editor of Health Policy Insight