At first blush, Rishi Sunak’s pledge to cut NHS waiting lists looks not just sensible, but absolutely imperative. The backlog since Covid alone numbers in the millions and horror stories of monstrous delays abound.
Even a seemingly obvious policy has its pitfalls though. According to Matthew Taylor of the NHS Confederation, focusing too heavily on waiting lists means the Government is ‘caught on an endless hamster wheel’, doling out ever more cash to treat sick people, because we haven’t focused enough on stopping them getting ill in the first place.
Taylor’s comments are reasonable, if not especially novel, in the context of British healthcare. Quite a few observers have noticed that we spend a relatively trifling amount on prevention, but an enormous amount on treating the already sick. (Indeed, it’s one of the issues we discussed on this week’s CapX podcast with Isabel Hardman of The Spectator.)
But that ‘hamster wheel’ analogy is a useful way of looking at other areas of policy where the Government is constantly picking up the pieces of deep policy failures, without really addressing their root causes.
Take reports that Rishi Sunak is about to clamp down on the number of students doing ‘low value’ courses. Part of this is down to his own predecessor’s decision to uncap student numbers in 2016, which has added to a surfeit of low-earning graduates who can’t pay back their student debt.
But it’s also a symptom of a much deeper problem of ‘elite overproduction’, whereby successive governments have insisted we produce a certain proportion of expensively educated graduates, rather than preparing young people for the realities of our jobs market. Capping student numbers might deal with the tip of that iceberg, but it won’t solve the underlying issue.
Or look at energy, where ministers have kept the hamster wheel spinning by subsidising household bills, at enormous cost. Of course, this was prompted by the war in Ukraine, but it also exposed decades of shortsighted policy on gas storage and infrastructure – decisions that went on to cost us all more in the long run.
Or look at childcare. As our deputy editor Alys Denby has written, the response to high costs has been to spend billions on various packages of ‘free’ hours. Far from freeing up parents to work more or ensuring the long-term vitality of the sector, we now have a policy that manages to be illusory, regressive, costly and detrimental to childcare providers all at once.
This week’s big issue of public sector pay is starting to feel a bit hamster wheel-y too. The recent agreement to raise millions of workers’ salaries by 6-7% (depending on which service you work in) may be good politics. But as Mark Lehain wrote on Friday, it risks sending a clear message that if you strike often enough, the Government will give in.
Not only is our chronic short-termism a very unsatisfactory way of making policy, but the hamsters spinning the wheel are struggling British taxpayers – and they are getting very, very out of breath.
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