Winter crisis in the NHS. 2023 began with renewed media attention on the crisis in the NHS. The Royal College of Emergency Medicine’s Dr Adrian Boyle warned that delays in A&E are causing between 300 and 500 deaths each week. Matthew Taylor, chief executive of the NHS Confederation warned that staff pressures are becoming “unbearable” and “the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised.” Excess deaths are at a 50 year high (9% more than 2019). 

History of underinvestment in capital. The FT’s John Burn-Murdoch explains how the Government has decreased spending on the NHS as a share of GDP relative to comparable economies since 2010, and how this has led to a squeeze on staff pay and a “dearth of [capital] investment” so that “the NHS finds itself hamstrung by acute shortages of beds and the equipment that gets people out of beds faster.” (The NHS required an extra £33bn capital investment between 2010-2019 to catch up to the EU14 average.) The government’s answer to this was the 2019 election pledge to build 40 new hospitals by 2030, however the latest information is that work has only begun on 7 of the hospitals with other projects well behind schedule.

The emergence of a two-tier healthcare system. More of the population are resorting to using private healthcare as an alternative to long waiting lists and declining quality of care. Persistent strain in the NHS has led some (e.g. from David Davis and Sajid Javid) to position insurance-based healthcare systems that utilise the private sector as solutions.  (See the Nuffield Trust CEO Nigel Edwards’s critique of social health insurance based systems.)

Labour’s solution sparks row. Sir Keir Starmer has said Labour would use the private sector in the health service more “effectively” if elected prime minister, which has attracted criticism from some on the left who  have accused Starmer of “ditching [his] pledge to end NHS outsourcing”. In the longer term, Labour has pledged a massive expansion in the NHS workforce, paid for by ending the non-dom tax status, but this would take years to bear fruit and would not help to deal with the immediate backlog.

Ultimately, clearing the backlog requires more funding. As Stephen Bush noted, “A good gauge for deciding how seriously you should take [either political party] is if their reforms are related to either of these two things: investment in healthcare capital and increasing bed capacity.” 

Weekly Updates

Energy and climate change

Energy bills and private renters. According to a new briefing by E3G in collaboration with National Energy Action, the Green Finance Institute and Generation Rent, new energy efficiency standards could save renters £570 per year and help meet fuel poverty and energy demand reduction targets. Currently, private renters are some of the most susceptible to the energy crisis, with over a quarter of renting households in the UK in fuel poverty. E3G says that the Energy Bill in 2023 is an opportunity to “revive” proposals for a revised Minimum Energy Efficiency Standard that the Government initially consulted on in 2020. 

Labour calls for prepayment meter ban. Labour has called for a ban on the forced installation of prepayment meters on households struggling to pay their bills, with shadow climate secretary Ed Miliband calling for the ban to last for at least three months. The number of people forced to switch from credit meters to prepayment meters rose from 380,000 in 2021 to 600,000 in 2022, according Citizens Advice. 

Press coverage of fracking. There were a record number of pro-fracking newspaper editorials in 2022, with 32 published by the Sun alone during this period, according to new research by Carbon Brief. The research highlighted a significant increase in energy coverage in general, with nuclear power and fracking seeing “the most dramatic upticks”.


Oxfam calls for wealth taxes. Oxfam has published a report this week, coinciding with the World Economic Forum conference in Davos, highlighting the extent of global wealth inequality and calling for new taxes to be levied on the super-rich. The report finds that $26 trillion of new wealth created since the start of the pandemic went to the world’s richest 1% and that for every $1 of new global wealth earned by a person in the bottom 90% over the last two years, each billionaire gained roughly $1.7 million. Oxfam is a supporter of the Stop the Squeeze campaign: a coalition of civil society groups who are calling on the government to tackle the cost of living crisis by raising taxes on wealth.

UK tax gap. HMRC is failing to collect billions of pounds worth of tax and is delivering an “unacceptable” service, according to the Public Accounts Committee. The tax gap - that is, the gap between the money owed to HMRC and what has actually been paid - rose to £42 billion in 2021-22, up from £32 billion the previous year. 

Wealth taxes for growth and efficiency? Wealth taxes, rather than capital income (or capital gains) taxes, are more effective in boosting productivity, argues a new academic paper published in the Quarterly Journal of Economics. The study finds that wealth taxes are not only better at lowering inequality, but also at promoting efficiency, because they lead to higher taxes on unproductive wealth. 

Work and inflation

Work and high temperatures. Nearly 30 million UK workers are “in danger from deadly summer heatwaves”, according to new analysis by Autonomy. The report echoes the TUC’s call for a new statutory maximum working temperature of 27 degrees celsius for strenuous work and 30 degrees celsius for indoor work. It also calls for retrofitting programmes to be expanded to include workplaces as well as housing stock. 

Anti-strike legislation. The Government’s Strikes (Minimum Service Levels) Bill passed its second reading in the House of Commons on Tuesday. The new law effectively prevents workers from withdrawing their labour, as trade unions in key sectors would be required to keep “a minimum service level”. 

  • Industrial action myth busting. At last week’s Prime Minister’s Questions, Rishi Sunak stated that the International Labour Organisation supports minimum service levels and that such measures are present in France, Italy and Spain. However, this claim is false, says King’s College London academic Dr Ewan McGaughey. Not only can all French workers take industrial action, claims McGaughey, but they work three hours less per week than their UK counterparts for more pay and only need to give 24 hours notice before a strike (compared to the UK’s strike notice period of two weeks). 

Personal indebtedness and industrial action. Over the last five decades, the rise of personal indebtedness has led to a reduction in the amount of strike activity across a number of countries, according to new research by the University of Bristol’s Giorgos Gouzoulis. Last year, Common Wealth found that although the current wave of industrial action looks set to continue, strike activity is still well below historical averages.

Poverty and inequality

Bright Blue calls for minimum income. Conservative think tank Bright Blue has said that the UK’s welfare system is “not providing enough adequate, accessible and fair support” and has called for a “minimum income” to be introduced. It suggests that a reformed and expanded Social Security Advisory Committee should “recommend levels and uprating of different social security payments to help low-income households meet the ‘minimum living’ income”.