Wednesday, 11 February 2015

Infrastructure

From the BBC

Speaking on BBC Radio Scotland ahead of her speech to the Constitution Unit research centre at University College London, Ms Sturgeon said the SNP would support a "modest" increase in public spending of about 0.5% in real terms.

She said: "Debt and deficit would still be falling as a percentage of GDP over these years but we would free up something in the region of £180bn over the UK to invest in infrastructure, in innovation, in growing the economy."

I don't think this country really needs any more infrastructure. Our problems with health aren't with a lack of hospitals, or even beds to patients to sleep in, it's the money for, and management of drugs, nurses and doctors, and that's mostly just spending. You could maybe count investment in health if people can't work because of illness, but in general, it's the old people who consume the health bill, not working people, and that's not going to pay off (which doesn't mean it isn't spending we shouldn't do, but it's not money-making investment).

We've got clean water, pretty good roads (and the potholes could be fixed for down-the-back-of-the-governments-sofa-money), billions being spent each year improving rail. School buildings seem to be pretty good. Electricity and drainage seems to work. We could do with more reservoirs, but the problem there isn't money, it's NIMBYs blocking development. Broadband speeds are getting faster to the point where most people are satisfied. There's a falling demand for libraries, plenty of lottery-funded sports centres around the place.

I'm not saying there aren't places we could spend more money, and some of that would even count as an investment, but I'm struggling to think of any infrastructure that we need to spend more money on. Anyone?
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MW adds, PC156 has gone off piste a bit: "Whilst you say that in general health spending is consumed by old people this doesn't appear to be born out by the data."

From the FT: "NHS England’s calculations break down how much the NHS spends on patients across 18 age categories. These show that those aged 60 to 64 cost the NHS twice as much as those aged 40 to 44, while those aged 85 and above cost about 10 times as much."

At least one-third of NHS spending is on people over retirement age, that much seems uncontroversial. I vaguely remember reading that it was half, but maybe that includes non-NHS 'social care' costs and subsidies for long term care?

23 comments:

Mark Wadsworth said...

hehe, nailed it.

But seeing as you ask...

1. Fix the potholes, keep existing stuff in good repair.

2. Build a load of state-owned nuclear power stations, same as the French.

3. Widen that one roundabout halfway between Colchester and Walton on the Naze at which the queue is about half an hour.

4. Allow the private sector to expand Heathrow or Luton or wherever. Allow TW to finish off the London supersewer.

5. Maybe do a bit more on the whole 'flood defence' front.

That's about it. More social housing is on the list, but that's not really 'infrastructure' in the way it's usually understood.

Lola said...

No, I can't think of anything. There is quite a bit of things I would un-build - traffic lights, all those pointless fire command centres built by Prescott, etc

The Stigler said...

Mark

Yeah, that's a good list. Nuclear power stations and some A roads.

I'd also say things like NHS software, but honestly, I don't trust government to spend my money wisely on software.

Mark Wadsworth said...

L, yes of course, 'unspend' on traffic lights and bloody speed bumps. But fair's fair, chipping in for better roundabouts, Zebra crossings etc won't go amiss.

TS, NHS software?? You're the expert at these things, I thought you'd dissed all this years ago.

And 'unspend' on anything involving Capita, G4S, A4E and the like.

Bayard said...

"We could do with more reservoirs, but the problem there isn't money"

I understand that much of the problem with water supply is ageing pipes and consequent leakage, which is the water companies' problem to sort out, now that it's all been privatised.

The Stigler said...

Bayard,

That's mostly a problem in London, where doing maintenance is very expensive. They're doing work on it, but they'd rather have a few more reservoirs.

But in Oxfordshire and North Wilts, we still have problems because of insufficient reservoirs. East Anglia doesn't have this trouble. And there's plenty of land around, it's just that the NIMBYs protest against them (it's really odd, because after a few years, reservoirs are actually quite nice to live near, but NIMBYs are so brainwashed against development that they oppose anything).

DBC Reed said...

Surely the whole point is that a halfway sane government would make infrastructure self- financing by taxing the higher land values that arise from its construction.
I can think of loads of major infrastructure and have had occasional letters published in The Guardian about merry madcap schemes which proves to my mind that they may be just about conceivable (at the outer limits of reason ).There was my plan to build a combined bridge/barrage /island/airport in the Thames Estuary to take an HS2 down the East of the country and cross it over to near the Chunnel.Then to back fill the Estuary and solve the shortage of residential land problem of London.I also proposed (I'm fairly sure)removing peat from the Somerset Levels and turning them into a western version of the Broads.Also something similar involving re-flooding the Fens ( the details escape me.)I have annoyed Lola on here by suggesting filling in estuaries generally.
I am sure if the eccentric fringe can come up with HG Wells type visionary schemes ( and don't forget he thought tanks or "land ironclads" would walk around on metal feet and his planes had flapping wings) then more reasonable technical people will eventually come up with similar ideas and be taken seriously.We need an HG Wells today (He was an ace land taxer too.)

paulc156 said...

Regards health spending we're spending far less than most of the developed economies per head of population. For all that we seem to get better outputs for rather less input than those same states but for example we have one seventh the number of MRI's per head of population than Japan and less than half the number that Oz has. And less than anyone the Commonwealth Fund tracks [12 developed economies].

Whilst you say that in general health spending is consumed by old people this doesn't appear to be born out by the data. Typically retired households consume less than double that of working age households in cash terms but only one sixth of the population is of retirement age. Perhaps you were lumping in pensions or non health related benefits?

As for hospital beds, that you seem to think we have enough of. We have less than anyone bar one, in Europe [23 nation comparison by OECD]. Less than half as many per head in Germany,Austria, France,Poland etc. Japan has many times the number we have as does South Korea.

School buildings seem to be pretty good? The Royal Institute of British Architects released a report last year stating that 80% of UK schools are operating beyond they're life cycle. 75% have asbestos in their construction. That we have a quarter million shortfall in capacity as of today. So you seem a little sanguine about some big ticket items.

The Stigler said...

DBC,

I'm all for a new HG Wells coming up with some good new infrastructure idea and making life better. I'm just asking what those things are, either with current technology or something more modern.

The Stigler said...

paulc156,

I'm not referring to health spending. I'm referring to infrastructure spending. Maybe we should spend more on treating people, but do we need more health infrastructure, meaning hospitals, health centres, MRI machines?

Show me your data on health spending by age.

No, we have plenty of beds, as in 6'x3' bits of metal on wheels with a mattress on them. I specifically referred to that rather than what people refer to when they say "hospital beds", which refers to a bed in a hospital with the staff for it, which is non-infrastructure.

And what's RIBA's definition of"operating beyond their life cycle"? 75% have asbestos? Is that harmful blue asbestos or the fairly harmless white asbestos? Is it somewhere buried in the roof of it, or somewhere that kids can breathe it? And what 250K shortfall? Are there kids not in school?

Lola said...

BDC Reed. Filling in estuaries doesn't annoy me, but on a civil engineering view it will more than likely create more problems than it solves.

paulc156 said...

MW & TS.
Mark, the figures for health spending on the elderly are pretty much what you quote from the FT. But you just quote the figure for over 65's being double [per household or person you do not specify] that for a 45 year old. From Parliament UK publications I got the simple stats that 1 in 6 individuals are over 65.
Then that there is a spend of 'less' than double per household;
"in 2007/08 the average value of NHS services for retired households was £5,200 compared with £2,800 for non-retired."
http://www.parliament.uk/business/publications/research/key-issues-for-the-new-parliament/value-for-money-in-public-services/the-ageing-population/

So if wrinklies cost twice as much as younguns but there are only one sixth as many of them how would they account for nearly half of health spending...? [and TS actually said "in general, it's the old people who consume the health bill, not working people". In general sounds like 'most' to me but hey...]

As I say you might want to throw in social care/benefits/etc to make the numbers add up to 'half of health spending'.

TS. You ask if we need more MRI's.
I think the onus might be on you to explain why we might not, since every other advanced economy seems to have concluded that 'they' do.
That info is easy to source. Commonwealth Fund do annual comparisons.
As for any need for additional health centres/hospitals the only country out of the 23 cited in the OECD's European comparison that I used that actually has fewer hospital beds [marginally] than the UK is Sweden. It states that they have invested heavily in local clinics/health centres which has alleviated hospital bed requirements. It could be argued that we don't need more hospital beds rather we need more polyclinics or whatever but to argue we need neither sounds implausible unless we can/already have devised a means of significantly reducing hospital/clinic residence time or admission to either...perhaps by instituting some form of self diagnosis and DIY treatment. :)

Your assumption that we have enough 'beds' just not enough doctors and nurses to man them is something you can corroborate? Only looking at the OECD data for all 34 OECD countries it lists the UK at 28 out of 34 in terms of beds per thousand population, pretty awful at first glance, whereas comparatively we are somewhat less awful regards nurses per 1000 of pop'. 18/34 and only pretty dire regards doctors per 1000 pop' 23/34. Which tends to point towards shortages in all three categories, but most obviously in beds.
http://www.oecd.org/unitedkingdom/Briefing-Note-UNITED-KINGDOM-2014.pdf

Regards schools. The 250,000 surplus of kids: Schools shove kids in libraries, music rooms, emergency classrooms in playgrounds...count the ways.
http://www.architecture.com/RIBA/Campaigns%20and%20issues/Assets/Files/BuildingABetterBritainChapter3Schools.pdf

Re asbestos colours. All three types[white blue and brown] are prevalent apparently;

http://www.publications.parliament.uk/pa/cm201213/cmselect/cmeduc/writev/1056/m1.htm

Re the 80% figure for schools beyond their shelf life. According to Tim Byles, former head of Partnership for Schools he gave the figure as follows; "The NAO-or it might have been the Audit Commission-report of 2002 identified that 80% of our school buildings were beyond their design life.". So that was 12 years ago and I have no idea what criteria either the NAO or Audit Commission may have used.

http://www.publications.parliament.uk/pa/cm201011/cmselect/cmeduc/c394-i/c39401.htm

Mark Wadsworth said...

PC, we have covered all that in other posts. You might or might not have a point and we might or might not agree with you, but I won't go into that here.

As to NHS spending on pensioners:

One in six gets £2 or £3 spent on them for every £1 spend on the other five-sixths.

1 x £2.50 = £2.50
5 x £1 = £5

So pensioners = one-third of total NHS cost.

Again, whether this is relevant to anything or even a 'problem' is a separate debate. Do you see NHS spending from an economic point of view or as a humanitarian thing?

paulc156 said...

MW. Either or? Both really. I'm looking at NHS spending in this instance purely in response to TS's post though. I didn't raise any point that was not addressed in his own comments.
I reckon it would be fairer to say "in general it's <> old people who consume the health bill" since two thirds of money is spent on working households.Or else "in general it's people of working age and younger who consume most of the health bill".

Every other comment I made [re hospital beds, MRI's, schools] was directly in response to specific points made by TS. ['We have enough hospital beds', 'school buildings seem good' 'do we need more MRI's?' etc] I added sources in my last post specifically because I was asked for them. I'd much rather TS had looked up the information so saving me the trouble.

paulc156 said...

That should read "I reckon it would be fairer to say "in general it's NOT old people who consume the health bill".

Bayard said...

"identified that 80% of our school buildings were beyond their design life."

Considering how long buildings used to last (hundreds of years in the case of some still standing), that may be because their "design life" was a concept not really rooted in reality. After all, what's there to wear out in a building, apart from the roof, and that can always be replaced.

Concerning asbestos, most mentions of it are to do with white asbestos nowadays, the vast majority of the blue and brown having long since been stripped out. White asbestos is no more harmful than other building materials like slate or sandstone, but the asbestos stripping industry has to keep going.

Lola said...

B. Buildings do depreciate, but that's not a real problem. Most can be refurbished for re-use at modest cost. My Lower School grammar school building was an 18th Century manor house and it is still in service.

paulc156 said...

Bayard "Concerning asbestos, most mentions of it are to do with white asbestos nowadays, the vast majority of the blue and brown having long since been stripped out"

Most of the time the stuff is left where it is, since it can be more hazardous to disturb it. But I see that in Wales as recently as 2009 the vast majority of schools still appear to have the stuff in considerable quantities and there seems to be just as much of the brown as the white.
Wales - schools - asbestos

Bayard said...

pc156, thank you for pointing me to a brilliant example of asbestos hysteria in the meeja. Note that, in order to keep the hysteria levels up, brown (harmful) and white (practically harmless) asbestos are lumped together, so that it appears that everything in those long lists contain brown asbestos, when, for the wording to be accurate English, only one item need contain brown asbestos and, as you rightly point out, even brown asbestos is harmless if left undisturbed in floor tiles.

paulc156 said...

B. No problem. Yes it is a bit sensationalist and the breakdown between the types of asbestos is vague but the point is there is more in the way of brown than you imagined. There was one entry for Conwy [69 schools] where a percentage breakdown is given for the three types of asbestos:

"Conwy: Out of 69 schools, 60 contain asbestos. 38% white asbestos, 59% brown and 3% blue found in floor tiles, ceiling tiles, boarding and panels to walls and ceilings and toilet cisterns." So in Conwy at least, Brown asbestos is the predominant type found.

Random said...

Reverse flood defense cuts. Perhaps some more social housing.
Biggest problem with NHS is not money but lack of real resources. We are stealing doctors and there is hardly a surplus of them in the world.

Bayard said...

Fair enough, but, suspiciously, it still doesn't give any idea of the actual amounts.

I'm surprised, TBH, that given those findings, the blue and brown asbestos hasn't been removed. Perhaps it has, by now.

James James said...

Do we have to have another runway at just Heathrow or Luton or Gatwick or Stansted? Why can’t they all get an extra runway? Plane tickets would plummet in cost.