If Britain is broken, here are ideas on how to fix it

Central London gathering of policy experts and academics hears suggestions about how to revive Britain’s public services and stuttering economy

Royal London Hospital: A report this week revealed National Health Service accident and emergency wait times caused 14,000 deaths each year. Photograph: Carl Court/Getty
Royal London Hospital: A report this week revealed National Health Service accident and emergency wait times caused 14,000 deaths each year. Photograph: Carl Court/Getty

On Thursday, as hundreds of policy wonks and academics gathered for a London conference on how to fix Britain, the Nesta think tank behind the Policy Live event erected an ideas wall at the venue on the south bank of the river Thames.

Conference delegates were encouraged to jot down on a coloured Post-it note a single idea to solve Britain’s myriad economic and social problems, and stick it up on the wall. The crowd included a large contingent of the young and eager academic types who tend to roll off the conveyor belts of Britain’s most prestigious universities and into think tanks and politics to work as advisers and aides.

“Include public opinion in policymaking,” said one Post-it. “Give childcare loans, like student loans,” said another. “Regulate supermarkets: healthier food on our shelves… Make arts education a core part of the syllabus… Ban smartphones for under-16s… Give parents extra votes for their children.”

Among the various ideas – from the practical to the quixotic – one Post-it stood out in the middle of the wall. “Votes for six year olds” it said, a slice of old-fashioned British gallows humour that neatly captured a sense of exasperation that has enveloped post-Brexit Britain; the sense that things are so bad they may as well put their kids in charge.

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Canvass the views of enough ordinary Britons and a theme will emerge: the National Health Service is “broken”, it’s hard to get a dentist appointment, living standards are declining amid a struggling economy, kids are growing up in poverty, work doesn’t pay, schools can’t find teachers, trains don’t run on time…

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Incantations of the “Broken Britain” mantra peaked ahead of the July general election, which the Labour Party won on a promise to usher in a “decade of national renewal”.

This week’s Policy Live event – facetious Post-it artists notwithstanding – chimed with the post-election sense that Britain now needs to find solutions. The wonks and academics, political advisers and officials who packed out the event spent the day identifying the nation’s issues and how to address them. If Britain is broken, here are a few of their ideas to fix it.

Patients at the Queen’s Hospital emergency room in Romford: There is a general sense that the National Health Service is broken. Photograph: Andrew Testa/New York Times
Patients at the Queen’s Hospital emergency room in Romford: There is a general sense that the National Health Service is broken. Photograph: Andrew Testa/New York Times

Health

The conference was held on the same day a report into NHS failings was released by Ara Darzi, a member of the House of Lords who was asked by Keir Starmer’s new Labour government to conduct a review. His findings were sobering.

Darzi’s report said NHS accident and emergency wait times caused 14,000 deaths each year. Cancer mortality rates were higher than other nations. The NHS was deprived of capital investment, resulting in “crumbling” infrastructure. The service was unable to cope with a surge in mental health conditions. Up to 2.8 million were unable to work due to poor health.

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Jennifer Dixon, a health policy expert renowned in Britain, chaired a Policy Live session on how to “save the NHS”. She noted that as Starmer welcomed the Darzi report, he said the NHS must “reform or die”. What he didn’t say, Dixon noted, was “invest or die”. The panel concluded that savings from NHS reforms must be ring-fenced for long-term investment.

Tina Wood, founder of advisory firm Collider Health, said the NHS system must be completely “digitised”. The frailty of the current system was underlined by a Microsoft IT failure in July that completely crippled the NHS system for doctors’ appointments and prescriptions. Wood suggested Britain must build sturdy digital systems of its own. She also called for reform of on-the-job training for NHS medical staff, which is inefficient and bureaucratic.

Siva Anandaciva, an analyst with the King’s Fund health think tank, suggested NHS policymakers were too distant from patients. He said patients should be directly “asked for their ideas” during the decision-making process, and not just simply presented with findings that have already been made.

Jeremy Hunt, the former Tory chancellor, told a later Policy Live session that the government should abandon the roughly 100 NHS target metrics that occupy the attention of managers. Labour, meanwhile, said it would tackle waiting lists by buying more diagnostic scanners to speed up the scans necessary before treatment can start, while also lengthening opening times of NHS facilities to increase the number of appointments.

A sign directs people to a local food bank in Leeds: Almost 30 per cent of British children live in relative poverty, rising to 47 per cent for children in black and other ethic minority groups. Photograph: Christopher Furlong/Getty
A sign directs people to a local food bank in Leeds: Almost 30 per cent of British children live in relative poverty, rising to 47 per cent for children in black and other ethic minority groups. Photograph: Christopher Furlong/Getty

Living standards and poverty

Maria Sloan, Nesta’s chief of staff, told the event that almost three in 10 British children live in relative poverty. This rose to 47 per cent for children in black and other ethic minority groups. The rates were highest in England’s West Midlands and North East.

Emily Fry, a senior economist at the Resolution Foundation, told the event that growth in real wages in the British economy had plateaued since 2008. Incomes growth was nonexistent, especially for lower-income workers, yet economic inequality had soared. It was, she said, “a toxic combination”.

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Paul Gregg, who was an adviser to former prime minister Gordon Brown, said earnings growth needed to become a core focus of government. There were too many low-paid jobs, he suggested, and having a job didn’t necessarily lift a family out of poverty as it would have in the past. He also advocated for government controls on rents and an end to “no-fault evictions”, which the Labour government has already said it will ban by next summer.

Many of the speakers at Policy Live concluded that the two-child benefits cap should be scrapped to help larger families out of poverty; Labour has said it cannot afford to lift the cap, however. Also, the conference heard that about £19 billion (€22.5 billion) of benefits go unclaimed each year because people do not know they are entitled to them.

“The direct solution to child poverty is money,” said Sarah Ogilvie, of the Child Poverty Action Group.

Reform of the planning system has been identified by the British government’s chancellor, Rachel Reeves, as key to increasing moribund economic growth. Photograph:  Darren Staples/PA
Reform of the planning system has been identified by the British government’s chancellor, Rachel Reeves, as key to increasing moribund economic growth. Photograph: Darren Staples/PA

Economy

Jeremy Hunt, who was chancellor for 21 months until July, suggested “welfare reform” was needed to address Britain’s chronically inactive workforce. More than one-fifth of Britain’s working-age population is not economically active. This includes the 2.8 million who are too sick to work, although Hunt suggested the benefits system also encouraged others not to work.

He said that if the government could prick Britain’s economic inactivity bubble, it would boost productivity and also ease social pressures over migration that had exacerbated political and social divisions, as companies would seek fewer workers from abroad.

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He also said Britain needed a “realistic” industrial strategy to drive growth, based on the tech-heavy economies of Korea and Israel. Diane Coyle, a Cambridge economist, said Britain also needed to come up with ways to spur public and private investment, which badly lagged other countries.

It was also suggested that incentives be developed to encourage more investment in companies run by “social entrepreneurs”, who run organisations that are not focused solely on profit and addressed social needs. Such businesses, said Holly Piper of Fair4All Finance, employed workers who were “further away from the traditional labour market” and their inclusion would drive growth and rates.

Reform of the planning system has been identified by the government’s new chancellor, Rachel Reeves, as key to increasing Britain’s moribund economic growth. Reeves’s predecessor, Hunt, said this should also happen alongside reform of environmental legislation, which he claimed was exploited by some to stymie planning. “A planning application goes in and suddenly there are concerns over the lesser-spotted vole,” he said. “We’ve got to overcome that.”

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