[MagnumOpus]

To put that 1.5% annual real-terms budget increase into context:

In the same decade the proportion of people aged 65+ increased from 16% to 22%ish of the population, an increase of a third. Since these are the people who consume the vast majority of NHS resource, the actual age-adjusted funding has been shrinking steadily every year.

[origin_path]

But we're not talking about whether budgets increased by as much as random HN commenters feel would be ideal, I said funding had increased massively i.e. in absolute terms, which it has.

Any discussion of the NHS budget has to accept this reality - the British state is already deep in deficit for decades and had built up incredible debts just trying to keep the NHS budget rising, which it always has. To say the NHS would works better with more money is simply to admit it's broken and can't be fixed, because the government can't even afford the current levels. Especially not after the attempts to stop COVID blew debt and inflation through the roof.

[Dagger2]

We were talking about the NHS being underfunded, and you said that funding has increased in absolute terms. Both of these things can be true simultaneously.

[origin_path]

But, we were not. This thread starts with the claim that "NHS funding has massively increased under the Conservatives" (true) and someone else saying "that's simply not true". But it is true.

NHS apologists always seem to try this switcheroo: someone will point out NHS funding has massively increased - an objectively true claim - and then they'll be accused of lying, by someone who claims it's "underfunded", an entirely subjective and different claim. As you point out, both can be true, but the latter is not disproof of the former nor even a well defined statement.

[Dagger2]

Looking up in the thread, I see "Another is the massive. underfunding of the NHS over the last decade" in the first post and things like "No, it isn't due to lack of funding, that's a lie" in the replies.

That definitely sounds like the thread was talking about underfunding/lack of funding to me.

Also, for what it's worth, I think your use of "massively" carries an implication to the reader that funding has increased above and beyond maintenance levels (i.e. that it's gone up in real terms, compared to inflation and demographic changes), as I think most people wouldn't describe increases that are below the level needed to maintain service relative to costs as being "massive increases". You'd probably get less pushback if you described it as "increased in absolute terms", or specifically pointed out that the funding increases have been lower than the underlying cost increases.

I know you did eventually add the "in absolute terms" part, but perhaps consider starting with that next time.

[origin_path]

Here's the post upthread I mean:

https://news.ycombinator.com/item?id=32540740

"I think your use of massively carries an implication to the reader that funding has increased above and beyond maintenance levels"

The word massive here just means a massive amount of money relative to other levels of government spending changes. From 2010-2020 most govt departments got budgets that went down (austerity), but the NHS was excluded and its funding continued to increase. The amount of money it got is truly massive even on the scale of government.

Trying to talk about "real terms" or "maintenance levels" with something like the NHS is impossible because demand for healthcare constantly increases even with a stable population demographic (some speculate that healthcare demand is actually infinite), as does demand for increased wages. History has shown that there is simply no level of funding increase that the NHS's supporters would ever consider sufficient because they can always claim that the system is strained, could use more people, better paid people, the latest treatments etc. So there's no fixed level that can be identified as maintenance, as one person's maintenance is another's underfunding, which is why all claims about underfunding are impossible to argue with - the statement is literally meaningless.

Related problem: enormous sums of money get allocated to it at a time when every other service gets cuts, explicitly earmarked for upgrades to capacity or buildings and it all gets immediately spent on pay rises in blatant defiance of direct government instructions. So service capacity doesn't change at all but govt can't do anything because too many voters worship the NHS and assume it's perfect except for lack of money.