| The current breakage is many things, including but not limited to: * Overloaded nurses retiring early or shifting career (one of my in-laws switched from nursing to become a builder). * Pay offer too low to encourage new nurses to join the NHS, as they are valued worldwide and have offers in other countries. * Long-term systematic political footballing. * Brexit (harder access to the UK from the rest of the EU combined with the exchange rate shock making the pay offer look worse). * Many elderly patients have nowhere suitable to go after they’ve been treated, because community care is covered by council taxes not central government and the local councils can’t cope. Fixing this requires shifting the tax burden in ways that the government does not have sufficient support to get through even if they wanted to, and it’s not clear to me if they want to. * Medical costs dominated by the elderly, combined with demographic shifts (important because the non-elderly not only pay the taxes but also do the actual work) which IMO was caused in part by newspapers in the 1980s and 90s deciding that the topic they wanted to treat as a social scandal was all the single mothers and teenage pregnancies, leading to government policy of making all the students of that era as frightened as possible of starting families ever, leading to later families, leading to smaller families, which combined with the social dynamics of basically ending the construction of new council housing (and any boost to the private sector being insufficient) meaning that poor people had a much harder time getting a home, and also the fact that effectively forcing widespread two-income-no-kids relationships without extra home construction leads to house price (and rent) inflation rather than people being able to afford more which again leads to the same demographic shift. Oh, and all that also makes the take-home pay of nurses much worse than it might otherwise be, making it even harder to get nurses from overseas or to keep nurses trained in the UK. * COVID and long COVID |