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Archive for the ‘Financial Crisis’ Category

NHS healthcare spending: we need a Plan B

Wednesday, August 4th, 2010

presentation1

Costing an Arm and a Leg: a plea for radical thinking to halt the slow decline and eventual collapse of the NHS - a new IFF report - was published last month.  It has attracted some attention and editorial comment in the Scottish, UK and specialist press.  But it carries an uncomfortable message that few want to engage with.

The argument it makes is very simply stated. The budget of the UK National Health Service has risen inexorably since its foundation in 1948 – in spite of every effort to curb costs. The familiar agenda of efficiency savings, shared services, technological innovation, reorganisation etc a) has not delivered in the past; b) cannot close the gap it is expected to close in the future; and c) to the extent that it does will also raise costs elsewhere.

In other words, the history of the past sixty years points inexorably to the conclusion that the range of measures currently dominating political and policy discussion cannot sustain the NHS as we know it.

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Efficiency savings, shared services, pay freezes… we’ll need to be more imaginative than that!

Tuesday, April 20th, 2010

audit-scotland

I spoke recently at the CIPFA Scotland annual conference - about the challenge to our public services in a recession.  With a nod to its location in Dundee, the conference was heralded as a ‘Voyage of Discovery’.  That seems appropriate for the spirit of adventure we will need in the next few years.  But I am not sure how many of the delegates were really ready for a journey into the unknown.

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Financial Crisis – seeds of hope

Wednesday, March 4th, 2009

black-swans-003IFF, like any other sentient organisation, has been thinking about the causes and consequences of the global economic and financial crisis.  We recently brought together a number of members in a workshop to take stock of our collective analysis, scanning and conversation of recent months - and to see what we might have to offer to a wider constituency. 

The IFF financial crisis workshop report notes that the financial crisis is now widely recognised as a ‘conceptual emergency‘ in IFF terms.  Part of the mainstream analysis is precisely about how we came to rely on concepts and mathematical models that proved (like all models) inadequate to complex human reality.  Wired’s article on David Li’s ‘formula that killed Wall Street‘ is a parable for our times on the often misleading power of simple answers to complex questions.  Paul Krugman makes the same point: 

‘Some people say that our economic problems are structural, with no quick cure available; but I believe that the only important structural obstacles to world prosperity are the obsolete doctrines that clutter the minds of men.’ 

In our workshop we explored some of those assumptions, doctrines, that are now open to challenge.  Here are a few:

  • ‘Events that cannot be predicted are not going to happen’ - Challenge:  black swans can be anticipated. 
  • ‘Better regulation will prevent future crises’ - Challenge:  the modern economy is an edge of chaos phenomenon, the cliff will always give way from time to time.  
  • ‘The stimulus packages will work’ - Challenge:  not if they fail to account for systemic effects beyond the intention of any individual rational actor, and not if they only serve to repair the bubble effect in the existing system.
  • ‘We just need to wait for the upturn in global economic growth’ - Challenge:  there are significant structural shifts in the global economy ahead that may have a big impact on global growth patterns, financial crisis or not.

If we are willing to entertain these challenges, and engage with the true level of uncertainty in the future environment, we will be both better prepared for anticipated future shocks and to take advantage of otherwise hidden opportunities. 

The workshop concluded with some of the ‘promising seeds of hope’ we see ahead, including the next big economic plays required to replenish the global coffers, and the opportunities for NGOs and others to shift the global system decisively towards more sustainable models.  Indeed, one of the great uncertainties is who will prevail:  those who seek to repair the old system or those who want to innovate the new?