A simple guide to us all being fatty lardbuckets


Allister Heath has picked up on the excellent work that Chris Snowden has been doing over at the IEA on the obesity issue. Weights are indeed rising but it is not because we are all eating more. The reason that's not the reason is that we're not all eating more: calorie consumption is falling as it has been for a century. The current median diet is today well below the level at which people would lose weight under WWII rationing. Something else has changed and it's actually the amount of energy we expend, not what we consume, which has. As regular readers will know we think that it's central heating which is the big issue here, not in fact exercise. Which, given that the main energy expenditure of mammals is temperature regulation makes a lot of sense to us.

However, Heath makes clear something that can be used as a very useful little tell tale:

We aren’t addicted to high fructose corn syrup either. For reasons relating to tariffs and agricultural policy, Americans consume 25 kilograms a year, against less than half a kilogram for us.

If anyone starts going on about how it's fructose which is the problem, or HFCS, then we can immediately dismiss them as a crank. Or at best, woefully misinformed. Because people are turning into fatty lardbuckets at similar rates in the US and UK. And across Europe too, where HFCS consumption rates vary. So, given the huge variance in fructose consumption, but the same problem everywhere, then it cannot be the fructose causing the problem.

This is not, obviously, a startling revelation, but it is a handy little mnemonic. Warbling on about fructose just doesn't cut it we're afraid.

Scrapping deposit insurance is a perfectly respectable idea

Our friends the Centre for Policy Studies have a report (pdf) out today, by banker/adviser Andreas Wesemann, which argues for the abolition of deposit insurance. This shocked and appalled some, including All Souls professor Kevin O'Rourke, who asked Twitter if Wesemann and the CPS could possibly be serious.

Yes, they could be serious. Scrapping deposit insurance is an idea with a fairly impressive pedigree. O'Rourke is presumably aware of the hugely-cited 2002 paper "Does deposit insurance increase banking system stability? An empirical investigation", in the prominent Journal of Monetary Economics (the 22nd highest impact econ journal by ideas.repec.org's most sophisticated ranking system). If he wasn't, Garett Jones pointed it out to him on Twitter. It looks at 61 countries between 1980 and 1997 and finds that explicit deposit insurance tends to lead to more banking crises.

This is, of course, precisely what the CPS paper argues. And one of the JME paper authors, with different collaborators, updated the analysis in 2015, looking at data from up to 2013 from across the world, with largely unchanged results (pdf). They point out that insuring deposits may restrain bank runs, but it encourages worse sorts of instability, and drives bank risk-taking. We might add that if debt is a worry, then subsidising deposits but not equity is yet another intervention encouraging debt over other, potentially less worrisome, ways of funding investment.

It's true that not every paper supports the CPS conclusion. Some find that deposit insurance cushions the market in bad times, even if it makes these bad times worse. Others find that the runs that a no-insurance regime allows are a key element of discipline in the system, working toward higher long run stability even as they destabilise in the short run. In the absence of systematic reviews and meta-analyses I can only give my own impression of the literature, which it seems to me sides mostly with the 2002 finding from Demirgüç-Kunt & Detragiache.

But whatever the overall tenor of the research, it's clearly an academically popular position that deposit insurance brings with it clear dangers. So I'd ask O'Rourke and others to tone down the shock and horror—abolishing deposit insurance is a perfectly respectable position. Now how about reconsidering all that Basel III business...

If only Owen Jones actually understood economic numbers


We do find it difficult to understand Owen Jones. He has, in recent years, told us that Syriza in Greece, Podemos in Spain, Chavez and Maduro in Venezuela have all been economic examples we might want to copy. Quite why such a collection of basket cases have been held up for admiration we're really not sure. But today we are at least beginning to have an inkling. Jones simply doesn't know: he doesn't know the numbers, doesn't understand what the various economic numbers are telling us and him. This might seem like a minor example we're to show you but it's part and parcel of that, well, that ignorance in fact.

But consider the plight of the majority of Americans. We know that, six years into his presidency, poverty was still higher than before the financial system near-imploded. While child poverty has been alleviated for many Americans in the past five years, for African-Americans it has remained stubbornly constant.

The link for the child poverty is to this report. And that's not a measure of child poverty at all. It's a measure of how many children would be in poverty before the things the US government does to take people out of poverty.

To understand: there are now two measures of poverty in use in the US. The Official Poverty Measure, which is three times a basic but nutritious diet in the early 1960s upgraded for inflation since then, adjusted for family size. It is an absolute measure of poverty: it does not consider how lifestyles in general have been improving over that time. The other is the Supplemental Poverty Measure: this is very much more like our own measure, one of relative poverty, relative to the median income. The SPM also includes the various things that the US does to try and reduce poverty and under that measure child poverty rates are quite similar to what they are here in the UK.

However, the thing about the OPM, which is what Jones is considering, is that it does not include those poverty alleviation measures:

The income and poverty estimates shown in this report are based solely on money income before taxes and do not include the value of noncash benefits, such as those provided by the Supplemental Nutrition Assistance Program (SNAP), Medicare, Medicaid, public housing, or employer-provided fringe benefits.

That it doesn't include taxes also means that it does not include the EITC, the US equivalent of our tax credits. And pretty much all of America's poverty alleviation efforts come through either that EITC or the direct provision of goods and vouchers: all the things not considered in this estimation of poverty. They spend about $800 billion a year or so on them, they do alleviate a lot of poverty. In fact, the one thing that the US poverty alleviation system is very good at is the alleviation of child poverty. When we measure against that OPM, but add in those benefits in tax and in kind, child poverty in the US pretty much disappears in fact.

The error that Jones is making, as so many others do, is akin to looking at the British figures before all taxes and benefits. Something that is done here. Figure 1 tells us that (using our relative poverty measure of less than 60% of median household income) fully 40% of Britain is in poverty. Which is of course a nonsense. Because we cannot measure, usefully, poverty before the things we do to alleviate poverty.

We can also test this in another related manner. The Gini is not quite the same thing but it is indeed related. And if we look at the pre-tax and benefits inequality of various countries the US does not stand out in any remarkable manner. It is, before that redistribution, less unequal than France or Germany, only a little above Sweden or the UK.

Is the final outcome in the US more unequal? Yes, indeed it is. They do less redistribution than most European countries. However, to go around measuring poverty by the gross numbers for the US, before tax and redistribution, and then try to compare it to the net numbers, after tax and redistribution, for other countries is simply absurd. Or, of course, ignorant.

As Mark Twain pointed out, it's not what you don't know that's dangerous, it's what you do know but ain't that is. And thus we think we've found our solution to the conundrum of Owen Jones. He simply doesn't know the subject he's pontificating upon, just doesn't grasp the economic numbers. And thus his being led into the error of being a socialist.

An Introduction to the Bank of England’s Stress Tests

This posting provides an introduction to the Bank of England’s recent stress tests on the UK banking system. It suggests that a stress test can be compared to a school exam: there is the exam paper or stress scenario and there is the performance of the candidate against a pass standard to determine whether the candidate passes or fails. More precisely, with a mild stress scenario, a highly gameable capital-adequacy metric to assess performance and a very low pass standard, the Bank’s stress tests can be compared to an exam that is extremely easy to pass. This bias towards a ‘pass’ result undermines the credibility of the entire exercise. (For the previous blog in this series, see here.)

The purpose of central bank stress testing is to assess the banking system’s capital adequacy, i.e., the ability of banks to withstand financial stress. A stress test has three key components:

  • An assumed adverse stress scenario – essentially a guess scenario generated by modellers at the central bank.
  • A metric to gauge the strength of each bank. This metric is the bank’s capital ratio – the ratio of ‘core’ capital to some measure of the total amount ‘at risk’ - the intuition being that core capital provides a buffer to absorb potential losses and keep the bank solvent in a crisis.
  • A pass standard by which we determine whether the post-stress value of the capital ratio is (or is not) high enough to merit a pass mark in the test.

There is a natural analogy here with a school exam, the purpose of which is to assess a student’s academic strength. It too has three key components:

  • There is an exam paper based on a set of questions, and underlying this, the issue of how easy or tough the exam paper might be. The easiness/toughness of an exam paper is comparable to the severity (or otherwise) of a central bank’s stress scenario.
  • There is the performance of the candidate in the exam, i.e., the mark they receive.
  • There is the pass standard, i.e., the minimum mark that a student must achieve in order to pass the exam.

We then draw our conclusions. For example, if we had an easy set of questions and a low pass standard and the student achieved a low mark, then we shouldn’t conclude that the student is academically strong.

Similarly, if we had a stress test with a mild stress scenario, a low pass standard and generally low post-stress capital ratios – all of which are in fact the case with the Bank’s stress tests – then we shouldn’t conclude that the banks are financially strong.

Yet this is exactly the conclusion that the Bank draws from its stress tests.

We should also say a little more on the capital-adequacy metrics and the pass standard.

To evaluate a bank’s capital adequacy, we need estimates of both the numerator (core capital) and the denominator (the total amount ‘at risk’).

By core capital, we mean the capital available to support the bank in the heat of a crisis. However, there are a number of different core capital measures available and some are more reliable than others. Their reliability is in inverse proportion to their broadness: the broader the capital measure, the more ‘soft’ capital it includes and the less reliable it is. The narrowest and best is Common Equity Tier 1 (CET1), which approximates to tangible common equity (TCE) capital plus retained earnings. In this context, the ‘tangible’ in TCE means that it excludes ‘soft’ items such as goodwill and other intangibles that cannot be deployed to help it weather a crisis, and ‘common’ means that it excludes more senior capital items like preferred shares and hybrid capital. However, in its stress tests, the Bank also uses a broader definition of capital known as Tier 1 capital; this is equal to CET1 plus some additional and therefore softer hybrid items.

As with any exam, a major concern is cheating – or ‘gaming’ to use the more polite language used in this area. In the case of the capital measure, the concern is with banks’ ability to exploit loopholes (e.g., by stuffing softer and less expensive-to-issue capital items into the core capital measures approved by regulators) and, of course, with their lobbying to create such loopholes in the first place.

Then there is the denominator, the total amount ‘at risk’. Traditionally, this was taken to be the total assets of the bank. However, for many years now the on-balance-sheet amounts at risk have been dwarfed by the amounts at risk off the balance sheet in securitizations, contingent liabilities, derivatives etc. These off-balance-sheet risks have long since made the total assets measure highly inadequate.

To make matters worse, the exposure measure long favoured by the Basel system is not total assets, which would be bad enough, but so-called ‘Risk Weighted Assets’. We can think of RWAs as a game to lower the ‘at risk’ numbers in order to get lower capital requirements. In this particular game, every asset is given a fixed arbitrary ‘risk weight’ of between 0% and 100%. So, example, the debt of OECD governments would be given a zero risk weight on the presumption that it is riskless – that’s right, Greek debt is considered riskless! - whereas commercial debt would be given the full risk weight of 100%.

The result is to create artificially low ‘Risk Weighted Asset’ measures that are much lower than total assets. To give an idea, latest available data for the UK banks that participated in the stress test show that their average ratio of RWA to total assets was a mere 33%, which means that on average across the system, two thirds of bank assets are deemed by this measure to have no risk at all! And one institution – the Nationwide - had a RWA to total assets ratio of just under 18%, meaning that no less than 82% of its assets were deemed to be entirely risk-free. So either these banks have indeed taken very low risks or they are just very good at playing the risk-weighting game. The evidence suggests the latter.

Going further, this RWA system is tailor-made for gaming: you load up on zero-weighted assets and you are rewarded with a lower capital requirement because you are deemed to have low risk. In limit, you could load up entirely on zero-weighted assets: you would then be deemed to have zero risk and incur a zero capital requirement. If we look at the data, we see that average risk weights across the big banks have trended down from about 70% in 1993 to a little below 40% by 2011. If this trend continues, then the average risk weight should hit zero by 2034 and every single risk in the banking system would be invisible to the risk-weighted measurement system.

There is also abundant evidence – most notably that provided in a widely cited paper published by the Bank of England itself [1] – to suggest that the RWA measure is so poor that it actually gives a contrarian indicator of risk, i.e., that a fall in RWAs indicates rising risk!

Part of the explanation is that banks were loading up on assets with low RWAs to reduce their capital requirements.

Even more worrying is that banks were also engaging in vast derivative and securitization transactions to move assets from high to low weight classifications to reduce their capital requirements even further. Indeed, this game even had a name – Risk-Weight ‘Optimisation’ (RWO) – and RWO really means risk-weight minimisation.

And this RWO that almost no-one has ever heard of was the main driving force behind the enormous growth in derivatives trading and securitization in the years running up to the Global Financial Crisis (GFC) – and in so far as it led to (much) greater risk taking and (enormous) capital depletion it was also a major contributing factor to the GFC as well. [2]

Thus, a low RWA does not indicate low risk; instead, it indicates RWO: it suggests that the banks concerned are taking more risks, but are better at hiding them from the risk measurement system.

To help deal with these problems, the Basel III international bank capital adequacy regime introduces a new measure of the amount at risk known as the ‘leverage exposure’. This measure makes a half-hearted attempt to incorporate some of the off-balance-sheet risks that do not appear in the total assets measure. However, the adoption of this new measure was subject to the usual bank lobbying and one must have serious doubts about it. Nonetheless, if we rule out the RWA measure, then we are stuck with a choice between total assets and the Basel III-based Bank of England version of leverage exposure as the only exposure measures available to work with.

With both the capital and exposure measures, we should also be concerned with the mischief that arises from highly gameable accounting rules. Examples include the abuse of hedge accounting rules to hide risks, and the abuse of International Financial Reporting Standards (IFRS) accounting rules to create illusory capital, which makes banks appear more capitalised than they really are, and to create fake profits, which can then be siphoned off as bonuses to the bankers who created them and in the process decapitalise the banking system. [3]

Returning to our main theme, the Bank uses two different capital-adequacy ratios in its stress tests:

  • The first is the ratio of CET1 capital to RWA – the so-called ‘CET1 ratio’ – and it is the tests based on this ratio that the Bank always highlights in its headline commentary on the stress tests.
  • The second is a supplementary capital ratio (the so-called ‘leverage ratio’), the ratio of Tier 1 capital to leverage exposure.

Neither of these ratios is entirely satisfactory: the first because it uses the worse than useless Really Weird Assets measure, and the second because it uses a softer capital measure (i.e., Tier 1 instead of CET1). However, notwithstanding this latter weakness and one’s doubts about the leverage exposure measure in its denominator, the leverage ratio provides a much better metric of capital adequacy than the ratio of CET1 capital to RWAs, precisely because it is not dependent on the fatal flaws in the latter.

It was therefore unfortunate that the Bank of England chose to focus on stress test results using the CET1/RWA ratio rather than the leverage ratio.

Then there is the question of choosing a suitable pass standard.

One approach is to choose a pass standard that reflects the minimum regulatory capital standards imposed on banks – most obviously, the standards imposed under Basel III. Indeed, the Bank itself suggested pass standards of at least Basel III quality. As it explained in the October 2013 Discussion Paper setting out the stress testing framework:

A key consideration [in setting the pass standard] will be the minimum level of capital required by internationally agreed standards. Banks need to maintain sufficient capital resources to be able to absorb losses in the stress scenario and remain above these minimum requirements.

The document then notes that under the Prudential Regulation Authority’s proposed implementation of CRD IV, the EU Directive on capital regulation, there is a minimum CET1 [to RWA] requirement of 4.5%, and it observes a little later that “CRD IV [also] requires banks to have at least a 2.5 percentage point buffer of capital above the 4.5% minimum.” [4] Note the word “required” here.

In short, the Bank suggests that the hurdle rate/pass standard should be at least as high as internationally agreed minimum required capital standards [read: Basel III] and it acknowledges that this minimum required standard is at least as high as 7%.

But for reasons best known to itself, the Bank then chose a pass standard that fell below these minimum standards: it set the pass standard at 4.5%.

A cynic might suggest that the Bank chose a mild ‘stress’ scenario, focused on a very ‘soft’ and highly gameable capital adequacy metric (the CET1/RWA ratio) and chose a very low pass standard to engineer an undeserved ‘pass’ result for the UK banking system.

I am not suggesting that the Bank actually did this, but the Bank’s stress tests could be construed that way.

And this is a big shame, because it undermines the credibility of the whole exercise – the Bank of England failed its own stress test.

In the next posting, I will start to examine the stress tests in more detail.


[1] See A. G. Haldane, “Constraining discretion in bank regulation,” April 9, 2013, p. 15, chart 2.

[2] See G. Kerr, “How to destroy the British banking system – regulatory arbitrage via ‘pig on pork’ derivatives,” The Cobden Centre, January 21, 2010.

[3] For more on these problems with IFRS accounting standards see T. Bush “UK and Irish Banks Capital Losses – Post Mortem,” Local Authority Pension Fund Forum, 2011, and G. Kerr, “The Law of Opposites: Illusory Profits in the Financial Sector”, Adam Smith Institute, 2011.

[4] Bank of England, “A framework for stress testing the UK banking system,” (October 2013), p. 28.

We're afraid that it's true, maternity leave does contribute to the gender pay gap


This might not be quite what people want to hear but it is in fact true:

Women's careers can nosedive if they take more than a year off after having a baby, experts warned yesterday. New mothers may struggle to get back into the workforce, earn less and be passed over for promotion in what has been described as a ‘motherhood penalty’. A panel of women representing the teaching, legal, medical and recruitment professions told MPs that mums who spent more than 12 months on maternity leave were ‘penalised’. Dr Sally Davies, of the Women’s Medical Federation, said: ‘Anything more than 12 months is a detriment – you will not be looked at quite in the same way, sadly, when you return.’ Amanda Fone, chief executive of F1 Recruitment, said she would discourage women and men from taking more than a year off to care for children because it was ‘so difficult’ to return to a role equivalent to the one they left. She claimed legislation had ‘got in the way’ of women being able to have honest discussions with their employers about their plans to have a family.

As we've pointed out many a time before we don't in fact have a "gender" pay gap any more. What we do have though is a motherhood pay gap. And this is made up of two rather different things. The first is simply the general societal background to the process of child rearing. Whether it should be this way or not (not that it is a surprise in a mammal species) it is true that in general women take on more of the child rearing work than men do. Thus things like careers, on average, take a bit more of a back seat for women than they do for men. Perhaps that should change: but a goodly part of the distinction between male and female average wages comes from that deep rooted fact of our society, not from any discrimination by employers.

The other cause is the actual process of having the children themselves and that associated maternity leave. Some part of the pay gap is not because of that lesser desire for the cut and thrust of business, but because of that time taken out of the workforce. Imagine, say, two years paid maternity leave: and the possible average of two children per woman who has any children at all (about right) that would be four years out of the labour force, or well over 10% of the average working life. Climbing that greasy pole is simply going to be more difficult with that disadvantage.

There isn't in fact a solution, at least not a legal or governmental one, to either of these points. whatever ones' views on this, or indeed innumerable other possible problems, it simply is just true that some conundrums just don't have solutions.

Shareholder 'say on pay' is completely irrelevant


I was on Radio Five Live the other day debating CEO pay. On my side, arguing that high CEO pay is not necessarily bad, was Chris Philp, the Tory MP for Croydon South who sits on the Treasury Select Committee. His arguments echoed those I regularly hear: shareholder capitalism is good generally, but it's bad that non-executive directors on remuneration committees set pay for executives; that these pay awards are rarely voted down; and that few shareholders actually vote. What we need to make sure shareholder capitalism is working, this popular argument runs, is to make sure that shareholders are vocal and closely scrutinising boards.

This is completely false. For the obvious, intuitive reason as to why this is false, ask yourself why all public firms, owned by shareholders, would choose to set pay by remuneration committee if that meant they'd waste millions overpaying their executives.

But wait—isn't this because shareholders don't vote enough on firm decisions and boards get away with murder? No, this explanation is also false. It's false because shareholders have two tools to make sure their money is in good firms: making the firms they have money in better or moving their money to good firms. In practice, doing the former through shareholder action is pointlessly costly, and shareholder capitalism has much better mechanisms, so shareholders overwhelmingly, and effectively, do the latter.

When firms do bad things, shareholders simply move their money out. Since board members and executives tend to be large shareholders in a firm themselves, the departure of other shareholders, driving down the share price, is a huge personal incentive to run it well.

But ignoring this, it's clear how the exit mechanism alone, combined with profit-maximising market institutions like hedge funds, will shift capital towards well-run firms and away from badly-run ones; towards firms whose remuneration committees use shareholder money well and away from those who don't without any need for a single shareholder voting once.

Centuries of capitalism tell us that the market values 'say on pay' very little, and aloof, powerful boards quite a lot. So does the academic literature.

Similarly, to those unfamiliar with the power of 'exit', the fact that shareholders allow remuneration committees to write lucrative 'golden parachutes' into executives' contracts—seemingly rewarding them for failure—is bemusing. But golden parachutes are actually good for firms that award them, as they make bosses less worried about revealing bad info about a firm to non-execs in a timely manner. Regulatory fair disclosure rules, by contrast, don't work.

If say on pay was so necessary to shareholder capitalism's success, why have firms practising it not taken over the market, and the world? That's the question Philp et al. need to answer before they pressure—or worse, force—firms into broader adoption of stockholder votes on pay.

ASI publications are now available in Farsi!


ASI publications have now been made available to readers in Iran, thanks to the Network for a Free Society and CAPTO. The publications have been translated into Farsi and published on CAPTO's website. Books available include "Public Choice- A Primer", "Foundations of a Free Society", and "The Condensed Wealth of Nations", all by our Director Dr. Eamonn Butler. The link to the books in Farsi can be found here.

Also featured on the website is a humanities based magazine "The Excellent Organisation", which this month features selected pieces from "Freedom 101" by ASI President Dr. Madsen Pirie, and "Foundations of a Free Society" by Dr. Eamonn Butler.

The magazine, "The Excellent Organisation" can be found here.


I'm afraid the doctors have this the wrong way around about the NHS


One of the joys of a market in things is that it's clear and obvious who it is who is the supplicant and who it is that is the boss. You check which way the money is flowing and you can tell easily: the person handing over the cash is the one whose wants, needs or desires are being catered to. That we don't have a market in the NHS is what causes logical failures like this:

Feckless patients who fail to take proper care of their health are to blame for a growing NHS crisis, doctors say. GPs said the public needed to take more responsibility for “managing their own health” instead of always turning to their local surgery. Rising patient demand means soaring numbers are struggling to even get through to their GP surgery to make an appointment, a recent National Audit Office report found. In total, around 6 million patients a year turn to Accident & Emergency department and walk-in centres because they have struggled to see a family doctor.

There's something Brechtian about this demand: that the doctors would like to elect a different population to cure and treat. But that's not actually the way that the treating should be going on. It might be masked, in that we pay taxes which then pay for the NHS, but it is still true that we are disposing of our cash on a service which we need, desire or want. The NHS is thus supposed to be at our disposal, not us at its.

What this means is that if we like the grape so much that our livers explode, well, treat us. Sure, tell us that our livers might explode if we do have that second bottle of port with lunch every day, but that's all you do get to do. Similarly with smoking and lung cancer, hamburgers and diabetes and so on. We are hiring you, keeping you in bedpans and nurses, with our money. We are the bosses and you, the medical professionals are, or should be, at our beck and call.

This is rather what Hayek was on about in the Road to Serfdom. That taxation as the method of payment is going to lead to that Brechtian position: that we the population should accord with the ideas of the bureaucrats rather than the proper relationship which is that the bureaucrats gain their salaries by serving us.

No, no one does want the US system of health care: but something more like the French or other European ones, where this relationship is properly pointed out would be an advance.

The NHS is there to treat us, not for us to live up to the standards of the NHS.

Five facts that undermine the junior doctors' strike


1. The maximum hours doctors can be made to work is actually decreasing. The British Medical Association is claiming that today’s strikes, in part, are about delivering safeguards to protect patients against the consequences that can arise from tired, over-worked doctors. While there is evidence that intervention into medical working hours can have mixed - and sometimes even negative - results, let's agree that no one wants a tired doctor attending to them. But maximum hours doctors are allowed to work are actually decreasing under the new contract. From the Telegraph:

The Government says the new deal would have an absolute limit of 72 hours in any week, lower than the 91 hours that the current arrangements allow. Doctors will not have to work for more than 48 hours on average due to the European Working Time Directive (ETWD), but they can opt out and work more hours - up to 56 - if they wish.

It appears EU law has limited the number of hours doctors can work per week, quite significantly. Furthermore, the BMA has already come to an agreement with the government regarding "safety issues" around "maximum working hours". The issue has been sorted.

2. This strike is over pay; not patient safety. Point one leads us nicely into point two; this strike is not about overworked doctors, and it’s not about patient safety. It is openly about pay.

Specifically, it is about how much doctors will get paid for working on the weekends. Both the BMA and government reps came to an agreement on 15 of the 16 points of contention the BMA had with the new contracts, but the discussions were ended over this last point on weekend pay.

The BMA should be honest about this. It might well be the case that junior doctors deserve higher salaries; but the money to fund that pay raise comes from the public’s purse. If the BMA wants to secure higher salaries for those in the profession, it needs to ask the taxpayer to foot the bill.

(Update, 10 February 2016: the "key sticking point" of today's strike "appears to be payments for working on Saturdays.)

3. The NHS is the only healthcare most Brits can access. The NHS in not unique in its delivery of universal healthcare. As Kristian Niemietz has noted, almost every developed country (apart from the United States) provides comprehensive healthcare services for its citizens.

What is unique about the NHS is that is provides care through one system that is both publicly funded and publicly run. There is no real market for healthcare in the UK, which keeps the cost of private healthcare sky-high.

It is simply not the case that when NHS doctors go on strike, Brits can turn to private provisions; most people have been regulated out of the market, and for them this has been made financially impossible.

4. Patient safety is at risk. Some folks out there are claiming that strikes are beneficial for patient safety because mortality rates actually decrease during strikes.

If this sounds wildly misleading, that is because it is wildly misleading.

On the one hand, studies have found that, in some cases, mortality rates do decrease during a strike; but this is only because risky operations and elective surgeries, which bump up mortality rates, are cancelled.

Putting off these kinds of operations can have very dangerous medium-term effects. Making patients wait for important surgeries is not simply an inconvenience; it can hurt their health.

On the other hand, there is evidence that health strikes can seriously increase mortality rates. Over at the Telegraph, Asa Bennett has highlighted a study from the States, where a nurse strike in New York increased morality rates at the hospital by almost 20%:

US academics Jonathan Gruber and Samuel Kleiner recently looked at what happened when nurses went on strike in New York in what they billed as the "first analytical evidence on the effects of health care strikes on patients". The professors, from MIT and Cornell University respectively, discovered in their paper – "Do Strikes Kill? Evidence from New York State" – that the rate of in-hospital mortality rose by 19.4 per cent among the 38,228 patients admitted during a strike, and the rate of patient readmissions increased by 6.5 per cent.

Only the aftermath will reveal how today’s strike has impacted on mortality rates; but one is certainly within their right to ask if the potential for increased death tolls at hospitals is ever worth the risk.

5. The British Medical Association is not a neutral body; it is a pressure group. The BMA is not an impartial medical association; it is a union for doctors, and their job is to negotiate the best deal for their members that they can get.

But the BMA isn’t negotiating. Despite coming to agreement on 15/16 issues with the government, they have still decided to hold the public to ransom over one issue, jeopardizing the quality and quantity of services the only healthcare provider in the country can perform.

When a country operates under a healthcare monopoly, its citizens are fundamentally at the mercy of the provider. That provider has an ethical responsibility to show up to work every day and look after its patients; if they don’t, no one else will


One final point: British patients are becoming increasingly aware that the NHS isn't all it's cracked up to be; some are starting to look look fondly across the channel to Europe, where patients are getting better treatment and experiencing better outcomes.

What is often neglected from these discussions is how doctors are treated by the NHS. Indeed, there is good reason to believe it is both patients and doctors who are getting the short end of the stick. Jeremy Hunt's new contract doesn't solve this issue, but neither do the BMA's demands. If the BMA is truly intent on bettering the working environment for doctors, it should look to reforming a system that only allows them to negotiate with one provider: a highly bureaucratic, government body.

Maybe Lin Homer is just pensioned out?


We find ourselves rather amused by this retirement of Lin Homer from HMRC. Because, while this is to a large extent just idle speculation from ourselves, there is still a nub of truth under the idea that it's as a result of the tax treatment of pensions. And it's going to people who have done well in the public service who are going to get so hard hit by those tax changes. We could, of course, just say "Aw, diddums" and go off for a celebratory pint but it's still true that this interaction of public sector pensions and the restrictions on tax relief, the taxation of amounts over the pension cap, which are going to hit those public services hardest.

So, the basic news is that Dame Lin is off:

The country's top tax collector who has faced intense criticism from MPs, is quitting her post in April, the Government has announced. Dame Lin Homer, the chief executive of HM Revenue and Customs, was due to give evidence to MPs on Commons Public Accounts Committee on tax evasion on Wednesday afternoon this week. HMRC sources said Dame Lin had told Sir Jeremy Heywood, the Cabinet secretary, last summer of her intention to leave her job at the end of the tax year.

That explains the when of the DBE at least. However, consider this career path:

She qualified as a lawyer in 1980 whilst at Reading Borough Council. In 1982, she joined Hertfordshire County Council where she stayed for 15 years, rising to director of corporate services. She then left to join Suffolk County Council as chief executive in 1998. After four years at Suffolk, Homer went on to be the chief executive of Birmingham City Council in 2002[1] and joined the civil service in 2005.

There's a 36 year public sector pension pot there. And we've now got the new rules about pension pots that exceed £1 million in capital value. And those rules now bite on final salary schemes as well as defined contribution schemes. And once you've got up into the rarified atmosphere of the upper echelons of the civil service a £1 million pot is easy peasy to achieve. Which means that rather a number of those up there are in the same situation as this doctor:

With just two years to go until her minimum retirement age (55), having had the benefit of the generous salary-linked NHS scheme, Gillian has broken through the £1.25m maximum lifetime pension allowance. Anyone whose pension is valued at beyond that sum (which falls to £1m next April) faces penal tax.

When the penal taxation on the accrual of greater pension benefits is taken into account then the marginal tax rate starts to approach insane levels of 70 and above percent. At which point our old friend the Laffer Curve comes into play again and people become subject to the substitution effect. Why spend the Golden Age shuffling paper if I'm not in fact increasing my lifetime income by very much by doing so? So, they don't.

As we say, this is speculation on our part about Homer herself. But it is a real change in the incentives faced by such people. And there's a certain joy to all of this as well: the people who have been calling loudest for these reductions in the gentle tax treatment of pensions are those over on the left. Those who also tend to believe in the idea that senior civil servants are very important people indeed who should be well paid. Rather than what we think they are, our hirelings there simply to handle society's scut work.

These tax changes will fall hardest upon those civil servants. Simply because they cannot opt out of greater pension accrual, unlike everyone in the private sector. Any one of us, when our pot limit is reached, can reach agreement with our employers to not add any more to our pensions: instead, just give us the cash. Not something possible for those locked into government and union approved contracts. Aw, diddums.

And perhaps this should be a lesson for those who scream loudly about tax reform: it's a complicated system, just as is the economy, and fiddling with one bit of it is highly likely to have unexpected effects elsewhere. You know, stop the fat cat FTSE directors amassing vast pension pots and you find senior civil servants all bailing out at 55.