How does a Modern Monetary Theory (MMT) lens explain austerity in the NHS
Description
Tackling health inequality in the UK: enabling people to live healthier lives, and rebuilding an NHS and care system that works for everyone. Considering how the MMT lens can empower NHS staff and the general public to demand more money for the UK's health services. A fantastic hour-long panel session.
Presentation from the MML UK Anti-Austerity conference in Bristol. September 2025.
Chaired by William Thomson, Political Economists, Scotonomics, alongside Dr. Jaideep Pandit (professor of Anaesthesia at the University of Oxford) and Emma Hughes (Just Treatment).
Welcome to our panel on health and the NHS as we frame the choices made by staff and patients within the context of fiscal austerity.
We will concentrate on fiscal austerity, which is the desire to reduce day-to-day spending on services like the NHS to reduce the government debt.
This desire to shrink the government deficit by reducing services ensures that this can only be met by shrinking our net financial wealth. On top of fiscal austerity, there are two other forms of austerity that affect our wellbeing: Industrial and monetary austerity.
Industrial austerity is structural. Our institutions are created and molded to ensure low wages, high unemployment, and de-industrialisation. By design, this leads to higher profits, the offshoring of negative environmental harm, precarious contracts, and hundreds of thousands of bullshit jobs. I am sure we will touch on this as we address low pay and conditions for many NHS staff.
Finally, we have monetary austerity. Although we won’t cover this in the conversation coming up, I want to explain this form of austerity as it provides context for our talk this morning.
Monetary austerity means generally high interest rates. The issue is magnified when interest is paid on reserves held by private banks at the Bank of England. Monetary austerity ensures that interest-bearing bonds (often inflation-linked - an idea that only sticks to borrowing from the wealthiest in society) represent a significant injection of purchasing power into the economy.
Want to know how significant?
Almost 160 billion pounds has been paid in interest on government borrowing in the last twelve months. All of this is paid as interest to the wealthiest in the country. That figure again in case you are still in shock, according to the ONS, is £160 billion.
Why is this context important? Last year, the NHS budget in England was only 30 billion more! It was £188.5 billion.
Now consider the debate and the discussions around the waste and unsustainability of NHS spending - money that literally improves wellbeing and saves lives - to the level of awareness around a very similar amount that is funnelled to those who have enough spare cash to secure, interest-guaranteed government liabilities. Where is the outrage? The calls for privatization? The Think Tanks analysing every £?
Context is important.
This huge sum (which is completely unnecessary) is never questioned. But every pound we spend on our NHS is scrutinised.
The government could direct perhaps £100 billion a year to the NHS without increasing its debt. All it would have to do is to switch off interest on new government debt and add 50% to the NHS budget.
It chooses not to do this. The MMT lens helps us understand why.
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