Thursday 21 June 2018

The NHS and the Brexit dividend



As we approach the two year anniversary of the EU referendum, it seems that British politicians have learned nothing about the economics of Brexit. Only last weekend, the prime minister herself announced that the government plans to raise the NHS budget by £20bn per annum by 2023, partly funded by a “Brexit dividend.” But like the unicorn and the Loch Ness Monster, there ain’t no such thing as a Brexit dividend.

It is a well-worn story that Leavers promised the UK would have an extra £350 million per week to spend on causes such as the NHS once it leaves the EU. It is an equally well-worn story that the number is a complete fabrication because it reflects the UK’s gross contribution to the EU budget, not the net figure – which is far more relevant. After all, the UK gets roughly half of its gross contribution back in the form of EU funding for domestic projects. Then there is the small matter of the Brexit bill: Assuming that the UK pays a sum of around £40bn to settle outstanding liabilities following EU departure, that is around four years of net contributions up in smoke. Moreover, since Brexit is widely expected to result in slower GDP growth than would otherwise have occurred, there is a strong likelihood that public revenues will be lower than in the absence of a Brexit vote. The OBR’s latest forecast suggests that by fiscal year 2020-21 total revenues will be £27 bn below the projection made in March 2016 (the last official forecast before the referendum, see chart). But even if revenues do somehow match 2016 expectations, the final exit bill means that the UK will be fiscally worse off on a five year view compared to pre-referendum forecasts.

So let’s be clear: There is no Brexit dividend. So why do politicians continue to say such things? Well for one thing, it is a snappy soundbite. Secondly, as this article points out, language shapes the way we think. Thus if a phrase is repeated often enough, it becomes an unconsciously accepted fact no matter how nonsensical it is. Thirdly, there is also a sense that the media increasingly does not hold the government’s misrepresentations to account. The interviewer to whom the prime minister made her claim did not challenge the notion of a “Brexit dividend.”

All that aside, nobody disputes the fact that additional spending on the NHS is welcome. But if there is no “Brexit dividend” where will the money comes from? The PM did suggest that “we as a country will contribute a bit more” which is code for higher taxes. The Institute for Fiscal Studies reckons that raising National Insurance Contributions (NICs) by 1 percentage point could raise around £8.5bn. Freezing personal allowances would raise around £3.5bn. Furthermore, the government is believed to be seriously considering not implementing planned cuts to corporate taxes which, as I pointed out in February 2017, would yield around £7bn. Putting all that together gets us close to the planned £20bn.

Rather than play with existing taxes, there is an increasingly strong argument for a hypothecated tax solely to fund the NHS. The Treasury has long been opposed to hypothecation, partly because revenues have tended not to be linked to individual projects but have instead gone into the general pot. Think of taxes such as the Road Fund Licence, which was initially introduced in the early twentieth century to pay for road construction and maintenance, but it soon became clear that revenue was not growing sufficiently rapidly to meet construction needs. Whilst hypothecation was abandoned in 1936, vehicle owners still have to pay their road tax. An additional objection is that tax revenue tends to be pro-cyclical which might starve the NHS of funds during times of downturn. Thus, if hypothecation is on the table, it would not be possible to use it as the sole source of funding but it could be a useful top-up option.

There is also no reason why the government could not borrow slightly more than planned. Although it unveiled a manifesto commitment to eliminate the deficit by the mid-2020s, there is no reason why it needs to do this. It could run a modest deficit relative to GDP whilst still running down the debt-to-GDP ratio (in simple terms, this is possible depending on the size of the primary balance and the extent to which the rate of nominal GDP growth exceeds the interest rate on outstanding debt). The economic logic of balancing the budget simply escapes me.

One of the standard definitions of economics is the study of the allocation of  scarce resources. Ageing European societies will increasingly have to make choices about how to fund rising demands on the health care system. Countries such as the UK will either have to cut spending on other areas or raise taxes in order to fund healthcare provision. But what is not possible is to use a “Brexit dividend” to pay for it. If it really were that simple, everyone would leave the EU.

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