In the fourteenth century, the Black Death swept through Europe, wiping out a significant proportion of the population. Entire villages disappeared, their history and their future stopped dead, literally, by the plague.

As a result of this drastic loss of population, there was an obvious loss of the workforce. Serfs who had been tied to one lord or manor, in servitude if not slavery, suddenly were being offered cash to work fields in neighbouring manors. This faced their own feudal overlord with a problem. Punishing the offenders would not get his own fields ploughed. It would merely deplete the labour pool and put the rate up.

An age of labour mobility was born. It took about a hundred years, long painful years of suffering and rebellion, but it got there in the end. Feudalism, at least in this country, was more or less over.

When shit happens, sometime roses grow. Or poppies.

At the end of the Second World War, there was a shortage of labour in this country.

This is an inevitable consequence of war. The one inevitable outcome, and it is amazing that even to this day, those who rule and know best, simply haven’t worked this out. Or don’t care.

To counter this, a bunch who were too stupid to know how stupid they were(the Dunning-Kruger effect) and therefore thought they were fit to boss the country, decided to introduce a National Health Service.

The idea was to counter the labour shortage by patching up the Undeserving Poo-er (they pronounce “poor” with two syllables to show their superiority) so that they could be sent back down the mines and into the factories and fields where they could continue working for the richer and therefore, clearly, better minority of the country, until they were no longer deemed fit to work. They would then be given a derisory pension on the understanding that they would have the courtesy to bugger off and die, neatly, quickly and without fuss, of some horrible disease that only The Undeserving Poo-er get.

Unfortunately, it all went titsup.

The Underserving Poo-er, with typical ingratitude, refused to die off as requested. Moreover, they, quite incredibly, expected to continue to be cared for by this new National Health Service. Such ingratitude should have been expected from a class of people who did not have the wits to be born rich.

They also expected to go on receiving the weekly insult from the Department of Pensions and even had the temerity to expect it to be related to the cost of living. As if the fact that they were receiving anything at all when they were not working was not enough. Just because they had been told to pay towards their pension all their working lives.

Now, of course, there were several problems with the entire scheme. One might almost say they should have been obvious to the meanest intelligence. But that vastly overestimates the mental capacity of the political class.

Firstly, they did not take over the operations of the general practitioners. The GPs refused to give up their independence under the aegis of the BMA/GMA/whatever. They realised that as independents, they could work for the National Health Service and dip in and out of it as their careers progressed. It would always be there as a fall-back option if things got sticky. This was simply an act of political cowardice, as would be expected. Without the incorporation of GPs and all consultants, this was doomed from the start. Naturally, the rich and deserving rulers did not see themselves as subject to the same ailments as the Undeserving Poo-er and therefore they must receive better, private healthcare and so they would not support the incorporation of all medical services.

It was also obvious, and still is, that total nationalisation was not a feasible or desirable option. The element of competition is essential to stimulate progress and a controlled profit margin would probably have become an acceptable feature.

Secondly, they did not think to disenfranchise the retirees. It seems fair; you are not contributing to the finances of the country or its productivity, so you don’t get a say in the government. This would not be possible now, but at the time, it would have worked.

As a result the Retired Undeserving Poo-er (RUP) kept voting for whatever would keep this thing going. And the longer the scheme ran, the more RUPs there were to vote for it.

The political class realised that RUPs were beginning to represent a significant demographic. To be courted for their vote. And they brought with them the soon-to-be RUPs and their rellies who were starting to worry about looking after Nan and Gramps. Pollsters of every flavour began to realise that upping the NHS would be a vote winner. And once any party had fallen into this trap, there was no way out. They could not, when it came their turn to be in opposition, point out any flaws in the scam. They had publicly bought into it.

It was now untouchable. The NHS became a Sacred Cow, a holy relic that had to be worshipped with offerings of money to assuage every conceivable shortcoming.

There is another problem

As shit attracts flies, money attracts scams.

Pretty soon, the NHS was overstretched. It was always bound to be, because it was not set up to cater for the welfare of the nation, it was set up to sustain the labour pool. It never had the funding for its professed purpose, only for its real intent.

It would always be impossible to overhaul and repurpose the NHS. It would have involved far too much intelligence and determination. It was always going to be easier to just throw money at it. After all, the money was just extracted from the taxpayer by one means or another. It didn’t really belong to anyone. Except the taxpayer, who is of no account to any government.

This is a demonstration of the principle of Trickle Down Economics. It is an even better demonstration of its failures.

I’m going to invent a phrase: “Fiscal Friction”.

This is a little bit like normal friction. When you push something, a bit of the effort is lost to friction, of wheels, axles, bearings, whatever and ends up as heat. There is no getting away from it and it happens everywhere all the time. It is impossible to transfer energy into moving something without losing some of that energy as heat. This happens everywhere, to every thing and system in the universe.

And “every system” includes financial systems. Even if you carefully carry a handful of cash to the corner shop, you will have worn away a little bit of shoe leather and eventually you will have to spend money on new shoes. Bank charges are the most obvious example. Without even considering profit, it costs the bank money to execute a transfer of funds, in utilities for its premises, wages for its staff, etc.

This is Fiscal Friction.

I have to break off here. I just heard the most wonderful phrase on the television:– “Same Day Emergency Care”.  As opposed to? “Just-lie-there-for-a-couple-of-days-with-a­-broken-leg-what-could-possibly-go-wrong Emergency Care” or “We-can’t-possibly-deal-with-that-now-instead-of-plastering-up-your-leg-we’ll-let-it-get-nice-and-septic-then-cut-it-off-and-you’ll-be-in-and-out-of-here-for-the-next-tweny-years Emergency Care”?

Finally, back to the matter in hand.

In Fiscal Friction, the loss in each movement of funds is expressed as cash. This can be a genuine loss, through the need for staff to handle administration, the equipment and buildings to house those staff and the consequent maintenance services. But, the more likely and more serious loss is through exorbitant and exaggerated, unregulated expense in consultancy fees, sinecure jobs, pointless ill-judged vanity projects and the like.

For Trickle Down to work, the theory is that the organisation can be considered as a pyramid. There are a few staff at each of the upper levels, and the number increases with each succeeding level until the lowest, “workface” level has the largest number of staff.

But, it don’t work like that.

In Real Trickle Down, the upper and middle layers begin to “bulge” as fiscal friction reduces the efficiency of funds transfer to the workface level. The organisation, as a lot of us in mid-life crises, develops a bulging corporate midriff of functionaries, some of whom are indeed working very hard. As the fatty deposits of fiscal friction build up, so the corporate waistline expands.

And now we have the Sacred Cow of the NHS in the final throes of Corporate Morbid Obesity. And all that government does is, every time, buy it a bigger mobility scooter.

As with obese patients, this approach fails to tackle or even acknowledge the underlying problem.

I think we are at the stage where all that can be done for the NHS is to provide larger and larger fiscal mobility scooters until its final and inevitable collapse and expiry. At that point, I am afraid, any real progress will be blocked by the entire political class. It would be an act of political blasphemy to do anything other than wail and beat one’s chest in sackcloth and ashes. I doubt that many of the assets, building and equipment, will be found to be of much use in reality. There will be a return to private medical services, available only to those who can pay. Eventually a new political class will evolve who do not owe allegiance to this derelict monster and we can only hope it will stop draining our taxes to make sacrifices to this monument to political hubris and stupidity.