Well, we survived the Mayan Apocalypse before Christmas, but my holiday reading suggested an even more contingent risk to western civilisation – and one which is a distinct possibility. If you’re a fan of maps, charts and other 19th century ways of finding your way around, On the Map by Simon Garfield is, if you’ll pardon the pun, up your street (like Google). He points out that the piece of kit which is in everyone’s pocket and on most dashboards, has come to rule our world.
The GPS, or NAVSTAR as it was originally, has really only boomed in the past decade, and those circulating satellites now control most of our existence. The satnav in your car or phone is merely a handy device for us all. Its more significant uses are that it controls just about all transport systems, whether airborne, nautical or on rails. It runs our traffic systems and directs food supplies to supermarkets and the energy grids we depend on.
The more geeky amongst us will also recall that it is living proof of Einstein’s 1905 General Relativity theory. The satellites are subject to much lower gravity, so their clocks run slower. But they also travel very fast, so their clocks run faster. A balancing time-delay of just 38 microseconds in their timing systems ensure we don’t all drive into lakes or off cliffs.
There are other relativities about too. This morning’s news – I’m writing in early January – was about proposed changes to the RPI, the standard measure of inflation since the Second World War. As it happens they haven’t made a major change, but you’ll probably recall that before Christmas, the Chancellor announced that he’d found more money by an early sell off of the 4G mobile telephone spectrum (better access to the satnavs again).
However, he also demonstrated that the rate of inflation for the coming year (2013-14) was now much lower, from 2.6 per cent to two per cent. Now, the NHS budget is linked to inflation. Its increase was set for 2.8 per cent next year but it seems pretty unlikely that that rate will be sustainable.
The Nuffield Trust has estimated that annual increases in healthcare demand will remain at about eight per cent a year, so the well-nigh impossible is being asked for, and for a sustained period, with overall deficit reduction now reckoned to take another seven to 10 years.
The Chancellor can muck about with the relativities, based on factors and predictions like RPI, but the ‘devolved administrations’ – politico-speak for the countries of Wales and Northern Ireland – get their money as a fixed sum for the year ahead (Scotland is more complex). So in Belfast, the hammer is hitting the piggy-bank as officials try to square their income with their expenditure.
Alongside proposals to reform the expensive adult care budget, dentistry has come under scrutiny as costs have risen over recent years due to increasing access and numbers of dentists. Unlike England and Wales, dentists are free to set up Health Service (HS) practices and enter into contracts. An overspend of £6m in 2011/12 is expected to rise to £12m this year.
The proposals are brutally straightforward and across the board. The introduction of a ‘core’ service for HS treatment, by effectively excluding molar endodontics, metal-based dentures, bridges and veneers through much more restrictive prior approval processes is one proposal. A major reduction in practice allowances and commitment payments is also suggested, together with increased time limitations on the provision of scaling and polishing claims. Finally, it is proposed that orthodontic claims will be considered only under the same IOTN screening regime as in the other countries of the UK.
It is estimated that the average practice will suffer a reduction of income of £3,000 per annum, with some orthodontists losing higher amounts. Relatively speaking these may not seem enormous sums, but in a continuing climate of recession they are a further blow to the sustainability of the high street practice.
Relatively speaking, whilst this is happening only in one part of the UK, as Einstein said, relativity is indeed general (and special).