The Week 4 April 2025
Research Manager and Head of Health
With all eyes on the market this week as Tariff – sorry – Liberation Day struck, speculation remains around the scale of financial pain that might be felt across the world. With the major US indices experiencing their worst day since the Covid pandemic, and Japan’s Nikkei index slumping to an eight month low, the UK got off relatively lightly with only a 0.36% in the FTSE 100 fall versus a combined fall of 10.01% across US indices.
Nevertheless, this makes the amount of fiscal headroom available to the Chancellor look even more precarious. But the focus on tariffs might mean we are overlooking signals in less high-profile domestic stories this week, which suggest even more struggles to come.
If I worked in a Government that was staking significant amounts of its political success on ‘deliverism’ – that is, people feeling the benefits of policy change in their pockets and their lives – my concern might be the financial pain felt this week not by the FTSE 100 but rather by ordinary people. With council tax and a long list of other household bills rising this month and any near-term improvement unlikely, the cost of living is a ticking time bomb.
Granted, economic improvement can be slow. But the second biggest opportunity for burnishing the deliverism credentials – the NHS – doesn't make for much more reassuring reading.
This week the annual British Social Attitudes survey, running since 1983, found that just 1 in 5 people in 2024 said they were satisfied with the way the NHS runs. This is the highest level of dissatisfaction with the health service since the survey began over forty years ago.
New Labour inherited a 34% satisfaction, the 2010 Coalition government a mammoth 70% satisfaction, 2019 a 60% satisfaction and 2024… 21%. Even if they manage to double that number like New Labour did, it still will not meet 2019 levels of satisfaction. The task ahead is immense (though one we at Reform can help with).
Thankfully, there has been a glimmer of good news that will have flown under the radar this week. On Monday, the Government announced it will invest a record amount in community pharmacy. Pharmacies do a lot of heavy lifting in the health system and their role is only growing: they already help to take away some of the low complexity, high volume demand away from GPs, and it is well established that bolstering pharmacies is a necessary precursor of the shift to prevention. This is likely to improve care on the ground in the immediate future and should be highly commended.
Read of the week
If like me, you are observing Trump’s approach to tariffs in complete bafflement, then I highly recommend this longer read deconstructing the rationale behind Trump’s hell-bent obsession with tariffs. Keen historians might enjoy the relevance of President McKinley (the president that Trump renamed a literal mountain after) while also getting a deep dive into how this might give him more control over federal money. Separately, I also recommend this piece which explains tariff economics while debunking the common defences coming out of the White House.