British Summer Time and the Impossibility of Planning an Economy

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As we can all observe these days there’s one of those regular upsurges in the idea that we can plan our way to economic wealth. If we just put all the bright people – self-defined bright, naturally – into offices where they can tell the rest of us what to do then everything will be better. We’ll do away with that chaos and inefficiency of markets and competition.

No, really, just look at the things people say about the NHS. A national, coordinated service is more efficient than one which contains markets. So we’re told at least. And that is those people insisting that central planning is more efficient than markets. We did actually try this of course. Scientific socialism was, from perhaps the turn of the 19th century onwards, regarded as being more efficient, because of that planning, than the waste of markets. Then we got to 1989 and that idea rather died the death. We’ve now an entire generation who’ve grown up after that explosive disproof of the contention. So, we’ve an entire generation of rubes willing to believe that planning works, haven’t we?

At which point this fun little story about British Summer Time:

When the clocks go forward next weekend, it will bring not only lighter evenings, but a general sense of wellbeing and fewer accidents on the roads.

Yet researchers have discovered British Summer Time is having an unexpectedly negative and costly impact for the NHS.

Psychologists at Lancaster and York Universities have found that when the clocks go forward more people miss their hospital appointments.

In fact, patients are five per cent more likely to fail to turn up than on a usual week. Although the figure may seem small, there are around 150,000 missed NHS appointments each week, so even a small increase could see an extra 1,000 missed appointments.

Lead author Dr David Ellis said: “We have been doing a lot of research looking at what makes people miss appointments. We’ve looked a the effects of different days of the week, or different socioeconomic groups and now we have found a new reason.

“We found more people missed their appointments after the clocks moved forward in spring.

“It could be that people are simply mixing up times and turning up too late. Or it could actually be the extra sleepiness makes it more difficult to attend appointments.

“Missed appointments represent a significant financial issue for healthcare systems and have an adverse impact on patient care. It may help to schedule fewer appointments in the week after the clocks go forward.”

No, don’t get fixated upon the details here, just regard the concept. An important part of which is:

Each hospital outpatient appointment costs £120 so missed sessions represent a significant financial issue for the NHS and have a negative impact on patient care. In the last financial year, there were eight million missed appointments.

There is a financial loss – a pure economic loss that is – from BST. There are also benefits – peeps like longer evenings even if nothing else happens. But note the important point here.

We’ve been having BST for just over a century. We’ve been having the NHS for 70 odd years. And we’re only just finding out about this effect of BST on the NHS just now. A 70 year delay upon information is a bit of a bugger for attempts to plan, isn’t it?

Note also that we’re still not really sure what the net effect is. An economic gain or an economic loss? How many other little ripples of effect are there through the economy from the time change? Both positive and negative, of course.

That is, Hayek was right. The centre just never can have enough information to be able to plan the economy in anything close to real time. That we’re 70 years late in even spotting this cost is a good enough example of that. Economic planning in any form of detail simply doesn’t work just because we cannot know what the detail is.

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Bloke on M4
Bloke on M4
6 years ago

“Missed appointments represent a significant financial issue for healthcare systems and have an adverse impact on patient care. It may help to schedule fewer appointments in the week after the clocks go forward.” Well, that’s only true if doctors are twiddling their thumbs because there’s no patients to see. The clinic is running on time and there’s no patients that turned up a bit early. The NHS *still* hasn’t implemented SMS reminders across all trusts, despite the fact it has a huge effect on missed appointments. Which leads to one of 2 conclusions: a) they’re too incompetent to implement what… Read more »

Jim
Jim
6 years ago
Reply to  Bloke on M4

And vets. I get a text the night before when I have a vets appointment. They even text me to remind me to buy regular medication, like flea and tick prevention stuff.

The veterinary industry also manages to operate a 24/7 customer service, at the same level as the GP surgery. I was personally involved when a friends dog seriously injured itself late at night – the vet was called (small town in Wales), we took the dog to the practice, emergency treatment was given, and the dog went in for an op first thing the next morning.

Rhoda Klapp
Rhoda Klapp
6 years ago
Reply to  Jim

So the National Vet service has much to be proud of. If it existed.

James in NZ
James in NZ
6 years ago
Reply to  Bloke on M4

Our local hairdresser sends the missus a reminder text and requires a “yes” response from her 48 hours before the appointment to keep the booking open.

In reality what happens is the text is followed up by a call at the beginning of the next day if there hasn’t been a response. But it means far fewer missed appointments and the ability to fill the slot should someone be unable to make it.

allthegoodnamesaretaken
allthegoodnamesaretaken
6 years ago

GPS still don’t get people to write out their own appointment reminder cards. That alone would make a measurable reduction in the number of missed appointments.

Dongguan John
Dongguan John
6 years ago

Each outpatient appointment costs £120? I can go see a private doctor in Hong Kong for less than that.

John B
John B
6 years ago

The NHS has never known how much anything costs, nor does it have to care. Since funding is a political issue, it knows it just has to squeal, ‘Lack of funding’ at an adoring public and politicians will give it whatever it wants. Since NHS is a cost centre on fixed budgets, reduced patient throughput whether from missed appointments, lazy staff, poor operating procedures, is a saving of direct costs. It is an aim of budget holders to reduce throughput, a) to string out the budget, b) to claim lack of resources to cope with workload in order to motivate… Read more »

Rhoda Klapp
Rhoda Klapp
6 years ago

If missed appointments cost money, do appointments which are not missed save money? Surely the other theory of economics is that there is an infinite demand for a free good. I’ve often head that in the NHS context. But I’ve not seen the funseekers queuing up at the doctor’s.

Geoff Taylor
Geoff Taylor
6 years ago

It’s fair to say that collection and analysis of patient behavioural data is orders of magnitude more sophisticated than 20 years ago, let alone 70.

I’m no disagreeing with the basic argument but I will ask the question – how much better does the tech need to be before it can effectively nullify Hayek’s argument? I fear that “not that much” is the answer.

Spike
6 years ago
Reply to  Tim Worstall

It’s not that. The problem with central planning is not that we can’t get all the data in one place. The US Postal Service, by demanding that we all append ZIP codes, then 9-digit ZIP codes, enabled machine sorting of mail down to the individual carrier route – only a decade after the invention of email, which it fought, kicking, screaming, and repeatedly proposing to tax.

Imagine using 100 years more of miniaturization of computing for the sake of enforcing total stasis.

Nautical Nick
Nautical Nick
6 years ago

If the is a predictable percentage of missed appointments, then the NHS should overbook, so that the time of staff is not wasted. I suspect that happens anyway, as some appointments over-run. I wonder also if there might not be an alternative conclusion to the one drawn by NHS research: that with more sunlight, more people feel better and therefore are more inclined to forget their appointments. Which would be a good thing, would it not? We are also not told whether the increase in missed appointments is consistent over the summer months. Is it the daylight or the hour… Read more »

PJF
PJF
6 years ago
Reply to  Nautical Nick

Not related to the NHS angle, and purely from a selfish point of view, I’d go with Summertime hours all year. Around the winter solstice any timing is irrelevant (there just aren’t enough daylight hours either way) but as the day lengthens the opportunity quickly arises to enjoy some light after work.

Spike
6 years ago
Reply to  Nautical Nick

Any company can change its nine-to-five (or whatever) hours to eight-to-four, and if it’s instantly healthier, perhaps all should, year ’round, without being told to by government.

And if it’s true that individuals often achieve better health by missing their appointments, perhaps the NHS should arrive each day, go through all their usual motions, and see no patients. A significant number would convalesce at home, some successfully, and no one would die of thirst in a corridor.

PJF
PJF
6 years ago
Reply to  Spike

“Any company can change its nine-to-five (or whatever) hours to eight-to-four…”

Not easily, since they usually have to interact with lots of other companies, and, of course, their customers.

This whole Gregorian calendar thing is just us being told by the government. We should all adopt whatever system we like and let the free market choose on a day to day basis. Sorry, an [arbitrary time period] to [arbitrary time period] basis.

djc
djc
6 years ago
Reply to  Nautical Nick

Or GMT year round as God & Nature intended. If its the enforced change of hours that causes the problem then that solves it, if it’s the extra sunlight then get up an hour earlier.

jgh
jgh
6 years ago

The “social” day is symmetrical around 2pm clock time, so the daylight hours should be arranged to be symmetrical around 2pm clock time.

Bloke in North Dorset
Bloke in North Dorset
6 years ago

The assumption that a missed appointment should be costed at full cost is specious and based on the assumption that staff will sit around with thumb in bumb and mind in neutral, they won’t. We are constantly told they are over stretched so we can expect [some) doctors to be writing up notes (some) nurses and admin staff to be caching up on missed jobs.

bloke in spain
bloke in spain
6 years ago

@jgh Given that people have freely chosen to live their lives around the daylight hours they do, how long would it be before the “social day ” was centred around 4pm? It’s only a fairly recent phenomenon that the majority didn’t optimise the maximum available daylight & wouldn’t have seen much of summer nights at all. The “working day” has moved at least an hour later in my lifetime. When I first started work, 8 o’clock starts were common & many started an hour or more earlier. Nine was “gentlemen’s hours” for the City of London (SE itself 9:30) toffs,… Read more »

Spike
6 years ago

“Noon shall occur at 11:00 in the morning” is really just a universally mandated game of pretend, isn’t it? Willingness to pretend is another reason for the failure of government planning. (I am reading about the bridge collapse in Florida, engineers and managers concluding that the concrete has cracked and the support cables have not been installed but no one has died yet; compare the Columbia Space Shuttle, where one official position was that we would be better off not knowing if there was a hole in the wing.) Reading Wikipedia, the initial decision, also the Double Summer Time decision,… Read more »

Gamecock
Gamecock
6 years ago

Correlation doesn’t prove causation.

BST occurs during the summer months. Missed appointments could be due to the season, not clock fiddling.

Pcar
Pcar
6 years ago

@djc March, 18, 2018 at 7:22 pm
“Or GMT year round as God & Nature intended…”

+1 Stay on GMT

Gov’t should stop interfering in this and many other areas.