Labour’s lack of ambition in going for a core vote 35% strategy is matched by the dangers of making the NHS the centrepiece of that approach. So far the more they mention the NHS the more their vote stays in the low 30s.
The first idiocy of it is the General Election in 2015 will not be about the NHS in Scotland or Wales. Health is a devolved issue, so what UK Labour says about the NHS is irrelevant for how the health service is run in Scotland, as Mr Brown’s vow made clear. As Labour needs to win back support from the SNP in Scotland, they need a UK appeal on Union policy to win Ā in May 2015.
The second danger is that Labour runs the NHS in devolved Wales, so people can compare and contrast the Welsh NHS under Labour with the English NHS under the coalition. The comparison is far from helpful to Labour. InĀ the border areas Welsh patients come seeking healthcare in English facilities. The financial settlement in Wales from the Assembly has been less helpful than the English settlement from Whitehall. The Welsh NHS has worse problems with the quality of care and waiting times than the English.
The third error is in supposing that most voters will buy the lie that a Conservative government would privatise and damage the NHS. This is the same lie that Labour hurled against Conservatives during the period of their wins from 1979 to 1992. It did not stopĀ Conservatives Ā winning then. Nor did that government privatise and destroy theĀ NHS as Labour claimed. The Conservatives just kept putting more money into the NHS, as the Coalition has done. Ironically it was Tony Blair who decided to privatise some treatments, in a bid to speed up patient care and cut waiting lists. All 3 parties have long accepted the use of private sector contractors and suppliers Ā in the property and hotel sides of the service, and for the purchase of drugs and medical equipment.
It will be interesting to see if Labour continue with this ill judged pathway to the Election. Every time the electorate want to talk about immigration, LabourĀ does another NHS story. Every time people want to talk about the impact of the EU on our borders or our energy bills or our criminal justice system, Labour says that is just a few Tories or UKIP Ā banging on about Europe. Labour says and offers nothing on the EU. Everytime people talk about Ā jobs, taxes and the deficit, Labour just talks about the minimum wage and attacks bankers.
They may discover that seeking to cut yourself off from much of the mainstream conversation by always visiting a hospital or finding some mistake with the English (but not the Welsh) NHS is not a good way to boost your vote. They also need to remember that mostĀ adults under Ā 70 years of age are fortunately normally healthy and not therefore personally preoccupied day by day with the NHS. They want to know there is free treatment available should need arise, but no main party in the UK wishes to take away that insurance.
October 21, 2014
Yes indeed, and nhs Wales. Plus many things people really know by word of mouth like waiting to go on a waiting list. This doesn’t appear to happen now but it damn well did under Blair as well as getting cancelled at the 11th hour.
The worst part of this is that they have this 35% strategy. That’d be majority with no mandate. It’s high time this issue was resolved. Boundaries can never be totally equal and are beyond fair at present. So why not have an MPs majority be the calculation in the division lobby as opposed to one mp one vote. Not as complicated as it sounds. There’s only 650 of you and the data only changes at election. So an MP with a majority of 17,000 would be worth far more in division than one with 94. Then every vote the public makes would come closer to counting and still have the safety fptp offers against fringe nutters.
October 21, 2014
Another way to deal with the unequal numbers of people in each constituency would be to make the weight of each MP’s vote proportional to the number of constituents he represents.
So the total number of people represented is counted instead of the number of MPs.
October 21, 2014
A good idea, however, it cannot work without first abolishing the whip system and making MPs genuinely accountable to their constituents rather than their party hierarchies.
October 21, 2014
There’s nothing wrong with the 35% strategy except that it could actually work to give a party 100% of the power exercised by the House of Commons, without the other chamber invariably exercising a countervailing power to restrain that party from behaving as an unbridled elected dictatorship..
It happens to be the Labour party at this time, but there is nothing to say that a bias in the electoral system could never operate in favour of the Tory party – indeed as I recall there was a small bias in favour of the Tories in 1992 – and I’m quite sure that if there was the same degree of bias as now but the other way around then the Tory party would be content to follow the same strategy.
Just in terms of the average number of votes needed to get an MP of a particular party elected the bias in favour of Labour and against the Tories was not huge in 2010, and if the Tories had taken just 6 more seats from Labour then the number of votes per MP would have been almost exactly equal.
http://news.bbc.co.uk/1/shared/election2010/results/default.stm
Total votes cast for each party’s candidates, divided by the number of Commons seats won by that party:
Tory 10,726,614 divided by 307 = 34,940
Labour 8,609,527 divided by 258 = 33,370
LibDem 6,836,824 divided by 57 = 119,944
The most obvious imbalance is between the LibDems and the two larger parties, but as far as the Tories being disadvantaged vis-a-vis Labour overall the effect was relatively small when expressed in those terms, with the Tories needing on average 4.7% more votes to get an MP elected.
Transfer just 6 seats from Labour to the Tories, and their respective positions would have been:
Tory 10,726,614 divided by 313 = 34,270
Labour 8,609,527 divided by 252 = 34,165
which would still have left the Tories 13 short of an overall majority.
Clearly the fact that the Tories actually got 7.3% more votes than Labour but still fell 19 short of an overall majority was not just down to the 4.7% pro-Labour and anti-Tory bias in the electoral system, it was partly because between the two of them they only won 87% of the seats, with 85 seats going to other parties all of which must be counted in with Labour as parties opposed to the Tory party and preventing it getting an overall Commons majority.
October 21, 2014
What are Labour (and others) going to say when their beloved homogenisers decide that what is required is a EU rather than just a NHS (or three or is it four?) because most certainly such a thing would not be free at the point of delivery or anywhere else.
October 21, 2014
Yes its very tedious listening to Labour politicians trotting out nonsense about Conservatives wanting to get rid of the NHS. Its ironic that the main Labour voice on this is the fatuous Andy Burnham, health secretary during the mid-staffs disaster! Most people, inc most Conservatives, want to keep the NHS but want to get the best healthcare we can for the money. So opposition by Labour and the health unions to any reform means we are more likely to get a better NHS under the Conservatives. If you want to see what the NHS would be like under Labour look at Wales and mid-staffs.
Likewise Labour’s reflex response whenever debate moves to the great Labour bust and recession is to blame nameless ‘bankers’ and talk about the need for a 52p tax rate and the minimum wage. Surely not even 35% of people will be taken in by this guff?
October 21, 2014
You ask:- Surely not even 35% of people will be taken in by this guff?
You would be surprised by how many are. This minimum wage just put some people of a job and closes some businesses down. So long as it is low enough it is not too bad but every time you increase it jobs are destroyed or exported.
We get richer by working more efficiently productively not by passing daft laws on minimum wages and silly employment laws.
Meanwhile the UK has a dreadful record on productivity:
According to data released by the Office of National Statistics, output per hour in the UK is 17 percentage points below the G7 average, while on a per-worker basis the UK was 19 points behind.
What is more, the trends are going the wrong way: output per hour was less in 2013 than in 2012.
October 21, 2014
An absurd discussion on Newsnight last night about the NHS. Where (needless to say) they all seemed to conclude it needed vast amounts of additional money. In fact the whole huge organisation is massively inefficient and has vast areas where money could be saved and the treatment quality vastly improved.
Cameron despite saying his priority in three letter was the N H S has done very little to improve matters so far. They have not even stopped free quack treatments and free vanity treatments yet. Nor do they charge most visitors. Lots of pointless “delaying” operations and techniques are carried out to hit targets and distort statistics. Vast sums spent covering up mistakes and on defending litigation. Lawyers and bureaucrat rarely add much to health care efficiency.
The first step is to charge Ā£20 per visit for all who can pay.
Newsnight went on to give us Chris Huhne say that rolling out over expensive PV cells, that generate almost nothing (and very intermittently) across cloudy England’s green and pleasant land, with vast tax payer subsidies, was a good plan! For whom one wonders the Farmers perhaps no one else.
R&D to get it cost effective perhaps but roll out before, at tax payers expense is clearly bonkers.
October 21, 2014
I think you make good points Lifelogic.
We do need a grown up discussion about exactly what we want the NHS to provide.
Is it right to fund IVF treatment? Is it right to fund cosmetic surgery? Should we fund gender reassignment surgery? Should we treat people who choose to take part in dangerous sports without requiring them to take out some medical cover? Should we treat the smokers, drinkers, fatties etc? Should we treat all the health tourists without at least trying to get the costs from them? Should people make a contribution towards the cost of the food and drink they consume whilst in hospital? Do we need so many managerial layers? These questions do not reflect my own views, they merely are things we need to ask when deciding the future, if there is one, for our NHS.
I have worked in both private hospitals and NHS hospitals and seen it from both sides. The last NHS hospital I nursed in was finacially crippled by a PFI contract with the PFI company providing the building, as well as all of the non medical services such as security, catering, maintainance, cleaning etc.
I suspect there is also another big lie told by politicians about the NHS. When I retired from nursing, I was replaced by two nurses. I was on a thirty-seven and a half hour contract, the two nurses who replaced me were on sixteen hour contracts however, politicians are able to say the NUMBER of nurses have been doubled but, they never mention the number of nursing hours which have been reduced; I suspect a similar situation exists with the record numbers of doctors too.
I am a great fan of the NHS but, it does need to change in order to survive and to do that, we do need a government which is prepared to have the discussion mentioned above without all the emotional blackmail and sentimental clap trap put out by the left and the state’s broadcaster. Personally, I do not think the NHS has ever been the organisation we are led to believe it is and we really need to remove the blinkers and rose tinted glasses when we examine it and its role.
October 21, 2014
Sorry, I also forgot to mention that the NHS cannot be in that bad a state if we can send so many staff and resourses overseas to help sort out the Ebola problem. It is a nobel cause but, if the NHS was in such a mess and so short of staff and money as Labour claims, how could we send so much to East Africa without our contry’s health service collapsing?
Perhaps we need to stop poaching staff from poor and developing countries and train more of our own people to take up these positions or is that too obvious for government to understand?
October 21, 2014
Well the NHS cannot afford the people but the government wants to appear to be doing something on Ebola so it happens. Like the cat walk with models in protection suits and the pantomime checks at Heathrow.
October 21, 2014
Well said Cliff.I couldn’t agree more .I was replaced by 2 Dr’s who subsequently were sacked. Never mind Cliff I am just warding off some free radicals with 2 glasses of Cab Sav , strongly advised 10 years ago to help detox. Trouble is as usual, the excesses of this grape stuff has caused our NHS bills to rise. This is why by nature I am conservative and not Tory.
October 21, 2014
Indeed, it has some excellent staff, but organisationally it is dreadful. Very far from the envy of the world it is so often presented as. I do think charging at least something to those who can pay (even say Ā£20 a visit) would make a huge difference.
Expensive capital, scanning equipment, plant and the likes should often be used nearly 24 hours a day to maximise the cost efficiencies.
October 21, 2014
It was being shown on the red button news pages yesterday, that we were in negotiation with a company, who were going to supply the UK with solar energy from a giant solar farm they intend to build in Tunisia. Madness in my opinion; how much power is lost transporting that power over such a great distance?
With the way the world is going, I believe we need energy security and food security as a matter of urgency. We need a government which will put the needs of our nation ahead of the wants of the world’s other nations and the ego of the leader of the party. We need to stop trying to be all things to all men and look after our own.
October 21, 2014
Indeed quite clearly bonkers but they do make a little more sense in sunny climes.
October 21, 2014
The thing you overlook John, is that Labour (indeed virtually all politicians from Wesminster) refuse to define their comments as referring to ‘the English NHS’ or indeed the Welsh/Scottish/N.Irish NHS.
They believe if they say just NHS, the people will think they refer to the (dis)UK NHS even though there is no longer such a thing, and for the most part they’re right.
We need a rule in Westminster to ensure MP’s discussing any matter devolved, must make it totally clear which country he or she is referring to.
Sadly, far too many of the general public still have little or no understanding of the territorial extent of devolved issues. Which of course suits the anti-English in Westminster
October 21, 2014
It’s not just Labour doing that, is it?
For all the old parties it is still better not to keep drawing attention to the unjust asymmetry of devolution, the process of transforming the UK from a unitary to a federal state which was started with the 1998 Scotland Act saying “There shall be a Parliament in Scotland”, and which has now become irreversible politically if not yet legally, but which is still incomplete to the detriment of England.
October 21, 2014
It is also instructive to look at one’s personal experience of the NHS. Current experience with a close family member tells me that it works pretty well at the actual clinical side. The obvious weaknesses are administrative. That is my observation in my own home area, but I would not be surprised to find that others share the experience.
October 21, 2014
I agree completely. My brother in law had a lot of work done after being knocked off his bike by a motorist jumping a red light. His clinical care was excellent but he needed treatment at three different London hospitals plus physio afterwards and the admin side of things was disjointed to say the least.
Usualy the people who know how to get things done are the consultant’s secretaries.
October 21, 2014
Yes my experience is the same.
October 21, 2014
And my experience too! Currently, my partner needs a very urgent invasive test procedure that can only be done at a Centre of Excellence 40 miles away. The letter sent from our hospital to the relevant surgeon went by post (perhaps they were out of native runners that day) 12 days ago, my partner’s health is deteriorating rapidly and we are still awaiting news – which will presumably be sent by pigeon post.
The delay means we will need an ambulance there and back, which I gather I will only be provided with if I (not the doctors involved) can persuade the Transport Dept at the Centre of Excellence hospital that the patient is sufficiently sick. In the meantime, neither our hospital nor our GP will give us care because they dispute whose responsibility it is, and we have been informed that if we go to A&E, we will be refused in-patient care because no invasive therapy is yet prescribed!
October 21, 2014
Well said.
A decent fraction of Labour’s core vote is surely still made up of the working poor. I can’t think of a group harder hit by the results of the last Labour government’s tenure.
I think that they should be reminded at every opportunity that cheap labour wandering in freely from the EU, which Labour have no problem with, hurts them more than anyone else. They should further be reminded to look out at the street and count the number of households enjoying a better lifestyle than them whilst working less (if at all) and asked if they’re happy about that and they want that number to increase rather than decrease.
Above all they should be reminded that if the current government is unsatisfactory it is because they have not completed the task of cleaning up the almighty mess left by the last Labour government quickly enough.
Perhaps I’m missing something here, but Labour seem to have gone out of their way to hurt their traditional core voters; and show no sign of stopping. I know the VAT rise hurt, but the income tax cuts surely compensate.
With all the arguments on here about whether we should support the Conservatives or the EU, let’s not forget who the real idealogical opposition is.
Not that I don’t have my complaints about the current administration, but let’s get things in perspective here. This is the Labour party we’re talking about here. I’d rather put a packet of hob-nobs in charge of the country. Only the Greens would be worse.
Perhaps I’ve missed something. Could it be that the working poor have stopped voting and Labour’s support comes from the public sector workers and the under/un-employed.
If you hire somebody to drive your car and they drive it into a wall and wreck it, then your mechanic takes longer than he thought he would to fix it; that’s not a reason to hand it back to the idiot who wrecked it in the first place, especially if that idiot doesn’t think he was wrong to drive headlong into a wall the first time and is promising to drive even faster into it next time.
October 21, 2014
Sorry that should have been “Conservatives or UKIP” rather than “Conservatives or the EU”
October 21, 2014
Your last paragraph should be put on billboards by the Conservative Party!!
October 21, 2014
John is free to pass it on if he’d like.
I’d shorten it to something like:
Okay, so the country’s not fixed yet. We’re working on it. Just don’t forget who broke it in the first place.
I think it was the PM at one of his early PMQs who said: “No more boom and bust? They got it half right.”
I may be paraphrasing here.
October 21, 2014
If Cameron is the mechanic he has surely not even opened his tool box yet. He needs to cut the endless government waste, HS2, cut taxes, deregulate, get some cheap energy and have real incentives to work. He has done virtually none of this, and he has nearly doubled the total government debt over his period of office too.
Meanwhile he falsely claims to be “paying down the debt”!
October 21, 2014
To be fair, the debt grows itself while the deficit remains. It is nonfeasance rather than misfeasance on the government’s part.
October 21, 2014
As I recall, the promise was to put us on a path to eliminate the structural deficit over 5 years. This was a promise I understood and expected them to work on. If the structural deficit only disappears at the end of the 5 years, the debt will only start to decrease toward the end of the 5 years, or perhaps a bit later depending on the economic cycle. This is what I understood and what I judge them by.
I think that a small (and only small) apology is called for the fact that the 5 year schedule was extended, but it was still, in general, the proper course of action.
A more aggressive cuts program would perhaps have been preferred, but to a first approximation I got the economic governance I was promised. Let’s not forget that if a bunch of (albeit very smart) people attempts a radical reorganisation of a government which has developed gradually over decades or even centuries in a very short space of time, a lot of things are going to go wrong and people will get hurt as a result.
You can’t reduce the size of the state from 50% of GDP to 40% or less in 5 years without making an almighty mess. I agree that we should be headed toward a much smaller state, but with due caution and attention to detail.
October 21, 2014
“You canāt reduce the size of the state from 50% of GDP to 40% or less in 5 years without making an almighty mess.”
Of course you could vast amounts of bloated waste all over the place. Private companies have to do similar things all the time. Anyway the state sector is 50% overpaid relative to the private sector and at least half of them do little of any real use. Correct that and the state sector overhead is reduced massively. Then cut the payments that encourage the feckless not to work.
October 21, 2014
What a strikingly sensible and moderate comment. What do you think you are doing on the comments section of a political blog?
October 22, 2014
Matt
What you want is happening.
They aimed to gently reduce the deficit and they have ended up with gently increased spending.
I believe that in political circles this is called austerity.
Anyone who runs a business that is in a similar state will know that budgets showing increased sales and reduced costs nearly always fall short of expectations.
October 21, 2014
All Party’s need to understand that the performance of the NHS is also influenced by the number of immigrants arriving here, who then can use the service.
Thus if our population grows by 10% then NHS patients will automatically grow by 10%, so spending needs to increase by 10% just to keep spending per head the same (without any inflation)
Given that spending needs to increase as more of our population live longer, the NHS needs vast amounts of money just to stand still, if it does not become more efficient.
I have absolutely no problem with some work/treatment being put out to the private sector if the standards are the same or better, and at a price that is lower than the NHS can provide.
Thus the key is more treatment for less, as long as at the point of treatment it is free to patients.
October 21, 2014
Alan–Just so long as the “more” (or maybe less) treatment is medically necessary, that is it is for people who are actually sick, and not just elective. The Left are happy as is of course, spending other people’s money as usual, but such an approach would have the advantage that it might work.
October 21, 2014
Leslie
“as long as the “more” treatment is medically necessary”
Absolutely agree, also agree with Cliff’s comments @ 10.56am
Ref : We also need to have a grown up discussion about possible treatment limits etc.
October 21, 2014
I quite agree. Whenever I need to go to a hospital the people in the waiting room are always 90% foreign. This is in London.
Also our legal system is clogged with foreigners all waiting for justice. I had a driving ticket and when I went to court out of about 30 people two were white English – astonishing.
October 21, 2014
Vanessa – You are wrong. NHS shortages are due to our ageing population, not the mass immigration of poor people.
October 21, 2014
“Save the NHS from the Tories and UKIP”
It’s a piercing dog whistle even if it isn’t true. An effective way of bringing back UKIP defectors to Labour.
The NHS is the industrial wing of Labour – the BBC its broadcaster. So it will work to some extent.
(Labour/Common Purpose have even planted an interloper at the head of the ‘Conservative’ government ! I really don’t understand what Emma Thompson has been complaining about – the Left have had things all their own way for so long.)
October 21, 2014
“Itās a piercing dog whistle even if it isnāt true. An effective way of bringing back UKIP defectors to Labour.”
It’s the only thing they have to counter the strong immigration issue.
October 21, 2014
Indeed the state sector unions, Labour & and the lefty BBC have indeed had it all their own way for years. The Tory party is also 50% of the left too. They nearly all voted for the idiotic climate change act and made 299 tax increases after all.
October 21, 2014
Yes, Labour think they own the NHS and that Saint Bevan founded it after the war (untrue). NHS staff even wear Chairman Mao style outfits so that doctors and nurses are more or less indistinguishable from one another. The Tories may be the foster parents of NHS at present but rotten irresponsible parent Labour wants the child back after 2015.
October 21, 2014
The NHS has figured as a key voter issue in recent polling and that it is perceived to be safer in Labour hands than in Conservative hands. I assume this is the reason that Labour keeps banging on about the NHS, even though as you point out Labour`s record is blemished. But when have the facts stood in the way of a propaganda campaign? Repetition of a message, however inaccurate, is the time honoured approach as we have seen in the global warming scam – and it will fool some of the people all of the time.
October 21, 2014
Dog whistle for Labour: “NHS !”
Dog whistle for UKIP: “Immigration !”
Dog whistle for Conservatives: “Ed Miliband !”
They accuse UKIP of being a one-man-band but the Tories are reduced to being a one-man-demolition exercise. What if Alan Johnson were to take over the Labour leadership ?
October 21, 2014
That would be ‘No Marks’ for AJ !
October 21, 2014
John, are you Ed Miliband’s advisor now!? Remember the old maxim – Never interrupt your enemy when he’s making a mistake, it’s bad manners…..
zorro
October 21, 2014
Given the irreversible move towards a federal system for the UK, with the NHS now almost entirely a devolved matter for three out of the four components of the federation, should the NHS in England still be a proper subject for a UK wide general election for a UK federal Parliament dealing with UK-wide matters, or should it be a subject for the elections to a devolved English Parliament? Why do the English alone now have to put up with direct rule by the UK federal Parliament and government, as if England was just a very large federal territory, or as if it was Northern Ireland in the midst of the troubles and not in a fit state to govern itself on most domestic matters?
October 21, 2014
Denis–The case you make does not need an English Parliament to fix it. The simplest of EVEL systems would unarguably go a long long way; does not seem any kind of big deal to me; and in any event would be a good stepping stone down the track if necessary dependent on how federalism does or does not pan out. A working hodgepodge is fine with me.
October 21, 2014
If you have so little pride in being English that you will accept whatever sop the politicians may be prepared to toss you then EVEL is for you. On the other hand if you see no reason why the English should have any less than the Scots have had for fifteen years now, and you want to be as sure as possible that any renewed efforts to break up England will be blocked, then you will dismiss the EVEL fudge and demand treatment equivalent to that given to the Scots, with a separate and separately elected devolved Parliament and government for the whole of England entrenched as a permanent feature of the UK constitution.
October 22, 2014
Dear Denis–You talk as if everybody agrees with you; but not everybody is as obsessed as you on the subject. Try and absorb that there are many who, so far from wanting to upset everything further with an English Parliament, don’t even want EVEL never mind that. My pride as an Englishman, not up for discussion thank you very much, would be reduced not augmented by some modern glass, plastic and concrete new building God only knows where.
October 23, 2014
It is NOT an obsession to want that which is yours by right !
Was it an obsession for Gandhi or the peoples of Eastern Europe to want to govern themselves ?
Yes, I accept the argument that everybody does not think like Denis or I. And yes, people like yourself maybe happy with EVEL. But what you fail to see, is that we as a nation have gone so far down a road where, the eventual break up of the UK will indeed happen, and it will not be pretty.
When negotiating, it is usually considered best practice to ask for more than you want or can reasonably achieve. This allows you room to reduce your position yet, still get most, if not all, that you want. Ask Alex Salmond, he’ll tell you ! š
October 21, 2014
Yes NHS is devolved to Scotland and Wales – maybe the media should make this clearer by referring the NHS England when talking about Labour’s election commitments rather than the NHS. A Labour election victory with a small majority would mean that a Westminster Labour Government could only legislate for NHS England with the use of the votes of Scottish MPs. Something the Conservatives should make a bit more of. Wages and wage increases will continue to stay low whilst we have net immigration at the present levels – something else he media seem reluctant to draw attention to. Similarly housing will remain scarce and expensive for the same reasons.
October 21, 2014
All parties avoid talking about things that embarrass them, from which you might expect Labour to be speechless. They have countless jugulars you can go for in the run up to May 2015. For instance:-
1.
The NHS in Wales, a lifeboat that the Welsh seem to be abandoning in increasing numbers.
2.
Their climate change act and it’s cause of most of our current energy problems.
3.
Immigration.
4.
Their refusal of English votes for English business.
5.
Their love affaire with the EU.
6.
Their dependency on extreme left unions.
7.
Their proven financial incompetence.
If you could encourage CMD to be unequivocal on red lines for continued membership of the EU, the electorate might start to react positively. If he thinks he can just talk it out until May 2015, he is making another grave error of judgement. The electorate have a very clear alternative to any more obfuscation on his part and their radar is switched on looking for it.
October 21, 2014
Indeed Miliband is clearly useless and misguided, but he is still almost certain to be the next PM due to Cameron’s “modernising” and sense of direction.
The tories are essentially just a tax increasing, fake green, pro EU, tax borrow and waste, soft socialist party.
What is the real difference?
October 21, 2014
Do not forget the impact and cost of health tourists.
October 21, 2014
There’s been for far too long the ‘cry wolf’ element in NHS funding also.
Brown essentially doubled the Health budget and scant years on are relentless cries that the NHS is ‘in crisis’, or that it is suffering ‘from cuts’. (If supporters of the NHS want to see what cuts look like, they should have a glance of what the long-suffering Armed Forces have had to put up with..).
Polly Toynbee has pontificated that to ‘survive’, the NHS needs another thirty billion pounds of magic money divined from the back of the enchanted sofa each year.
I think many people are now becoming aware that there is possibly no identifiable amount of money that might exist that could be pumped into the NHS in a manner that it won’t be ‘in crisis’ to some political agenda or other quite soon after. The NHS is being used as a Ulysses’ Siren to attract votes – there’s no coherent debate about how the NHS could be sustained under its existing (biblically generous) budget. Other than ‘more money’ these people have no answers.
October 21, 2014
The political debate in the UK is usually notable for the absence of highly relevant facts.
This often avoids embarrassment for one political party or another, sometimes, as in the case of the EU, all three.
At present we have the figure of Ā£30Bn being bandied about as the shortfall the NHS is likely to face.
Why isn’t there an independent audit report in the public arena telling us the facts and proposing solutions ? By solutions I don’t mean just raising taxes. That’s just too easy.
Some facts would also help in the immigration debate. For example, with net immigration at 250,000 pa, how many extra school places, prison places, Police Officers, social workers, teachers, GPs, hospital beds and Doctors, homes and other infrastructure will be required for each five year period this continues ?
How much of the NHS shortfall of Ā£30Bn is accounted for by the level of immigration we have had since the numbers increased so dramatically under Blair and Brown ?
What is the gross cost per immigrant and how much of this is offset by the measurable economic benefit of them being here ?
Why can’t we ever get a proper answer on our trade with the EU ? The EU apologists like Clegg go on about 50% but completely ignore the Rotterdam effect ( as well as the Bremen and Antwerp effect, for that matter) ?
I suspect these figures are alarming and would lead to very difficult questions for both ministers or shadow minister alike.
If some properly conducted research was publicised in a clear and understandable
way by effective Politicians and Journalists, maybe we would find a better consensus on some of these issues.
October 21, 2014
Yes, let us unashamedly name the guilty men – “…as Mr Brownās vow made clear”! lol
The Labour Party’s near exclusive emphasis on the NHS points, it seems to me, to its great weakness, that being that it no longer has any true identity, the redefinition imposed by the New Labour project now being exhausted and leaving behind a hollow shell. Why the other political parties do not make much more of Labour’s many and serious failings in its last stewardship of the NHS is a puzzle.
October 21, 2014
JR: “most adults under 70 years of age are fortunately normally healthy and not therefore personally preoccupied day by day with the NHS.”
That line sums up why I’ve always been baffled by the obsession Labour has with the NHS as a central election issue. I’ve been in hospital once or twice, have a couple of kids etc, but I don’t find myself checking the state of the NHS every day just in case I happen to get run over or ill. I’ve also never had any problem with the NHS (sometimes a bit of patience is required) apart from the astronomical parking fees we now have to pay if we need treatment or want to visit someone – a legacy of the Blair/Brown years I believe!!!
October 21, 2014
I have recently had some excellent NHS treatment although I had to go private for a hernia op to avoid a ruinous waiting list. I was amazed at the number of foreign staff and patients. Whilst we continue to treat the world, standards will decline with the ever increasing population due to the government policy of mass immigration. Only half a million this last year. When will it stop? .
October 21, 2014
Same old song from Labour – keep throwing money at the NHS and up the benefits. Perhaps if one of the parties could think along the lines of (a)immigrants to have health insurance for at least three years (b)no benefits paid for five years – the voters might feel that a realistic approach was being taken to both NHS funding (its protection from abuse by health visitors) and an end to easy benefits.
October 21, 2014
Supposing for the sake of argument that the particular Labour politicians elected to the Welsh Assembly by the voters in Wales have made a mess of running the NHS in Wales, then obviously that is a failure by those Labour politicians which those voters in Wales should take into account at the next elections for the Welsh Assembly; but how much should even the voters in Wales allow that to influence their decisions on how to vote in the elections for the UK Parliament, let alone the voters elsewhere in the UK?
Supposing again that Labour candidates in England, either for the UK Parliament as it is now or for the English Parliament as it should be, openly admitted that their colleagues on the Welsh Assembly had made a mess of the NHS in Wales, and said that they would not pursue the same mistaken policies in England?
Are we to assume that the average voter cannot distinguish between different elements of the overall governmental apparatus and understand their respective responsibilities, and will never be prepared to vote differently in the elections for different parts?
October 21, 2014
It is a tragedy that we can’t have a proper discussion about the best way to develop the NHS without the vested interests trying to scare us witless.
I have travelled frequently to and have friends in the USA. If anyone propose changes to their health system they are told they will end up with socialised medicine like the NHS which would be a disaster. Whenever changes are proposed here we are told we will end up like the USA. In both countries the vested interests are using fear, uncertainty, and doubt to make us too scared to change anything and prevent politicians having an honest debate.
October 21, 2014
Several times I have heard the argument from the Left that they do not want people making a profit from healthcare.
Yet, the NHS is a professional service and not a volunteer service with thousands of health workers making a profit from it in their wage packets.
Some are agitating for even more profit.
October 21, 2014
Wages are not profits. That is basic economics.
October 21, 2014
Anyone taking a wage from the NHS is making a “profit” from it. Unless perhaps it cost them more to do the job and get to work than they are paid to do it!
October 22, 2014
You are obviously not aware that a large proportion of the NHS is and always has been private and run for profit.
GPs are self employed contractors to the NHS they are not employees. Their income is classed as profit after expenses such as staff, vehicle and office costs are deducted.
Furthermore, many GPs own the building their practice operate from. I know because in the past I have arranged finance for some. The NHS pays a very generous rate of rent which allows them to fully fund a repayment mortgage so when that is paid off, they reap the benefit in full. They can then continue to receive rent after they have retired on a generous pension package which they can also top up at the maximum rate of tax relief.
Many GPs operating in rural areas particularly also operate the only pharmacy adjacent to the premises and this is a growing profit centre for them.
I know one rural GP practice where the four partners are taking profits of over Ā£200,000 each, about Ā£40,000 of which comes from the pharmacy. And this without having to provide any out of hours services. They have an average of only 1600 patients each.
These are recent figures and show what a profitable business a GPs surgery can be if it’s efficient and takes maximum advantage of the incentives on offer. The latest being Ā£55 for every case of dementia diagnosed.
The contract negotiated by Labour under John Reid was ridiculously over generous and as a result we now have the highest paid doctors in Europe.
I don’t blame GPs for this, they are intelligent individuals and are simply doing what’s in their best interest and which mostly coincides with the interest of their patients. The exception is out of hours services.
The disastrous transfer of out of hours responsibility to health authorities is costing hundreds of millions a year extra for an infinitely worst service. GPS could not believe their luck when they were able to opt out of providing it for the loss of a very small annual sum.
This is being addressed but is likely to prove difficult to solve without paying GPs even more money to take it back.
So, it is certainly not true that The Conservative party is privatising the health service. Your first point of contact with it has always been a free enterprise organisation.
October 21, 2014
I’m afraid John, that the constituency issue means that unless the SNP gobble up Labour seats in Scotland and Labour refuse EVEL then Labour will win.
UKIP took many votes from the Tories in around 7 seats in the last election and they will take more this time. The abject performance of Tory Paul Uffal, opposite Carswell, on DP yesterday doesn’t bode well.
Additionally John; talking about the NHS with logic as you do is incomprehensible to Labour’s core vote, many of whom represent Romney’s 47%. Logic won’t beat the present electoral system. Massive pressure in Scotland and tangible achievements in Europe will.
October 21, 2014
The voters will buy Labour’s lies John unless the Conservatives start getting a bit more vocal on the NHS. Their silence on the matter is pathetic and only helps to confirm in the public’s view, Labour’s lies. Instead the Tories should be shouting from every rooftop from here to the election and reminding the public at every opportunity of the NHS in Wales, North Staffs, East Thurrock, PFIs, mixed wards, people in England being constantly denied life saving cancer drugs on their watch, MRI, Labour’s massive privatisation programme etc. etc. Why don’t the Tories go on the attack and tell it how it is – that the NHS is not safe in Labour’s hands. Instead they just seem to accept the myth that the NHS is ‘Labour’s baby’ and say nothing. Anyone would think they are deliberately trying to lose the next election!
Also, as Denis Cooper says, why should NHS England be a matter for a UK wide election? If Cameron was really serious about EVEL, this could be used to emphasise the need for an English legislature and a good place to start would be an ENGLISH manifesto. Will we be seeing an ENGLISH manifesto John alongside the Conservative Scottish, Welsh & NI manifestos? I suspect not, which will be a big mistake. Why should England take the Tories seriously on EVEL if they can’t even be bothered to produce a manifesto for it?
October 21, 2014
I don’t know why you still refer to it as the NHS john -we all know that it is now a free for anyone from anywhere health system, with us picking up the bill. After having read a few days ago that anyone can walk in, get a NHS card/number, and the example given was HIV, get treatment for LIFE -which could be a million pounds – I was speechless. Unsustainable. Deliberate destruction of the NHS as well as the nation itself.
Another case was the recent one of the American drug dealer, sentence over, was going to be deported to the USA, claimed he couldn’t afford the insulin for his diabetes and wanted the NHS to pay for it – and a judge allowed him to stop. Presumably that judge hasn’t got ANY concern that the rest of us will be paying for this man’s obvious multitude of other benefits as well as his health treatment. Ruling made -rewarded for life for dealing drugs, where HE wasn’t bothered about other people’s lives, but made sure WE have to pay so HE is alright ( why didn’t you give him enough to pay for his insulin – and put him on a plane?)
If you want votes, start looking after the people who have lived and worked here for years, paying taxes so the country could be built up – instead of your leader throwing millions to the financial black hole called the EU. Stop throwing millions to foreign despots who want us to pay for their luxury. Stop wasting millions on people who should NOT be here, hate us and our ways, but still love sponging off our benefits.
The way your leader is behaving is that it looks like he DELIBERATELY wants to lose, so someone else will get the blame and have to try to put it right. One thing is sure -HE HATES EVERY SINGLE ENGLISHMAN.
October 21, 2014
Continued membership of the EU will mean the end our system of free (at the point of delivery) healthcare, whichever party is in power.
Our free-to-all-comers NHS is one of the UKās strong immigration pull factors and will eventually become unaffordable.
October 21, 2014
For all the noise from Labour about the privatisation of the NHS, those of us in South Bucks have nothing to complain about when it comes to the privately run “NHS Diagnostic Centre”.
My wife had a problem and the GP said that he would make arrangements for scans. Having previously had long waits for such things, she put it out of her mind, but a couple of days later she had a phone call from the Centre asking her when she would like to come in for the scans. An appointment was made for 10am a two days later and she was asked to come in about ten minutes beforehand so the paperwork could be completed. We arrived in plenty of time, there was free parking and they saw her exactly on time.
If this is privatisation, I’m all for it! And if someone made a profit out of good service, well I’ve certainly no objections.
October 21, 2014
EP
Family member had a similar experience in Berkshire last year.
Seen within days, results immediate.
October 21, 2014
Presumably the finance for the NHS in Wales has been top-sliced to pay for the officials employed by the Welsh Assembly Government? This would help to explain why there is less money spent directly on health in Wales than in England. The top-slice is always removed first once any block grant is received.
October 21, 2014
Unlike in England, in Wales the NHS budget was not ring-fenced, but cut in proportion with reductions of government spending in other areas.
Presume less, research more.
October 21, 2014
I can only tell you that the top-slicing of grants occurs in the area of education – or certainly used to. Moreover there are cunning ways of increasing the top-slicing method by subdividing administrative areas so that from one large area you create more and more smaller areas, each of which has its own senior administrative positions paid on the same pay scale as the people who administer the large areas.
I know how bureaucracy works. If you look at university budgets you will now (since the early 1990s) find growing proportions consumed by administrators and shrinking proportions given to the employment of teaching staff.
October 21, 2014
Labour’s claim that the Tories would privatise the NHS is mere sloganising. Someone should ask them what exactly they mean by that. Vast areas of the NHS already have suppliers who make a profit out of it – the provision of medicines and drugs for example is entirely met by profit-making private companies but Labour are not suggesting they should be excluded – why not ?. Even in the “state” part of the NHS big profits are made – for example every GP in the country is in Labour’s hated top 1% of salary earners. Several state health services with better clinical outcomes than the NHS are run with a mix of state, independent not-for-profit and profit-making hospitals and other services – Germany for example. As long as the NHS remains free at the point of delivery I couldn’t care less on the precise economic status of the provider. I think Labour’s message is simply aimed at stupid people who think “privatise” means “you will have to pay to use it”.
Incidentally, how come Welsh residents are allowed to travel to use the English NHS if places are available for them in their own local NHS system WHICH THEY VOTED FOR ?
October 21, 2014
This NHS dependent scrounger can honestly say the NHS has never figured in any voting judgement of ours.
Methinks the Tories are missing a trick – when aiming their attacks on Liebore – unless they be keeping their powder dry…
Liebore always has been the party for the public sector – whether right or wrong – it is all part of their post war DNA.
But…
Liebore has never before been a single issue party – unlike now – the public sector party in general and the NHS party in particular. Not much to vote for in the great scheme of things.
October 21, 2014
None of what you say will make much difference to the lies that all the socialist parties will continue to churn out concerning the Holy-Cow NHS in the run up to the next election. You can state your case on behalf of the Tory Party for as long as you like but it wont make any difference. The propaganda war will continue and the Leftists are very good at it as they have devoted all their energy and have had years of practice to hone their techniques to perfection at the Marxist University of Hate.
I don’t agree that ‘The NHS is not a great election issue for Labour’ because the truth is irrelevant and Labour lie, lie and lie again; it comes as naturally to them as breathing.
October 21, 2014
“No-one in England will have to wait more than a week for cancer tests and results under a future Labour government, the party has pledged.”
Must be great news for health tourists.
October 21, 2014
As usual your incisive comments are right, John, and are agreed by like-minded people. However, Labour shout their lies LOUD AND OFTEN and people believe them because the BBC tells them to.
It’s not your policies or your performance over the past 5 years which will lose you this election, it’s the Silence of Cameron. By the looks of what I see and read from you and from other (non-BBC) sources, the Cons have got the gist of what the country wants (or England at least) and should have a solid manifesto which would appeal to most people in England. But if Cameron keeps that manifesto under his bed for much longer people will think he actually wants to lose. That would certainly stop him being the PM who left the EU – so maybe he does!! Surely there’s some way you and your colleagues can make him start hoisting his flags up the pole.
October 21, 2014
Good afternoon.
As currently constructed, the NHS simply cannot carry on. A free ‘for all’ service that meets an ever widening remit of health issues, coupled with the fact that, no matter where in the world you come from, you will be treated regardless, is a noble ideal, but someone somewhere has to pick up the bill ! Remember, it is FREE at the point of service, and not FREE, as in completely.
To make matters worse, it has been made a political ‘sacred cow’. When such an issue is allowed to be reserved, being able to discuss and deal with the issues at hand becomes next to impossible. Arguments, common sense and reason simply go out the window, and so, the whole matter never gets resolved.
I have, for various reasons, had had call to use the emergency services. Whilst traveling in an ambulance, I remarked at how different it was to all the others I have traveled in before. To my surprise, it was manned by a private company. The journey, to my relief, was free (I did not have my wallet) and the care as good as I have come to expect. I shall not name the company concerned, but I believe that a well know Marxist (ex or otherwise) and former Labour Minister and Peer, has some financial interest in them. Funny that !
Eventually, the NHS will go all private, with some contribution at the point of service or private insurance. The trouble is, the tree main political parties have not got the stomach to come out with it. So they privatise by stealth, just like they sell the UK down the river.
Shame really, it was such a good idea when first conceived but, it was by no means the only idea.
October 21, 2014
John,
We already give the Welsh Ā£1,300 of English taxpayers’ money more per head to spend on their NHS if they want to. Who is picking up the tab for the all the Welsh health tourists crossing the border to get treatment? Is this coming out of the English NHS budget? In that case, are there any Barnett consequentials or do Barnett consequentials only work one way? I don’t remember when life saving cancer drugs were being denied to English patients under Labour, but not elsewhere in the UK, there being any suggestion of English cancer patients being offered these drugs by the Scottish or Welsh NHS. I can hear the uproar now if English cancer patients had been treated using ‘valuable’ Scottish or Welsh resources even though it is English tax payers’ money. Isn’t this just another case of we English being taken for mugs yet again because there is absolutely NO-ONE in the political elite who actually gives a toss about ENGLAND!!
October 21, 2014
Yes indeed John,
I suppose Labour still think they run Scotland’s NHS… Who in that party is going to tell G. Brown that they do not !
October 21, 2014
The NHS has become far too big to handle, efficiently. It is Europe’s largest employer with around 1 million employees, ALL funded, totally, by UK tax payers – to the tune of around Ā£4000 each. Now what would the professional private healthcare services be able to supply with the sort of cash?
The NHS has become a Public Sector behemoth and home to old trade union rule. The service is grossly overweight in Admin and too lightweight in front line staff – it requires a complete overhaul. We British tax payers have to be weened off the idea that the NHS MUST be free for all at the point of delivery. We cannot afford it.
If it is to be saved from collapse, it is inevitable that charges will have to be made. First to non-citizens, who should be made to pay up front for ALL treatment outside of A&E and then to the citizens to visit their GP but for a small nominal fee – subject to the usual exemptions. This is the normal practice elsewhere in Europe so why are we so different?
October 21, 2014
The NHS is crap anyways, personally I want to see a much better model of healthcare than the Stalanist nonsense people put up with now.
The scare stories should be rubbished. But there are much better models of healthcare in the developed world than ours.
The dirt, the waits, the out of date treatment options, the lack of choice, the state thinking it controls the treatments your children get, the lack of access to or choice of GP, all this and so much more need changing.
Far more buying power needs handing to the patients.
October 21, 2014
Is the English NHS claiming back the cost of treatment from the Welsh (and Scottish and N. Irish) NHS? If not, why not? They are, again, stealing what little money the English get from Westminster.
October 21, 2014
ONS Public Sector Finances, September 2014. I am being serious today, no sledging; OK.
JR, please try and discourage Osborne from trying to claw back his overspending, detailed in the above. I am hoping wiser heads at the Treasury, are telling him that his overspend has measurably improved aggregate spending in the economy by the little people. Hence, improved GDP growth percentage. Alas, not household real disposable income per capita; the ultimate metric for the little people.
We are currently running a 4.4% BoP Current Account (Trade) deficit. We have about a 6.2% (of GDP) Budget Deficit. That leaves the private sector a little room (1.8%), to net save or pay down some household balance sheet debts. Unfortunately, the numbers continue to show that far too much of Gross National Income, is going to capital owners and not enough to salaries and wages, which is slowing aggregate demand to a crawl.
ONS Trade stats show exports have declined and imports have declined even more. M3 Broad Money growth has been negative since Q1-2014. This is not the time to be reducing government spending any further. A drop below 4.4% budget deficit, will cause the private sector to start spending its savings; “equity releasing” from its property; taking on more debt when its credit cards are still 90% maxed out.
The guys at the BoE will need another “serious incident plan”, should a suicidal attempt at a “zero deficit” be attempted. Or; they may pray that we find billions and billions of barrels of oil under our feet to sell. Then, you could run not only a zero deficit but a bloody great budget surplus.
October 21, 2014
John that is a sweeping statement. Most under 70 year olds etc….My patients are mainly under 70 and it is a case of preventing their bad health status worsening thereby trying to avoid a desperate situation and hospital confinement/ NHS expenditure.
October 22, 2014
I agree!
In my experience, but it is generalising again, the health of people tends to be related to their socio-economic position, if one ignores genetic disorders and conditions.
The poorer a person is and the less educated a person is, the less healthy they’re likely to be.
Although we have thrown money at health and education, just like a giddy aunt with a box of confetti at a wedding, we have not, in my opinion, seen much of a return on that investment(sic). We still see an uneducated underclass who are poor compared to others within our society. They tend to eat badly, smoke and drink more than they should and exercise very little. I suspect their offspring will see that lifestyle as the norm and will adopt it themselves when they become adults. This is the ticking time bomb we should be more worried about, in my view.
When I first went into nursing, most hospitals had on site nurse’s homes; usually blocks of flats and bedsits. Even Broadmoor had it’s own staff village.
We now hear politicians bleating on about affordable homes for key workers and yet over the last decades we have sold off police houses, Fireman’s houses, nurse’s homes etc.
Nursing is now pretty much a graduate only profession and for a person to saddle themself with huge levels of debt at the start of adulthood is asking of would be nurses too much, especially when combined with high housing costs.
I went into nursing for what seems to be rather old fashioned reasons today, namely I cared and wanted to make a difference, I doubt I would do so now if I could my time over again; don’t get me wrong, I love psychiatric nursing, but I would not want to saddle myself with huge levels of debt nor would I want to subject myself to the stress, worry and frustration my former colleagues talk about today within the profession.
I noticed in Reading blocks of student flats. Why can’t we have similar arrangements for hospital staff, police, firemen and teachers etc?
Surely many of these institutions which these key workers serve have some land on which homes could be built; this would also help stimulate the local economies too.
October 21, 2014
All of this is very lucid and rational. But are enough people reading it? I get the impression that the Conservative Party is very good at preaching to the converted.
And the Conservative poll share is still flat lining at 32%. On the economy, we won’t get the feel good factor going because people have been pricing themselves back into employment and immigration has added 3 million job seekers since 1997.
Change of subject: why has government borrowing increased this FYR? Is it failure to control public expenditure or a shortfall in tax revenue – or both?
October 22, 2014
I don’t understand the obsession Labour has with the so-called “privatisation” of the NHS. Nor do I understand why “privatisation” is thought to be irredeemably bad.
Most people contact the NHS through their GP. GPs are self-employed. Surveys frequently show that patients value and trust their GPs ahead of the general NHS. So what is the problem with the private sector contracting to provide services to the NHS?
October 22, 2014
I am attempting to watch Prime Ministers question time, but i have had to put the tv off as there is the usual shouting and mayhem. The subject is the NHS and both Milliband and. Cameron are trying to outdo each other. When will the politicians realise that the public are turned off by these juvenile antics! All the politicians of all parties do is try to outshout each other. Frankly I feel like not voting for any of them!