NHS Waiting lists

There are some people in need of treatment who are waiting too long. Despite the appointment of more than 200,000 extra staff since 2019, and putting in many billions more money the stated waiting lists have  risen. There are said to be 7.7 million waiting. The strikes have not helped. The NHS does need to ensure people in pain where treatment can help should get the treatment they need in a timely way.

There is also a large amount of duff data as in so much of the public sector. Talking to a recent NHS Minister I am told the rapidly rising numbers of executives and administrators have not managed to clean up the lists and produce meaningful figures.

The first problem with the waiting list figure is it includes many people who want to see a consultant to see if there is anything seriously wrong, with people awaiting test results,  with those who are awaiting treatment after tests and diagnosis, with people who have completed treatment and may or may not need a follow up appointment.

Apparently if you are after treatment you may stay on a waiting list in case you need to come back, just as you are on a waiting list whilst awaiting test results or diagnosis.You need to say you are happy  with treatment and sign off.

There are people with more than one condition who may be on the waiting list more than once, waiting additionally for a second or third possible condition. There may even be people who have died of something else whilst registered as waiting under one or other of the categories of waiting.

It would help if all those extra  administrators got the lists into better shape and told us how many different people were waiting  for diagnosis, waiting for tests and waiting for treatment. That would help in the important task of getting different waiting times down.

Deletion of posts

I have been overwhelmed by multiple over long contributions. To catch up I have just deleted some for being overlong and one of several from the same contributor.

The way for the government to win back lost support is to be more Conservative

There are some who say that the Conservatives must shift leftwards to rise in the polls. They say they must resist Conservative ideas for fear of putting off so called centrist floating voters. This  is a very old fashioned view of politics.It. certainly  does not fit the current mood.

The reason the Conservatives are low in the polls is a lot of voters who voted  Conservative in 2019 are not happy with what has happened and are sending a message to the government through pollsters. Most of them are unattracted to Starmer and Labour . Lib Dems languish on low poll ratings. Some of the former Conservatives are saying don’t  know or wont  vote to pollsters. Some say they will vote Reform, a great way to deliver a Labour government which they do not want.

I will set out in future pieces Conservative philosophy and policies the government could implement soon to reassure  voters that they understand them. Many people did not vote Conservative in 2019 to get a blue version of Labour. They wanted lower taxes, more freedoms, an independent democratic country and the greater prosperity free enterprise and wider ownership can bring. Your thoughts would be welcome.

The Ukraine war

President Biden was unable to offer the President of Ukraine much money when he visited Washington this week. Instead of the $60 billion the President asked Congress to approve, he made available just $200 m . The amounts the previous  Congress has approved are running out. The House elected at the mid terms with a narrow Republican majority is saying they want the President to give priority to strengthening US border defences to keep out more of the illegal migrants who turn up every day. House Republicans are cooling on more money for Ukraine anyway. They are asking for a clearer military plan of how the war will be conducted and what might be the results and timescales.

The West has been financing Ukraine on a large scale.  Total EU aid since February 2022 totals Euro 85 billion and US Euro 71 bn. There is the military aid, often given free. There is the substantial financial aid to allow the government of Ukraine to function against a background of an economy impaired by war damage, loss of territory and the massive diversion of effort to military activity. There has also been a sharp loss of people as many have sought exile elsewhere. The EU has sent most money, followed by the US, for non military purposes. The US has been the main provider of weapons. The three small Baltic states and Norway have given the largest amount relative to their GDP, as they feel the Russian threat more closely than others.

President Biden says he is still keen to help Ukraine and to encourage Ukrainian resistance to the violent invasion by Russia of Ukraine’s lands. However he may be forced to compromise over the money now he has lost control of the House, which in turn may affect his relationship with Ukraine. Meanwhile the Europeans struggle to meet the demand for weapons and ammunition from Ukraine as the conflict is using large quantities of both. The EU is also having budget disagreements of its own.

I think NATO was right not be drawn into this conflict and not to offer membership of NATO to Ukraine. Instead NATO led by the US has been willing to offer substantial assistance in the form of weapons, money, training and ammunition. NATO countries have been keen to avoid direct conflict with Russia, and have laid conditions on weapons supply that they are only to be used within Ukraine.

So today two big questions loom. What should the rest of the West do if the US political system decides against further large contributions of military equipment and money from that source? What is the strategy for winning the war and what would Ukraine need from the west?

Some will propose a negotiated solution with compromises on both sides. Mr Putin is unlikely to want to compromise ahead of his re election as he places his country on a war footing and seeks to arouse strong Russian nationalist passions. Ukraine, having done so well in resisting the invader starting with a much less powerful  military is in no mood to compromise either. What advice should the West be giving Ukraine?

The Rwanda bill

I did not support the Rwanda bill in the Commons . It is a flawed draft in need of substantial revision.

I did not vote against it  because I agree with the aim of the policy to stop illegal migration into the UK. The Opposition parties who voted against the measure want more legal migration.

I have made various suggestions to Ministers over how they could reduce illegal migration more rapidly. I want them to make cutting legal migration their priority to make a bigger impact on the pressures affecting housing and our public services.

Growth and the money squeeze

The Bank of England is the only one of the three big western Central Banks  (EU/US/UK)  to be selling lots of bonds at  big losses and sending the bills to the taxpayers. The UK is the only one of the three to be reinforcing a major money squeeze with a fiscal squeeze at the same time.

The US has offset a lot of its big money squeeze with a major expansion of spending and borrowing in the year to September 2023. It would have been better to have achieved the same effect with lower taxes. Despite the increases in interest rates and bond sales with uncovered losses the US economy has been achieving a good rate of growth.

The European Central Bank refuses to sell bonds at big losses and has paused its rate rises at a lower level than the US or UK. The EU economy is performing poorly, and may well persuade the ECB to be the first of the 3 wayward Central Banks to start to lower rates again.

All 3 Central banks printed too much money and bought too many bonds well into the covid recovery period. This proved to be inflationary. The Swiss and Chinese who did not do the same did not have the rapid inflation as a result despite experiencing the high energy prices. It is a bad idea to compound the error of creating too much money and keeping rates too low by now creating too little and selling bonds at huge losses to be paid by the  Treasury.

The Bank needs to think again. It needs to speed its review of its past forecasts and its inflation model. It needs a new one urgently to avoid more errors.

What is the cost of large scale migration?

The EU are locked in long and acrimonious talks over EU plans to take over more the tasks of running migration policy at EU level. The EU is wanting burden sharing arrangements. It wants member states receiving a large number of migrants and asylum seekers to be able to send some of them to other countries, or to receive payments from other member states in lieu if taking more migrants.

President  Biden meanwhile  has lost a vote in the Senate to send more money to Ukraine. The Republicans demand he spends more at home on border security to tackle the millions now coming annually over the Mexican frontier. The President who campaigned against Donald Trump’s extension of the border wall is now going ahead with 20 miles  of new wall himself.

The UK when it hit 745,000 extra people in one year coming  here  needed to build   three cities  the size of Southampton just to take that one year’s net arrivals.,You do not just need to build lots of homes for them but also  shops, power stations, water works, schools, surgeries, hospitals and roads. Many of these items require public money raised from taxpayers.

The government is battling the illegals but needs to concentrate more on the legals running at almost 20 times more than the small boat people. If it wants to control public spending, relieve pressures on housing and calm passions about migration cutting the numbers of legal migrants urgently and substantially is the way to go

 

The Rwanda Plan meets political reality

Today a large number of Conservative MPs will be mulling over the legal advice and predictions for Mr Sunak’s Rwanda scheme.

Five of the Conservative groups who want to end illegal migration and think the UK Parliament should instruct  all courts accordingly will be told this draft bill does not do that. It undermines its endorsement for UK control with permitted appeals to an international court.MPs from the ironically named One Nation group want to embed rights of appeal to all courts including foreign ones more clearly. As always they do not trust our country, its people and Parliament and wish to constrain the government through international treaties and courts.

It is a great pity the PM put so much on this scheme  and then turned it into a constitutional struggle over whether we can govern ourselves or not. Having two senior Law Officer Ministers from the One Nation group  means legal advice that prevents Parliament instructing the courts to stop the boats in the area of international law where different lawyers take very different views of what is possible.

My advice to him is to concentrate on getting down legal  migration more rapidly and by more than his current plans. This would do more to relieve pressure  on housing and public spending. It is difficult to see how his compromise bill can get through the Lords as well as the Commons. Meanwhile  there are other obvious steps he could take to stop some more small boats.

The policy options on migration

The PM has to consider what to do with the draft Bill in the light of reactions to it and the Parliamentary arithmetic I set out yesterday.

There is no point in amending the bill in the way One Nation and the Opposition want. A weaker bill would lead to more court challenges and delays. Far from Rwanda being a deterrent to migrants they would see such a weaker bill left them more time to get here as the courts generated more uncertainty. Nor are there likely to be enough One Nation rebels to stop the current bill.

He could try to talk those who think the bill is too weak into  allowing  it a 2 nd reading and to spend more time with them to see if amendments can be agreed to meet legitimate worries. He would need sign off from enough rebels to make amendment worthwhile to give him a small majority. It would increase the  chances of the bill working.

He could try to push an unamended bill through. This would be possible if Labour abstain but very difficult if they do not. If the  bill then leads to more delays and court challenges he is worse off than not trying to legislate. If the bill works he triumphs.

He could conclude that thanks to the Opposition parties, The Lords  and some Conservative rebels he cannot legislate. He would need to develop more ideas to whittle  down the number of illegal migrants. These could include increased surveillance in France against illegal boats setting out, more police resource to follow the money, more mystery shopping for  the boat trips, exposing the gangs, intercepting  the boat purchases and breaking more  into the sales and support systems of the travel organisers.

Whatever he does he would be well advised to turn more attention to the  easier but larger task of deflating legal  migration numbers which are so excessive. Many who want the small boats stopped  also want much lower overall migrant numbers. Meeting their  wishes on that would help a lot. To do this he and his Chancellor have to win a battle with the OBR and Treasury officials. They need to correct their wrong numbers, and understand just how much all the extra public sector and housing costs fpr migrants adds to spending and  the deficit.

 

Voting arithmetic on the Rwanda Bill

It is one thing for the Prime Minister to want to stop the small boats. Who sensibly disagrees? It is another to voice the right way to do this, and to gather the votes needed to bring it about. The draft law he has proposed now has to find its way through both the Commons and the Lords.

In the Commons the government has a current majority of 56, meaning it can carry any legislation as long as fewer than 28 Conservative MPs vote with the Opposition, or fewer than 56 abstain.

This Parliament has been characterised by more MPs than usual losing their party whips for actual or alleged misconduct. There are currently 18 Independent MPs though none were elected as that. One  is an SNP MP who disagreed with his party whip and wants to be Independent. One is the former Leader of the Labour party, now in policy exile. There are 9 Labour MPs suspended from the whip and 7 Conservatives, with one from Plaid.  This may give the government a little more leeway on its majority.

The small boats Rwanda Bill will be difficult for the government to whip. One group of  Conservative MPs is annoyed that it does override some Human Rights legislation and gives stronger instructions to courts. Another group of Conservative MPs thinks the Bill needs to be tougher to rule out any legal challenge to the policy to ensure success. The attitude of Labour becomes an important consideration in working out what might happen. If 198 Labour MPs all oppose the Bill, with the other Opposition parties also likely to, then the government does need to reduce the number of rebels to under 28. If Labour abstain then the government can afford 126  rebels before losing.

There are 98 Commons Ministers who have to vote the government line. The last list of Parliamentary Private Secretaries to Ministers showed 41 in post. We are awaiting an updated list which may  be longer. They too have to vote with the government. So to win a vote the government needs to persuade just 84 backbench Conservatives to support if Labour abstains, but 181 if Labour opposes.

The One Nation Group that wants a weaker Bill puts out it has 103 supporters. This is greatly overstated. I do not believe anything like 103 Conservative MPs will vote against the Bill because it is too strong. The likely effective rebel voting strength of One Nation is below the 28 vote threshold to overturn the majority. It also is the case that a disproportionate number of the One Nation group are Ministers so they could not vote against even if they wanted to. Of course if they staged a number of resignations to vote against that could destabilise the government badly. That seems very unlikely as they have a strong position within the government and seem to like being Ministers .

There are considerably more Conservative MPs than 28 who want a stronger bill than the government version . Whether they will allow 2nd reading of this bill and seek amendments remains to be seen. Some  will think a quite strong bill worth a try. Others will think it futile to enact another bill that just gets bogged down in courts again.

 

The Lords has its majority of peers who always want to do down the UK and who support every international criticism and attack on us. There are plenty of peers who put the wishes of lawyers acting for illegal migrants above the wishes and needs of legally settled UK workers and taxpayers. Getting any bill that toughens our law against illegal small boat operators and their paying passengers through the Lords requires good majorities in the Commons and plenty of political will by the  government.

Tomorrow I will write about the PM’s  policy options.