Dame Lucy thinks it’s all going swimmingly

I had begun to fear I was not going to get any more leaked letters from the senior civil service, when across my desk in a brown envelope the following turned up. It is one of Dame Lucy’s latest to her deputy, Dr Roy Spendlove.

Dear Roy,

I am writing to reassure you. The government may be saying it no longer takes green policies seriously, but the requirements of the climate change agenda have been built in strongly at the EU level as well as into domestic laws and regulations. The same is true of the open borders policy which the previous government embraced with enthusiasm. Our Treaty obligations and the twin constraints of the European Court of Human Rights and of the European Court of Justice will require Ministers to stay true to the policy of the free movement of people throughout the EU.

In a long pre election period we should expect political statements about the wish to cut the price of energy and the wish to control numbers arriving in the UK from one of the governing parties. We should always question Ministers to make sure it is the Coalition speaking and not just a wish by one party within the coalition. We should also of course seek to do as Ministers wish, but our first necessity is to ensure they and we remain within the rule of law.

Knowing of your concerns, I would like to make you responsible for ensuring all colleagues dealing with Ministers understand the need to have a good understanding of EU law. We must avoid infraction proceedings against the government we serve, and help the government to avoid statements or policy demands which could annoy our European partners. I know consultancy and related budgets are tight, but I do have a contingency fund which we can use should need arise to ensure we have enough good legal advice on hand. I do not wish to see years of patient and careful diplomacy undermined by rash words and promises from Ministers not entirely in sympathy with our European approach.

I am pleased to see colleagues in DECC are well aware of the need to stay within the requirements of the Large Plants Directive to retire older generating plant, and within the ambitious targets of the Renewables policy to provide enough new windfarms. I would like you to help keep the Treasury and Business Department on board. There is no likelihood of any change to the fundamental EU law on this important matter. Ministers seeking some relief to electricity bills may be able to find a temporary subsidy from elsewhere in their budgets, but in the end it is Ministers’ duties to explain to the public that the EU anti global warming policy is important and does require rationing of energy use by price.

I am more concerned by the recent spate of comments, speeches and polls on the topic of the free movement of peoples. Free movement rests at the heart of the European project which the British people chose in a referendum in 1975 and have endorsed in all subsequent General Elections by their votes. It is true now that one of the Coalition parties wants a renegotiation and a new relationship, but we must be clear. This is not Coalition policy and so the civil service must in no way assist with it. It will be debated in future elections in 2014 and 2015. Until and unless a government is elected pledged to do this we must continue with the EU policies that have been ably implemented in recent years with substantial Treaty increases in EU powers.

In the meantime, if the Coalition as a whole is now asking for a revised approach to open borders within the EU, we need to offer them the strongest possible advice that the previous government signed us up to free movement. There is little sign that the rest of the EU wishes to alter these fundamental requirements of the amalgamated Treaties.

Yours

Lucy

Who controls our borders?

We are fast approaching the change of border rules. In January the transitional arrangements which limited entry to the UK and other EU states from Bulgaria and Romania comes to an end. This has posed two big questions for the government.

The first concerns welfare payments. Is the UK too generous to recently arrived migrants from the rest of the EU? Should the UK, like some continental countries, state that we have a contributory system, and require new people arriving to pay money in before they can qualify for benefits out – unless they have been born and brought up here?

The second concerns the numbers of people we should invite into our country to take the many new jobs the economy is now creating, at a time when we still have a lot of unemployed people already settled here. Many UK voters think there should still be some limits on inward migration from the rest of the EU, as there is from non EU countries, all the time we have a large number of unemployed people.

The question arises, should the UK government be doing more to retain and assert control over our own welfare system and borders. Presumably these are two critical areas which we would wish to renegotiate come the day. Maybe the Coalition government should try to gain an extension to the current transitional arrangements, as some of us have tabled as an amendment to the Immigration Bill this week. Maybe it should also look further at eligibility for benefits, and move our system more in the direction of the contributory principle.

The EU offered the free movement of workers, not of benefit recipients. The last Labour government, when signing away so many of our powers at Nice, Amsterdam and Lisbon, assured us we would retain control of our benefit system. If the EU does allow full mobility and eligibility to receive benefits anywhere in the EU, then many more people will gravtitate to the countries that pay the highest benefit levels.

Mutual mistrust

I am not against mutuals. Nor am I starry eyed about them in the way some people are.

They can be a way of giving more of the profit of an activity to the depositors or savers, as they pay no profit and dividend to company shareholders.

This can mean they are riskier than a shareholder business, as they do not have PLC style retained profits as part of their shareholders’ funds or reserves. They might pay too much out. There are no shareholders to fall back on and ask for more capital.

Some people seem to think they are morally superior to for profit businesses. This is odd, as the banks and insurance companies are still for profit, but they want more of the profit to go to the savers or users of their businesses.

The UK mutual sector is now damaged by two spectacular collapses. The UK’s oldest mutual insurance company, Equitable Life, was brought low by promising more than it could afford to pay out to policyholders and savers. The mutual sector’s largest bank, the Co-op, has just reported large losses, insufficient capital and a Chairman who lacked the qualities of mind and character to be a successful bank chairman.

It is difficult to see how either of these businesses had a more moral approach to business than the for profit competitors they faced daily in the market. The Co-op bank was not averse to using the complex ways and products of modern finance. Equitable Life got its sums hopelessly wrong, and ended up dashing the hopes and legitimate expectations of a generation of its savers.

I have no problem with a good well run mutual. This recent history should, however, be a warning of the special risks mutuals can pose. With no shareholdersto provide capital and insufficient conventional profit reserve some financial mutuals can be very risky. I myself always steered clear of Equitable Life because of its structure. As a result I have been able to represent my constituents caught up in that problem without conflict of interests. Quite a lot of MPs were in EL themselves.

No put down week?

I was asked to write a supportive letter, if I agreed with the idea, to a secondary school running a No put down week. I thought it was a great idea.
I have decided to use the text as today’s blog, as some of you might like to disagree,given the way you often write about others. If only Europsceptics could learn from this idea, who knows what we might achieve together!

Dear Students,

You know how it hurts if someone says something unpleasant or untrue about you. None of us likes being put down or abused,even if it is only words.You feel the world is so unfair when it’s all lies. It’s even difficult to take if what they say has some truth in it, but you cannot help the feature or action they are attacking. So why do it to others?
I find I get more out of life if I am positive about what I can do and what others around me are doing. To me the glass is half full, not half empty. There is usually some good in everyone, and something worth our praise in what each can do.
I also find that if I am positive about the people I work with, they are likely to be more positive about me. It can be a win win. You should avoid putting people down because it is better for them. The irony is, it is usually better for you as well. If you are looking for something good in them, they will find it more difficult to keep on highlighting what they think is bad in you.
Try it. You should have a sunnier week. If it works for a week, why not make it a habit for the future? If you think I’m wrong at the end of the week, at least your friends will have enjoyed a week off your nasty comments.

Yours sincerely

John Redwood

Wokingham Times

Mr Hunt, the Health Secretary, announced last week that all people over 75 would have a named GP in charge of their healthcare. The main criticism of the policy I heard was why can’t we all have that? Mr Hunt said he would like to, but had to introduce it gently to work with the GPs. Let’s hope more can benefit from this sensible policy before long.

Last week I visited the Berkshire Health Authority. It was a timely visit. It meant I could support Mr Hunt’s policy, encourage the local service to follow it up in the right spirit, and add some observations of my own concerning home care based on conversations and cases I have had in recent months.

The Health Trust raised the question of what happens when the named GP is away or having time off? The idea of the scheme is that the GP can set up the necessary pattern of treatments, home visits and other services when he or she is in the surgery, and make sure there are arrangements with other parts of the NHS to follow up, with emergency cover for when he is away. Most of this work is not urgent or time critical, so it can be organised in normal hours to the mutual convenience of patient and doctor.

I asked that the local NHS has a good look at how they handle discharges from hospital, or people who are told they need extended home based treatment following examination and diagnosis. I have heard of people who need medical equipment which is supplied without proper instruction on how to use it, or without technical back-up for maintenance and repair. I have heard of people who need supplies of special foods or medical items who do not get the ones they need in a timely way, or get sent the wrong ones, or who have a large delivery with more than they need. Good control of stock, timely delivery of what is required, and reappraisal of need from time to time would make for happier patients and less wasteful expenditure. I pointed out that people have told me the NHS is bad at collecting medical equipment which people no longer need, even to the point of not wanting crutches or other substantial items if people turn up with them at the supplying hospital.

The Health Secretary is seeking to shine a light into the NHS on the basis that greater clarity of what is happening can but lead to better service and in many cases to better control of costs at the same time. I will follow up with Berkshire Health Authority to see how they are getting on in due course.

The Trust told me they have plans to improve Wokingham Hospital as a local centre to provide necessary services in the local area. Meanwhile the new surgery in Wokingham is nearing completion.

The AFD and no more bail outs

I met a senior member of the German AFD yesterday in London. He was optimistic about his party’s prospects, anticipating they will win seats in the Euro elections next year. He explained that his party is now on 6% in the national polls, which would give them representation in the next Parliament if there has to be an early re-run of the election.

Their main policy is to insist on no more bail outs within the Euro zone. They are not calling for the immediate exit of certain countries from the zone, nor are they in favour of an early break up of the whole single currency. They think several countries will be unable or unwilling to accept the continuing discipline of the Euro, and will seek financial help from other member states. At that point those countries should be invited to leave rather than receiving money from the stronger countries.

The AFD see the damage the current level of the Euro is doing to some members, and the way high unemployment and little or no growth is stalking much of the zone. They think freeely floating currencies and monetary independence worked better in the past and would work better in the future.

They support the various legal challenges to the German government, made in an a effort to stop the use of German money prop up other parts of the zone. They see the difficulty Mrs Merkel is having in forming a new coalition government, and would like to see new elections. They point out that the substantial votes for Free Democrats and the AFD has not be translated into any seats in the Parliament, limiting their scope to influence the Parliamentary process.

It is still quite likely Mrs Merkel will do an eventual deal with the SPD. Such a government will be less wedded to policies which promote freedom and enterprise, and more inclined to support further EU integration and the transfer of subsidies. However, many of the German public agreee with the AFD’s central point, that there should be no more bail outs.

Who wants to leave the EU?

The latest polling on the EU is worrying for all those who think with one referendum we will be free. AFter a long period when those wanting out have exceeded those wanting to stay in by at least 10% and sometimes by 20%, the current polls show Out and In tied around 40% each.

It implies that the continuous false propaganda from a handful of senior business people at the CBI that membership of the EU is crucial to jobs and future prosperity is having some impact. The arguments that Germany and the others would not wish to lose their profitable exports to us and would come to a sensible trade arrangement with us do not get a sufficient hearing. The BBC is ever ready, along with some other media, to run and re-run the tired old arguments that we would lose 3 million export based jobs the day we left, without ever pausing to see how absurd this idea is.

The German Finance Minister himself has said Germany would want a trade agreement with the UK if we voted to leave. Of course they would, as their large exports of cars to us would otherwise be at risk. If Germany needs tariff freee access to our car market, as she clearly does, she would have to grant us continuing tariff freee access for our vehicles to the EU, the one demand our UK based motor manufacturers legitimately make. I find it odd that anyone thinks this would not happen.

Polling does also show that people are worried by the free movement of people, and apprehensive about further mandatory border easing in January next year. Whilst a large majority dislike this policy, it is curious that at least at the moment in the wider polling it is not sufficient reason for more to want to vote for Out.

It all goes to show that the UK can only reliably have a new relationship with the EU which is much less intrusive and frees us to have our own borders, energy and criminal justice policies if a government wins the election that can negotiate such a new deal, or can demonstrate that such a negotiation is not possible and that exit is therefore our best option. Today, with no negotiations allowed, the public is by no means united in simply wishing to leave.

Several of you will now doubtless wish to shoot the messenger, or attribute false motives to me. I merely report political reality as it is. You need to understand it if you are going to help extricate us from EU control.

Visit to Bearwood primary school

John Redwood visited Bearwood Primary on Monday 18th November. He was shown round all the classrooms, library and play areas by two memebrs of the Schools Council, who were most informative about the school.

He then spoke briefly about Parliament, the job of an MP, Big Ben and the Palace buildings, before anwering a good torrent of questions. There was an early pre Christmas flavour to the proceedings, with questions on Christmas presents and how people spend Christmas morning, as well as questions about the life of an MP. John Redwood was able to confirm he did know David Cameron and met him regularly, and explained how an MP was chosen to do the job by the voters.

John said “I am gratteful to the pupils and staff for welcoming me to their school and telling me so much about it. I encourage the pupils to come and visit Westminster when they come to London, as Parliament is a great building which can tell you a lot about our history and our democracy”.

Looking after patients and taxpayers

 

            On Friday I met the Chairman and the CEO of the Berkshire Healthcare Trust.  Part of our discussions were about matters which are national as well as local in their impact, so I am posting this  report here as well as on my local pages.

            We met against the background of Mr Hunt announcing that in future an elderly patient coming out of hospital will be under the guidance and protection of his or her own GP, who will be responsible for ensuring their continuing care and treatment goes well. I welcomed this. The Trust replied that some GP s work on their own, and all GPs need time off, so they were sceptical about how  this responsibility works. I suggested they could help provide the backup to the GPs, with a telephone answering service with qualified people to ensure that out of hours calls can be dealt with promptly, and if something urgent is needed the right professionals can be put in touch with the patient. This did not get in the way of the GP being responsible for orchestrating the self treatment and nurse treatment needed for continuing care in his or her normal business hours, and ensuring appropriate services including emergency cover are in place.

          I explained the problems for patients – and the consequential issues for taxpayers – that the current arrangements can produce, based on conversations and case histories from my local experiences.

Problems for  patients

1. Difficulty in securing the correct supplies for continuing treatment

2. Lack of support when issuing new medical equipment for home use

3. Lack of support in providing maintenance and repair for home based  medical equipment

4. Attendance by health professionals who may not have the knowledge or information to answer the actual query of the patient, even where the query  is known in advance of the home visit

 

Problems for taxpayers

1.Wasted  home visits by people who cannot deal with the patient’s query or problem

2.Issue of supplies that are incorrect for the patients needs

3.Oversupply of items required, leading to write off at end of treatment

4.Failure to get medical equipment and reusable supplies back at end of treatment

Solutions

1. Proper analysis of patient needs on exit from hospital or on first diagnosis of a home based condition

2. Suitable training for patient where they have to use medical equipment or handle supplies for self treatment, from people who know the equipment

3. Back up supply and maintenance service for medical equipment and self treatment supplies by people who are expert in these matters

4. Attendance of nurse on visit where nursing skills are needed, with the nurse properly briefed on the treatment

5. Inventory and audit of medical equipment, to ensure return of reusable items at the end of the treatment, and safe disposal of other items.

Not all these matters require home visits. Some patients can be helped over the phone or by internet where they are happy with these methods.

 

 

 

 

 

A privatised NHS?

 

          I find that the really popular part of the NHS that most voters wish us to protect and continue is the fact that most NHS service is free at the point of need , and all UK citizens are eligible for that treatment based on their need, not their means. All main political parties in the Commons – and I think UKIP – support this principle. The political debate is often about how a monopoly healthcare provider can deliver a good enough service without queues, without  high rates of hospital infection and  without bad treatment.

         There is always, however, another foolish debate about whether Conservatives secretly plan to privatise the NHS, with most people rushing to condemn any such move. Successive Conservative and Coalition governments have remained wedded to the free at the point of use  principle, and the next Conservative Manifesto will doubtless reaffirm it. Labour governments have also normally stayed true to this principle, though a former Labour government did break it by introducing prescription charges which have subsequently been accepted by all governments as a modification to the main principle. Many people are now exempted from these payments based on their own needs and resources.

         There is however, another way of looking at the Labour concern about “privatisation”. Whilst no recent government has and no future government after the  2015 election will seek to introduce charges or want to change free at the point of use, not all NHS care is delivered in NHS owned establishments by directly appointed staff. Again the irony is that the accusers over privatisation, Labour, have in office bought in private sector care for NHS patients themselves, sometimes preferring a private sector contractor to their own in house staff. All major parties accept that it may be sensible to outsource catering, cleaning, legal work or even some clinical and medical services.

        There is also one huge elephant in the room for those who claim to be against all private involvement in the NHS. That is the GP service.  The primary care GPs were never nationalised in the first place. To this day they remain as a collection of small businesses, running their own practises, with payments from the NHS under contracts for services they provide.

     As proof of their private sector status they can perform private sector work in their surgeries, offering holiday and  travel advice and vaccinations, private consultations, work for legal cases and the like for fees and charges. The GPs arrange their own properties, finance their own practises and hire their own staff. They may  run their own dispensing service to earn  additional revenue.

       The latest GP contract reminds us of their independent status, and of the controls and limits on their NHS work conduct imposed by government through the contract for services which the NHS buys. Few of those who claim to hate private involvement turn their attack on the GP model. No government has wanted to fully nationalise the GP service, and make all doctors state staff turning up for duty in NHS owned surgeries with no right to undertake private competitive medical business. Maybe this should give pause for thought when next the cries go up about the dangers and undesirability of  private involvement, and remind people that it is the no fee and charge that people most like, not the details of how the service they receive is organised.