Autumn Statement and the "Just About Managing"

Have the indignant amongst you considered that there is a not insignificant cost to policing health tourism.
1. trained admin staff need to examine identity documents. They have to know things like: If an Indian passport is stamped "Leave to remain; No recourse to public funds" what does that actually mean? This is definitely not the kind of work nurses or doctors do, or should be asked to do.
2. It's very hard to tell the legitimate from the non legitimate, so even if you inspected the documentation of everyone who looked foreign, sounded foreign, had a foreign sounding name (think of all those Irish names!) that would be a lot of people.
3. That would be discriminatory, so you'd have to check everyone
4. Once you have decided to screen everyone and identify the relatively small number of ineligible people coming through your doors every month, you have to set up an accounting system, with trained staff who can do the money side of it. The accounting system would have to have a way of costing all possible combinations of medical treatment. Such a system would not be cheap to set up (or buy)
5. You have to pay someone to collect the money, send receipts or chase a debt.

So I can well imagine that if you were a hard-pressed Trust manager, in most areas of the country, you would not think it was worth spending thousands of pounds on extra staff, IT systems and staff training in the hopes of recouping a modest amount in return.
If you are in one of a small number of hot spots e.g. St Georges, then you might think it worthwhile.
These are the sort of decisions NHS managers are well able to make - whereas politicians, journalists and random members of the public are not.

Well, according to durhamjen each and every one of us is going to have to produce photo id or a passport for any hospital treatment in the near future (see various NHS threads). Presumably that will require more staff and necessitate yet more paperwork...

Jacob Rees-Mogg?
Zac Goldsmith?
Douglas Hogg?
Seem quite toffish to me.

I agree, JessM. I was thinking about this as I drove home half an hour ago. I don't have a passport, so would I be denied treatment?

Eligibility does not depend on nationality, but residence. How would somebody prove that? In my case, I could, because I pay my own utility bills in my own name, but what about those who aren't heads of household? What about students who haven't got round to getting themselves on the electoral role?

The only way to be sure would be to set up a department to check eligibility and issue people with some kind of eligibilty certificate? How much would all that cost?

In any case. £900 million is peanuts compared with the financial black hole. It would be far more cost-effective to use the money to investigate tax evasion.

And once all this money has been recouped/saved, who's going to guarantee it will go to the JAMs? That would require political will, which I believe isn't there.

Even outside of the EU - our son in Kuwait says that I wouldn't be able to get a visa to visit them now (age) because they're restricting health tourism.

Not according to me, Ana.

According to the DOH.

'Chris Wormald, the Permanent Secretary for the Department of Health, told a committee of MPs that “for the majority of free healthcare, hospitals do not routinely either check identity or charge, so we are trying to introduce this system”. He also mentioned that some hospitals are trialling a system of asking patients for two forms of identification, their passport and proof of address.

The Department of Health told us that "The NHS is a national - not an international - health service and we are determined to stamp out abuse of the system to ensure it remains free at the point of need in this country. We consulted earlier this year on extending the charging of migrants and visitors using the NHS. We will set out further steps in due course to ensure we deliver on our objective to recover up to £500 million a year by the middle of this Parliament.” '

They are trialling it in Peterborough. If it works - which I doubt - it will come to a hospital near you.

It's all relative, dj. Cameron has blue blood - those people don't. They come from 'barrow boy made good' stock.

The idea that working class people can't make it good makes me quite cross. They can, if they have the right attitude - even in today's Britain.

I wrote "the rich upper class who are governing us."
I should have said that those who are governing us are financially supported by the rich upper class. And not necessarily rich by birth.
Mainly via the media.

Yes, but David Cameron is 'blue-blooded' from the wrong side of the blanket.

So many people in this country are descended from Charlemagne through Edward III that it would be impossible to count them all!

www.opendemocracy.net/ournhs/kailash-chand/nhs-passport-proposals-are-just-more-grubby-politics-from-may-and-hunt

Much more important than discussing Cameron and cronies.
The NHS didn't get a mention in the Autumn statement, apart from mentioning the additional £10 billion which had already been called a lie by Corbyn in PMQs.
Sarah Wollaston agreed with Corbyn - no extra money, just £4.5 billion.

Our economy has been growing for years and we are the 5th largest economy. Where has the money gone? It's globalisation. Corporations have filtered the money away. We can blame different sectors in the country but fundamentally the money has not staying in the country and shared out fairly. That's down to lazy governments who instead of making our own jobs, investing in infer structure and education. They have encouraged large corporations to give us low paid jobs to keep the unemployment figures down.

It's down to rich greedy people who do not pay their taxes properly.

This is for those who do not trust Labour on the economy.

theconversation.com/autumn-statement-2016-tories-shift-to-growth-strategy-in-an-ed-balls-style-pirouette-66531

The discrepancy between the money for health care between UK and France is most likely to do with the number of retired Brits in France against the number of retired French in UK. There is a bi-lateral agreement about healthcare and the U.K. pays France an agreed amount for each Brit receiving health care in France. Younger Brits living and working in France pay the relevant taxes to obtain their own entitlement in France.

Our economy has been growing because our population has been growing. However, our productivity per head has been shrinking. It's more complicated than just blaming globalisation. (There's that 'blame' thing again!) It's or own government which hasn't been collecting enough tax from those who could/should be paying it and has not been distributing the money more fairly.

The UK has had one of the most globalised economies in the world for centuries. In the past, the country has benefited from it. What's happened is that we didn't keep up with changes elsewhere in the world. We can't turn the clock back. What we can do is make long-term plans for the future, but it would appear that no government will do that. The nation's collective values seem to be shifting increasingly to a 'me me me' position.

Some info about expats claiming free NHS healthcare:

www.telegraph.co.uk/news/health/expat-health/10628246/NHS-axes-free-health-care-for-expats.html

www.telegraph.co.uk/news/health/expat-health/11571256/British-expats-from-outside-Europe-must-pay-for-NHS-hospital-care.html

In the past, the country has benefited from it.

Hmm. I'd suggest that, until the growth of Unions and the post WW2 'consensus' (when the gap between rich and poor was narrowing) only a portion of the country (if you're using that term to encompass the inhabitants of the country) benefited, just as happens today. Writers and observers such as Dickens, Engels, Gaskell and Mayhew weren't making up their accounts of deep poverty and the enormous gulf between the wealthy and the poor.

I agree with you, Maizie. I was in a hurry when I wrote my last post. That's why the growth in GDP is irrelevant unless the benefits of the growth are distributed fairly.

Being a wealthy country does have benefits, such as being able to borrow money cheaply and being a 'voice' on the world stage. However, as you say, what really matters is how the wealth is distributed and how happy citizens feel.

The UK did benefit, because the country was able to afford to let the plebs have a bit more than the crumbs from the high table. Unfortunately, we're going backwards, which is something the UK hasn't experienced in living memory. How we manage it now will define our future.

What bothers me dd is that it is our generation that benefited the most from the move towards a more equal distribution of resources yet it seems to be our generation that has supported the swing back to inequality. I acquit us of doing it deliberately but I do feel some sympathy with the younger people who castigate us for selfishness.

A fair bit of wealth is siphoned off into tax havens. Several of these tax havens are under UK's wing but not attempt has been made to tighten up.
Size of economy does not necessarily relate to accumulated public money though does it. National borrowing is driven by the difference between the tax paid and the amount paid out on public services. Ironic to see the Chancellor doing some of the things Ed Miliband was scorned for in the Osborne years.
But I don't think many people are happy that we are going ahead with HS2 (Osborne's favourite vanity project) and Trident when the NHS is being systematically undermined.

Profits are growing though, but not productivity because of lack of investment in the businesses, in skills etc. Greedy shareholders grab the money and give no thought to the future, or pay their taxes.

That's true, whitewave, and we seem to have a government which is totally indifferent. It's becoming increasingly clear that there's no coherent plan for anything.

I find this quite frightening because, one way or other, it can't carry on. The Labour Party is faced with an open goal, but doesn't seem to want to run with the ball. It needs some strategies to win an election and it doesn't have them. When people feel that they have no political voice and nobody's listening to them, they become a recruiting ground for extremists.

The group of people who win elections - 'squeezed middle', 'hard working families' 'Just about managing' (whatever you like to call them) - are being ignored. Cameron tried to drive a wedge between them and the 'scroungers', but people are beginning to see behind the rhetoric, because an increasing number of them are finding themselves moving in and out of 'just about managing' and not managing at all.

Frankly, I find this whole situation with the Autumn statement and forecasts from OBR and others terrifying. There is something fundamentally wrong with the way the economy is being run, and it is patently obvious, that whatever your politics, Osborne and Cameron's recent policies of austerity are not and have not worked, in fact quite the opposite. Anyone with a basic knowledge of economics knows that austerity, as a long term plan does not work. This country just cannot keep on reducing spending on infrastructure such as NHS, Education, Police, Prisons etc etc etc without there being terrible impact on society. If a magic wand was waved, and I was put in charge I would do 2 things immediately;
Firstly, recruit and train well paid Tax Inspectorate staff to hunt down and prosecute those not paying their fair share.These people would pay for their own salaries many times over.

Secondly: I would cancel the three 'H' projects; namely Heathrow expansion, Hinckley Point, HS2. These are all vanity projects and are not necessary.

I'd cancel Trident too, but I'd second you, if I had a support magic wand.

Initially, I was enthusiastic about HS2, because I do think wealth and business needs shifting to the North and I support investment in infrastructure. However, when I looked at the details, I realised that it wouldn't really benefit many people. I would far rather money were spent on upgrading existing cross country (ie East-West) rail links and express bus links to stations, where branch lines have been closed.

If struggling workers are JAM does that make the well off CONSERVE?

Hinkley will of course be built with private money and the operators paid back in the very long term via price of electricity.
Long gone are the days when the public purse paid for power stations of any kind.
Not sure about HS2 and how that will work. There will be private funding involved I assume but how this will be recouped not sure. Lots of expenditure going on to try to get it off the ground no doubt. Ditto Heathrow.
But seems like Heathrow expansion will lead to the Government breaching its own rules about energy emissions...