Government Watch - 2

Figures out today show that trade with the EU has gone up by 2% and down by 1.4% with the rest of the world.

An interesting article by Richard Murphy.

"There has been much, unsurprising, discussion to mark the tenth anniversary of the start of the Global Finanical Crisis this week. I think that appropriate: I still have contributions to that discussion to come. But something else caught my eye this morning. The NHS now has the longest waiting lists in a decade. And this matters: it is an issue of cause and effect.

It was bankers who created the Crisis. It wasn’t Labour. It wasn’t excess spending. If either had been true it would not have started elsewhere and been global. Excessive banking practices, deliberate deception and a far too relaxed attitude to regulation, based on neoliberal thinking, was what created the Crash.

Discussion on the anniversary has noted all too often how banking has recovered and is now robust and ready for the next downturn, which few now deny is on its way. I agree with the latter, I am not sure banking is that much stronger (time will tell) and like many I remain quite appropriately aggrieved at banks’ and bankers’ near risk free recovery.

But what has been too little noticed is the effect. The lost wages. The growing inequality. The creation of insecurity for most people as the price of strengthened bank balance sheets.

And NHS waiting lists: the sign that the state has shrunk under a wholly unnecessary policy of austerity that has let the neoliberals win and cost us all, dearly. When the economy demanded more government Osborne et al delivered it less precisely so that the bankers and their neoliberal guides could deliver lower taxes to the wealthy, which is what their philosophy demands and what they got.

They ignore the pain, the anxiety and the suffering. Preserving wealth is all that matters and if you have not got it then you do not have the right, in their opinion, to complain. This is their logic. And it has been the logic of too many politicians in this country as well.

Ten years on we – or rather, the vast majority of us – are paying the price for that. For the bankers and their clients the Crisis did not go to waste. We have to hope next time it will be different. "

Cause and effect. It didn't have to be this way, though. It's only because of Tory ideology and the will to privatise the NHS.

I could have also put this under other threads. In fact it's amazing how many articles I read these days are covered by many threads.

It still annoys me that the bankers got away with little punishment after causing such distress to many people. I assume that most of the staff at Lehman's who lost their jobs were able to find employment at another bank.

I see Davishas accepted a lucrative position to the tune of £100k with Copper1909.

The director Hannah was dismissed from JP Morgan having been found guilty of market abuse. He was later fined £450k by the FSA - one of the largest individual fines ever handed down.

Davis gave Hannah his undivided support in a recent court case appealing the fine. The fine was upheld.

www.theguardian.com/business/2017/aug/13/half-of-landlords-in-one-london-borough-fail-to-declare-rental-income

I hope all our MPs have declared the rent they collect to the taxman.

Trending on twitter

Hunt has claimed £44k for a new bathroom on expenses!

Wonder how many nurses could afford to pay that?

According to the story from The Times the DoH have responded by saying that Hunt requested a facility for cyclists and joggers in line with those provided at other DoH establishments. Of course, it doesn't say whether he is the only cyclist/jogger in the building who will have access to it. (I don't know how readable the image of the story will be)

The story I saw, Maizie, was that there are other shower facilities in the building, but this is for Hunt's personal use, so he doesn't have to mix with the others.

www.welfareweekly.com/dwp-announce-plans-axe-800-jobs/

DWP doing really well, to announce this after the unemployment figures are out.

Hunt again. I can't believe he's telling Stephen Hawking that he's wrong about statistics.

www.theguardian.com/politics/2017/aug/19/jeremy-hunt-says-stephen-hawking-is-wrong-on-the-nhs

Love this

Stephen Hawking as criticised this government over its treatment of the NHS.

Cringe worthy embarrassment as Hunt tries to suggest that Professor Hawking doesn't understand the evidence.

Oh I didn't see that dj !!!

Mind you its worth posting twice!

The arrogance

I bet he wished he hadn't now, the number of experts who disagree with Hunt.
I like this comment from Madders.

"The shadow health minister, Justin Madders, weighed in on the row: “It doesn’t take a genius to work out the Tories are wrecking the NHS.

“Professor Hawking has given us answers to many of the universe’s most challenging questions, and even he can’t work out why Jeremy Hunt is still in his job.” "

good humour

You need a good sense of humour to read this without swearing.

www.theguardian.com/politics/2017/aug/18/bridge-940m-bill-boris-johnsons-mayora-vanity-projects-garden-bridge-routemaster-bus

This is the man who is in charge of Brexit. How much will he cost us there on abortive projects?

•" Peterborough Civic Society, along with the local newspaper and residents, has been campaigning for a new city centre cycle/footbridge across the city’s river Nene. Our city council has said that it cannot currently afford the £2.5m necessary for the project. This figure pales into insignificance when compared with the £37m of public money wasted on the now abandoned Thames garden bridge. I wonder if Joanna Lumley and chums could just check down the back of their sofas and, if any loose change turns up, please chuck it our way.
Toby Wood
Vice-chairman, Peterborough Civic Society"

A letter in the Guardian.

Hunt has accused Hawking of pernicious falsehood over saying that NHS is being privatised. Hunt doesn't know what's going on, obviously.

inews.co.uk/essentials/news/health/nhs-estates-surplus-land-strategy/

Three companies involved through the Naylor report, one of them Assura, which is owned by Virgin Healthcare.

"Private investors are already weighing in. Last week, the UK’s three leading primary care property investment funds pledged £3.3bn to “kick-start next generation of NHS medical centres” and support the Naylor recommendations. Primary Health Properties plc, Octopus Healthcare and Assura plc, said their pledge could fund as many as 750 state of the art primary care centres through third party development across the country over the next parliament.

Sir Robert welcomed the pledge. “It is encouraging to see the private sector step forward to play their part in meeting the recommendations set out in my review published earlier this year – with a credible plan and offer on the table for the NHS and Government to respond to,” he said.

“Investment to improve and grow a fit-for-purpose NHS estate is absolutely critical after years of underinvestment… The NHS needs a workable model for estates investment that sees genuine value delivered in the long-term – the 3PD proposition put forward is clearly a step in the right direction.” "

"We have an NHS for three reasons.

The first is human compassion: I suggest that it is our natural pre-disposition to wish to relieve suffering in others.

Second, after World War 2 a unique confluence of sentiment, circumstance, political will and Keynesian economic thinking allowed a radical transformation of health care provision in the UK.

Third, people liked the outcome and are deeply reluctant to let it go.

That, however, has not stopped people trying to abolish what has worked so well. The result of their efforts is an NHS in crisis.

This crisis is not necessary: it is the result of the deliberate attack by neoliberal politics on the NHS. Neoliberal politics and the economics that underpins it assume three things.

Firstly, it says that all human beings are simply rational economic actors, reducing all decisions to an assessment of personal advantage.

Secondly, it says that only markets can in that case respond appropriately to the reality of human decision making because they alone allocate resources on a strictly competitive basis.

Thirdly, and consequentially, it argues that the size of the state must be shrunk because it has no role in supplying services that the market might deliver more efficiently in accordance with the spending wishes of consumers, including healthcare.

Neoliberals do, however, know three further things.

The first is that people don’t want to give up the welfare state: they really rather like it.

Second, they won’t as a result directly vote for neoliberal programmes.

And so, thirdly, neoliberalism has to be delivered by subterfuge. The irony of this – which implies that people don’t rationally know what neoliberals think they rationally want – is apparently lost on those promoting the cause.

Austerity is part of that subterfuge. It shrinks the size of the state. It happens to also shrink the economy. And it cannot also theoretically and practically work. But so what? Shrinking the size of the state is what matters. And so NHS budgets are cut.

Breaking up national services into small, vulnerable, local services is also part of the subterfuge. Vulnerability is key to competition. Who cares about inefficiency, cost and not meeting need? The option to fail must be built in to the system: competition demands it. So we get NHS localisation and fragmentation.

And the myth of informed patient choice is the third obvious subterfuge when most patients clearly want expertise and guidance and not to be left on their own to decide their fate.

As a result I stress that the NHS is where it is because of political subterfuge that is designed to undermine its very existence."

This is from an article by Richard Murphy, who was giving a presentation at the same place as Hawking today.
If you want to read the rest it's on taxresearch.

www.thedailymash.co.uk/

You can probably find the Jonathan Pie video about Hunt on the same link.

www.thedailymash.co.uk/politics/politics-headlines/may-back-from-holiday-with-terrific-idea-20170811133932

By James O'Brien.

"On holiday so may be missing something, but it seems Jeremy Hunt is teaching Stephen Hawking science while his party argues with a bell?"

A response to James O'Brien.

"Yes, that just about sums it up. I hope you're having a lovely holiday, but can you hurry back please? Your country needs you! "

The NHS
Where we are
The NHS is under funded.
In cash terms budgets have increased but by rates far lower than population, demand and medical inflation requires, delivering an effective cut in capacity to meet need which is having a severe impact on a system where there was very limited excess capacity.
Social care has come out of this particularly badly.
Integrating social and health care will be hard because of differing payment models.
Holistic approaches to issues are but distant memories.
Super-specialisation may be leading to over medicalisation and excess treatment on occasion.
Generalism is now an undervalued discipline. Nurse led systems may help restore balance on occasion.
No one has a clue who is in charge in much if the NHS Ministers are reduced to campaigning for reform in the system for which they are no longer responsible. There is no co-ordinated planning because no one knows who can do it and no one knows who picks up the cost.
Despite this health and social care employs more than 3 million people: about 1.5 million in the NHS and the rest in social care. Many are on low pay. Increasing numbers work in outsourced posts.
Despite the claim that privatisation is not happening increasing numbers of contracts are being given to private providers. This does, however, remain a minority of service supply and is rarely in the most complex areas.
Back door privatisation, for example via the Naylor Report, is, however, possible.
Staff morale is very low.
There is a recruitment crisis.
There is a pay crisis.
Patient satisfaction remains incredibly high despite this.
There is fear of another NHS reorganisation: on average organisation structures in the NHS are lasting less than five years: many cancer patients have significantly better survival chances.
What politicians say
The NHS is in crisis.
All politicians think they have the solution.
According to the Tories (and in English politics they really matter) this solution quite emphatically does not involve privatisation, but then they quite emphatically said there would be no top down reorganisation of the NHS in 2010 and then delivered the biggest and worst one there has ever been in 2012.
In general, an assurance from a politician is not treated as of value.
What think tanks say
There appears to be little confidence in the medical think tanks. The Nuffield Trust did appear at the event whilst others were more notable by their absence.
The think tanks that were felt to be timid, too pro-market, too uncritical of ministers before the event, especially in 2012 and lacking backbone and vision in general.
I think there was a feeling that many felt the medical Royal Colleges had shown some similar traits. In their defence it was said that they had immense difficulty appearing apolitical as required by their charitable status but there remained a feeling that they were reactive, and too slowly, and that the medical profession had not been willing to deliver an alternative vision for the NHS that might solve the problems many could diagnose.
What the medical profession says
That it’s tough at the front line.
They are not driven by money but need to be paid.
Many are concerned junior staff are being underpaid,
Almost everyone in the NHS could find alternative employment involving fewer body fluid discharges that many in other professions would find unsettling.
There was an over-arching theme of getting back to a past where there was a clear NHS management structure from a minister downwards. There is now just a sense of hopeless, unco-ordinated drift.
What I said (for what it’s worth)
See here.
I added in discussion:
The current confusion is deliberate: it evidences that the invisible hand is at work.
Ministerial absence is deliberate: it is meant to indicate shrinking state control.
Uncertainty is deliberate: the system is designed to create the possibility of failure. You are meant to fear it because you will not behave appropriately unless you do.
A shortage of funds is deliberate: you cannot fail if you are properly funded.
The current NHS crisis is planned and working as anticipated.
What Stephen Hawking says
A publicly funded and publicly provided health service is the most efficient way of providing health services to all that are free at the point of supply and which do not discriminate on the basis of ability to pay. Private sector involvement distorts this outcome, unavoidably and so is to be resisted. This service will however not be perfect. Seven day a week service would be optimal. The reality may well be that social (i.e. staffing) and cost constraints will prevent this, even if he would like it otherwise. These compromises are necessary. The current direction of travel, which appears to be towards privatisation and more insurance involvement is a threat to the NHS model and universal healthcare as well as efficiency: insurers do not like paying. (I précis, I hope fairly).
The legal opinion
David Lock QC, who is also a former Labour MP, offered an opinion on the current NHS reform programme reflected in the STP (Sustainability and Transformation Partnership) programme, now well under way. This is my summary of what he said and my not entirely reflect his views.
This programme is crippled by the fact it needs legislative backing and the government has neither the the will, the majority or the time for another NHS reform.
STPs are meant to take markets out of some aspects of NHS management (although it was pointed out that STPs are designed so that they can be delivered by private companies).
Whether it is legal to now take market contracting out of some areas of NHS supply is doubtful: STP programmes may be a potential source of litigation as a result.
The STP programme has been under-publicised and needs to be subject to much more analysis. Local authorities have a duty to do this as they are involved and so access to this issue via local councillors should be possible.
The STP programme could open up a whole new hornet nest of problems by being done without statutory backing and by creating another layer of reorganisation without necessarily attracting funding to do it, whilst subject to legal risk.
Where to go from here
It is apparent that people want NHSD reform, with a passion that is rare in much of politics.
It was also noted that much of this was specifically focused e.g. on a hospital closure and not on systemic issues that often have much higher health impact e.g. the closure of smoking cessation campaigns and issues to do with preventive medicine in childcare (let alone child poverty). Fox hunting delivers bigger mails bags to MPs than the NHS still does.
Campaigns are not co-ordinated.
There is no central vision of what is required for a good NHS. We can look back to learn lessons but change only takes place in the future.
The challenge
Building that vision. At which point I say this blog has been long enough.

www.taxresearch.org.uk/Documents/Talk%20NHS.pdf

Same thing in a mind map.

There was an article in one of the papers about Lloyds giving out £60,000 car loans without any credit checks and then it dawned on me that the car was the security.

I must be "old school", any form of debt worries me.

www.bbc.co.uk/news/uk-40993450

Private hospitals get big tax break.