Wednesday, February 22, 2012 

It's the new poll tax!

Slightly churlish as it is to criticise Ed Miliband when he's finally making some headway at prime minister's questions, it would be nice if we could consign the "this could/will be their poll tax" analogy to something like John Rentoul's banned list. Handy as an allusion as it is, it most definitely doesn't work when applied to the coalition's NHS reforms. No one is going to have to pay a flat rate to use the NHS if the bill gets passed, even if it might in the long run lead to further privatisation.

What's more, using it tends to ensure that the issue will never become as toxic for the government or prime minister personally as the poll tax did for Margaret Thatcher (and it's worth remembering in any case that it was the Conservatives themselves who turfed her out, not the electorate). During Labour's time in office sub-editors, comment piece writers and campaigners variously described the err, privatisation of the NHS, road tolls, the London congestion charge, foundation hospitals, ID cards and the 10p tax rate as all having the potential to become as totemic as the poll tax was (and there's doubtless some I've missed). Of those, road tolls and ID cards never became reality, the London congestion charge is regarded as something of a success, the reforms in the NHS took place and polls suggest that as Labour went out of office satisfaction with the health service was at record highs, while the 10p tax rate was all but forgotten as the economy imploded.

This isn't to suggest that if the reforms do go wrong, and considering how Cameron and Lansley seem determined to ram them through against the wishes of almost every major health organisation that it might not have an impact come the next election. I suspect though that it will come back to how the economy overall is doing, and how the cuts have panned out. Not quite as snappy a soundbite, that.

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2/22/2012 09:39:00 pm | |

Monday, November 14, 2011 

Stupid question, stupid answer.


Health secretary Andrew Lansley is to announce that he is prepared to sack NHS bosses who attempt to save money by rationing treatment or making patients wait longer for operations.

So when exactly is Lansley going to sack himself?

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11/14/2011 03:01:00 pm | |

Tuesday, June 14, 2011 

Pause? Repeat.

There are times when you can't help but marvel at the amazing feats of rhetorical dexterity achieved by politicians. It's even more remarkable when the modern media, that supposed cynical, feral beast which always manages to cut through the bullshit to the truth takes on the main role of convincing the nation that their leaders aren't in fact men with feet of clay.

The government's success in turning its "pause" on their proposed NHS reforms into a substantial victory will probably become a case study in how to rescue presumed lost causes. Just two months ago Andrew Lansley stood up in the Commons and announced that his seemingly well-laid plans were in fact causing such disquiet that they needed to be brought to an immediate halt. Never mind that the consultation period on his initial white paper,which the Department of Health had presented as giving overwhelming support to his proposals had long since passed. There now needed to be more scrutiny, more thinking done on something so major.

Those of us who imagined that this was another example of the government attempting to legislate too quickly and not being able to see the wood for the trees couldn't have been more wrong. Everything had been sown up in advance. In was brought Prof. Steve Field, a practising GP, not an outright critic of Lansley's plans but in fact a keen supporter, albeit it one with some reservations. He and his future forum would review everything, and make recommendations in due course. Out would go the worst excesses, those parts which would have always been politically unacceptable once it was actually noticed they had been proposed in the first place, such as the opening up of the NHS to any outside provider who could offer a better deal and the role of Monitor in actively promoting such competition, and in would come ever so slight changes which most likely would have been inserted during further readings or forced by the Lords. Hence now the commissioning boards which would have been purely made up of GPs must have at least two lay members, as well as a nurse and a consultant on them, while the 2013 deadline for the abolition of primary care trusts will be "relaxed".

Everyone then has either had their personal objections somewhat pandered to, or can claim victory for their part in either ordering or demanding the "pause", with the exception of Lansley himself. GPs concerned they were going to be left holding the blame if things went wrong can point to the others on their boards, not to mention the health secretary, who takes on ultimate responsibility for the NHS and its continuation as a "comprehensive service". Managers, hospital consultants and nurses have all been told their views have been taken on board and will have representatives at various points of the commissioning process. Those healthcare firms looking to cream off the easy jobs might be perturbed at first, but nothing has actually substantially changed from the initial plan: their opportunities will just be "slowly phased" in. The Liberal Democrats can claim it was down to their sudden discovery of how disastrous the bill was that the "pause" took place, as they did at the weekend, despite Clegg and friends having initially signed off and voted for it, while Cameron has had a smashing time over the past few weeks making the same speech over and over again about how much he loves the NHS, just to drill it in to anyone who thinks the fact he's a Tory means he secretly wants to privatise the whole damn thing as soon as he can. The Tory backbenchers, ever wary of the Lib Dems gaining the upper hand, looked like mutinying until they saw the actual changes and decided quite reasonably that they're fairly minor. Potential banana skin sighted, the Conservatives have deftly skipped over it.

As for the media, the majority still can't get enough of Cameron's shiny bonce. The novelty effect of having another party leader alongside him also hasn't yet worn off, and everyone's written Lansley's obituary already anyway, so it was only natural to portray this as another great success for this new Teflon leader. Oh, and there was a shouty doctor too, always helpful when going into actual details is as mundane as it is on this topic. This whole nauseating stunt had it been attempted by Labour would have resulted in those involved being pilloried for resorting to such spin, a word it seems which has mysteriously fallen out of favour now the Tory-supporting press have their one true loves back in power. Only a few naysayers are pointing out that this top-down reorganisation, the exact thing the coalition promised they wouldn't do is now going to take place just as the NHS needs to be making massive efficiency savings. Cameron after all made his one great promise that he'd cut the deficit rather than the NHS, while Labour for once being both realistic and honest declined to ringfence the health budget, knowing that savings have got to come from somewhere.

This isn't by any means the end of the matter; it's just another temporary sticking plaster on reforms that haven't been anywhere near properly thought through, where it's still not clear that GPs are ready to take on a commissioning role despite have signed up to the pathfinder consortia, and where if the waiting lists continue to increase real, open, discontent with the coalition's promises and policies will begin to develop. A highly embarrassing political mess though, one of the coalition's own making, has been turned into a shining example of Cameron's leadership abilities and the Liberal Democrats' influence within the government, with all the blame shifted onto the unfortunate Lansley. Everyone wins, except for us plebs in the long term. And isn't that what modern politics sets out to achieve?

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6/14/2011 11:44:00 pm | |

Tuesday, April 05, 2011 

An accident prone coalition.

For a government less than a year into its first term, the coalition is already becoming remarkably accident prone. All governments through initial hubris or power of will tend to implement reforms which they either later regret or have to put right; others become so addicted to legislation that they either manage to bore or overwhelm those potentially opposed into submission: just witness New Labour's astonishing 21 criminal justice acts, a figure which itself can't be properly verified so prolific were the additions to the statute book.

The key difference with the coalition is that the policy u-turns and clarifications it's been forced to make ought to have been glaringly obvious to anyone even slightly in touch with the political mainstream. Caroline Spelman's crackpot scheme to sell off the nation's forests, regardless of the possible merits of reforming the Forestry Commission, was the kind of idea which should have been squashed when first proposed. Excepting banning the WI and riding roughshod over objections to new housing developments (which, oh, the coalition is also planning to do) nothing could be more seemingly calculated to rile up the Tory heartlands than the potential padlocking off of local woodland. Yet somehow it not only went through cabinet, all but three from the respective coalition parties also voted against an amendment urging the government to rethink the sell-off.

Once again proving the truism that politicians and indeed we as a species never learn anything from our mistakes, Andrew Lansley duly stood up in the Commons yesterday and channelled Spelman over his reforms to the NHS. While the changes are not being abandoned wholesale as the forest sell-off was, we are instead going to have a "pause" or a "natural break" in the proceedings as everyone is being urged to reconsider their respective positions. Lansley's gambit from the beginning in promoting his white paper was cunning, so cunning in fact that it was just too clever: his idea was through handing over commissioning to GPs, many of whom have long believed that they could do a much better of running the NHS if only they were given the chance, he could at the same time buy support for the work of building on Labour's introduction of the private sector, allowing or more accurately forcing the newly formed GP consortia to buy services from "any willing provider".

What's more, it almost worked. With most GPs so delighted at the prospect of wielding the knife as it were, with "pathfinder" consortia already representing 87% of England, it took a while for most to take notice of the other changes being introduced. It was only last month at an extraordinary special representative meeting that the British Medical Association called for the withdrawal of the entire Health and Social Care bill, while the Liberal Democrat spring conference, motivated by the opposition of Shirley Williams and Evan Harris called for major changes.

Quite why it took the Liberal Democrats so long to realise that they'd been duped is unfathomable. After all, the coalition agreement specifically called for an end to top down restructuring of the NHS, while the white paper proposed the abolition of both primary care trusts, which the Liberal Democrats had wanted to democratise, and strategic health authorities. It's the top down restructuring to end all top down restructuring, and yet without the disquiet at the speed of the reform rising they may well have voted for it regardless. Whether you go with Nigel Lawson's observation that the closest thing we have to a national religion is the NHS, or Tory MP David Ruffley admitting that it even makes them socialists, the only thing more popular than trees is our free at the point of use health care system, however much we complain about it and want to improve it. Once you get even close to suggesting that much of what it does can be farmed out, or that private firms can cherry pick what they want to do at a profit while the state is left with the hard cases, you have a problem on your hands.

And yet David Cameron, the man who said his priority was the NHS and that he'd protect it from cuts was up until very recently not only defending the bill but praising Lansley's work to everyone. Almost needless to say, along with everyone else in the cabinet who'd let Lansley get on with it, Cameron was nowhere to be seen as his health secretary was forced into his new strategy of delay. If Gordon Brown became known as Macavity, never being around when the shit hit the fan or when it was time to take responsibility, then Cameron is putting in a remarkably similar performance. This failure to pin the blame directly on the prime minister has been the biggest failure of the opposition to the coalition so far: Nick Clegg and the Liberal Democrats have rightly been targeted for propping up a Tory government intent on using however much time it has to embark on an economic and social experiment of slashing the state and hoping the private sector can fill in the gaps; unfortunately this has been to the detriment of properly nailing Cameron first and the Conservatives second for their aloofness at what they're about to unleash.

This ultimately is why Lansley's plans have had to be temporarily frozen. It's not that the Liberal Democrats are threatening to oppose the bill, or that the doctors themselves have become militant, it's that Cameron's image, carefully cultivated as the protector of the NHS, was in danger of being permanently sullied. Lansley instead is the one being left out in the cold, widely being described as dogmatic and unwilling to compromise, having only done what was asked of him regardless of it conflicting so obviously with both the coalition agreement and indeed with the manifestos of both parties. It could well be that this is a bluff, with only piecemeal changes to the bill made, as after all, Cameron himself is still fully behind plans which would see the entire public sector opened up to the private sector. More likely however is that the Liberal Democrats will be given enough compromises to claim that they've stopped Lansley's worst excesses, something they'll especially prize if the AV referendum fails, while the Conservatives will show themselves as being willing to listen to reasonable criticism. Even if this turns out to be the case, it shows once again that the coalition firstly isn't as clever as it thinks it is and secondly that through the right strategy and target it can be potentially defeated. Cameron, if it wasn't already clear enough, is the key.

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4/05/2011 11:59:00 pm | |

Monday, January 17, 2011 

Thatcherism, Blairism, Blameronism?

There's something seriously odd about the Conservative half of this government. British politics ever since the breakdown of the post-war, nominally social democratic, one nation consensus has been dominated by two all but interlocking personalities and philosophies: Thatcherism and Blairism, to the extent that both overwhelmed their successors. If the pattern is to continue, then Cameron has to start setting out his own related, but still distinct brand of governance.

While it isn't so strange that Cameron has shown no signs of beginning to do so, what is unique is that he's so clearly wedded to continuing and building on the public service reforms started by Blair and in their view, frustrated by "vested interests", for which read trade unions, never the public sector workers which make up those organisations, and Gordon Brown. Even taking into account the seven year gap between Thatcher and Blair, it would have been electoral and political suicide for him to openly state his allegiance to her methods of doing things. Cameron today did the diametric opposite: he name-checked Blair twice, said he had read his "intriguing" memoir and made clear the lesson he had drawn was that he needed to act both quickly and forcefully in pushing through reform.

To be sure, this isn't the first time it's been apparent just how closely the Cameron set has been following the Blairite book of politics. The child benefit cut was arguably an attempt at playing the party off to the benefit of the leader, although one which was flawed. Michael Gove has also long made clear his, as far as we know, unrequited lust for Blair. Never before though has Cameron been so completely transparent in where his inspiration and influence is coming from, not from past Conservative heroes, but from the most successful "Labour" leader of all time, at least in terms of winning elections. His entire speech today could have conceivably been given by Blair at any point during his first term; while it lacks his trademark verb-less sentences and other ticks, it makes up for it in the sheer belief which to the cynical looks like rank insincerity and to seemingly everyone else as evidence of the passion it requires to change obdurate and unyielding bureaucracies. He even uses the term globalisation to describe the pressures facing the British economy, a neologism which has somewhat fallen out of favour over the last few years.

Cameron's trick to define him and the coalition as different is to compare and contrast the approaches of the last Conservative and Labour governments, without doing so terribly accurately. He stereotypes Thatcher and Major as introducing choice and competition to public services without respecting their ethos, while Blair and Brown overemphasised the state and relied on bureaucracy and targets for their improvements. Naturally this leaves Cameron to insert his pet "big society" into the middle, a concept now so voluminous as to encompass private sector providers of healthcare within it. This is nothing more than cover for the extension of Blairite policies without New Labour's way of measuring their effectiveness - the targets which in healthcare the coalition has already gone some way towards abolishing. New initiatives meanwhile, such as Gove's oxymoronic English baccalaureate, have been imposed with the same level of contempt and lack of warning which characterised the worst Blairite interventions in policy.

The key difference is that Blair's reforms took place as spending was inexorably rising - now Cameron is proposing to do even more just as austerity bites, indeed even claiming that he will be focused on getting more for less in our public services. That old impossibility is already becoming a reality in those NHS trusts which are banning operations they can't afford to perform, something that goes unmentioned underneath the rhetoric of liberation for the workers and competition for the companies who have long wanted to get a slice of the NHS pie. Cameron's evidence of how everyone wants this is just as weak as Blair's ever was: it's not exactly surprising that high-performing schools have signed up for the increased freedoms of the academy system when it was originally designed to turned failing schools around, nor is it overwhelming that so many GPs have already organised themselves into consortia when if they don't the government will do it for them in a couple of years' time.

Also missing, even if Cameron refers to the coalition six times, is any real mention of the Liberal Democrats. Vince Cable referred to some of the proposed reforms in his unofficial interview with the Telegraph "as a kind of Maoist revolution ... they haven't thought them through ... [W]e should be putting a brake on it." Even if there aren't immediate signs of more mass mutinies such as the one over tuition fees in the offing, it's clear the party has far less electoral authority than the Conservatives with which to introduce such dramatic reforms; their manifesto was vague or opposed across the board to such measures. Nothing however quite equals the chutzpah of Cameron, trying to avoid recognising the coalition has broken their promise on top-down reorganisations of the health service, claiming that turning commissioning over to GPs is in fact a reform from the bottom-up. It was enough to wonder whether he had been given verbal diarrhoea due to a doctor somewhere similarly confusing which end to put the suppository in.

There is one thing that Cameron and his cohort of Blair fanciers haven't factored in, just as Blair himself didn't, and that's the public themselves. No amount of persuasion is going to convince some that these reforms are about people's lives, rather than the ideology or theory, and should they go as wrong as Iraq did then the fallout will be even more far reaching. It took seven years before Blair's certainty, messianic tendencies and ever more ridiculous rhetorical flights of fancy began to bring him down. Cameron seems prepared to emulate just those mistakes in record time.

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1/17/2011 10:46:00 pm | |

Wednesday, December 15, 2010 

Opaque consultations and Andrew Lansley's NHS reforms.

As political U-turns go, the Liberal Democrat about face on tuition fees has absolutely nothing on the promise made in the coalition agreement that the new government would not indulge in top-down reorganisations of the NHS. The full pact between the Lib Dems and the Conservatives was published on the 20th of May; on the 12th of July the government published the Liberating the NHS white paper, advocating the abolition of strategic health authorities and primary care trusts. If you were feeling cynical you might fall into the belief that the two parties had no intention whatsoever of honouring the pledge made in the agreement, and had been planning all along to do exactly the opposite. Appropriately enough, the website setting out the coalition's Programme for Government has already been closed down, and is now only available through the National Archives' cache.

Today the government published its response to the consultations launched by that previous health white paper. Considering how quick the coalition was to abandon its opposition to carrying out the kind of top-down reforms which had so angered and demoralised NHS staff during Labour's years in power, you'd expect it to at the least recognise or catalogue just how many responses were either in favour of their proposals and how many were against. While this would be time-consuming as there were over 6,000 submissions, it would not only signify this government's dedication to transparency but also enable us to ensure that they aren't misrepresenting the overall tone of those responding.

Instead the document cherry picks from this vast cache of opinions, and while it does provide a small amount of space for trenchant criticisms of the original plans (paragraph 1.15, page 10), it quotes at far greater length those who were supportive, which it describes as coming from "across the spectrum". It's impossible to know whether this is an accurate summary of the consultation submissions for the simple reason that the only thing we have apart from the tiny pieces directly lifted from them littered throughout the paper is the names of the organisations that took part. These are listed in this highly professional 58 page PDF file (original mirrored here in case it's replaced), 27 pages of which are either completely blank or have what may have been the remnants of earlier edits to the document strewn across them.

This wouldn't be so bad or so hilariously hypocritical if the document itself didn't propose an NHS "information revolution" (paragraph 2.23, page 22), the kind where "information can drive better and safer care, improve outcomes, support people to be more involved in decisions about their treatment and care, and, through extending opportunities for people to provide feedback on their service experience, improve service design and quality". Such as by perhaps asking whether those responding to consultations would mind having their submissions published alongside the official government paper, ensuring that their own objections and proposals can be used to hold the department to account? A further consultation was incidentally launched on this "Information Revolution", alongside another on greater choice and control, with very little fanfare back in October (an introduction to the "IR" on the DoH website has so far received only 18 comments). Most will only now be learning of them, with the consultations closing on the 14th of January, leaving little real time for many to respond.

It may well be the case that the responses to the consultation have somewhat altered the government's plans, as it sets out (paragraph 1.13, page 8), although you certainly wouldn't know if from the way it's presented the opposing submissions. For instance, while the summary of how the government has listened suggests that it's changed its view on the commissioning of maternity services due to the response, a look at the actual relevant section (paragraph 4.97, page 79) sees four different organisations quoted as supporting the original plan while another four, described as representing the majority view, differed. Here's where it would have been incredibly useful to have the full submissions to be able to see the real strength of opinion. Without them you're left to take the Department of Health's word for it, which judging by previous performance would be a very foolish thing to do indeed.

As with so much else the coalition is proposing, speed is being favoured over properly thinking through the possible consequences of such rapid and untested reform. The response given in the white paper to those arguing that the proposed changes are a "revolutionary" leap in the dark (paragraph 1.20, page 12) is that they would be better characterised as a logical evolution of the reforms put in place by the last government, with it commenting that practice-based commissioning and GP fundholding have been around for 20 years. This is despite Andrew Lansley previously arguing that comparing the former and GP commissioning is meaningless as they are completely different things. It also doesn't make clear that £80bn of NHS funding will be going straight to the new GP consortia to allocate and spend, a truly massive change, and one which the government is yet to prove the majority of GPs actually want. The cost of this reorganisation, yet to be revealed despite the health secretary apparently knowing the figures, comes as it seems unlikely the government will be able to keep its other promise of a real terms increase in spending on the NHS without making further cuts in other departmental budgets. If no one other than NHS staff originally cared about the breaking of the "no more top-down reforms" pledge, millions of voters will come to if it leads inexorably to Cameron's "cutting the deficit rather than the NHS" policy becoming just another election soundbite.

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12/15/2010 11:25:00 pm | |

Tuesday, July 27, 2010 

The Con-Dems and the race to legislate.

Whether it's attributed to either Emma Goldman or Ken Livingstone, the idiom that if voting changed anything they'd abolish it/make it illegal has always been one of those pithy statements which sound good but which fall apart under scrutiny, unless you take it as a criticism of so-called liberal democracy itself. Voting does change things, it's the politician's promises which are always broken. One of the things the Tories assured us they would not do prior to the election, with the Liberal Democrats making similar noises, was legislate to the extent which New Labour did, notoriously driving through over fifty criminal justice bills in thirteen years. Something they would also do would be to consult, and not in faux exercises like Labour's Big Conversation, with the whole thing micro-managed by spin doctors. They also wouldn't impose top-down reforms on the public services without doing the above, recognising how they had demoralised and demotivated the NHS especially, as well as wasting valuable time and resources. They even put the last one in the coalition agreement, such was the dedication to learning from the mistakes of the past.

Less than three months after the election and formation of the Conservative-Liberal Democrat coalition, and the one thing which strikes you about this government is just how much of a hurry it's in. On one level this is to be expected: even if for the moment the leadership of the two parties is still dedicated to making this partnership work, the murmurings from the backbenchers on both sides are undeniably getting louder. For six Liberal Democrat MPs to vote for a rebel amendment to the not just rushed through but rammed through academies bill is significant at such an early stage, especially on legislation which was similar to that which they promoted in their own manifesto. While the Lib Dem left is worried, it's the Tory right, not sated by the swingeing cuts yet to come which finds itself marginalised by the Cameroon revolution. Jibes about a "brokeback" coalition might seem relatively frivolous, yet it's little wonder it's miffed when it comes to prison policy and its liberal mushiness, which certainly wasn't hinted at prior to the election or in the manifesto. Their opposition to the AV referendum is less easy to understand, such is its chilling potential affect on Labour rather than them, yet all is certainly not well.

Some of the haste is then undoubtedly down to the potential instability of the coalition. Compared to New Labour's first few months in office, which were reasonably well planned in advance and included the independence of the Bank of England and the imposition of a windfall tax, it didn't really inspire its first proper rebellion against legislation until the revolt against the cutting of single parents' benefit at the end of 97. New Labour did however have the potential luxury of time, such was the disarray in which the Tories found themselves in along with a majority which effectively established an elective dictatorship. It was only later that Tony Blair regretted not pushing harder during his first term for public sector reform, although not when it came to the timidity of following the Tories' budgets for the first couple of years. It also wasn't until the fuel protests of 2000 that Labour found itself behind in the polls for the first time, giving it the kind of security that this current government would all kill for. The Tories find themselves only four points behind Labour in the latest ICM poll, long before the cuts begin to bite in the autumn, and on the back of exceptionally positive economic growth figures.

Even so, the slamming through of the Academies Bill was more akin to Labour's treatment of emergency anti-terrorism legislation than carefully considered and combed over drafting and re-drafting, as Tom Freeman noted. The argument made by Michael Gove in favour of the rush was that the topic had been endlessly debated over the last few years, as if this were an acceptable replacement for the usually more staid parliamentary process. In reality the rush was to be able to ensure that those schools that have applied for academy status can indeed have it when they reopen in September, although if we're to believe Julian Glover almost every aspect of reform which the bill covers is already available under previous legislation; in that case, why do we need a new bill which seems to do so much at the expense of the consultation which this government had previously promised? The big society it seems only works in favour of those that want the change which the Tories have already pre-determined which the public wants; if you'd rather your child's school didn't become an academy, then tough luck, as it's going to become one anyone. You can of course set up your own "free school", but it'll take years and you'll have to do all the work, or rather the private and voluntary sector firms you'll employ will.

More perplexing has been the relative silence over the proposed reforms of the NHS, where at least the legislation itself is at yet still to come. The coalition agreement clearly stated there would be no top-down reorganisations, while the primary care trusts would be reformed and elections held to ensure there was public representation on them. Eight weeks later and this went completely out the window when the health white paper was published: PCTs would be abolished altogether, local authorities instead providing the the democracy previously lacking, while GPs, the biggest winners out of Labour's own reforms with their pay increasing massively, would be given the task of commissioning services and organising themselves into consortia, whether they want to or not. This relies entirely on GPs being the well-informed heart of the health service which they are often assumed to be, knowing who delivers the best services in their area. It doesn't matter that plenty find their work with patients to be stressful enough, and prefer the management to be taken care of by others, and that they often simply don't know which is best locally as they don't have information on which to make such assured decisions upon, as the management side will probably be provided by the private sector firms itching to get a larger slice of the NHS budget, this was what wanted wasn't it? Aren't they pleased the government has been listening to them?

We can't however say we haven't been warned about the policing white paper. Ignore the parts about the setting up of the umpteenth "British FBI" and volunteers picking up the slack and/or patrolling with the actual police, the latter of which is a legal mindfield and almost certainly won't happen, it's instead the election of local police commissioners which has long been promised. This is without doubt the worst possible thing you could do to the police, as similar schemes in America have abundantly proved. At the moment there is at least a smidgen of operational independence between police and politicians, although New Labour first and then Boris Johnson have both tried their best to undermine that. It's not so much that it will open up the opportunity for the likes of the BNP to get themselves onto the boards of police authorities, the possibility for which is exaggerated (more realistic is local independents who'll demand to see more police on the beat and less teenagers on street corners), but more because as much as we complain about them, the police themselves generally do a reasonably good job at determining what the local priorities in their area are. Undoubtedly those who will put themselves forward for election will know what the problems in their very localised area are, but will they over a far larger radius? The opportunities for imposing their own tin-pot ideologies and prejudices on the police at large (and that goes for both right and left) will also doubtless be far more limited than they at first seem, but the potential for them to sack chief constables who will almost certainly disagree with them and instead install someone more amenable is a recipe for disaster and endless disputes that will distract from the police work itself.

As no one can even begin to put an estimate on how long the coalition will last, and few really believe that this is a marriage which can last much longer than a couple of years without major disagreements and fights breaking out putting the entire government in jeopardy, the potential for ill-thought through, badly drafted and overly rushed legislation ending up on the statute books is not much lower than it was under Labour. Of course, that this is all being conducted under the auspices of a government that believes so deeply in individual and community involvement in the political process and change from the talking to the hand which occurred under the last government means that history couldn't possibly repeat itself. They've learned from the past mistakes and are dedicated to transparency above everything else. What could possibly go wrong?

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7/27/2010 10:30:00 pm | |

Monday, November 19, 2007 

Scum-watch: We know better than the workers.

Today's Scum is highly annoyed about Brown and Alan Johnson daring to decide not to hand over yet more vast sums to private health companies who were getting paid for operations and treatments regardless of whether or not they actually were used or not:

GORDON Brown was slammed last night for blowing £100million of taxpayers’ cash scrapping Tony Blair’s NHS reforms.

The PM could have built two children’s hospitals, or hired 4,000 nurses with the cash.

Instead, he has used it to compensate private health firms after axing their NHS contracts.


Instead of leveling the blame with Blair and Johnson's predecessors for drawing up contracts which paid a lump sum to the private sector firms rather than on the actual amount of work they did, Brown gets in the neck. £100million is a disgraceful amount of compensation to pay to firms which must be laughing all the way to bank with the way the NHS works; they build hospitals with fewer beds than the ones they're replacing, and then have years' of payments still to look forward to under the hugely wasteful private finance initiative, and when they get their contracts canceled because they're not treating enough patients they still get paid! The blame however lies with Blair and his ideological fervour for marketised solutions which has imposed such madness on the NHS.

The Scum's leader knows who's really to blame though, and would you believe it, it's the unions:

AXEING private contracts for the NHS is foolish.

Gordon Brown should think again.

The NHS needs competition to drive up standards. It needs private firms to perform the ops and services so waiting lists can be cut.


This is nonsense. Almost all of the centres being scrapped were not seeing the volume of work they expected to; patients were voting with their feet through the choice system to go with the state rather than the private sector, even if it meant a slightly longer wait. As Alan Johnson set out, one of the services in the West Midlands had a take-up of 5%. Continuing to pay for 100% take-up when it was only doing 5% is economically insane.

 Spending £100million to compensate companies for tearing up their contracts is shocking.

True, but so is continuing to pay private health firms in full when their centres were sitting idle, especially when their introduction in the first place was completely unnecessary.

And it’s a disgusting price to pay for appeasing the unions, who only care about protecting jobs.

Christ, unions caring about protecting jobs? What's next? The police only caring about catching criminals? Rupert Murdoch only caring about his own self-interest? In any case, the unions don't just care about protecting jobs; they also care about how the NHS is little by little being broken up, being readied for inevitable full-scale privatisation whenever the government decides that a free at the point of use service is no longer "economically sustainable", as the treatment of Karen Reissmann demonstrates.

Mr Brown should ignore their selfish bleating.

And put patients’ lives first.


Quite right. The Sun and the CBI know better than the workers on the front line what's best for the NHS, and yet more private snouts in the public trough is the only way forward.

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11/19/2007 06:01:00 pm | |

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