Thursday 12th January 2017

[AngryAsWell]

Labour are constantly campaigning on the NHS - indeed some Blairite types actually attack them for doing so ("comfort zone" blah blah)

And this is an area where on the ground activism can have as much impact as media appearances.

Getting the mess the NHS is in at the moment in the news, highlighting cases like the one I just posted for instance, isn't happening. As I said maybe I've missed something, but I haven't heard any Labour person on the news calling this what it is - a disaster.

[Tubby Isaacs]

Anna Soubry MPVerified account
‏@Anna_Soubry
It appears there will be no parliamentary debates on #SingleMarket #CustomsUnion #FreeMovement before A50 is triggered. This is unacceptable

That "deal" with the Government over a "plan" went well then.

[AnatolyKasparov]

And even if true (and I have seen Jonathan Ashworth a fair bit on the TV this year, at least) would that all be Labour's fault? Of course, we know it is not.

[WelshIan]

MSM doing a better job of highlighting the NHS problems than Labour at the moment

Erm, really?

Considering the NHS is Labours biggest "trust" factor in the public eye - yes. Corbyn did well yesterday, but they should be out shouting about NHS loudly and clearly everyday.
Or maybe I've missed it.

If the BBC is a main source of news then yes, you would have missed it - there is only 1 article (on their website) from 9th Jan that mentions Jon Ashworth, whereas a Google search brings up a number of other news sources with quotes from him (including his letter to Jeremy Hunt yesterday).

Here's the link: http://labourlist.org/2017/01/hospital- ... remy-hunt/" onclick="window.open(this.href);return false;

I think it is the ongoing problem for Labour - if the MSM choose not to report what they are doing or saying then the impression is created that they are not doing anything.

It also does not help when the likes of Caroline Flint say that Labour shouldn't be talking about the NHS (http://www.huffingtonpost.co.uk/entry/w ... 1f093889e4" onclick="window.open(this.href);return false;).

[AngryAsWell]

'No access': Rex Tillerson sets collision course with Beijing in South China Sea
Comments that China should be barred from using artificial islands will anger Xi Jinping and could lead to a military clash, experts fear

https://www.theguardian.com/world/2017/ ... ?CMP=fb_gu" onclick="window.open(this.href);return false;

[Tubby Isaacs]

'No access': Rex Tillerson sets collision course with Beijing in South China Sea
Comments that China should be barred from using artificial islands will anger Xi Jinping and could lead to a military clash, experts fear

https://www.theguardian.com/world/2017/ ... ?CMP=fb_gu" onclick="window.open(this.href);return false;

But, but, Hilary Clinton was the warmonger.

[WelshIan]

Actually, the BBC website is dreadful on the NHS crisis full stop.

Their lead item in the Health section is an article on the effect of stress on heart attacks.

[SpinningHugo]

Labour are constantly campaigning on the NHS - indeed some Blairite types actually attack them for doing so ("comfort zone" blah blah)

And this is an area where on the ground activism can have as much impact as media appearances.

Not that it matters much, but of course Labour should campaign on the NHS. Not to do so would be ridiculous, and to claim that critics argue that stupid proposition is to make them sound like fools.

The criticism takes five forms.

First Labour can't expect to win by placing all its emphasis on the NHS. It is (or at least was) ahead on that issue, and was under Foot and Kinnock. It needs to win on leadership and economic competence primarily.

Second Labour always overplays its hand. So saying there are "X days to save the NHS" or "the NHS will be finished if the Health and Social Care Act is passed" now looks ridiculous. The Tories won, the Act was passed, but we observably still have an NHS. Similar is the Red Cross "humanitarian crisis" line. There are some major underfunding problems with the NHS, and those will lead to tragedies, but this isn't Aleppo, and by claiming that it is the critics sound like they're crying wolf.

Third is misdirected fire. The Tories aren't privatising the NHS, and outsourcing really isn't the big source of the problem. Underfunding is the issue. The NHS just needs more money, the structure is a second order issue.

Fourth is producer capture. The NHS employs a hell of a lot of people the majority of whom should be sympathetic to Labour, at least in England. But health professionals are not economists. There is no necessary reason to think that surgeons have any particular insights into how to run the NHS: that just isn't their area of expertise. There are good reasons, for example, why we should try and make 7 day 24 hour use of the NHS plant and capital in the same way a manufacturer does of plant and capital. There may be good objections from those who work in the business, but to deny that there are any possible efficiency gains from that is silly.

Fifth is localism. "Save our hospital". Often it makes no sense to keep all hospitals open. Sometimes efficient provision requires amalgamation. The much derided managers know this.

We can of course list off many and varied rightwing fallacies about the NHS. It isn't possible for it to achieve the efficiency gains of, say, the telecoms industry, It is cheap, not expensive, and does overall deliver good outcomes. Stuff about health tourism is basically bullshit. We are going to have to spend a higher proportion of GDP on it, and the current crisis is caused both by not doing so, and the even worse crisis in social care. Attacking managers and calling for all funding to go to frontline care is juvenile.

But, one thing I hate about the UK left is the treatment of the NHS as a holy cow, incapable of improvement with the only relevant international comparator always used being the USA. There are good and powerful reasons why no other modern state organises their health system along the same lines as the NHS. The main way the NHS achieves its low cost is through being illiberal (ie you cannot pay more to get better, save by opting out altogether.).

The fetishising of the NHS has meant we took our eye off other areas of the State that have been much more seriously underfunded: local government, criminal justice, social care, disability benefits. The main reason is that these are a minority concern, whereas most of us will have to make multiple uses of the NHS in our lives. By over focusing on the NHS the left made it too easy for the Tories to protect that, while destroying other things.

But, as I say, it doesn''t really matter now as Labour isn't on the pitch to play the game.

[gilsey]

Sky Views: May weaponising NHS all by herself

http://news.sky.com/story/sky-views-may ... f-10725599" onclick="window.open(this.href);return false;

The NHS has been put on a pedestal, made sacred and untouchable

Why do they always feel the need to put that bit in? It wasn't even true 10 years ago.

[AnatolyKasparov]

'No access': Rex Tillerson sets collision course with Beijing in South China Sea
Comments that China should be barred from using artificial islands will anger Xi Jinping and could lead to a military clash, experts fear

https://www.theguardian.com/world/2017/ ... ?CMP=fb_gu" onclick="window.open(this.href);return false;

But, but, Hilary Clinton was the warmonger.

You mean she wasn't?

Her hawkishness (much more so than Obama) was one of the things many found hardest to stomach about her.

[Tubby Isaacs]

Fifth is localism. "Save our hospital". Often it makes no sense to keep all hospitals open. Sometimes efficient provision requires amalgamation. The much derided managers know this.

Is there much of this silly campaigning by Labour? It was always a more Lib Dem by-election thing, which Cameron then really went for too.

[Tubby Isaacs]

'No access': Rex Tillerson sets collision course with Beijing in South China Sea
Comments that China should be barred from using artificial islands will anger Xi Jinping and could lead to a military clash, experts fear

https://www.theguardian.com/world/2017/ ... ?CMP=fb_gu" onclick="window.open(this.href);return false;

But, but, Hilary Clinton was the warmonger.

You mean she wasn't?

Her hawkishness (much more so than Obama) was one of the things many found hardest to stomach about her.

Indeed. I mean the way people claimed Trump wasn't one too. It's Putin good, Chinkies bad.

[StephenDolan]

Actually, the BBC website is dreadful on the NHS crisis full stop.

Their lead item in the Health section is an article on the effect of stress on heart attacks.

I wonder what coverage they'll give the demo/march in March. Norman Smith?

[Tubby Isaacs]

Fourth is producer capture. The NHS employs a hell of a lot of people the majority of whom should be sympathetic to Labour, at least in England. But health professionals are not economists. There is no necessary reason to think that surgeons have any particular insights into how to run the NHS: that just isn't their area of expertise. There are good reasons, for example, why we should try and make 7 day 24 hour use of the NHS plant and capital in the same way a manufacturer does of plant and capital. There may be good objections from those who work in the business, but to deny that there are any possible efficiency gains from that is silly.

Nobody said it wouldn't be wonderful to run more expensive machines at weekend. It's the cost and the staffing, and surgeons have plenty of insight into that.

I've got the impression that people who work at a senior level in the NHS seem to be keen on the NHS. It's very different to Rail (supposedly the worst privatization imaginable). Bloke I know who's basically in charge of upgrading a line, for example, wouldn't work for Network Rail if you paid him more.

[SpinningHugo]

Fifth is localism. "Save our hospital". Often it makes no sense to keep all hospitals open. Sometimes efficient provision requires amalgamation. The much derided managers know this.

Is there much of this silly campaigning by Labour? It was always a more Lib Dem by-election thing, which Cameron then really went for too.

True, it is probably true of all parties, especially when they are not in government and are not faced with the choices that have to be made.

Perhaps i mean a more general failure to emphasisie that some costing choices have to be made. Say there is a drug that save 15 lives out of a thousand of those that suffer from disease X, but costs £200,000 per person to deliver. Well, a choice has to be made whether to fund it or spend an equivalent sum on something else. Life in the NHS cannot be beyond price.

[gilsey]

The NHS does run expensive machines at unsocial hours, it's not uncommon round here to get an appointment for an ultrasound scan at eg 8pm on a Friday evening.

[SpinningHugo]

It's the cost and the staffing, and surgeons have plenty of insight into that.

I've got the impression that people who work at a senior level in the NHS seem to be keen on the NHS. It's very different to Rail (supposedly the worst privatization imaginable). Bloke I know who's basically in charge of upgrading a line, for example, wouldn't work for Network Rail if you paid him more.

1. No they don't. They have no specific expertise in that (save for being jolly clever and being on the ground - but that is not the point).

2. The NHS has huge efficiency gains, and means that doctors/surgeons etc spend their time doing medicine, constantly, and not other things.

I'd stick with the NHS because the costs of moving to any other system that maybe marginally better are too high.

One advantage of Brexit is the Tories should not be able to afford the political cost of any further reorganisation or underfunding. It shows what happens when you have no viable opposition that they aren't panicking.

[SpinningHugo]

The NHS do run expensive machines at unsocial hours, it's not uncommon round here to get an appointment for an ultrasound scan at eg 8pm on a Friday evening.

Of course it does. That wasn't the point. The point is that you don't make different levels of use according to day/time (see a car plant).

[citizenJA]

'No access': Rex Tillerson sets collision course with Beijing in South China Sea
Comments that China should be barred from using artificial islands will anger Xi Jinping and could lead to a military clash, experts fear

https://www.theguardian.com/world/2017/ ... ?CMP=fb_gu" onclick="window.open(this.href);return false;

But, but, Hilary Clinton was the warmonger.

You mean she wasn't?

Her hawkishness (much more so than Obama) was one of the things many found hardest to stomach about her.

Female politicians in the US campaign more hawk than hawk so they don't get called sissy chicks. Doesn't mean they'll pull the trigger.

[gilsey]

This is worth reading, back to the future with the NFU.
https://anewnatureblog.wordpress.com/20 ... ckoo-land/" onclick="window.open(this.href);return false;
Anyone who thinks the CAP is mad and the UK can do better should read it and weep.

In these straitened times, the NFU couldn’t possibly be thinking of reintroducing the notion of price support! Well you would be wrong.

It seems the NFU has been delving back through its long and distinguished history to come up with some new (ahem) proposals for what a farm subsidy system might look like post-Brexit. The policy document I have seen suggests that the NFU wants to propose a support system with an emphasis on “delivering for food, for the nation and for the public.” Note that it does not specifically say “supporting farmers”.

What appears to be the main element of this support system is a scheme of payments to “mitigate volatility”. This is jargon for price support, and there we are taken straight back to 1947.

[Tubby Isaacs]

Fifth is localism. "Save our hospital". Often it makes no sense to keep all hospitals open. Sometimes efficient provision requires amalgamation. The much derided managers know this.

Is there much of this silly campaigning by Labour? It was always a more Lib Dem by-election thing, which Cameron then really went for too.

True, it is probably true of all parties, especially when they are not in government and are not faced with the choices that have to be made.

Perhaps i mean a more general failure to emphasisie that some costing choices have to be made. Say there is a drug that save 15 lives out of a thousand of those that suffer from disease X, but costs £200,000 per person to deliver. Well, a choice has to be made whether to fund it or spend an equivalent sum on something else. Life in the NHS cannot be beyond price.

Again, I don't know if they go for those things too much. They tried to depoliticize the drugs with NICE, only for shitbag Cameron to show incredible cynicism).

More centralization and specialization is a good thing, and politically sellable. Wonder if some sort of imaginative "statist" policy could be done there on eg accommodation.

[citizenJA]

I'd stick with the NHS because the costs of moving to any other system that maybe marginally better are too high.

(cJA edit)

Yes, this is demonstrably true.

[Tubby Isaacs]

It's the cost and the staffing, and surgeons have plenty of insight into that.

I've got the impression that people who work at a senior level in the NHS seem to be keen on the NHS. It's very different to Rail (supposedly the worst privatization imaginable). Bloke I know who's basically in charge of upgrading a line, for example, wouldn't work for Network Rail if you paid him more.

1. No they don't. They have no specific expertise in that (save for being jolly clever and being on the ground - but that is not the point).

2. The NHS has huge efficiency gains, and means that doctors/surgeons etc spend their time doing medicine, constantly, and not other things.

I'd stick with the NHS because the costs of moving to any other system that maybe marginally better are too high.

One advantage of Brexit is the Tories should not be able to afford the political cost of any further reorganisation or underfunding. It shows what happens when you have no viable opposition that they aren't panicking.

I think the internal market has stopped senior medics from being ignorant of logistics. They probably know a bit about recruitment too from unfilled vacancies. I agree that we don't rely solely on them, but their knowledge is decent and their good campaign fodder. I think it would be perverse not to use them.

[RogerOThornhill]

I'd stick with the NHS because the costs of moving to any other system that maybe marginally better are too high.

(cJA edit)

Yes, this is demonstrably true.

Except to ideological nutters who think that we need even more reform and not simply more cash (.cf. schools)

[citizenJA]

http://touchstoneblog.org.uk/2017/01/we ... worse-off/


We are more equal (because we are all worse off)

People trading their labour for wages are all earning less in real terms now than prior 2007.

[citizenJA]

I'd stick with the NHS because the costs of moving to any other system that maybe marginally better are too high.

(cJA edit)
Yes, this is demonstrably true.

Except to ideological nutters who think that we need even more reform and not simply more cash (.cf. schools)

We've had enough 'reform'.
Tory government don't fund public services properly.
Don't return them to government, turf them out as soon as possible.

[citizenJA]

Enough.

[HindleA]

Beg to differ,some things maybe,definately not dialysis where the exact opposite should be the case,at home if possible,as close to home next.The difficulties,ridiculous expense of transport is legendary.It used to be the aim,I hope it still is.

[HindleA]

It pays for itself at home in short shrift if the waste of machinery is opined.

[Tubby Isaacs]

This is worth reading, back to the future with the NFU.
https://anewnatureblog.wordpress.com/20 ... ckoo-land/" onclick="window.open(this.href);return false;
Anyone who thinks the CAP is mad and the UK can do better should read it and weep.

In these straitened times, the NFU couldn’t possibly be thinking of reintroducing the notion of price support! Well you would be wrong.

It seems the NFU has been delving back through its long and distinguished history to come up with some new (ahem) proposals for what a farm subsidy system might look like post-Brexit. The policy document I have seen suggests that the NFU wants to propose a support system with an emphasis on “delivering for food, for the nation and for the public.” Note that it does not specifically say “supporting farmers”.

What appears to be the main element of this support system is a scheme of payments to “mitigate volatility”. This is jargon for price support, and there we are taken straight back to 1947.

Thanks. I need to know much more about this.

[HindleA]

Had thrice weekly 50 +mile trips whilst "training",it was bloody knackering and I was supposedly fit.

[PaulfromYorkshire]

My recollection of reports from the Nuffield Trust is that the NHS problem goes beyond funding and the social care problems and relates to the "flow" of patients right through the system, which I think got much worse after the Coalition reforms.

Put simply, far too many people being cared for by the NHS are in the wrong place at the wrong time! And that is largely David Cameron and Andrew Lansley's fault, with assistance of course from the Lib Dems!

[PorFavor]

Jaywick (Essex) is to be evacuated owing to a threat of flooding. (Just heard it on the news.)

[Tubby Isaacs]

Jaywick (Essex) is to be evacuated owing to a threat of flooding. (Just heard it on the news.)

Local MP, Douglas Carswell, will be shouting out to libertarians to sort it out.

[HindleA]

'kin ell.What next a plague of locusts.

[Tubby Isaacs]

My recollection of reports from the Nuffield Trust is that the NHS problem goes beyond funding and the social care problems and relates to the "flow" of patients right through the system, which I think got much worse after the Coalition reforms.

Put simply, far too many people being cared for by the NHS are in the wrong place at the wrong time! And that is largely David Cameron and Andrew Lansley's fault, with assistance of course from the Lib Dems!

Interesting. Is it much different in Scotland, Wales, and NI?

[PaulfromYorkshire]

My recollection of reports from the Nuffield Trust is that the NHS problem goes beyond funding and the social care problems and relates to the "flow" of patients right through the system, which I think got much worse after the Coalition reforms.

Put simply, far too many people being cared for by the NHS are in the wrong place at the wrong time! And that is largely David Cameron and Andrew Lansley's fault, with assistance of course from the Lib Dems!

Interesting. Is it much different in Scotland, Wales, and NI?

I haven't got time to reread those reports just now, but when I have a quiet moment I'll try and summarise.

[HindleA]

https://www.theguardian.com/football/20 ... are_btn_tw" onclick="window.open(this.href);return false;


Hillsborough investigators pass 23 cases to CPS for possible charges

he cases it had sent to the CPS include possible charges of gross negligence manslaughter, perverting the course of justice, misconduct in public office and offences for breaches of the Safety of Sports Ground Act 1975 and health and safety laws.

[HindleA]

https://www.theguardian.com/us-news/201 ... ier-author" onclick="window.open(this.href);return false;

Intelligence sources vouch for credibility of Russia dossier author

[WelshIan]

The NHS do run expensive machines at unsocial hours, it's not uncommon round here to get an appointment for an ultrasound scan at eg 8pm on a Friday evening.

Of course it does. That wasn't the point. The point is that you don't make different levels of use according to day/time (see a car plant).

What hospital plant and capital are you thinking of here? I'm struggling to come up with any examples - I don't think you're talking about appointments, non-urgent surgery,etc. I can't think of anything else that would fit though.

[SpinningHugo]

The NHS do run expensive machines at unsocial hours, it's not uncommon round here to get an appointment for an ultrasound scan at eg 8pm on a Friday evening.

Of course it does. That wasn't the point. The point is that you don't make different levels of use according to day/time (see a car plant).

What hospital plant and capital are you thinking of here? I'm struggling to come up with any examples - I don't think you're talking about appointments, non-urgent surgery,etc. I can't think of anything else that would fit though.

The big building with the sign hospital, the rooms inside, and all the stuff like knives that are used.

[WelshIan]

Of course it does. That wasn't the point. The point is that you don't make different levels of use according to day/time (see a car plant).

What hospital plant and capital are you thinking of here? I'm struggling to come up with any examples - I don't think you're talking about appointments, non-urgent surgery,etc. I can't think of anything else that would fit though.

The big building with the sign hospital, the rooms inside, and all the stuff like knives that are used.

I still don't understand your answer. What are they supposed to do with that hospital? They are already open 24/7.

I really do not appreciate this sort of condescension to a serious question.

[Eric_WLothian]

The NHS do run expensive machines at unsocial hours, it's not uncommon round here to get an appointment for an ultrasound scan at eg 8pm on a Friday evening.

Of course it does. That wasn't the point. The point is that you don't make different levels of use according to day/time (see a car plant).

What hospital plant and capital are you thinking of here? I'm struggling to come up with any examples - I don't think you're talking about appointments, non-urgent surgery,etc. I can't think of anything else that would fit though.

The components in a car plant don't sleep at night or use public transport to get there. Patients don't "work" shifts, even if the staff do.

[Tubby Isaacs]

This sounds a bit Ron Hopeful.

http://www.ft.com/content/7ec41a92-d822 ... eb37a6aa8e" onclick="window.open(this.href);return false;

City lobby group gives up on passporting, and goes for equivalence- ie we copy all the EU rules we like and hope for a special deal.

Interestingly, the argument we'd get a special deal is the complete opposite to the "BMWs" argument. They want to buy the services off us.

[PorFavor]

This sounds a bit Ron Hopeful.

http://www.ft.com/content/7ec41a92-d822 ... eb37a6aa8e" onclick="window.open(this.href);return false;

City lobby group gives up on passporting, and goes for equivalence- ie we copy all the EU rules we like and hope for a special deal.

Interestingly, the argument we'd get a special deal is the complete opposite to the "BMWs" argument. They want to buy the services off us.

Or - hope they don't notice the bits we've left out.

[PorFavor]

The rain here is torrential, and has been so all day - with no sign of it letting up.

Over.

[AngryAsWell]

The best the Donald Trump inauguration can do is a Bruce Springsteen tribute band
He couldn't get The E Street Band, but he did land 'The B Street Band'

http://www.independent.co.uk/arts-enter ... 23436.html" onclick="window.open(this.href);return false;

[RogerOThornhill]

The best the Donald Trump inauguration can do is a Bruce Springsteen tribute band
He couldn't get The E Street Band, but he did land 'The B Street Band'

http://www.independent.co.uk/arts-enter ... 23436.html" onclick="window.open(this.href);return false;

Wouldn't be at all surprised if The Boss tried to stop them playing any of his songs...

[Tubby Isaacs]

This sounds a bit Ron Hopeful.

http://www.ft.com/content/7ec41a92-d822 ... eb37a6aa8e" onclick="window.open(this.href);return false;

City lobby group gives up on passporting, and goes for equivalence- ie we copy all the EU rules we like and hope for a special deal.

Interestingly, the argument we'd get a special deal is the complete opposite to the "BMWs" argument. They want to buy the services off us.

Or - hope they don't notice the bits we've left out.

It's more race to the bottom stuff, potentially. If the EU is at all competent on financial regulation, they should be able to see us off.

[PorFavor]

The best the Donald Trump inauguration can do is a Bruce Springsteen tribute band
He couldn't get The E Street Band, but he did land 'The B Street Band'

http://www.independent.co.uk/arts-enter ... 23436.html" onclick="window.open(this.href);return false;

Rather a perverted version of a "tribute" to Bruce Springsteen. Do you think that they realise?