Saturday 6th &.Sunday 7th January 2018
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Re: Saturday 6th &.Sunday 7th January 2018
There are upsides and downsides to all systems. A centralised single payer system like the NHS has the advantage of coverage and being cheap to deliver. It has two big downsides though
1. It is illiberal. That wasn't so much of a problem in 1945, I think it is now, and will increasingly become one.
2. As it is government funded, there is no guarantee it will be properly funded, and now it isn't. Some will answer "elect Labour then" but even if (which I doubt) we see a majority Labour government in power within the next decade, it wont be in power in perpetuity, or indeed looking at past experience all that long. Most of the NHS's history has been under Tory government, and probably will be in the future.
Looking at data on coverage, cost, choice and, most importantly, outcomes, I think the we could do better than the NHS, but the transition costs are too high. So best to try and make do with what we have. It is a national religion and any reform is bitterly opposed, whoever puts it forward.
Other things I know: you can't use your own experience to judge it. I've had two bad experiences with the NHS this year, one because of doctor incompetence, the other just the usual almost unbelievable delays. But the system is so huge that you cannot extapolate from that. Even a lifetime living and working in the NHS won't give you the information you need to judge it.
So saying "you need to have lived in country X and have experienced its system to judge it" is a bit dim.
1. It is illiberal. That wasn't so much of a problem in 1945, I think it is now, and will increasingly become one.
2. As it is government funded, there is no guarantee it will be properly funded, and now it isn't. Some will answer "elect Labour then" but even if (which I doubt) we see a majority Labour government in power within the next decade, it wont be in power in perpetuity, or indeed looking at past experience all that long. Most of the NHS's history has been under Tory government, and probably will be in the future.
Looking at data on coverage, cost, choice and, most importantly, outcomes, I think the we could do better than the NHS, but the transition costs are too high. So best to try and make do with what we have. It is a national religion and any reform is bitterly opposed, whoever puts it forward.
Other things I know: you can't use your own experience to judge it. I've had two bad experiences with the NHS this year, one because of doctor incompetence, the other just the usual almost unbelievable delays. But the system is so huge that you cannot extapolate from that. Even a lifetime living and working in the NHS won't give you the information you need to judge it.
So saying "you need to have lived in country X and have experienced its system to judge it" is a bit dim.
Re: Saturday 6th &.Sunday 7th January 2018
Good-afternoon, PorFavor!PorFavor wrote:Good morfternoon.
I've missed you.
Do consider fewer adventuresome jaunts.
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Re: Saturday 6th &.Sunday 7th January 2018
She has been speaking to extremely dubious characters.
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Re: Saturday 6th &.Sunday 7th January 2018
SpinningHugo wrote:There are upsides and downsides to all systems. A centralised single payer system like the NHS has the advantage of coverage and being cheap to deliver. It has two big downsides though
1. It is illiberal. That wasn't so much of a problem in 1945, I think it is now, and will increasingly become one.
2. As it is government funded, there is no guarantee it will be properly funded, and now it isn't. Some will answer "elect Labour then" but even if (which I doubt) we see a majority Labour government in power within the next decade, it wont be in power in perpetuity, or indeed looking at past experience all that long. Most of the NHS's history has been under Tory government, and probably will be in the future.
Looking at data on coverage, cost, choice and, most importantly, outcomes, I think the we could do better than the NHS, but the transition costs are too high. So best to try and make do with what we have. It is a national religion and any reform is bitterly opposed, whoever puts it forward.
Other things I know: you can't use your own experience to judge it. I've had two bad experiences with the NHS this year, one because of doctor incompetence, the other just the usual almost unbelievable delays. But the system is so huge that you cannot extapolate from that. Even a lifetime living and working in the NHS won't give you the information you need to judge it.
So saying "you need to have lived in country X and have experienced its system to judge it" is a bit dim.
I would suggest I know the Swiss system and how it works much better than you do - or are you telling me you do know?
I am in no position to extrapolate outside that apart from what I know from the UK system
The Swiss system is relatively simple to understand - there is a basic insurance and you build on that due to ability to pay. The insurance companies will try to avoid paying if they can and there are often huge arguments whether something is an accident or illness (as these are covered differently)
In order to reduce monthly cost there is a franchise system so you pay around £2000 before insurance kicks in which can be an issue for those with chronic conditions and often hospital stays are not included
Once ill the care is generally terrific but that is not the whole story is it?
I do not like having to share my medical history with an insurance company, especially their sales staff who you need to engage with if you want to take advantage of 'competition'
I suggest you read Willow's posts as they seem to know a lot more of the general comparisons than I do, and I guess you do.
All I would like to add is there is a fair agreement and evidence that health is linked to wealth. Switzerland is a wealthier country than the UK and the focus on healthy living is much more pronounced here. That means looking at just outcomes can be misleading - and of course is the difference in overall spending as % of GDP and per capita
Is the NHS the 'best' system? - I would guess no system can be shown to be better as the culture, infrastructure, the societal and even the environmental conditions differ so greatly - and so something that works in one place will not necessarily work elsewhere.
All systems need continual improvement but they also need investment and good management - the Tories have shown that they cannot be trusted on either
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Re: Saturday 6th &.Sunday 7th January 2018
The biggest dimfuckery as Willow alluded to is neglect to consider wider contexts and interconnecting systems,the salient feature particularly since 2010 has been the purposeful attempts to residualise indisputable vast cost saving (not least the NHS)investment to account for health and related needs,bespoke income for such purposes are the cheapest and most efficient use of resources.I let others decide whether fourty years experience on "both" sides can be so easilly dismissed.
Re: Saturday 6th &.Sunday 7th January 2018
the Monaco connections?HindleA wrote:She has been speaking to extremely dubious characters.
Re: Saturday 6th &.Sunday 7th January 2018
The NHS is 'illiberal'?
Re: Saturday 6th &.Sunday 7th January 2018
Umm....
This was so jaw-dropping, I was doubtful about re-posting it, until I followed a link posted in the replies to the actual article:
http://www.nosacredcows.co.uk/golden_ol ... ticle.html" onclick="window.open(this.href);return false;
What an absolute child.
" onclick="window.open(this.href);return false;Emma Kennedy
@EmmaKennedy
Sorry, but I’m going to keep banging on about this. Toby Young disguised himself as a woman in order to have sexual contact with lesbians. He wrote he wanted them to “find his penis”. This is not a man who should be elevated to anything.#marr
10:02 am · 7 Jan 2018
This was so jaw-dropping, I was doubtful about re-posting it, until I followed a link posted in the replies to the actual article:
http://www.nosacredcows.co.uk/golden_ol ... ticle.html" onclick="window.open(this.href);return false;
What an absolute child.
"Fall seven times, get up eight" - Japanese proverb
Re: Saturday 6th &.Sunday 7th January 2018
Commonwealth Fund latest
Excellent posts from friends here on this topic this morning, thank you allMirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care
Performance Varies Among Health Systems
http://www.commonwealthfund.org/interac ... or-mirror/" onclick="window.open(this.href);return false;
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Re: Saturday 6th &.Sunday 7th January 2018
apparentlycitizenJA wrote:The NHS is 'illiberal'?
I think the argument is that it is monolithic and precludes the addition of different layers based on the ability to pay (if I remember previous discussions)
Some people would like the option to get better room, better food, quicker access etc based on ability to pay for it
The fact that this would introduce the need for a bureaucracy to manage this is not taken into consideration.....
I do know (because my sister is one) that there are people employed now to check patient's entitlement to treatment now - apparently very few cases are found (quite a lot are people like me with an NHS number, NI number and British Passport) but it takes a lot of resources as the UK has no straightforward way to prove residence
Re: Saturday 6th &.Sunday 7th January 2018
So here we are then. Page 3. Who knew?
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Re: Saturday 6th &.Sunday 7th January 2018
citizenJA wrote:Commonwealth Fund latestExcellent posts from friends here on this topic this morning, thank you allMirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care
Performance Varies Among Health Systems
http://www.commonwealthfund.org/interac ... or-mirror/" onclick="window.open(this.href);return false;
I think Willow helped a lot here - I can only speak for one (and in my view quite flawed) system
I think the point is that these comparisons are difficult and imprecise so we should not be too parochial or dogmatic - there are some clear outliers there (like the US) though - and from my own personal experience I would always support the universal and equitable approach of the NHS.
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Re: Saturday 6th &.Sunday 7th January 2018
The best hospitals have a shared care/mutually beneficial approach,communication,respect,trust is key eg.if feeding,ablutions etc the time consuming but essentials are a problem,facillate,be flexible in visiting hours,allow/engage relatives/friends(obviously with patients agreement)in such endeavours.I have had "interesting" discussions with the more prison warder view staff over such things but it seemed to be changing.Equally,instead of bemoaning staff and seemingly standing by while people were drinking from vases,do something about it.
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Re: Saturday 6th &.Sunday 7th January 2018
Anyone see how Leeds did today?
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Re: Saturday 6th &.Sunday 7th January 2018
citizenJA wrote:The NHS is 'illiberal'?
Yes of course.
Re: Saturday 6th &.Sunday 7th January 2018
(cJA edit)howsillyofme1 wrote:---citizenJA wrote:------Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care
Performance Varies Among Health Systems
http://www.commonwealthfund.org/interac ... or-mirror/" onclick="window.open(this.href);return false;
I think the point is that these comparisons are difficult and imprecise so we should not be too parochial or dogmatic - there are some clear outliers there (like the US) though - and from my own personal experience I would always support the universal and equitable approach of the NHS.
Yes, exactly. From the report linked above...
The Health Systems Achieving Top Marks Do So in Diverse Ways
The three countries with the best overall health system performance scores have strikingly different health care systems.
All three provide universal coverage and access, but do so in different ways, suggesting that high performance can be achieved through a variety of payment and organizational approaches.
Experts generally group universal coverage systems into three categories: Beveridge systems, single-payer systems, and multipayer systems. These three systems are represented among our highest performers.
Re: Saturday 6th &.Sunday 7th January 2018
This comment seems to suggest that the structure of healthcare funding in the UK makes our healthcare system uniquely vulnerable to political mismanagement and interference. Yet healthcare and how to pay for it is a hugely political topic in the USA right now and it seems to me that an individual's access to certain treatments and services can always be changed on the whim of government. As such, I find this a weak argument against the NHS but a very strong argument against our constitutional democracy as it's clearly our political system that is failing in this respect, not our healthcare system, if the NHS is being underfunded.2. As it is government funded, there is no guarantee it will be properly funded, and now it isn't. Some will answer "elect Labour then" but even if (which I doubt) we see a majority Labour government in power within the next decade, it wont be in power in perpetuity, or indeed looking at past experience all that long. Most of the NHS's history has been under Tory government, and probably will be in the future.
"Fall seven times, get up eight" - Japanese proverb
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Re: Saturday 6th &.Sunday 7th January 2018
"We can now concentrate on not getting promoted"
Re: Saturday 6th &.Sunday 7th January 2018
Good. Effective national healthcare provision requires it.SpinningHugo wrote:Yes of course.citizenJA wrote:The NHS is 'illiberal'?
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Re: Saturday 6th &.Sunday 7th January 2018
Calling me a "liberal" is as bad as "Tory",to me.Freedom to throw others under a bus,never appealed.
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Re: Saturday 6th &.Sunday 7th January 2018
Willow904 wrote:This comment seems to suggest that the structure of healthcare funding in the UK makes our healthcare system uniquely vulnerable to political mismanagement and interference. Yet healthcare and how to pay for it is a hugely political topic in the USA right now and it seems to me that an individual's access to certain treatments and services can always be changed on the whim of government. As such, I find this a weak argument against the NHS but a very strong argument against our constitutional democracy as it's clearly our political system that is failing in this respect, not our healthcare system, if the NHS is being underfunded.2. As it is government funded, there is no guarantee it will be properly funded, and now it isn't. Some will answer "elect Labour then" but even if (which I doubt) we see a majority Labour government in power within the next decade, it wont be in power in perpetuity, or indeed looking at past experience all that long. Most of the NHS's history has been under Tory government, and probably will be in the future.
As so often, just comparing the UK with the US (the very worst system) is unhelpful.
If you have a system that isn't funded solely out of cetnral taxation, but instead also draws on insurance premiums, employer contributions, and pay as you go charges, it just isn't as vulnerable to cuts in state funding as it doesn't solely depend on them. It just won't matter as much whether party X or Y is in power.
The US and the UK seem particularly bad with respect to healthcare being such major political issues, partly because the funding in both societies is unstable. Infamously, we probably wouldn't have had the vote for Brexit if the NHS had not been such an issue (not just the ludicrous £350m pledge, but also the idea that immigrants are taking up precious NHS resources).
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Re: Saturday 6th &.Sunday 7th January 2018
SpinningHugo wrote:citizenJA wrote:The NHS is 'illiberal'?
Yes of course.
I find comments like this quite unhelpful really - in some ways the NHS is 'illiberal' or I would rather say monolithic as I am not sure an organisation like the NHS could ever be seen in terms as 'liberal'
It can be slow to change and it can be too conservative but that is the price the majority seem to be prepared to pay for the equitable and assured access to healthcare
I know from previous posts that you mean that you would like to be able to pay for a single, better room and other perks and that is what you would like to liberalise. We have seen when the NHS has previously tried to 'liberalise' in this respect by allowing access to entertainment systems etc it really has not had a positive reception and is resented by the patients
There is always some scope to improve but I think the issue at the moment is that people are dying on stretchers in corridors so calling for provision of a nicer room for someone with a bit of money could be seen as, at best, misguided and, at worst, callous
Liberalising in the extent of bringing in competition and private provision is not, in my view, proven to add anything and my own personal view is that it is just another example of moving public money into the pockets of private companies to no benefit to the taxpayer
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Re: Saturday 6th &.Sunday 7th January 2018
citizenJA wrote:Good. Effective national healthcare provision requires it.SpinningHugo wrote:Yes of course.citizenJA wrote:The NHS is 'illiberal'?
Which is the politicial choice. If you want it cheap, make it illiberal. If you want more choice, it will cost. See (if you want an analogy) the difference between Lidl and Sainsbury's.
If you're time rich and money poor, this lack of choice is what you'll prefer. If you're either time poor or cash rich, it won't be. I'm (often) time poor, which is why I find the NHS deeply frustrating when I have to use it, but I (hopefully) understand and accept it.
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Re: Saturday 6th &.Sunday 7th January 2018
I may be a Marxist but I find the idea of choice and competition in healthcare to be distasteful
If you allow someone to access healthcare more quickly in the NHS on the ability to pay then those who don't will have their treatment delayed
If you allow someone to access healthcare more quickly in the NHS on the ability to pay then those who don't will have their treatment delayed
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Re: Saturday 6th &.Sunday 7th January 2018
Anyway, as someone who is very jaded with the political system, I know that the days of the NHS are numbered
The British people want the NHS but they continue to vote in a party that wants to destroy the ethos of the NHS and move towards more privately run and the introduction of ability to pay - possibly eventually letting in the concept of personal insurance
We have seen how monopolistic 'markets' work - in water, utilities and rail where there is no real choice and costs increase to the consumer with everything being hidden away by the concept of 'client confidentiality'
The British people want the NHS but they continue to vote in a party that wants to destroy the ethos of the NHS and move towards more privately run and the introduction of ability to pay - possibly eventually letting in the concept of personal insurance
We have seen how monopolistic 'markets' work - in water, utilities and rail where there is no real choice and costs increase to the consumer with everything being hidden away by the concept of 'client confidentiality'
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Re: Saturday 6th &.Sunday 7th January 2018
What absolute nonsense,please outline your evidence,even disregarding that more often than not the self declared "time poor" tend to spend an inordinate amount of time telling everybody how little time they have whilst doing naff all,that the "time rich" don't want the best possible/accept less.for themselves or loved ones.Patronising piffle.
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Re: Saturday 6th &.Sunday 7th January 2018
Perhaps could spend less time posting on the internet? May help free up some of his time?HindleA wrote:What absolute nonsense,please outline your evidence,even disregarding that more often than not the self declared "time poor" tend to spend an inordinate amount of time telling everybody how little time they have whilst doing naff all,that the "time rich" don't want the best possible/accept less.for themselves or loved ones.Patronising piffle.
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Re: Saturday 6th &.Sunday 7th January 2018
Put another way, if you wanted to maintain the same level of basic provision for all as we now havem whilst introducing more choice, it would take more resources to increase provision (which you pay for from the contributions of those wanting more).
Which is why the UK system is relatively cheap when compared to other systems which offer the same (or better) level of basic provision but offering more choice (like almost all other European systems).
Which is why the UK system is relatively cheap when compared to other systems which offer the same (or better) level of basic provision but offering more choice (like almost all other European systems).
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Re: Saturday 6th &.Sunday 7th January 2018
Correct me if I am wrong someone but you can decide to go private without using the NHS - if you are time poor and cash-rich then you could just pay privately?If you're time rich and money poor, this lack of choice is what you'll prefer. If you're either time poor or cash rich, it won't be. I'm (often) time poor, which is why I find the NHS deeply frustrating when I have to use it, but I (hopefully) understand and accept it.
Or get your own private insurance - you just cannot use the NHS resources once you have decided to pay for faster access I believe is the case
I feel some sympathy for the time poor, cash-poor especially with unsympathetic employers - but in their cases being able to pay for quick access is probably not an option - and the NHS is actually a joy for them to behold! If there is a two-tier system then these will be the ones who get pushed to the back of the queue
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Re: Saturday 6th &.Sunday 7th January 2018
Not totally immune from it,myself,to be fair.It was just the "generalisational" depiction(s)Anyway,I really haven't got time for this ....
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Re: Saturday 6th &.Sunday 7th January 2018
SpinningHugo wrote:Put another way, if you wanted to maintain the same level of basic provision for all as we now havem whilst introducing more choice, it would take more resources to increase provision (which you pay for from the contributions of those wanting more).
Which is why the UK system is relatively cheap when compared to other systems which offer the same (or better) level of basic provision but offering more choice (like almost all other European systems).
Why don't you stand for Parliament on that platform then - reform of the NHS so those who have more money can access perks that the poorer can't?
Can I suggest you try somewhere in South Wales or the North East to detect the popularity of this idea?
Last edited by howsillyofme1 on Sun 07 Jan, 2018 3:30 pm, edited 1 time in total.
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Re: Saturday 6th &.Sunday 7th January 2018
you never claimed to be 'time-poor' though MrA......HindleA wrote:Not totally immune from it,myself,to be fair.It was just the "generalisational" depiction(s)Anyway,I really haven't got time for this ....
Re: Saturday 6th &.Sunday 7th January 2018
Exactly what I meant by my post up yonder, well saidhowsillyofme1 wrote:I may be a Marxist but I find the idea of choice and competition in healthcare to be distasteful
If you allow someone to access healthcare more quickly in the NHS on the ability to pay then those who don't will have their treatment delayed
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Re: Saturday 6th &.Sunday 7th January 2018
I have hinted/suggested ways of facillitating "choice" that overwhelmingly matters,certainly in terms of making an in hospital.experience better,that is mutually beneficial.People are different,but having someone who knows you's involvement would certainly trounce the size of a TV screen etc in priority terms,for me.
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Re: Saturday 6th &.Sunday 7th January 2018
@Howsilly it depends,obviously if I didn't/haven't got something done,it was because I was far too busy.....
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Re: Saturday 6th &.Sunday 7th January 2018
citizenJA wrote:Exactly what I meant by my post up yonder, well saidhowsillyofme1 wrote:I may be a Marxist but I find the idea of choice and competition in healthcare to be distasteful
If you allow someone to access healthcare more quickly in the NHS on the ability to pay then those who don't will have their treatment delayed
The issue is that if you introduce this type of service is that lots of people will try to get access to the care quicker by paying for it - and how then is it prioritised, or then becomes no different than if you hadn't paid
Those who will benefit will be the richest who will always be able to pay more and the ones who lose will those who are unable to pay
There is also a risk that people will try to pay for things that they cannot afford - the British, culturally, are more accepting of debt than the Europeans so I can see there being loans for health access being offered
What can seem trivial to begin with can open the door for lots of subsequent issues
Let us concentrate on making better what is actually a very well regarded systems by the academics and not looking to undermine its ethos
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Re: Saturday 6th &.Sunday 7th January 2018
I think this choice thing is disingenuous.eg.if the situation arises where you need a wheelchair,they are a variety of ways of getting one,bespoke allowances may or not be used towards the cost,maintenance etc in general mobility needs.The majority of my posts are about facillitating choice.Ironically,it is these such choices that particularly inflame,the "free car" brigade what was wrong with the green threewheeler death trap etc.
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Re: Saturday 6th &.Sunday 7th January 2018
The Government has purposefully attempted to remove "choice" on the fakery of already "given"/need attended to.
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Re: Saturday 6th &.Sunday 7th January 2018
In between undertaking my duties of supreme leader of both the known and unknown Universe,happened to spot this,obviously I haven't got time to read it in full...
https://www.theguardian.com/business/20 ... ood-forest" onclick="window.open(this.href);return false;
Ineos 'misled' public over fracking in Sherwood Forest.
https://www.theguardian.com/business/20 ... ood-forest" onclick="window.open(this.href);return false;
Ineos 'misled' public over fracking in Sherwood Forest.
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Re: Saturday 6th &.Sunday 7th January 2018
I recall Andy Burnham launching a really ambitious proposal for the future of the NHS and its integration with social care, written I suspect in the main by Debbie Abrahams.
I wonder if it's worth a dust down.
I wonder if it's worth a dust down.
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Re: Saturday 6th &.Sunday 7th January 2018
https://www.kingsfund.org.uk/blog/2015/ ... ing-vision" onclick="window.open(this.href);return false;
labours-10-year-plan-health-and-social-care-bold-and-compelling-vision
From 2015
labours-10-year-plan-health-and-social-care-bold-and-compelling-vision
From 2015
But the thinking has moved on – Andy acknowledged the influence of a number of reports in shaping the plan, notably two independent commissions led by Sir John Oldham, and the Commission on the Future of Health and Social Care in England led by Dame Kate Barker. But in several respects Labour’s plan marks a decisive break, not only from the policies of other political parties, but from Labour’s approach when in government. This is most striking in the unequivocal rejection of markets in the NHS – though not apparently the separation of commissioning and provider roles.
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Re: Saturday 6th &.Sunday 7th January 2018
Letter to Gauke from Mo Stewart.
https://blueannoyed.wordpress.com/2018/ ... o-receive/" onclick="window.open(this.href);return false;
https://blueannoyed.wordpress.com/2018/ ... o-receive/" onclick="window.open(this.href);return false;
Re: Saturday 6th &.Sunday 7th January 2018
The dangers of hydraulic fracturing are known. CH4, methane, shale gas, a fossil fuel more successful at trapping greenhouse gases in the atmosphere in smaller amounts than CO2. This is a gift to fossil fuel corporations - nothing more. It's insane allowing hydraulic fracturing in the UK. There's no need to do it. Costs of renewable energy sources fall making them the best investment.HindleA wrote:In between undertaking my duties of supreme leader of both the known and unknown Universe,happened to spot this,obviously I haven't got time to read it in full...
https://www.theguardian.com/business/20 ... ood-forest" onclick="window.open(this.href);return false;
Ineos 'misled' public over fracking in Sherwood Forest.
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Re: Saturday 6th &.Sunday 7th January 2018
https://www.theguardian.com/world/2018/ ... e-sothebys" onclick="window.open(this.href);return false;
Fragment of Nelson's flag from Battle of Trafalgar up for sale
Fragment of Nelson's flag from Battle of Trafalgar up for sale
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- Prime Minister
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Re: Saturday 6th &.Sunday 7th January 2018
Re: Saturday 6th &.Sunday 7th January 2018
Would you buy a used flag from this man?HindleA wrote:I'm hoping to getIt's expected to get £100,000
Re: Saturday 6th &.Sunday 7th January 2018
Certainly not
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- Prime Minister
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Re: Saturday 6th &.Sunday 7th January 2018
Let's not forget Arsenalhowsillyofme1 wrote:Anyone see how Leeds did today?
"IS TONTY BLAIR BEHIND THIS???!!!!111???!!!"
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- First Secretary of State
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Re: Saturday 6th &.Sunday 7th January 2018
AnatolyKasparov wrote:Let's not forget Arsenalhowsillyofme1 wrote:Anyone see how Leeds did today?
I don't think we should.....
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- Prime Minister
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Re: Saturday 6th &.Sunday 7th January 2018
Btw my response to "the NHS is illiberal" is - "even if it is, so what?"
"IS TONTY BLAIR BEHIND THIS???!!!!111???!!!"