The Coalition of Expensive Chaos

[Alty]

Because no one else wanted to clean up his mess

There is a school of thought that says if the Government gives in every time health workers decide they want a Health Secretary gone, then you'll never be able to make any worthwhile reforms.

I've tried but can't quite summon up the energy to work out the rights and wrongs of the junior doctors dispute. It looked to me like there were pros and cons in as much as doctors would have been paid better for work in normal hours, but less for overtime. And they wouldn't have been forced to do overtime. Overall many doctors would have been taking home less cash because they work lots of hours. That's fine. But what I didn't particularly like was the argument consistently used by the doctors that this was all part of a Tory plot to destroy the NHS. That made me very suspicious. Sounded like doctors peddling a myth to protect their own interests, frankly.

 

[Alty]

Good appointments by May overall, by the way. I think the Boris move is a stroke of genius in as much as (whether you agree with them or not) Fox, Davis and May herself are sane and will be doing a lot of the international work in the coming years. Johnson is being given a big title but with diminished responsibility.

 

[blade1889]

Good appointments by May overall, by the way. I think the Boris move is a stroke of genius in as much as (whether you agree with them or not) Fox, Davis and May herself are sane and will be doing a lot of the international work in the coming years. Johnson is being given a big title but with diminished responsibility.

And not only that but it reduces the likelihood of him sounding off about the government not acting on the leave voters wishes.

"We didn't decrease immigration enough"
"Well Boris...that was part of your role, didn't do it properly or was what you promised impossible?"

As opposed to the leader of the leave campaign still being able to sound off on whatever he wanted and not have any responsibility to take. Now he can't possibly sound off and not come up with the plans to resolve the issues.

Very clever move in my opinion.

 

[silkyman]

Mrs May has just shut down DECC and had its role absorbed by a wider agency for business.

Yeah. Climate Change isn't anything we need to worry about, is it?

 

[mnb089mnb]

Mrs May has just shut down DECC and had its role absorbed by a wider agency for business.

Yeah. Climate Change isn't anything we need to worry about, is it?

Looking at the news recently it seems like the world will end before climate change gets us anyway.

I guess that's the end of David Cameron's "greenest government ever".

 

[ThisTinpotLeague]

I guess that's the end of David Cameron's "greenest government ever".

I think that probably ended when he resigned.

 

[mnb089mnb]

I think that probably ended when he resigned.

Not sure it ever began.

 

[Max]

He walked into No 10 not wearing his NHS badge but left wearing it, time he stopped wearing a badge of an organization that he wants to destroy.What the hell was May thinking? If she wants a battle with junior doctors at the start of her being PM then she's a bigger fool than i thought she was.

I would suggest that the mess with the junior doctors has already been caused, and cannot be put back in its bottle.

Jeremy Hunt is actually a better health secretary than Andrew Lansley, whose reforms were toxically unpopular among the public and doctors. The Health and Social Care Act intended for doctors to take a much bigger role in management, taking power away from the health secretary and government, to encourage competition.

This had the benefit of trying to get doctors to make efficiencies and help management. This way it could be blamed on them if they made the wrong choices, and also meant that doctors might have a better idea of where to make savings. The NHS has been used to getting 4% extra per year, I believe, and it's not getting that any more, hence all the horrible missing of targets etc. Also one could argue encouraging competition has the added benefit of paving the way for privatization of the health service.

However Lansley went too far, and was replaced by Hunt. Immediately thereafter the Mid-Staffs thing came about, and Jeremy Hunt, quite rightly, decided patient safety and oversight was the biggest issue of the day, and has been banging that drum ever since. Of course, he then hopelessly politicised the issue by mis-using a bunch of stats about weekend mortality, losing the confidence of the medical profession. But as someone else has pointed out, everyone always hates the health secretary, and Jeremy Hunt is actually better with the media than other health secretaries have been. Added to this was the minor scandal that leaked when the BMA were revealed to be not actually trying to negotiate, but to make the crisis go on as long as possible.

Theresa May was very popular with the police, and ... well, most people have forgotten about that, except the police. Although the public still support the junior doctors, the largest part of that controversy has now passed. Hunt weathered the storm, and May clearly values continuity, so she's kept him. It would have only caused more problems to move him, and whoever is the health secretary, the funding gap for the NHS is going to be a massive issue in the near future. Might as well pile it onto his plate.

 

[Benji]

Mrs May has just shut down DECC and had its role absorbed by a wider agency for business.

Yeah. Climate Change isn't anything we need to worry about, is it?

I imagine they must have a long-term ecological plan.

 

[silkyman]

If they did, they wouldn't have shunted it into a generic business department.

And... Hahahahaha... A 'plan'!

This government's plan for leaving the EU apparently involved doing individual deals with Germany, France and Italy... They don't have a fucking clue.

 

[Alty]

If they did, they wouldn't have shunted it into a generic business department.

And... Hahahahaha... A 'plan'!

This government's plan for leaving the EU apparently involved doing individual deals with Germany, France and Italy... They don't have a fucking clue.

What the hell are you talking about?

 

[silkyman]

http://www.independent.co.uk/news/u...ket-trade-deals-unaware-mistake-a7136121.html

 

[Alty]

http://www.independent.co.uk/news/u...ket-trade-deals-unaware-mistake-a7136121.html

I strongly suspect the Independent journalist has misunderstood what Davis was saying. The point about EU negotiations (as someone who's been involved in one - albeit as a junior bod) is that even if you end up signing a single document, you have to negotiate with the important Member States and the Commission separately. On our JHA project we had to have regular meetings with the French and the Germans as well as the Commission.

The bloke used to be Europe Minister so I judge the likelihood of him misunderstanding to the extent the journalist implies to be virtually nil.

 

[silkyman]

That certainly isn't what is implied here.

So either he doesn't have a clue or he was, if not outright lying to people, he was deliberately misleading them on what a post Brexit trade deal could look like. How would you expect the public to interpret those?

What's your view on the allegation that we don't actually have anywhere near enough negotiators to even make a start on all this?

 

[silkyman]

And are you Guido Fawkes? Because he had exactly the same argument before He was pointed towards to the actual tweets and he gave up and went to bed.

 

[Alty]

I don't think those tweets disprove what I'm saying at all. It all comes down to whether you think by "deal" he meant bilateral trade agreement, or acquiescence to the point of being unwilling to veto (our exit deal is voted on by each Membr State, remember).

I accept that the layperson could get confused reading those tweets. But tbf the former Europe Minister probably didn't think that he'd have to explain himself to politicos writing for the Independent.

The shortage of trade negotiators is certainly true, but to claim that means Brexit is a bad idea is typical of the small-time, low confidence mentality of much of the Remain side. It also reflects the establishment view - particular common among senior civil servants - that principles aren't that important, what we should really focus on is the logisitics of the here and now, the steady management of the country and generally trying to rock as few boats as possible.

The trade negotiators we have are good and we can fill the gaps with experienced negotiators from friendly countries like Canada or Australia.

All this stuff won't be easy. Few people on the Leave side ever said it would be. But I'm cautiously optimistic about our position at the moment. We certainly got the best person available in as PM.

 

[silkyman]

So it's ok to make intentionally misleading statements on a public forum because it's up to other people to explain them in great detail and debunk them?

 

[Alty]

So it's ok to make intentionally misleading statements on a public forum because it's up to other people to explain them in great detail and debunk them?

I think this is one of those situations where you have to put yourself in his position and try to think logically. What would he have to gain by saying bilateral trade agreements with individual member states are possible? He'd be called out as a liar/idiot straight away. The Indy have sort of proved that by running the story they have, which looks to me like a misunderstanding on their part.

 

[.V.]

Cameron/May logic is that private businesses can run public services better as they are more efficient, which is why companies owned by the French, and now Chinese, governments, are paid to build our new nuclear power plants

 

[Abertawe]

Cameron/May logic is that private businesses can run public services better as they are more efficient, which is why companies owned by the French, and now Chinese, governments, are paid to build our new nuclear power plants

Well it isn't simply Cameron/May logic is it? Every PM since Thatcher has held the same logic.

 

[SUTSS]

Well it isn't simply Cameron/May logic is it? Every PM since Thatcher has held the same logic.

It has certainly taken a massive step up since the Conservatives got back in power. It's gone from having some private involvement to everything must be privatised. You know that really they don't want a public sector at all, you can't say the same about Blair or Brown.

 

[Alty]

It has certainly taken a massive step up since the Conservatives got back in power. It's gone from having some private involvement to everything must be privatised. You know that really they don't want a public sector at all, you can't say the same about Blair or Brown.

Oh come on. You know that isn't true. A handful of free market true believers aside, the Tory Party aren't wild libertarians. There's very little difference between Blair, Brown, Cameron and May on this stuff.

I fear that as the population gets older we're going to have to accept unpleasant reforms to the NHS. Even in social democratic countries like those in Scandinavia there's a role for the private sector in public health and even appointment charges to see doctors and dentists. I suspect cradle to grave fully-funded care (which I suppose isn't quite what we have anyway given dentists, opticians, prescriptions charges) is going to be a thing of the past because we just can't fund it using public money alone.

The key is going to be settling on a well-funded model that doesn't leave anybody unable to access treatment. Drifting towards an American system would be madness.

 

[AFCB_Mark]

There's an extra 20m people in this country than there were in the 60s
The demographic of that population is increasingly older
Our lifestyles have arguably grown more unhealthy over the decades
Science and technology of healthcare is progressing faster and faster and staying at the cutting edge of that (as we a 'first world' nation heavily involved in the research of would expect to remain) becomes increasingly expensive.
A lot of the NHS infrastructure and buildings are decades old, whilst significant building replacement has been undertaken, there's far more that could be done.
We seem to be rather crap in this country at taking on / completing large projects to any kind of budget or timescale target.

It all results in an insatiable black hole -esq appetite for cash.

The private sector is one method of obtaining the needed cash. The population paying more in is another method. And I think most would agree that a mixture of both is the only logical way. Obviously everyone is going to differing views over what balance between them is struck.

Personally as someone lucky enough to be comfortable-ish in living, I would be happy to pay a bit more. Perhaps in tax / NI. Perhaps more in some kind of means tested payment at the point of treatment. That will upset some given the NHS's founding principle of being free at the point of use, but in reality as Alty points out above there are many areas in which this simply isn't the case and hasn't been for some time.

Perhaps whilst I'm younger and earning whilst (hopefully) not needing too much care, I could pay into a pot of money that I can then draw on to pay for the likely more frequent care that I'll need later in life, or when my circumstances change, - but I appreciate that's bordering on a health insurance policy and we know the pitfalls of those from America. I find the American system somewhat nefarious, where you have a few giant health insurance companies getting chummy with a few massive pharmaceutical companies producing the drugs, creating a kind of money racket. And they don't even try to hide it over there.

There is no easy answer to this, but be that as it may it's a huge issue we do and will need to tackle now and in the future. Successive governments both Labour and Tory have fiddled around the edges for decades, tweaks to organisation structure here, splits and mergers there. But in reality it does little to address the systemic fundamental issues. New contracts for Doctors is again just fiddling around the edges.

Billions extra gets pledged every few years yet it's never enough to quench the thirst. The current funding model doesn't really cope well enough now and certainly won't cope in decades to come when we all live to be 100 odd. We're going to have to get creative and think differently about how we fund our healthcare. It can't be a sacred cow that we're afraid to touch. Otherwise it'll fall in on itself with burnt out staff and crumbling infrastructure - and that'll do none of us any good.

 

[Pilgrim Meister]

Only way round it without privatising it completely, would be to bring in a New Health Tax. It won't replace National Insurance, but the rate of NI would reduce (still needed for JSA and Benefits etc). It would also knock a few % off Income tax and in some cases, duty on alcohol and tobacco products would be slashed, with this taken into account on the amount of health tax

Example:
Amount of Health tax paid would be determined by an assessment of your health records via a points system to determine what percentage of your earnings would go towards this tax. So if you are fit as a fiddle, it would be a low percentage, however, if your health needs are high, then a higher percentage of tax would be slapped onto you, but that % would also be capped. Those that are out of work would of course pay nothing.

Of course, there should be a base % for migrants with no medical records.

Ok, you can mess around with who pays what to suit your political agenda, but the idea to have a separate health tax would ensure that NHS funds are ring fenced and pressure is not put on the Treasury to make cuts to other services in order to make up the shortfall. Yes it would be more tax, but the only other option is an insurance based system and privatising it all. Getting rid of the NHS altogether would be political suicide. The way the NHS is funded now is not sustainable.

If the Labour party don't whip themselves into shape, it could guarantee decades of Tory rule, and if the Tories get a big enough majority in 2020, expect to see the NHS vanish on a new mandate if there is no credible opposition.

 

[silkyman]

Example:
Amount of Health tax paid would be determined by an assessment of your health records via a points system to determine what percentage of your earnings would go towards this tax. So if you are fit as a fiddle, it would be a low percentage, however, if your health needs are high, then a higher percentage of tax would be slapped onto you, but that % would also be capped. Those that are out of work would of course pay nothing.

'Hello NHS... I think I've got cancer...'

'Ah. Sucks to be you. Let's 'ave a look...

<sucks teeth>

That's gonna cost ya...'

'But I'm going to need time off work to recover and I can't really afford to pay more tax...'

'Well.. The good news is that if you lose your job, we'll fix you up for nothing'

'But then I'll lose my house when I can't pay my mortgage'

'That or a slow death from cancer mate. Your call.'

 

[silkyman]

Personally as someone lucky enough to be comfortable-ish in living, I would be happy to pay a bit more. Perhaps in tax / NI. Perhaps more in some kind of means tested payment at the point of treatment. That will upset some given the NHS's founding principle of being free at the point of use, but in reality as Alty points out above there are many areas in which this simply isn't the case and hasn't been for some time.

Perhaps whilst I'm younger and earning whilst (hopefully) not needing too much care, I could pay into a pot of money that I can then draw on to pay for the likely more frequent care that I'll need later in life, or when my circumstances change, - but I appreciate that's bordering on a health insurance policy and we know the pitfalls of those from America. I find the American system somewhat nefarious, where you have a few giant health insurance companies getting chummy with a few massive pharmaceutical companies producing the drugs, creating a kind of money racket. And they don't even try to hide it over there.

There should, in my opinion, never be a financial element to whether someone choses to go and see the doctor. Even people with a decent income can feel the pinch a bit towards the end of the month. 'I've got a pain in my chest and my left arm is tingling... Should I go and see the doctor?' 'Hang on.... Let me just check the Nat West app'

But even without that consideration, there's no way that could be introduced as there's no party who would allow it. There's be thousands of rich arseholes demanding faster service because they are the ones 'paying for it', or bemoaning that the poor people are getting the same service for less/free, and you can't argue that as a general rule the 'I'm alright, fuck everyone else' brigade form a reasonably large portion of Tory support. And Labour/Lib Dem simply wouldn't even go anywhere near anything like that. UKP might, but see also the 'Selfish bastard' element.

 

[Techno Natch]

Only way round it without privatising it completely, would be to bring in a New Health Tax. It won't replace National Insurance, but the rate of NI would reduce (still needed for JSA and Benefits etc). It would also knock a few % off Income tax and in some cases, duty on alcohol and tobacco products would be slashed, with this taken into account on the amount of health tax

Example:
Amount of Health tax paid would be determined by an assessment of your health records via a points system to determine what percentage of your earnings would go towards this tax. So if you are fit as a fiddle, it would be a low percentage, however, if your health needs are high, then a higher percentage of tax would be slapped onto you, but that % would also be capped. Those that are out of work would of course pay nothing.

Of course, there should be a base % for migrants with no medical records.

Ok, you can mess around with who pays what to suit your political agenda, but the idea to have a separate health tax would ensure that NHS funds are ring fenced and pressure is not put on the Treasury to make cuts to other services in order to make up the shortfall. Yes it would be more tax, but the only other option is an insurance based system and privatising it all. Getting rid of the NHS altogether would be political suicide. The way the NHS is funded now is not sustainable.

If the Labour party don't whip themselves into shape, it could guarantee decades of Tory rule, and if the Tories get a big enough majority in 2020, expect to see the NHS vanish on a new mandate if there is no credible opposition.

Not sure that can work as your basically punishing people for being ill. I assume you'd have to exempt people who have conditions such as CF and what about people who suffered poor mental health? Should they then be penalised for returning to work?

 

[Pilgrim Meister]

Not sure that can work as your basically punishing people for being ill. I assume you'd have to exempt people who have conditions such as CF and what about people who suffered poor mental health? Should they then be penalised for returning to work?

Maybe it wouldn't work quite like that. Maybe just a % of earnings then, same way NI and income tax is charged, but as a separate tax, regardless of condition, with duty from tobacco and alcohol also going into the health budget (as of now). There is talk of smokers etc being refused treatment on the NHS, that's where I thought of that idea. The issue with a tax system based on earnings alone, those who work hard to keep themselves fit and healthy are paying the same % of tax as a person who is obese and smokes 40 fags a day. Robbing Peter to Pay Paul comes to mind.

Anyway current system no longer works, and a separate tax would be the way forward, so that funding is ring fenced, and tax payers can see exactly what they are paying into the system.

Which ever way you change it, it won't be popular, as taxes will have to rise to pay for it. If anyone has any better ideas without raising taxes and effecting the service the NHS provides, then I am all ears

 

[silkyman]

That £350m extra a week will certainly help, mind...

 

[Pilgrim Meister]

That £350m extra a week will certainly help, mind...

Anyone with a brain will realise any money saved from EU membership will be used to offset WTO tariff costs, in a bid to avoid large co-operations upping sticks and heading across the channel