NHS Reform

Why should the NHS be improved? Well nothing is perfect and some feel that competition improves business. It may be the case that competition within the NHS can be healthy (no pun intended) but competition brings its own layer of bureaucracy and inefficiency. There may also be improvements to be made with accountability in the NHS . I am old enough to remember community health councils and at that time I had access to local politicians who were part of the decision making process. I have not had that ability for many years so some parts of the latest bill may be good.

The Labour Party seems to have forgotten that they were pro-choice in the NHS and wanted private companies to tender for NHS work. Now they seem to be against it. Obviously they feel that the latest bill is a step too far but I just haven't heard any detail because Labour is too busy scoring points about David Cameron's "no top down reorganisation of the NHS".

Labour don't mind privatising parts of the NHS and this may be a vote winner for them but it is almost certainly a vote winner for the Tories. Both of these parties will tell us that the NHS is free at the point of access and safe in their hands but is it right that private companies can hive off one small section and work it for a profit? So if there are amendments that limit the break up of the NHS workforce I think it is fair to say that they come from the Liberal Democrats. The problem is that this message is not clear. We can only assume that Liberal Democrats are making these amendments because ministers bear collective responsibility and they can’t tell us which bits they don’t like.

It is nice to hear politicians from all parties telling us that the NHS is safe. The trouble is that NHS morale is low and the service cannot be as safe as it was on these grounds alone. Whether the details of the bill are good or not sounds like the basis for a thesis but headlines are made by the general acceptance or rejection by the professional bodies and they are rejecting it.

David Cameron is certainly wrong about the importance of choice within the NHS. He is right about choice if this means that those who can afford it get private treatment but those who seek care within the NHS don't want choice. They want a good local service. They don’t care if the ambulance is private or public. They don’t want to choose between a doctor in the local hospital or one who does a similar job twenty miles away.

You may not be able to tell where Liberal Democrats are able to amend the bill but they were doing the same job in opposition when Labour were busy doing their bit setting up private organisations e.g. the privatisation of the out of hours service for GPs which has been a disaster. The current bill is significantly different from that which was originally proposed, and which would have been a Conservative disaster if the Conservatives had been able to do just whatever they wanted.

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23 Years of Frustration

I recently signed an e-petition to accelerate the Liberal Democrat proposals to raise the tax-free threshold to £10,000. Not only do I believe in tax cuts for those who are less well off, but I also appreciate that I can participate in this e-petition and affect governmental procedures. You can add your name at http://epetitions.direct.gov.uk/petitions/28640

Another e-petition was set up by Anne Williams whose son died at Hillsborough. I would certainly have added my name if I had heard about it, as according to the people around him Kevin died at around 4pm and according to the authorities he died before 3.15pm. Time matters, as does cause of death, because something could have been done to save Kevin's life.

All Hillsborough deaths were recorded as accidental and all deaths occurred before 3.15pm, but why would the authorities get things so wrong on something that mattered so much? The answer is easy. They were covering their backs. They did not want to be held responsible for fatal errors.

The MP for Liverpool Walton, Steve Rotheram reckons that this cover-up was "literally their get out of jail free card". Evidence is mounting. Today I saw an interview with one of those who carried Kevin's stretcher and I also saw an interview with the policewoman who was with him when he died. I believe them when they tell me he died around 4pm.

We all know that huge errors were made and those who made the decisions will have to live with that responsibility for the rest of their lives. However, to me it is much more serious to organise a conspiracy which leads to three requests for inquests being turned down and to 23 years of frustration.

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Bring on a smoking ban

This morning I saw someone in a car with a cigarette hanging from their mouth. I thought this was quite a skill in itself even if the cigarette were not lit. Then I thought of the calls from the BMA a few months ago to ban cigarette smoking in cars. At that time I thought this was a step too far as it doesn't affect the health of others and would be hard to police. I was of the opinion (and still am) that those who smoke while the car is stationary are doing no harm to others but this morning's sight made me think again.

I have never smoked so give me a cigarette and the skill of letting it hang from my mouth would be quite eventful. Multiply that by a hundred if you asked me to light it. Then ask me to drive and the risks increase again. I would have to put the ash somewhere and each time I concentrate on the cigarette I am not thinking about driving.

As for the difficulty policing, it is just as difficult to monitor the use of a mobile phone as it is smoking. There is also no difference between the two if the car is not moving. It is easy to pull over to make a call or to smoke. It is not so easy to have a 'hands-free' cigarette.

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Opposition to NHS reforms

There are many who see the NHS as a shining example for the rest of the world. It is free at the point of access, a phrase that tells you that nothing is free but at least the recipient doesn't pay. However many decisions seem to be based on finance rather than patient care. My grandmother told me how the local community collected money to build a local hospital. Shortly after the hospital opened it was taken over by the NHS and years later it was closed because it wasn't efficient (she didn't get her money back).

Hospitals need to be large to be efficient. Similarly G.P. surgeries have to be larger and share facilities with other surgeries. On-call is apparently cheaper if it is run by another organisation. Services are open to tender because this is apparently more efficient. Private companies come in to take over shortfalls in waiting lists, so surgeons may be brought in from the other side of the world. At another level ancillary services may go to private companies.

Patients want a local service in which they see doctors and nurses that they know. They don't want to explain their symptoms every time they meet another member of staff. They want continuity of care. They want NHS staff to listen to them.

Last week the local A&E only wanted people to turn up if it was absolutely necessary. The bad weather had caused more car accidents and more people to fall. I say local A&E, but there used to be one a lot closer. Another A&E within this area closed too and the one that remained didn't want anyone (my definition of absolute may be different from theirs).

I get the impression that opposition to NHS reforms is based on GPs having more administrative tasks. The opposition is nothing to do with getting a local service from someone who knows you and someone who will listen.

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England need a responsible manager

Two days ago I wrote that Fabio Capello's authority had been undermined by the FA. It looked like the authority for naming the England captain rested with the FA and not the manager. As well as a lack of responsibility Fabio could not speak his mind. Now he has resigned but it sounds to me like constructive dismissal.

Maybe I am wrong and Fabio took the job with his eyes open. Maybe Fabio knew he couldn't name the captain or speak his mind. Let's hope the next manager is able to say what he thinks and manage the whole team.

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P.S. I just posted the blog and this quote came on TV from Fabio's son: "For the time being we are not going to say anything because that is the agreement we have with the FA". It wasn't constructive dismissal then. It was a compromise agreement.

P.P.S. The main article on the news is Fabio's 'resignation'. It seems that he told the Italian press that the FA insulted him and damaged his authority. Now Fabio and his son claim this quote is not true. That's just what would happen with a compromise agreement. I wonder how much this mistake cost the FA!

Winter Fuel Benefits

Ann Widdecombe does not support the Winter fuel allowance and from what I heard on The Daily Politics today her main argument is that the allowance goes to any household in which there is a pensioner irrespective of the amount of money going in. This is a principled position but one which could be opposed on principle. Some may say that means testing is complex and adds to the cost of the benefit and if it is not universal then the benefit may not get to those who need it due to the complexity of the process.

Ann is looking for the Government to change to a system in which pensioners have to ask for the benefit or only give it to pensioners earning less than £40,000 or £50,000. The problem with the former is that pride comes into play as well as other aspects which make the system unfair. The problem with the latter is that safety nets cause poverty traps.

My impression is that those with earnings of £40.000 are not going to die from the cold but I could be wrong. There may be many who fall into Mr Micawber's misery category. "Annual income twenty pounds, annual expenditure nineteen six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery".

Pensioners do die of cold and Ann tells us that inadequate heating contributes to the death of thousands. She doesn't like the idea of millionaires getting the government handouts and neither do I. There may be some millionaires who are miserable according to Mr Micawber but they won't get much sympathy.

There are clearly arguments on all sides of this particular benefit debate. Ann may well be right in supporting a cap on winter heating benefits however I can see more arguments against the cap on all benefits and this is a debate which sounds like it could save the government a lot more money.

Is Fabio gagged or impotent?

Fabio Capello has defended the former England captain John Terry because the FA stripped him of the captaincy pending the outcome of his trial for racial abuse of QPR's Anton Ferdinand. There were two aspects that took my notice and neither concerned John Terry. Firstly I don't mind if a manager defends his captain as this may be the usual course of action. However, David Davies, the former FA executive director feels that he has breached his contract and the FA are taking the matter seriously. This led me to the main reason for writing the blog.

If Fabio has been involved with the FA decision to take the captaincy off John Terry then he must have been outvoted. In this case the manager must not have responsibility for naming the captain and that begs the question how much responsibility does he have? I would guess not much. The other scenario is that he was not party to the decision. In this case he is being criticised for expressing his view. If David Davies is right and Fabio can't do this then we have a gagging clause on the England manager.

The news is about John Terry but for me it says we have an England manager who either can't speak his mind or lacks responsibility.

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Job losses on the Heysham peninsula

I was going to write a blog about The Big Questions, the Sunday morning television programme with Nicky Campbell as there are always points of contention - my main inspiration for blogs. However I was sent an email about the possibility of losing the ferry services from Heysham and this has taken priority. You can see the article yourself, not on a website related to Lancashire, but one that is concerned with the city where the business looks set to go - Liverpool. The article is here http://www.bbc.co.uk/news/uk-england-merseyside-16885732

If I were in the ferry business it would make sense for me to place my business where it could be accessed by many. I have campaigned for a link road for years, along with the Liberal Democrats who were the lone voice for its support, and they took losses in the council chamber for the sake of supporting the link road. What a pity all those voters who work at Heysham docks did not see this coming as they may have voted to save their jobs.

I don't want to claim the whole support for the link road comes from the Liberal Democrats as there are other elected officials who now support the link road but a vociferous opposition has meant delay upon delay which now looks like causing a further loss of jobs for the Heysham peninsula.

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Not doing something for nobody

I know I have written on the subject of traffic lights as recently as the 19th November 2011 and concluded that we could manage without them. Last night I was driving home around 7.30pm in Lancaster and I was keeping near to the speed limit as there were not that many cars on the road. However I was stopped by a Pelican crossing and nobody was there to cross. I don't blame the pedestrians for crossing or walking away, as long as it was safe to do so, but it did meant that I stopped for nothing.

Zebra crossings are much friendlier crossings. Drivers aren't forced to stop but generally do and it is also much quicker for pedestrians who don't get fed up waiting for the lights to change.

I don't normally use sentences with double negatives but as well as Zebra crossings being friendlier you will never have to stop for nobody at them.

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