2011 April » Tax Research UK

Why the NHS reforms really are the end of the National health service

Apr 212011

One of the most pernicious aspect of the Tories’ NHS reforms is one of the least known.

At present we have a National Health Service because the Department for Health (and it’s Welsh, Scottish and Northern Ireland equivalents) all have a statutory duty to ensure that there is a health care service for all in this country free at the point of supply.

That will not be the case after Cameron’s reforms go through. The Department for Health will ot have such obligation in England, at all.

GP consortia will have a legal obligation to provide services to those registered with them. But note, you have to be registered t enjoy the service. It will not be a right: it will only be a right if you are registered.

And there will not be an obligation on consortia to provide universal health care free at the point of delivery, quite extraordinarily. If a consortia decides it cannot supply a service because it is too costly or it has run out of budget then it will be able to decline to do so. GP consortia will not be an NHS: they’ll be a selective healthcare service because they’ll have a statutory duty to supply a service for which there will be increasing demand at ever reducing cost and that will necessarily mean they’ll ration – which will impose impossible conflicts of interest on GPs.

And what for those who do not or cannot register with a GP consortia or who need the services their GP consortia cannot or will not supply? For them their health care supplier will be their local authority. Yes, it is local authorities that will have the duty to supply universal health care after the reforms come into effect.

Of course, local authorities have no mechanism to make those health care supplies. And nor are they being given any budget to deliver them. But you can already hear Cameron saying it’s not his fault that they won’t be able to deliver – it’s their legal responsibility and if they fail it won’t have anything to do with him.

Except of course it will. He, Lansley and Clegg are responsible for this reform. The reform will end the right to universal healthcare. And it signals the end of national healthcare – and brings in an era of supposedly local healthcare when there is no mechanism to supply it.

That’s not chance: that’s further evidence of designed in failure in the scheme the ConDems are proposing. And there’s only one reason for that designed in failure: it is complete contempt for democratically controlled supply of services for the benefit of all the people of this country when what Cameron and his friends wan is the opportunity to capture control of those services so they can rake billions off them to enhance their personal wealth.

We don’t have long to stop this deliberate act of destruction. And if the Lib Dems toe the party line we have no hope of doing so.

Will dogma destroy the NHS? I hope not – bit only vociferous action can prevent it. That I do know.

Looking for Plan B: What Next for Island Hosts of Offshore Finance

Secrecy jurisdictions, Tax Havens, Tax justice, Tax Justice Network 1 Response »

Apr 202011

The latest edition of The Round Table (theCommonwealth Journal of International Affairs) has a focus on small states and includes a paper by Dr Mark Hampton (University of Kent) and TJN’s John Christensen. Mark and John have been working together on their research into tax havens for many years and their latest paper explores the development options for small island tax havens in the light of sustained international initiatives against offshore secrecy.

Titled “Looking for Plan B: What Next for Island Hosts of Offshore Finance” the paper uses path dependency theory to explore the extent to which small island economies – Jersey is used as a case study – are able to shape their destinies in face of extensive state capture and limited development options. Although we cannot make the full paper available online, here is the abstract, and the entire paper is available for download here.

As the synopsis says:

This paper examines offshore finance centres and tax havens that are hosted by small island economies (SIEs). In many cases, hosting offshore finance has been a lucrative activity for SIEs since the 1960s in terms of employment (direct and indirect) and overall contribution to GDP and government revenues. Despite the scale and reach of the global offshore economy, at present many SIE hosts face an unsettled future in light of significant international pressure from nation states, international organisations such as the EU and OECD and, increasingly, from civil society in both the developed and less-developed world. Given the economic importance of hosting offshore finance for many SIEs around the world, the development options facing many island jurisdictions are discussed. The paper poses the fundamental question: what has changed since the major initiatives around the year 2000? Then the situation facing many SIE hosts, the changing global political economy and their shifting negotiations and alliances within it are discussed.

Reposted from Tax Justice Network with permission

HSBC: your offshore bank

Banking, Secrecy jurisdictions, Tax avoidance, Tax Havens 5 Responses »

Apr 192011

I wonder if they list some of the most common uses?

And will the Rev Lord Stephen Green be telling the government how to stop them?

Discussing Plan B

Economics Comments Off

Apr 182011

George Irvin introduces some of the issues involved in developing a Plan B for the economy here.

I’m involved in the debate.

GPs getting into the lifeboat

NHS 1 Response »

Apr 182011

I read a great comment from one of the leading GPs in the country at the weekend, reacting angrily to the ConDems claim that 90% of GPs were showing support for commissioning by joining GP Commissioning pilot consortia.

As he put it “Getting in the lifeboat doesn’t mean you approve the sinking of the ship.”

Neatly put.

And apart from all but a very few diehard market enthusiasts in GP’s ranks, whose very enthusiasm proves they do not understand in their naivete the issues they are addressing, he is typical of 89% of the 90% who may now be involved in this process. They’re reluctant, but coerced. Don’t mistake it for commitment.

Only a fool would.

That fool is Cameron.

A week on it’s very clear Vickers got it wrong

Banking 2 Responses »

Apr 182011

I tweeted yesterday that it was good to see William Keegan and Will Hutton in the Observer saying the Vickers report has got it wrong on banking.

It was good to see Larry Elliott saying the same thing today – and his arguments are easily the best of the three for saying so.

As he argues, strength is in diversity, as real sciences recognise but economics does not.

Vickers seeks to maintain homogeneity in banking: keeping in place a few over-large banks. These will remain too large to fail. They will still fail to innovate – which is why they are hopeless suppliers to the UK’s small business sector who they so obviously do not understand.

Worse, they will remain dependent upon government guarantees to underpin their risk. And as is already obvious, the so called ‘ring fences’ to protect the retail component of these banks will be completely permeable making them a charade that will be worse than useless. Not least because, quite rationally, if the investment banking arm of such an entity is failing there will, inevitably, be a run on the retail part whether a ring fence is in place or not.

Only by separating Britain’s banks, not just by breaking up those we already have to ensure investment and retail banking can never be mixed again, but by re-mutualising Northern Rock, by ensuring RBS becomes a bank for sustainability, by creating a Post Bank that delivers basic banking services for all, and which provides loan repayment mechanisms linked to direct deductions for benefit payments to replace the Social Fund and consign doorstep lenders to history for good, plus real support for credit unions and real building societies, will we create the diversity the UK’s banking sector needs to sustain ur well being into the future.

Vickers is not yet a lost opportunity.

It could be.

It is a consultation: please write and tell it what you want. And don’t rely on someone else. They might not deliver for you. But you can.

Search the Independent Commission on Banking to find comment details.

(Sorry – no links – short of time – but easy to find on Guardian web site).

A day in the forest

Conservatives 1 Response »

Apr 182011

It’s school holidays.

And it was, for at least some of the day, spent with my sons in the forest – Forestry Commission forest.

The forest Cameron wanted to sell.

To deny ordinary people access to the most extraordinary countryside.

As he now wants to privatise health.

To deny ordinary people access to the most extraordinary healthcare.

We beat him on forests.

We need to beat him on the NHS.

And if, very soon, that means protests to show health professionals they have the support of ordinary people in opposing the destruction of our health service, so be it.

They do have that support.

They need to be empowered to ‘just say no’.

If you believe in equality please comment

Uncategorized 4 Responses »

Apr 182011

The government is undertaking an absurd exercise called the Red Tape Challenge.

It is biased against all regulation because, of course, they think that impedes ‘competition’ when it actually seeks to create a level playing field.

One of the consultations is on equality regulation. They say:

Equality regulations are designed to help ensure fairness in the workplace and in wider society. They include regulations and laws on discrimination and harassment.

You can find the Equality Act 2010 here

Tell us what you think should happen to this Act and why, being specific where possible:

Should they be scrapped altogether?
Can they be merged with existing regulations?
Can we simplify them – or reduce the bureaucracy associated with them?
Have you got any ideas to make these regulations better?
Do you think they should be left as they are?

Note the inherent bias in the questioning and their ordering.

If you believe in equality.

If you believe that regulation promotes equality.

If you believe regulation protects those who suffer from discrimination.

Please say so. Leave a comment on the government web site.

Redefining flexibility

Economics 4 Responses »

Apr 182011

I thought an article on the Real World Economic review blog by Merijn Knibbe fascinating, He began saying:

Unemployment in Norway is 3%. Unemployment in Spain is 20%. This difference is remarkable, even exotic. Why did the Norwegian labor market do so much better than the Spanish one?

His answer (in a nutshell):

The answer is: flexibility. But in this case ‘another kind of flexibility’. Generally, economists tend to equate ‘flexible labor markets’ with USA style ‘easy fire and (so they hope) easy hire’ policies which are supposed (despite the dismal post 1999 job creation record of the USA) to increase the number of jobs. But in the Norwegian case, not the number of jobs, but the number of hours has been flexible.

One of the hallmarks of the GFC has been that in some countries declining demand led to an increase of firing and a decrease of hiring, with rising unemployment as a result. Spain is an extreme example (see graph below). In some other countries, the problem was solved by decreasing the average number of hours worked. Norway is an extreme example. But in Germany the average number of hours also decreased so much that the number of people at work actually increased!

I’m not saying this solves all problems: it doesn’t. But it’s miles better than 20% unemployment.