I'm meant not to be blogging and to be concentrating on a few days off, but since stopping thinking is like stopping breathing, I noticed a truly excellent blog by Simon Wren-Lewis yesterday that compared Oxfam's supposed failings with those of the government over the NHS.
Simon posted this chart:
Simon's argument is:
Contrast the behaviour of politicians and the media in relation to what is currently happening in the NHS. Quite simply people are dying because there are insufficient resources to cope with needs. Thousands have had operations postponed, leaving them in pain. Patients are lying in trolleys because there are not enough beds. Huge numbers, more than ever before, are having to wait for more than four hours in A&E.
The reason for all this is not mysterious. Health has been starved of resources by this and the previous coalition government like never before.
To which he adds:
This [chart] shows neglect on a scale that make the leadership of Oxfam's misdeeds look trivial. Yet where is the media scandal? The man who has been in charge of the NHS while this has happened and is happening in front of our noses is still in his job. The government continues to fail to provide the resources the NHS needs, while promising to protect the NHS, and yet it has not been held to account for killing people and leaving them in pain by the same media that has been happy to pursue the leadership of Oxfam. The Minister for International Development told the leaders of Oxfam that “an organisation's moral leadership comes from individuals taking responsibility for their actions”. Quite.
The rest is well worth reading, but I note this to theorise it in a way Simon doesn't.
Simon is, I think, making a suggestion that both Oxfam and the management of NHS resources represent cases of negligence. But there is a difference.
Oxfam did not intend to be neglectful. And they certainly never condoned the actions of their staff. They have accepted responsibility. Long before publicity arose they were taking steps to improve matters.
Jeremy Hunt on the other hand has intended to deprive the NHS of resources. That is what the deliberately chosen and economically unnecessary policy of austerity means. He knew pain and suffering would be the consequence. He also knew it was within the government's power to alleviate this situation, he has not argued that they should do so. He has sought to blame everyone but himself. He is still health secretary. And the neglect, pain and unnecessary deaths are continuing.
The difference in the situations is to be found in the legal concept of mens rea. This can be explained as:
The intention or knowledge of wrongdoing that constitutes part of a crime, as opposed to the action or conduct of the accused.
Has a crime been committed? If crime is an affront to the accepted standards of society then, yes, that can be argued in both cases.
But to be found guilty of most crime mens rea has to be established; that is the intent to commit the act. This provides a simple but effective indicator of culpability here.
Did Oxfam have any intention to undertake wrongdoing? Clearly not. So they are not guilty of the crime. There worst misdemeanour is not being as candid as they might. They suffered an excess of embarrassment that certainly clouded their judgement. That was an error, no doubt. But a crime? I still don't remotely think so.
In contrast, did, and does, Jeremy Hunt knowingly cause harm by his actions? The answer is unambiguously yes in my opinion. This is because there is amply evidence to suggest that alternatives are available; that he knows of them and does nothing to act on them. He is, then, guilty of causing pain and loss of life when both could be avoided. It is not just his judgement that has erred; his actions have been informed by that judgement despite knowing what would happen.
Sometimes a little theorising helps.
In this case it also makes clear who should not be standing in judgement.
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The graph shows health spending at the same levels as 2007 i.e. after 10 years of large increases under the previous Labour government. This does not constitute starvation of resources.
The comparison with France is misleading as it has a much greater degree of private sector health provision. I think French state spending on health is similar to NHS levels, the difference in the total numbers is the much larger private sector.
So the UK population enjoys less spent on healthcare
Is there a problem in saying that?
You know , Sam,
In this forum those sort of assertions often come with links attached or some sort of evidence – like this:
https://theconversation.com/how-healthy-is-the-french-health-system-83329
or this:
https://data.worldbank.org/indicator/SH.XPD.PUBL.ZS
both of which took me 2 minutes to find on Google and allow me to say in all fairness that this assertion:
“I think French state spending on health is similar to NHS levels”
is utter bollocks and that you picked the wrong place to make it.
One might add that the usual measure quoted is as a %age of GDP. That does not account for population. The UK has poor productivity – ie GDP per head. Over 20% less than France. and worse than most other developed nations. That makes our health expenditure per head even worse.
Are you suggesting that there might be a legal case to be made against Jeremy Hunt, for deliberately causing suffering through his handling of the NHS? And against the government as a whole for deliberately perpetrating suffering through austerity?
It’s an interesting idea
Yes they should all be hung, drawn and quartered. And that is just for starters.
So, what you’re saying is: the UK doesn’t spend enough on healthcare as a percentage of GDP, so we should adopt the US system which spends approximately two and a half times as much as France does as a percentage of GDP on health?
Why don’t you do some charts yourself… just adding the US on that chart above shifts the argument entirely.
Oxfam and the failings of charities in general have nothing to do with spending on health as a percentage of GDP.
I note your email address
I’d assume some ability to think
It appears to be wholly lacking based on the comment made
Can you follow an argument? If not I’d suggest a little more rigour is required in your studies
Thank you for some really clear thinking at last.
If the tax-dodging billionaires who own the media weren’t promoting stories about Oxfam, they’d find something else to act as distraction. It’s the distraction bit that counts, not what’s being used for it this week or next week. If the media’s full of something then it’s wise these days to give extra thought to what it might be empty of, in terms of political convenience. Good grief, as if media owners could care less about Oxfam and the poor…
I’m feeling rather down today.
Your points (and Simon’s) are relevant. Truly.
But out here, people are still more interested in Coronation Street, Game of Thrones or Hollyoaks.
Our society seems to be nothing more than the Devil’s playground for the unscrupulous, unaccountable and hypocrites these days.
I’d like to think that all this tells us that change is in the air but it is taking along time.
As a % of GDP those last 6 data points are the highest 6 data points there have ever been.
Are you sure the NHS is suffering spending restraint here compared to the past, and it’s not just a misallocation of resources coupled with the union restricting the number of UK-trained doctors coming through?
As things stand it looks like you and Simon Wrong Lewis have chosen a baseline of 2009 for political reasons and are saying that anything less is truly dreadful.
There is no union restricting access
That rather undermines all else you say
And reveals it to be nonsense
When you say Jeremy Hunt has committed a crime, do you mean that literally, i.e. he should be arrested and prosecuted?
You know that is not possible
It does not stop him being responsible for the consequences of his actions
You have to be a bit careful how you read this graph. You might think that funding shot up in 2009 and has been eroded since when actually what happened was that GDP plummeted in 2008/9 while health spend stayed about the same so the ratio health spend as a percentage of GDP went up. Spend as a percent of GDP was higher in 2014 than 2008 so this is not a great graph to make the point that we need to spend more – Jeremy Hunt will tell you that we are.
The point is really that the number needs to be closer to 10% of GDP rather than 7.
This site has some good comparisons between countries.
https://visual.ons.gov.uk/how-does-uk-healthcare-spending-compare-internationally/
The declining figures are planned though….
I really dont know why you keep on bringing this up using the means of “relative defence”…to take it to an extreme i could argue Robert Mugabe didn’t commit as may atrocities as Joseph Stalin but so what does that make him in anyway a better person? No it doesnt.
“Oxfam did not intend to be neglectful” – well neither did SocGen but they gave Jerome Kerviel the platform to lose 5bn euros of the banks assets
“There worst misdemeanour is not being as candid as they might.”..in other words they covered it up, that in itself is a deplorable act given the crimes involved.
It really looks like you are continuously trying to deflect the criticism by offering an astonishing amount of “protective” analysis. Please stop defending the indefensible and making it into a neo liberal plot by a right wing newspaper. There has been universal condemnation from all sides of the media and from people in all walks of life.
With respect, there ha not been universal condemnation
Which is precisely the point I was making
As was Simon Wren-Lewis
7.5% !!
7.5% in 2014 and falling. So now its less than 7.5%. Well, that puts things in perspective.
All the crap that’s is said about the aging population and the rising cost of advanced medical technology and this and that and anyone would think that the viability of the NHS is the biggest concern going and proportionately huge and it is a piddling 7.5% or less
Sure 7.5% is kind of big but nowhere near the existentially giant problem that we are led to believe this is.
How embarrassing (nationally). No excuse could be acceptable. So now all Corbyn has to do, if he gets in, is raise proportionate health expenditure to French levels in a reasonably efficient way and he stay in Number 10 for as long as he likes.
BTW I know that Hunt is abominable but the Chancellor and the Cabinet set the expenditure level. Hunt merely administrates it (albeit badly). So we should probably be putting the entire Tory party in the frame for this one.
Of course even if expenditure is static, as more and more NHS services are contracted out then you get fewer and fewer resources actually to do the same job because they are going on writing contracts and receiving bids and then the contractor will want some profit.
People complain there is too much admin in the NHS – which is a self fulfilling prophesy if you’re contracting out more and more. If money is ‘short’ then that’s the last thing you should be doing.
Otherwise known as Hunt’s gross mismanagement.
Hi Richard,
apologies for posting this here but I don’t know how to contact you.
The extract blow is from the EU’s Brexit Negotiation Page. I might not be understanding this correctly but it seems to be saying during transition we will not be able to produce the money we need to run the country as we wish without the agreement of the EU. Please forgive me if I’m wrong and for wasting your time but I thought it might be of interest.
2. For the purposes of the Treaties, during the transition period, the parliament of the United
Kingdom shall not be considered to be a national parliament.
3. For the purposes of Articles 282 and 283 TFEU and of Protocol (No 4) on the Statute of the
European system of central banks and of the European Central Bank, during the transition
period, the Bank of England shall not be considered to be a national central bank.
https://ec.europa.eu/commission/sites/beta-political/files/transition.pdf
I think you may be misreading this
The clause is designed to deny the U.K. representation rights.
Those clauses deny representation rights to the U.K. parliament and BoE so that they cannot partake in decision making.
Thank you. I do hope I’m misreading this.
My concern is simply that the UK might be leaving home but under the Conservatives it’s not leaving the neo-liberal family. I suspect any final agreement will allow the continuation of the project and to stop, as much as is possible, a Labour government that might want to renationalise public resources or move quickly towards MMT.
Maybe….
Also worth highlighting that the standard comparisons are based on %age of GDP which does not take into account population and hence expenditure per person. As the UK’s productivity, GDP per head, is as I understand it more than 20% worse than France’s (and worse than most other developed countries) that makes our health expenditure per head 20% worse – in this case about another 1.5% off the GDP comparison.
Given that this is a significant amount, Im always surprised that this is not highlighted more often. Unless Im wrong….
Good point
I could of course have used gdp per head data….
“And they certainly never condoned the actions of their staff.”
I’d say sacking someone for involvement with a prostitute then rehiring him comes close.
Allowing someone to serve out a notice period when there were grounds for an immediate sacking on the grounds of gross- misconduct comes close.
Not telling the charities commission the full facts.
I wonder how many lives could have been saved if money spent on puff reports and vanity projects had been spent on the poor instead? You might have thought those dedicated to relieving the plight of the poor would have worked for no more than the living wage. Or even for nothing if they were getting that from other sources. Alas no.
But then what you’ve just said is not actually factual
It’s an abstraction from reality
And that’s not useful
Or just
Or a reflection of sound judgement
George & Jim
In football parlance – you’re taking the man – not the ball.
We have to ask why Government has turned to NGO’s for this sort of work. The answer is because they are cheap with fewer checks and balances required than in mainstream services.
And who sets the context and regulation for the NGO sector with its lower standards? Why of course – the Government – and this is being picked up in media outlets too.
All I want is responsible Government who take these responsibilities seriously. Ours does not. And since it does not, why not share with us what you think a Government is there to do?
You won’t publish this as it doesn’t fit your narrative, but look at the same graph using GDP per capita.
https://data.worldbank.org/indicator/SH.XPD.PCAP?locations=FR-GB
Oh look, Tories narrowed the gap, it blew up under Gordon Brown and since 2010 has narrowed. But that’s not the story you want to tell.
Noel
The gap widens at about 2008 when the Credit Crunch hit – remember that? Even New Labour bought into the austerity bullshit.
And yes – it climbed but why? What about the inflation of medical equipment and drug prices because we know that prices tend to rise after crashes as suppliers attempt to get more income from fewer transactions?
But I mean really – your crowing about ‘closing the gap’ must mean that you are too easily pleased. Or is it just cheap point scoring?
My view: the gap should not exist and our expenditure should match that of France. Because that is the correct thing to do.
Obviously some of us have higher aspirations than yourself.
The French eat well and like their butter and red meat, they smoke and they like their alcohol. But they also work less hours and their health service seems based on what people need rather than ideological ideas about budgets.
Maybe that is why French life expectancy is higher than ours? And the United States (which is lower than the UK)?
About the NHS:
I remember a campaign early on in this Government by 38 Degrees over the attempts to break State responsibility for the NHS.
38 Degrees supported their campaign with legal opinions from barristers and got us to write to our local MP which I did. My local MP sent me a letter and HIS counter legal opinion from a barrister.
It seems to me that what the Tories did to the NHS constitution ties in with the underfunding since 2010. It would be very interesting to see if Hunt and the Government could be taken to court.
But the mens rea element is there for me: change the legal nature of responsibility for the NHS by Government (effectively insulating it from legal redress) and then underfund it.
But this is why BREXIT gets me so angry. I fully support and respect Gina Miller and her stand but where is the Gina Miller character for the NHS? We did not need to go near BREXIT – it was diversion.
BREXIT and the NHS crisis are concoctions of chaos – forced upon us by a City fuelled Tory party where chaos is used regularly to achieve ‘change’ and personal profit. And Oxfams’ troubles (also caused by indifference to the NGO sector by Government) has been used to add to the chaos.
Never mind ‘rotten boroughs’. We are living in a rotten State.
Those of you coming here denying the ‘design’ of all of this had better wake up. It is unpalatable I agree but this is the neo-liberal shock doctrine at work – well established by the CIA and RAND in the Cold War.
Add in other diversions like soap operas, apps, sport and other content and all I see is a society sleep walking into hard and nasty future.
Our rulers know how to rule us – there is no doubt about that in my view. And they are succeeding too.
Dear Pilgrim Slight Return, in spite of 38 degrees efforts, the Coalition did in fact remove the National Health Service to replace it with the Health and Social Care Act 2012 which among other things removed the Secretary of State’s Duty to Provide and Secure health services for all.
http://tedxexeter.com/2014/05/06/allyson-pollock-privatisation-of-the-nhs/
An 2015 amendment to the HSCA 2012, mandates competition and tenders from anywhere in the world to provide services to the NHS (if I remember rightly. Sorry I don’t have time to find the link).
Now, with the new Integrated Care Systems, (another top down redisorganisation), Government wants to reduce or abolish competition without the requisite change in the law. Which is why there are now 2 x legal challenges launched by members of the public.
https://www.crowdjustice.com/case/jr4nhs-round3/?utm_source=sendinblue&utm_campaign=Update997onUrgentLegalActionforOurNHSJR4NHSJanuary302018&utm_medium=email
https://www.crowdjustice.com/case/healthcare4all-stage3/
Stopetc.,
Yes I know – 38 Degrees tried and failed. But they had a go. I remember share in American health companies going up in value when this was done.
The link to the SoS must be restored.
And thank you for the links. I wish them the best of luck.
But here we are with the MSM attacking Oxfam when the Tories have effectively and purposefully abrogated their responsibility for the NHS and where was the outrage about this.
The Tories have got away with it for now.
It would be interesting to see the number of MPs who have used prostitutes. The problem seems to me to be not so much that these people (wrongly) took advantage of vulnerable people, but that the system our Government so enthusiastically subscribes to, was, is, and will be, taking advantage of vulnerable people.