I am trying, very hard, to keep calm this morning having read the following article on the front of the Sunday Telegraph:
It is very apparent that Labour is intent on pursuing its anti-doctor, anti-NHS, agenda.
It is also very apparent that Labour is intent on putting itself in the place that David Cameron was in after 2010, as the party of austerity intent on appealing to the middle-class, Torygraph reading voter who hates the state and all it can do for us, as leading Labour politicians so now very obviously do as well. Why else promote ideas behind that far-right newspaper's paywall?
And what is also clear is that Starmer is as utterly incompetent as Wes Streeting when it comes to this issue. I have already discussed this article with a doctor this morning (it helps to be married to one) but I will quote other doctors who share her view, including Rachel Clarke:
So why would Starmer do this? Because the private medical sector hates GPs, of course, because they are so bad for its business model. That is precisely because one of the most basic tasks of a GP is to protect people from unnecessary medical interventions at best (i.e. if they are actually well), and to direct them to the ones that are really needed, so eliminating unnecessary duplication if things are at their worst (i.e. when there may be something wrong).
But, along with Rachel Clarke, I agree the NHS needs reform. Most of all, people need to avoid it. Right now GP appointments are running at double the number that they were only a couple of decades ago. So let's start with the reform that is really required - which is the one needed to keep people away from doctors in the first place As Dr Philip Hammond has said on this:
He could have added air quality too. That is the most pressing need when so many people are now in hospital because of respiratory diseases that are avoidable with masks and measures to improve air quality which could have a massive impact on health, just as improving water quality did in the 19th century. But Labour won't talk about that: it is far too right-wing libertarian to discuss issues such as public health. Only meeting consumer demand concerns it. And, of course, it is refusing to open its chequebook.
Nor will it talk about the bureaucracy that really needs to be removed from the NHS. That would involve eliminating every hospital and ambulance trust and all the commissioning groups, each with their own massively expensive and duplicated systems, standards, rules and accounting and reporting requirements as well as quite unnecessarily expensive management. Simply replace the lot with accountable regional integrated health authorities covering all health and social care in significant geographic areas. That's where the reform of the NHS is required. But of course, that would make it harder for the private sector to get their hands on the service, so Starmer and Streeting aren't going there.
I have spent thirteen years now opposing neoliberal Tories who have moved ever further right, and are now neo-fascist, as Suella Braverman makes clear by her comments, time and again.
But now I have to face the prospect of a Labour government that is both utterly incompetent, as Starmer's comments noted above prove, but also wilfully negligent in its responsibility to its members and the people of this country in abandoning anything even close to a left-of-centre principle.
How much lower can politics in this country go?
Thanks for reading this post.
You can share this post on social media of your choice by clicking these icons:
You can subscribe to this blog's daily email here.
And if you would like to support this blog you can, here:
I am trying to keep calm after having read this post. It isn’t that I didn’t already know about this, it is rather different seeing it in b&w right before your eyes. It is, of course, important not to forget this message and lapse back into thinking that things will get better after Labour get in. It may, but by how much. If you are right, and the omens are that you are, then it may well not improve enough. This would amount to a betrayal, by the Labour Party, of those who voted for it.
I hoped for Blair and lived with the disappointment for a long time
With Starner I am getting my disappointment in early – and am offering due warning
At the expense of dusting off my thesis for my PhD in the bleeding obvious surely what matters is a system that works rather than exactly how you propose to do it/which groups you want to put the boot into etc etc etc…….
That and of course looking at what you can do NOW to get a result quickly, people not having any money being the most blindingly obvious area
I’ve noticed that when you criticise Starmer or the current Labour Party, a lot of LP supporters slag you off on Twitter and elsewhere as they fear that your interventions will help reduce Labour’s chances of winning the next General Election. There are those that simply won’t brook any criticism of their favoured team, and then there are a lot of people who are sympathetic to your arguments, but still would rather you kept your mouth shut, as they believe that even a flawed Labour government being elected in 2024 would be a vast improvement on the current bunch of self-serving clowns. Personally, I would love to be in the latter camp, but I find it increasingly hard to imagine that a Labour government under Starmer would actually make a real difference and address all the pressing issues of the times. It seems that every time they respond to an issue, they invariably choose to make utterances that are anathema to people like myself who desperately want progress on the social, economic and ecological car crash that is modern life in 2023. If the LP and Starmer could only give us a hint that that don’t really mean to ape the neo-liberal semi-fascist climate armageddon-promoting politics of the Tories if they finally gain the levers of power. Just a little wink and a nod…something to inspire a modicum of confidence that better times are ahead! But no, sadly all the evidence points in the other direction. Apparently, Starmer says, the coronation of King Charles is an occasion to give us hope! I am forced to conclude that those LP supporters who want you to shut up in the hope it will lead to better days under Starmer are delusory. And yet! And yet, in 2023-2024 there is no realistic chance at all of any government to replace the Tories that does not include the LP. Is there any wonder many people despair and become apathetic?
Agree with all that
And as for LP members who don’t like what I say, I really do not care
I speak truth to power and their leaders are exercising their power irresponsibly, already
I’ve tended to give Starmer the benefit of the doubt, recognising his need to distance himself from the worst excesses of the Corbyn era and establish himself as a credible, reliable alternative to the chaos on the opposite benches. However with this on the NHS he has blown it.
I follow the Kings Fund, Roy Lilley (highly recommended), Dr Phil Hammond and others who I see as deeply knowledgable sources on the NHS, relatively free of dogma. They all come back to the sustained squeeze on NHS funding leading to the stark shortage of beds, doctors and nurses we see today. Add to that the lack of capital investment in hospitals, IT and equipment. Then you can add social care, prevention and the rest.
Starmer/Streeting trotting out the Tufton Street trope about over management when the Kings Fund has done the analysis and demonstrated that if anything the NHS is under managed. It also shows that it has improved productivity rather more than the private sector. All the private sector, not health.
Then the trope about more use of the private sector. Ignoring the fact that the private sector has no magic source of doctors and nurses – it takes them all from the NHS and contributes nothing to their training. Plus the private health sector is the supreme example of cherry picking. If it’s complicated and life threatening you will be rushed to NHS PDQ.
As for organisation, I take Richards point. The legacy of Lansley’s fragmentation. However, imposing drastic reorganisation on an an organisation that is already struggling and desperately short of resource is a recipe for disaster. Reorganisations need spare time and resources.
This seems to be a wholly unprincipled, political play by Labour. Pandering to the soft Tory vote and the right wing media. Relying on the mass of the public not knowing any better. Trying to duck the need to argue for higher spending and taxes. Disastrous for both health and the wider economy (and society).
Depressing.
I agree Robin
Would you care to expand on the ‘worst excesses of the Corbyn era’?
As I see it , ‘‘A National Care Service” was exactly what was needed along with Nationalised Mail, Rail and continued membership of the SM and CU.
Had the 2017 election not been sabotaged, this country and it’s people would not be in such dire straights.
New party, yes! Starmer, no!
Those of us with longer memories will remember (only 5 years) that one of the causes of the NHS malaise were too many big reforms, i.e. when a reform had just bedded itself in some new ambitious minister would set another major round of organisation in motion with all the disruption that went with it.
Reform is one of those meaningless words when it comes to the NHS and its code for something needs to be done but we don’t know what, but it doesn’t involve more money. Again those with long memories will remember that we are in a similar place to the mid 90s when junior doctors were on 60 to 100 hour shifts which was neither good for them or their patients. And then when the working hour regs (max 48 hrs) came in and the recruitment was in place, the Tories then had the gall to say that the NHS was run more efficiently under them. Likewise what were labeled as expensive contracts for GPs and dentists, and the Tories unwound, were probably at the ‘market’ level or the job retention rate.
That Labour is talking of reform is probably election talk and this one will soon prove unworkable. Just imagine the extra admin for the top specialists and the trouble caused by those who don’t get to see them. It will be on a par with the current secondary school selection. These specialists will need to screen that work load and who is best place to do that, the GP, but I’m sure someone would make the case to outsource it. Those same GPs that we were once going to outsource a lot of hospital work to. Do I trust Wes Streeting and ‘Sir’ Keir to get this right, no. Improvements can be made to the NHS but the last thing the NHS needs is another round of reorganisation, lets tweak the current model.
A damming cartoon from the Telegraph and I heard Dr Phil Hammond speak very wisely on this subject on Marks Steels What the F*** available on Twitter.
I’d second the Phil Hammond recommendation
Since Starmer has made it increasingly obvious that he intends to take the New Labour route to try to win the next election and then to govern, it is worth making a clear assessment of the pros and cons of the period of New Labour Government.
From my own experience and what I read I would say that the Chief pros were: a massive improvement in the NHS; a massive improvement in the real educational attainment of children; turning UK cities back into desirable places to live and trying to make official statistics once again credible.
The huge negative was the complete failure to get rid of the Thatcher economy. An Economy that not only did not work but needed to increasingly corrupt, manipulate and destroy the Democratic processes of this country in order to survive.
Of course we all may have similar or totally different lists but if you accept that any likely replacement government has to be better than the current bunch of Tory Neo-fascists, the question is, to what extent are you prepared to let the best be the enemy of better.
Personally, I remember vividly in 1995-1996, like millions of others who subsequently voted Labour, having to grit my teeth and bear it every time Blair and Brown spouted Thatcherite rubbish, but in the end they were elected and the NHS and Educational changes alone hugely improved the Life chances of millions.
Again personally, and I do not expect many to agree, I think winning the next election is only a beginning and I would vote for any Labour, or Lib Dem, or Lab/Lib, or Lab/Lib SNP coalition that might achieve it.
The real battles will then be fought over the need to dismantle our present corrupt and incompetent economic system and the complete reform of our democratic processes
Which a leads to the difficult problem of who to vote for.
Not Tory, but now not Labour either since there is virtually no difference.
Libdems try to be all things to all people and can’t be trusted not to break manifesto pledges (where is Nick Clegg now).
In the FPTP system there seem to be no good options.
I fear that many will vote Labour thinking “Things can only get better”, which seems unlikely. Or, worse, Reform.
That leaves Green …..
It is difficult
Richard,
Surely this is just the opportunity for a new party for the masses, which you could lead.
You have so much knowledge about so many issues that affect the wider population and can talk credibly about all of them.
Rather than admirably trying to challenge from the sidelines with blogs and twitter, with over a year to the next general election you should be engaging with the right people to pursue funding and support for a proper campaign.
If the far right and other neoliberals can get away with Brexit and the like, surely as an MP you can start to turn the tide against this government and their facist agenda?
You are far too modest and probably don’t want the attention, but Kier Starmer certainly isn’t the person to do it. Although we will miss your informative blogs, many more people will be able to benefit from your understanding.
So the question should not be ‘why?’ it should be ‘why not’?!
I am simply not suited to party politics
Sorry
From that old mantra governments losses elections… but oppositions need to be in a position to capitalise on it. What history also tells us is that neither wing of the Labour party can an election by itself i.e. 2015 and 2019. Although there are parallels with 1997 the difference was that were ambiguities to the New Labour argument kept the left on board. Not so today. Another issue is Brexit, with public cooling on the project the party that offers a new referendum may gain significant votes. Throw in Cambridge Analytica’s attempts to maximise disenchantment on the centre and left, and the Tories could do better than they current polls would suggest. I suspect that the Greens will gain seats on this basis but could it be at the expense of Tories limping back into power. This isn’t a call to subvert democracy or blindly follow the current leadership but a call for it to be more inclusive. That not going to happen, so the future is looking bleak.
The trouble with voting Green under FPTP is that they will get their usual one seat.
I’m inclined to vote for anyone in my FPTP seat who has a chance to beat the Tory. Anyone except Reform or whatever Farage does. Trouble is, I live in a Tory stronghold. I will not vote to give credibility to FPTP and just make up the numbers. I am sick of FPTP. It is a major part of the problem.
At its conference Labour voted for PR.
The Labour conference has overwhelmingly backed a motion calling on the party to embrace a proportional electoral system…
https://www.theguardian.com/politics/2022/sep/26/labour-delegates-back-motion-calling-on-party-to-back-pr
The Labour leadership seem to ignore it as do many MP’s. They seem to believe that as they now have a big poll lead that the two party system is fine and dandy. It isn’t.
Starmer wants to get rid of the Lords. I agree with him. He should do that and as a first stage move to real democracy he should announce that the second chamber will be elected by PR. I bet he won’t.
Shame really. It seems that Labour would rather win and just keep the seat of power warm for the next Tory Government. I really do believe that PR, along with other key changes like mandatory voting and reducing the voting age to 16, kills off the Tories for good. That’s what I want.
Starmer is playing FPTP politics, afraid to say boo to a goose. His election will just guarantee a Tory return in five or ten years. They will then methodically undo anything good that might come out of the Starmer years. It’s what Tories do.
I so agree with you
I agree that electoral reform – of the House of Commons – is the absolute key here.
That’s why the ideal outcome of the next election is a hung parliament in which Labour need the Liberal Democrats (and the Greens and Plaid and – but don’t mention them! – the SNP) to take power. And it’s why I’ve worked on electoral systems (e.g. https://www.macs.hw.ac.uk/~denis/STV2023.pdf) – and stuck with the Liberal Democrats despite the betrayal of key manifesto promises in 2010 by the Cleggites who had used the opportunity of Charles Kennedy’s sad alcoholism to take over the party 3 or 4 years earlier. Thankfully Clegg and most of them are gone, and the present leadership understands that real PR is a non-negotiable demand for our support.
There’s a wide alliance of Labour reformers (Labour for a New Democracy, Labour for Electoral Reform) and other progressives supported by non-party (Make Votes Matter, Unlock Democracy, GetPRdone) and cross-party (Compass etc) organisations that needs support if you can help any of them build up public pressure for reform.
Thanks
I reviewed the note
It is worth it
And we can’t think of anything else to do other than vote. I suggest this is our conditioning at work, that which masquerades as education and is forced on us in our formative years, and that the way around it can be found via the psychedelics. Turn on, tune in, drop out – the 60s mantra regarded as heresy in some quarters precisely because it encourages thinking outside the silo we’ve been conditioned to accept as normal perhaps now points the only way forward and out of this dilemma.
I don’t think psychedelics are going to be of much use countering miseducation. Many of the people I can remember being heavily into LSD in Oxford in the late 60s went on to be leading lights of the Tory party.
They won’t all have done and those who did, well, they probably didn’t have any interest in changing the status quo. Further, we have knowledge today which we didn’t have back then. I think shrooms are much better understood now, for example.
The sheer stupidity and complete failure to understand the implications of his suggestions are mind boggling. How the f** does Starmer think the NHS will cope with everyone taking themselves off to physios/ Consultants etc? The waiting for an out patient appointment will balloon, the costs will surge, the actual treatment they need as they take themselves to the wrong place will be delayed and meantime the idiot says there will be virtually no more money.
Just how much money has Starmer and Streeting taken from private healthcare providers? A truly fantastically effective investment for the Private Sector.
Starmer may win some Tory Telegraph voters – I wonder how many more Labour supporters he will lose? Most NHS staff and their families I would wager.
Completely agreed
His proposals are total madness – which I can see as someone who knows quote a moot about managing systems
They also totally fail to understand the NHS problem (not enough medics of all sorts trying to see too many people)
And they deny the real problem, which is underfunding plus the failure to address social needs in society
Utter irresponsibility
The “National” in NHS disappeared some time ago. There are different health service models in England, Northern Ireland, Scotland and Wales. NHS England is in the process of yet another massive top down reorganization into 44 Integrated Care Systems (ICS). I come under the Cambridgeshire and Peterborough Integrated Care System (https://www.cpics.org.uk/our-places) which is split into two “Places”, North and South. I’m in the South Place. Within that I am in an Integrated Neighbourhood (although I don’t know which one). Like our Prime Minister I am registered with an NHS GP. I’ve a nasty feeling that all of this complex structure will be under the all-seeing eye of Palantir Foundry. How long before cunning algorithms decide whether my GP can refer me for further diagnostic tests or where I will be placed in the queue? Will it depend on if am from a “hard working family, doing the right thing”?
I have no idea how the Starmer / Streeting proposals will improve this situation.
John
I have just read the Kings Fund explanation of “Integrated Care Systems.” I have to admit that I didn’t know much about them and I would imagine most of the public don’t either.
Two of the aims are tackling inequalities and promoting broader social and economic development That does suggest the more holistic approach that Richard has been talking about. Housing, education, air quality and social services etc. are all essentially run at local level. But they do need 1) a real commitment and clear goals 2) adequate funding and 3) local involvement by voluntary and social enterprises. It is , in the broadest sense, a more ‘socialist’ than the one we had 2012 with its market ethos of securing contracts. I was working with MIND in those days and the manager of of local MIND spent long hours preparing ‘bids’ and even if she secured them, they would only be for a limited period. It was an unnecessary waste of time and stress.
Oe of my family worked for Home Start -similar to Sure Start at a time when the latter started being closed down. They had referrals from schools, local authorities and mental health but no money. Lottery money was used but it only lasted so long.
Other charities would fund raise for them but, as with the local MIND centre , they both had to close through lack of funds-not lack of need.
Yet the academic research shows money spent in early years can save money later.
I asked a local councillor if the District Council could use property they had not yet sold off or pay the rent for one of many boarded up shops so it could act as our centre. He was in agreement but his party did not run the Council. It often seemed to me that the powers that be were trying to show they were responding to need but their main pre-occupation was not spending ‘too much’. It comes back to the ideology of how to fund state spending.
Provision of such services is not like running a commercial business.
It is good to see that a lot of the development of ICS s seems to have been from the bottom up. One similar example is Croydon where the NHS staff re-organised things for the pandemic and there are now few waiting for treatment. Our public service staff have many talents and most have a public service ethos despite the insinuations of ‘being greedy’ or ‘putting lives at risk”. They often have better ideas than most politicians .
Like you, John, I am not sure how Starmer will make a difference apart from providing enough money to make these ideas work.
https://weownit.org.uk/end-nhs-privatisation-save-lives
https://weownit.org.uk/act-now/rebuild-our-nhs
I’ve been putting these links on about ICSs for ages. But nobody bothers reading them. Another waste of time, I presume.
Nothing happens fast
40 minutes worth listening to.
https://www.youtube.com/watch?v=g2WT7ics9cg
At 33 minutes Johnbosco was asked about if there were any examples around the world which were better than the NHS. The response was that the NHS pre 2010 was the best in the world.
If they all want to get rid of doctors perhaps that explains this, which I confess I found puzzling… https://www.theguardian.com/education/2023/jan/14/ministers-refuse-fund-medical-school-uk-doctor-shortage
I think that article is basically some PR special pleading.
The government announced in 2016 an intention to increase medical school places, resulting in permission for several existing medical schools to expand entry (which could be done quite quickly) and a bidding process for universities currently without a medical school to apply for funding to set up one. Five of those applications were successful and now have students in training, but some were unsuccessful of which the University of Worcester was one.
It seems that what Worcester have done is to go ahead anyway with a “private” Medical School restricted to those who can pay international student fees (there is some precedent for that). Unfortunately that isn’t going to plan: the GMC (who are crucial as the validator of medical degrees in the UK) apparently told them to defer opening for a year which suggests they lacked confidence in the course delivery plans.
Even so, it looks like Worcester are now going to the press asking for the government to reverse the original decision not to fund their medical school proposal at present. This is quite different from government making a considered decision based on bids to set up new medical schools, with investment in the neighbourhood NHS to provide placements as well as in the universities concerned. However if Worcester succeed with their private medical school it might put them in a good position if there is another bidding process in a year or so, simply because by then they should have a course in place and a record of GMC validation visits.
interesting to know, thank you!
The problem with training doctors is that the student fees fall significantly below the cost of training. The govenment hates making up the difference.
During moments of reflection I find myself wondering whether the current narratives from Kier Starmer, Wes Streeting, Rachel Reeves et al are all a ruse to positively influence the right wing media and those voters that won’t vote for a “left wing” party, and that once elected we will see a seismic change in approach with a move towards PR, properly funded public services and investment in infrastructure that supports sound climate change objectives…..
The smell of coffee then wafts under my nose and I am woken from my hallucination with the true horror of what might be.
Depressing…..
I guess with tomorrow being Blue Monday what else could I expect.
Still always a good reason to play some New Order!
Take comfort where it can be found
Agreed, the last thing the NHS needs is another top-down management re-organisation. Labour know how to turn the NHS round, they did it 1997-2010, and it is all about giving staff the resources to do a good job.
The frustrating thing about Starmer is that he says things that are so vague that you can’t really tell if they have any sense. If “slashing nonsense bureaucracy” means getting rid of the internal market and the associated admin that gives no benefit to patients, then I am all for it. But he just uses the same language as the Tories, which we know can mean disruptive restructuring whose only outcome is demoralised staff.
(Similarly he talks vaguely about “constitutional reform” – does that mean tinkering around the edges of the House of Lords, or a set of proper changes including a written constitution defining power and limits of power in law, a completely re-thought upper house, and a lower house elected so that its mix of members reasonably reflect the electorate’s votes? Or “closer relationship to Europe” – does that mean just being a little less obstructive than the Conservatives, or a real attempt to restore some of the lost benefits probably initially by limited treaty agreements but in a direction that could slowly bring alignment with the Single Market?)
Who knows?
But I have given up hope of him actually delivering
I think he means what he says
Years ago this was understood that poverty was a sickness creator. but spending money on the NHS is a positive expense which takes no account of the costs and actual expense – both individual and for the economy in general of poverty and the ill health it leads to:
http://www.progressivepulse.org/economics/health-is-made-at-home-hospitals-are-for-repairs
“How much lower can politics in this country go?”
Given an FPTP electoral system requiring the support of no more than 25% of the total population able to vote, or about 35% of the electorate who actually vote; in either case ensuring a huge majority for neoliberalism; I hazard – potentially a lot lower.
You are right
Two of my recent Tweets on Labour and the NHS
1).Streeting and Reeves? Not only the Abbott and Costello of SKS’s Faux-Labour Shadow Cabinet, but also the Burke and Hare!
2) The ONLY reform the NHS requires is to clear out all the managerial bullshit, started under Thatcher, & followed by EVERY govt since, aimed at destroying it under the guise of “reform”, & get it back to a State-owned FREE service to EVERYONE at the point of need. Hands off chum!
So when it comes to voting in the next General Election we have very little else other than two brands of shit to choose from. What a mess. No hope.
A lot lower. Nicholas Ridley once opined that he couldn’t see why a local Council needed to meet more than twice a year; once to dish out the contracts for the services provided and one to review progress on meeting those contracts.
As for salaried GPs, they’re already working for Centine, not the NHS – it’s a US insurance outfit that has taken over dozens of GP Practices and “works” for the NHS.
It looks as if it’s soon going to be tricky trying to distinguish between what the Labour Frontbench are suggesting and what Nick Ridley would be happy with.
Starmer’s “partnership model, where the agile and active State,” commissions the NHS service through the Integrated Care Boards, who buy the services from a range of “NHS Providers” would fit Nick Ridley’s model perfectly.
The system’s ready for take-off, Syphon-economics will be the order of the day with the freedom to boult on a few extras. Sadly, it will take a Labour Government to pull it off.
https://www.bbc.co.uk/news/health-61759643
Operose is the English company owned by Centene. Weownit has managed to get many ICS boards to agree not to allow private healthcare companies like Operose on their boards. That’s a start. Follow weownit and you’ll find lots of other ways we can try to stop private healthcare from taking over. They have also stopped Operose from taking over certain groups of GP practices. The problem is finding out what they own and where.
https://weownit.org.uk/act-now/rebuild-our-nhs
I’ll say again that this country needs another Clean Air Act – this time to deal with diesel cars and not coal induced smog.
It needs to seriously deal with sugar addiction too and anything else we know – how about the carcinogenic world our corporations create for us?
But no – what they want to do instead is turn the wave of misery and unhealthiness that they say the NHS can’t cope with into an income stream for the private sector!!
Well done Stymied and the Laboured Party.
Bought and paid for I’d say.
The solution to this is simple—at least in principle.
Nobody seems happy with current Labour except the candidates currently acting as MPs and wanting to be re-elected.
There is huge popular support out there for the workers on strike …postal, nursing, transport, etc. There is gut-twisting terror rampant in the UK just now. Unaffordable energy costs, lack of access to health care, jobs going down the pan because of decisions taken at Westminster, increasingly difficult and remote access to service provisions, climate change accelerating flooding and other environmental disasters—these issues are directly affecting people NOW, and scaring us to death. And who do we turn to? Our basic infrastructure is falling apart, and the government—and now its potential replacement—seems hell-bent on accelerating that process.
Working people in England are desperate for a decent, focused, citizen-oriented party to vote FOR. (Fortunately Scotland has the SNP …but that provides a lesson as well. The SNP started out as a laughingly marginal party. They are now the leaders in Scotland and have been for some time, because—independence aside—they promote the values of the people of Scotland. They’re not it it for the 1%.)
So where are the dissatisfied English Corbynites, etc? Including Corbyn, if he still has the stomach for it. Surely there is scope out there for a new UK party that will promote the values of the working people of England.
Somebody should start one. Now.
The UK is politically polarised, but a huge portion of the “pole” has no representation at Westminster—or any chance of any under the current Tory/Labour system. So step away from Labour, provide desperate people with real representation, and the result may be heartening.
Nothing to lose. We really do need a NEW Labour to vote for, don’t we? Even the threat provided by one might be enough. The threat of right-wing parties like UKIP certainly put fear into the Tories and caused them to veer to the right. Maybe Starmer ought to experience the same kind of threat.
There a hoards of small parties
No one pays them any attention
This sums it up perfectly!!
https://www.theguardian.com/commentisfree/picture/2023/jan/15/ben-jennings-on-keir-starmers-hopes-of-cutting-nhs-waiting-times-cartoon
The big problem is not Starmer or Streeting – although they harbour problems of their own.
The big problem is the ex-BOE official Rachel Reeves. She genuinely believes in the “sound money begets a sound economy “.
This is a misreading of economic history (its the other way around). But has been adopted by the ruling classes since the International Commission on Public Finance ,Brussels 1920. (see Mattei -Capital Order).
The consequences are that public spending is seen as an anomaly, nationalisation an aberration, and that laissez -faire capitalism and free trade will solve all problems -a priori.
Its not true but explains why the NHS has been underfunded, undermined, and as a symbol of an alternative of a publicly funded and successfully managed public enterprise decried in case it is seen as a successful model for other parts of the economy.
The NHS is a model for how an industry can be nationalised successfully. Hence the forces levelled against it. But if a Labour government is not up to running it successfully then it takes away the rationale for its own existence.
Streeting is right to identify increased staffing as part of the solution; but they need modern facilities , sufficient capacity, and incentives to provide healthcare rather than incentives to not provide healthcare (cash limited budgets).
Someone also needs to tell them that the NHS already spends more on preventive care already than anyone else https://www.oecd-ilibrary.org/sites/507433b0-en/index.html?itemId=/content/publication/507433b0-en and less on social care.
Sorting Social Care is a precondition for sorting healthcare- but it has been largely privatised already. This means that extra funding will leak to overseas tax havens irst rather than to reduce the burden on the NHS. This means it will be very expensive to solve Social Care. In Europe most social care is provided by local authorities and socially owned organisations. That should be the case in the UK.
It is not difficult to manage the NHS – its managing it with your hands tied , in inadequate facilities, with too few staff, inadequate capacity, where incentives are misaligned.
Its another point about Europe that seems to be glossed over. It is often implied that Europe is mostly ‘privatised’, ie not so far from the US model. Reality is that both the insurers and the hospitals as I understand it are mostly not for profit organisations This is very different to private hospitals in the UK or the private equity owned care homes we have.
I know a little about the German model. Around 10% of Germans have private health insurance. 90% are insured via insurance schemes set up for public benefit and strictly regulated by the government to ensure that everybody, regardless of financial means, has the same access to healthcare. German per person expenditure is way above that in the UK. The complex insurance system is less efficient than the NHS model, but it does provide a decent standards of healthcare based on need, not income. Higher overall fuding translates into many more hospital beds per 1,000 people, smaller waiting lists, etc. Worth remembering that the system started back in the 1860s and was then revived after 1945, i.e. it’s been developed over decades. It’s not something another country could just copy. And it’s definitely not what the likes of Rishin Sunak want!
Its the same thinking that sees the NHS along with the rest of public services as merely a cost to be born. Incapable of seeing it as an investment with a very real return, with assets (people, infrastructure, the nation’s health) that decay just as surely as any other asset that is not maintained and invested in.
For me its not unrelated to the problems in the private sector where we have had decades of under-investment. Its not too hard to work out that the primary cause of poor productivity in the private sector is under investment in people, infrastructure, R&D and so on. In turn driven by a focus on maximising short term profit – wealth extraction rather than wealth generation. (How that wealth is spread is another topic). That of course is driven straight from a City that is now almost entirely focused on speculation and trading, and has long forgotten what real ‘investment’ looks like.
I particularly liked a piece of work by the Kings Fund that highlighted how the NHS is remarkably productive and has improved its productivity by significantly more than the private sector. Another myth debunked. Not sure Streeting, Reeves or Starmer have heard of the Kings Fund… Reeves feels like a product of the worst of City thinking.
Unfortunately the Kings Fund has been penetrated by McKinsey who represent their clients in the US promoting accountable care.
Which is why Richard needs to be clear what he means by accountable when presenting solutions.
In the US sense of “accountable Care” it is delivering to contract with gaming of the contract uppermost in mind – implying sliding out of responsibility , billing for extras and denial of care to the non-members and mis-billing if you can get away with it. It also implies a new managerial layer managing the contract at great expense.
That’s not what Richard understands by the term but it only goes to prove that use of language has been penetrated by the big consultancies.
The Kings Fund speaks with forked tongue; but occasionally they get it right . But the ONS have been producing statistics on productivity for a long time making the same point, including on the private sector which lags public sector productivity.
For those who have not found him, Roy Lilley’s latest missive on the NHS. Well worth following.
https://myemail.constantcontact.com/We-don-t.html?soid=1102665899193&aid=eS4ReD8wpx8
The gist is that we’ve been here before – NHS in crisis, shortage of beds and people etc. so put in the resources needed. New Labour, whatever their other failings, did fix the problems.
More coming from me on this…..
Starmer lied to win the leadership of the Labour party; his team are hand-picking compliant candidates to represent the party at the next election (rejecting many effective and popular candidates previously selected locally who he seemingly cannot rely on to toe the line).
His apparently stupidly illiterate proposals for queues at consultants’ doors have attracted incredulous derision from all over the commentariat. And now Polly Toynbee has this to say in his and Streeting’s defence:
https://www.theguardian.com/commentisfree/2023/jan/16/keir-starmer-nhs-reform-tory-labour
Be very interested to hear any comments on what Toynbee has tendered as Starmer’s knowledgable and reasonable arguments.
I have to say Polly (who I have known for many years, where many tends to 40) is acting as an apologist here and I do not think that helps