2012 London mayoral campaigns kick into life

This video from the Livingstone campaign is an unusually good one, prompting an immediate riposte from Boris' HQ.

It marks what should be an interesting (and probably very close) campaign for the office of Mayor, with numerous factors at play.

Will Labour's large lead over the Tories in the capital help Ken achieve one of the great comebacks in modern political history?

And how well will this approach by team-Ken play? If wages continue to be outpaced by inflation as they have been in 2011, then the cost of living should be a key issue come next spring and this may well add momentum to this line of attack.

Having said that, Boris continues to enjoy a Teflon-like ability to protect his own popularity, even despite some clangers in recent months, not least wading in to the debate on the financial crisis to defend some of the frankly indefensible practices of bankers and speculators.

We'll all pay for Osborne's ideological gamble

For years now numerous voices, conveniently ignored by the bulk of the media, have sounded an alarm. Including Nobel prize-winning economists Joseph Stliglitz and Paul Krugman, along with like-minded experts such as David Blanchflower in the UK, they have warned of the folly of slashing government spending whilst the economy teeters on the edge of recession. Krugman termed it the 'austerity delusion' - and it was witnessed in its most ridiculous form in the early draft of David Cameron's recent conference speech.

However, on this one, the Prime Minister wasn't out of step with many of his fellow travellers. Many on the right have wheeled-out the 'credit card' analogy at every attempt, in a patronising attempt to persuade the masses of the validity of their arguments, none of the latter can supposedly grasp concepts more complicated or distant than the piece of plastic they carry in their wallets.

The coalition, as we all know, took a different track. It was a simple one: state spending - not the banking crisis - caused the deficit, never mind the fact that UK debt was on of the lowest in the G7 prior to the financial crisis. And, so the argument goes on, we must plow this course, lest 'the markets' (the deity-like entity that, despite utterly failing in 2007, has a unique intelligence on these matters) punish us. Finally, for the ideologically pure, the happy side effect is that the state will 'get out of the way' of the hard-pressed wealth-creators, despite scant empirical evidence that this theory really works.

Where has this left the UK? Well, under the stimulus packages that preceded this government, the British economy was growing out of recession at slow, but apparently robust rate. Since George Osborne's spending brakes were applied - just as the Keynesian critics warned - the economy has stalled and looks increasingly likely it'll slip into reverse.

In a strikingly blunt editorial, the New York Times had this to say:

"For a year now, Britain’s economy has been stuck in a vicious cycle of low growth, high unemployment and fiscal austerity. But unlike Greece, which has been forced into induced recession by misguided European Union creditors, Britain has inflicted this harmful quack cure on itself".

"Austerity was a deliberate ideological choice by Prime Minister David Cameron’s ruling coalition... It has failed and can be expected to keep failing. But neither party is yet prepared to acknowledge that reality and change course".

The warning, borne out by recent figures on government borrowing, show the irony of the slash-and-burn approach to public spending: that cuts will reduce demand leading, in the medium term, to even more cuts:

"Slashing government spending in an already stalled economy weakens anemic demand, leading to lost output and lost tax revenues. As revenues fall, deficit reduction requires longer, deeper spending cuts".

Finally, it signs off thus:

"Austerity is a political ideology masquerading as an economic policy. It rests on a myth, impervious to facts, that portrays all government spending as wasteful and harmful, and unnecessary to the recovery. The real world is a lot more complicated. America has no need to repeat Mr. Cameron’s failed experiment".

It's the economy, stupid

The economy now looks in a pitiful state. Unemployment is at a 17-year high, with youth unemployment at dire levels. Meanwhile, those in work are being squeezed by rocketing energy bills, transport costs and other inflationary pressures.  And, as if part of some terrible joke, many at the highest echilons of the finance sector continue to living the good life, pushing up rental and purchase property prices in the capital and provoking the ire of even those they would expect to support them.

And herein lies the critical problem for David Cameron. If this continues, history tells us he will lose the election, and badly.

Arguably, the issue that the New York Times highlights - that cuts in public spending may cause more cuts as demand (and therefore tax revenue) drops - may not be a big deal for many in the Tory Party. In fact, many on the political right would positively relish the opportunity to continue their ideological crusade to roll back the state, all in the name of deficit reduction.

But, whatever the impact on public services and other recipients of government spending, one political reality remains. If the economy doesn't recover - if Osborne's great gamble has failed - the Tory Party will suffer the consequences. Cameron and his Chancellor chose to ignore the lessons of history - including those drawn from the mistakes of the 1930s - and the electorate will be unforgiving if what is left is stagnation and decline.

Lansley's Bill marches on



© Steve Bell, Guardian, 2011 on the NHS



The Lords should remember this: no-one voted for these NHS changes

As today's letter to the Independent newspaper from leading clinicians makes clear - coupled with the announcement from the BMA that they remain opposed to the Bill in its current form -  there is huge disquiet amongst health professionals with the legislation as it stands,  including senior medical staff not known for engaging in politics.

Moreover, the evidence base upon which the Bill is based is weak and its proposals ill-though out. In fact, empirical evidence has demonstrated rising, not falling, satisfaction amongst the British people (in numerous different surveys) with the quality of care in the NHS and - as the Commonwealth Fund demonstrated - the health service performs strongly in comparison to those of most other developed countries' health systems.

Evidence also points to the fact that investment in the NHS has resulted in improved standards of care. Crucially, although some of the challenges outlined by supporters of the Bill do indeed exist - rising health costs, increasing demand, the causes of these are in fact common to health systems of all hues, including insurance-based models. These include the increasing costs associated with medical technology and the significant demographic changes the western world has seen over the past half century.

The solution that this Bill proposes is therefore flawed in four different ways: it lacks support (and has plenty of opposition) amongst health professionals; the base of evidence on which it is based is limited; it has many aspects that could create huge practical difficulties and, finally, in defending the Bill, its supporters seek to attribute problems that health systems of all hues are facing to be those particular to the National Health Service.

This Bill lacks a democratic mandate, it lacks public and professional support, it has fundamental flaws and - most damagingly for our democratic processes - its path so far through Parliament has been marked by a lack of sincere and rigorous examination that a Bill of such magnitude deserves.

NHS reforms: GPs target NHS patients for private work

The news last week that a medical practice in York wrote to a number of its NHS patients claiming, incorrectly, that the local NHS would not fund a number of routine operations - and then proceeded to promote private care from a company wholly owned by the same medical practice, is deeply worrying. Not only does it appear to be a dangerous new phase for the health service, but it also exposes what one commentator called (quite rightly) a "massive conflict of interest".

These kinds of conflicts of interest were highlighted by critics of Lansley's reforms, and this is no doubt one of the first of many such cases.

Meanwhile, news that many NHS hospitals are expanding the proportion of private patients only underlines the worries that so many people have over a bill that - as another commentator rightly points out - nobody voted for.

Yet more professionals oppose Lansley's bill - and still the Government pushes on

The fact that four hundred experts in public health have joined the British Medical Association and the armies of other health professionals calling for the withdrawal of the revised Health & Social Care Bill is hardly surprising - the Bill is flawed, and potentially ruinous.

What is more surprising is the sheer depth of ideological commitment the Government has to push ever onwards towards privatisation of the health service, despite the manifest failings of this legislation.

Is this why Osborne opposes a financial transaction tax?

These stories, of course, may be utterly unconnected.

Gove is no longer the biggest liability in his department

Dominic Cummings, special adviser to Michael Gove, is becoming a liability for a minister already accustomed to his fair share of clangers.  The latest allegations that he obstructed civil servants from answering parliamentary questions on the New Schools Network, if proven, will make his position very difficult.

From its inception, the New Schools Network itself has been problematic and demonstrates how desperate the government is for the Free Schools experiment to work - not least in the nature of how it has obtained funding in the past from central government and in the apparent favours it has received.


Meanwhile Gove - according to the Financial Times - has allegedly been using his wife's email address to discuss government business. If true, this - coupled with yesterday's revelations - will make it pretty much impossible for him to preach the value of 'open government' to his colleagues again.

Michael Gove and 'open government'

If one was being unkind, one could comment on the hypocrisy of a government preaching the virtues of open government to their own civil servants, whilst apparently doing precisely the opposite themselves.

EtonMess would, of course, never stoop so low...

Mind you, it's not as if Michael Gove is a stranger to this kind of controversy.

The NHS: its over to the Lords...

Evan Harris persuaded a majority of attendees at this week's Liberal Democrat conference to back his call for a vote on the NHS reforms - something that would have caused a huge headache for Clegg. However, the proportion of those supporting a vote wasn't high enough, so no vote took place.

This is a shame - the Bill is still potentially disastrous for the NHS, as leading health groups continue to warn. Let's just hope that Shirley Williams has more success in the Lords.

And for those that missed it, her recent article in the Observer should leave readers in no doubt of her strength of feeling on this issue.

Efficient, popular and fair: why Cameron is wrong about the NHS

The NHS is efficient, fair and popular

There is one central argument. which forms the basis of the Conservative Party's drastic changes to the NHS, that needs addressing. The NHS, Cameron, Lansley and their right-wing media allies argue, is inefficient, bureaucratic and unsustainable. Consequently it needs reform.

Now, as this blog never tires from pointing out, numerous studies have demonstrated that this situation is quite the opposite - the NHS is in fact demonstrably more efficient than the US-style health system that the Tories are so keen to emulate.

Let's get something out of the way first: the NHS faces challenges.

Our population is getting older. The number of elderly people as a proportion of general population is rising. With these demographic changes comes severe challenges for health care systems - more older people with associated medical conditions, and a relatively smaller proportion of working-age people to pay for their care. At the same time there has been a rapidly growing costs associated with medical technology.

Health costs in the UK are consequently rising, and will continue to do so.

But this is not a uniquely British problem. It is a global one. Take a look at the US: health care costs rose a to a staggering $2.3 trillion dollars by 2008, with rising drug prices and an ageing population cited as factors. But, crucially, high administrative costs cited as a major factor too.

In fact, a number of studies have demonstrated that the central argument deployed against the NHS by the Tories is highly misleading: the US system is highly bureaucratic, with an estimated 31% of health spending in the US consumed by administrative costs. Conversely, the Commonwealth Fund has identified the NHS as more efficient and effective than the US, Germany and Australia.

Full Commonwealth Fund report: http://bit.ly/ouyyP1

So, what is to be done? Well, a simple repetition of the facts amongst supporters of the NHS would be a start:

• The NHS is one of the most efficient health systems. 
• Patient satisfaction over the last couple of years is as high as it has ever been.
• The quality of care in the NHS has been improved by investment through taxation.
• The size - and unified nature - of the NHS puts it in a strong position when bargaining with pharmaceutical companies.

It is these arguments that need to be made: for too long those on the right have framed supporters of the NHS system as more concerned with 'moral' arguments than practical economics.

Well, these are just some of the benefits of NHS that go beyond that. For not only does it, almost uniquely, offer universal health coverage to every man, woman and child on these islands, but the National Health Service does so at comparatively excellent value.

Gerry Robinson: "This could be the end of the NHS"

Will the Lib Dems support the NHS reforms?

Having earlier indicated the Health and Social Care Bill will be supported by the Lib Dem leadership, Clegg now appears to have wavered in this view somewhat.

It's not surprising - there is immense unease amongst the wider membership (and, on left of the party, outright opposition) to the reforms amongst the Liberal Democrat Party.

Not for the first time, Clegg - whose view are in many ways firmly to the right of his party - has had to backtrack on his initial support for Tory policy.

Whether this translates into a further challenge from his party this week remains to be seen.

The storm over the NHS resurfaces

After a summer lull from endless criticism from those connected to the health care sector about his plans, it appears that Cameron's hopes that he would be able to slip through the Heath and Social Care Bill this week with less difficulty look to be misplaced.

First, the British Medical Association  made it clear that, despite some amendments to Lansley's original proposals, they remain in opposition to what they describe as "an inappropriate and misguided reliance on "market forces" to shape services".

And now, Shirley Williams has reaffirmed her opposition to what she believes could be the effective end of the NHS. She also asks why the Tory Party seems intent on replicating aspects of the American model of health care delivery. This is a valid point: this blog has previously drawn attention to the independent Commonwealth Fund's research that has identified the NHS as being both more efficient and more effective than the US health care system.

It will be intriguing to see just how far the Liberal Democrats will be willing to go the extra distance to ensure that the demands they made earlier in the year have actually been met. As the (independent) legal advice recently commissioned by 38 Degrees has demonstrated, even the supposed concessions that Lansley has made may not be quite what they seem.

How much difference have the Lib Dems really made?

Here is an interesting thought: is it possible that the Liberal Democrats' position in the coalition has succeeded in neutering the worst aspects of Conservative policy making?

Take the NHS. It is arguable that, if it wasn't for the revolt at the Lib Dem conference in late 2010 and resultant effect on the positions of the Liberal Democrat leadership on this issue, that the Tories may have tried to ram through Lansley's proposals without amendments. Of course, it is also arguable that the massive opposition from doctors' groups, nurses and other health professionals would have had the same effect anyway, but it is an interesting debate.

And what about the recent attempts by Christian groups to take abortion advice off abortion providers. Did the Lib Dem's persuade Cameron to change his mind? The right-wing press clearly thinks so.

And, most recently, how about Clegg's claims that he managed to defeat Michael Gove's attempts to allow Free Schools to turn a profit come a second term of a Tory government.

Now, there is the counter-argument: that despite all this, the Liberal Democrats, in conceding to the largest public spending reductions in modern times, have capitulated on the most important issue and handed the Tories the opportunity to provide cover for their economic decisions.

Furthermore, it is easy to list a range of areas - including higher education reform (including tuition fees), EMA and, in fact, the existence at all of the NHS 'reform' programme - where the Liberal Democrats have needlessly agreed to support proposals that were in neither the blue nor yellow manifestos.

Nevertheless, it is an interesting thought: could it be much worse. And, equally intriguingly, if it is Lib Dem influence that has tempered many of these decisions, does it demonstrate how shallow Cameron's so-called moderate convictions really are?

Why does the modern Tory Party belittle professionalism so much?

One clear theme that has emerged in little over a year since the Tory Party effectively returned to power is at best an ambivalence and at worst an active belittlement of professional staff, particularly those in public service jobs.

A case in point - Working Families Everywhere - the government-backed third-sector programme (it wouldn't be state delivered, now would it?) that proposes to send volunteers free from the trappings of qualifications and experience into the homes of our underclasses to teach them to turn into deserving, rather than undeserving poor. These volunteers will, of course, be far far better than professional social workers... for why should years of evidence-based degree study count for anything?  'Let amateurs fill the gap', as one news report less kindly put it.

Most recently, this has included proposing that ex-squaddies - a number of whom, with due respect, are hardly models of good behaviour - will somehow be infinitely superior at teaching young children than highly trained, dedicated teaching staff.

Whether it is teachers, social workers or many civil servants in scientific, economic and policy roles, this government clearly has an instinctive distust - and lack of respect - for their work, qualifications and experience.

What explains this? Interestingly, it can (at least in part) be explained by two strands of modern Conservative thinking (I use the latter term in its loosest possible sense).

The first is small-state neo-liberalism. Most, if not all, of these workers are in state jobs. They are therefore, by definition, something to be outsourced or done away with altogether. The kind of job they are doing is therefore less important that who they work for.

The second strand is familiar to anyone who has flicked through the pages of the Daily Mail or Telegraph -  a nostalgic yearning for the 1950s. A time before political correctness. An era when you could give your child a clip round the ear, or your wife a friendly battering, and the namby-pamby interfering busybodies from social services weren't there to object. When we all knew that the history of Britain was thousands of years of glorious military triumph, grateful colonies and good old fashioned Christian values, in clear black and white (although mostly the latter). And an era, in this rose-tinted view, in which there was no bad manners, little crime, close family communities and a highly stable, educated society. A time that never really existed.

It is this second strand that is, if anything, more pernicious than the first. It has manifested itself in right-wing circles in the United States as an inherent fear and distrust of professionalism per se - particularly of scientists and aspects of modern medicine. Evidence-based policy making has increasingly given way to a kind of pre-enlightenment attitude, where God, nostalgia and gut instinct takes precedence over all else. Nadine Dorries aside, this has yet to become so apparent here. But it may not be too far off.

In the meantime, we have the British Tory version: a constant criticism of proessional staff that are dedicated to public service. And one can only wonder about the hypocracy of a government that on the one hand preaches the value of education whilst on the other hand belittles those that commit to educate and better themselves.

Property: a tale of two countries

If there is any hallmark of the divided nature of our country in the present day, it is in property.

Whilst property owners benefit from rock-bottom interest rates, and a wealthy minority make a small fortune from so-called property investment - which in fact is little more than the accumulation of mulitple houses - a generation of young people are faced with a stark reality: unless you have a very high paid job indeed, you will need to borrow off the bank of mum and dad or face the fact that owning your own home won't happen.

Recent reports of banks requesting deposits of in excess of 30% for first-time buyers, coupled with sky-high prices are contributing to the reversal of years of increases in home ownership.

Today's report that house ownership is slipping back to levels not seen since the 1980's is in this climate unsurprising.

And yet the government does nothing to help, working as it does to defend the interests of the already wealthy. 

The question is this: at what stage will the locked out become a constituency powerful enough to create poltical change in this area?

Until then, it's property investment programmes on Channel 4 and buy-to-let schemes for some, and years of renting at increasingly high prices for others.

More evidence that Tory voters aren't really that...Tory

This blog has posted before on polls that have demonstrated highly significant levels of support amongst self-declared Conservative voters for such (not very Tory) views as increasing the minimum wage, raising taxes on the better off (and on banks), granting better employment rights to temporary workers and for improving rights for interns.

Well, the Telegraph has recently written about the recent YouGov poll that shows that only a minority of Conservative voters support scrapping the 50% top rate of tax, and a majority give their backing for the so-called 'mansion tax'.

This follows on from polling undertaking in 2009 that showed consistently high levels of public support for the renationalisation of the railway system, including a larger proportion of Tory voters favouring this, or the not slightly less radical option of increasing government involvement in the sector.

This is an interesting phenomenon that the right-wing press often choose to ignore. The often cited 'silent majorities' for right-wing proposals are frequently nothing of the kind - more often these are the loud bellows of Tory-leaning press and right-of-centre think thanks.

Admittedly, there is a caveat to to bear in mind: most polling firms add political weightings to their overall 'headline' figures, so analysing polls by sub-groups is therefore open to larger margins of error. Nevertheless, such significant proportions of Conservative voters expressing these views means that these margins of error are unlikely to seriously impact these conclusions.

It just goes to show that that left-of-centre politicians should fret less about public backlashes to progressive policies: they are more popular that people often think.

Holidays

This blog has been quiet of late, but will return in September. In the meantime, EtonMess has a mobile site, courtesy of Blogger.

Jon Stewart and the UK's odd parliamentary 'satire' broadcast rules

US debt talks: The Republican Party are mad

The sheer scale of cuts Obama has offered the Republican Party in the latest round of talks on raising the US debt ceiling has shocked many Democrats. And yet, even this apparent victory for the austerity-fetishists on the political right in America wasn't enough.

The truth is, for a group increasingly dominated by the Tea Party, the Republicans would seem happy only to see the federal government dismantled altogether. They are extremist ideologues, with no grasp - or interest in - reality.

And the strain of dealing with these people is showing on the normally unflappable president, as yesterday's news conference showed:

Cameron's Big Society has nothing to say about corporate excess

The recent scandals that have engulfed News International have - despite the recent efforts of parts of the Tory press to downplay them - shocked many people. The sheer scale of apparent collusion between the legal establishment, the press and the political classes have been surprised even to the most cynical observers.

News International, and its parent company, News Corporation, appear to have wielded such immense power, that they were able to exert influence over the key established power centres of a liberal democracy. That they were able to do this surely leads to one conclusion: that they are too big.

It isn't just political influence that comes with such immense size. As the banks amply demonstrated, large corporations can act in a manner that may be detrimental to the general population. That is because large corporations can become too big to be worried about the concerns of ordinary people. Even individual customers without major wealth ultimately become unimportant.
Strikingly, David Cameron's Big Society agenda - which is relentless in its attacks on the dangers of 'big government' -  has nothing to say about the problems that big business can create. Amazingly, despite the abject failure of a deregulated approach to the banking sector and to the press, Cameron's project remains firmly concerned with dismantling the supposed 'barriers' to business growth.

It is this failure to address these issues that creates cynicism about the Big Society project. If it genuinely is about localism, about returning power to local communities, then surely it would have something to say about how large corporations can - and do - act to disempower ordinary people.

And that is why Ed Miliband's recent comments on corporate irresponsibility are so important. Indeed, in identifying the increasing lack of power held by ordinary middle class people (alongside lower income groups), he may have finally rediscovered the purpose of a social democratic party - to represent the collective will of people whose individual voices are increasingly marginalised. 

And that is a potentially very powerful message.

Will energy price rises invite calls for a new windfall tax?

The news today that British Gas will follow Scottish Power with huge price rises - in the case of the former, price increases of almost 20%, following on from a 7% rise at the end of last year - raises significant problems for a large number of people and a major headache for the government.

These significant rises - set against falling household disposable incomes, a weak economy and inflationary pressures - will hit people even harder than the headline figure suggests.

What can the government do? Well, its already been reported that Chris Huhne has met with smaller energy suppliers to try to increase the diversity of providers in the market. Now, this is a very free-market, neo-liberal approach to tackling this issue. Rather like the Republican Party in the US and their reaction to sky-high medical insurance premiums, the preference of right-leaning parties will always be for trying to increase competition as a method of tackling high prices, rather than using more direct regulation.

But intervention and regulation - proper regulation - can be far more effective than this more hands-off approach. And one piece of intervention that would be both hugely popular and would be a useful source of revenue for the government would be to resurrect one of Tony Blair's earliest policies - a windfall tax on utility companies.

The original tax in 1997 raised an estimated £5billion. The level of income in 2011 would be much higher, and could be used to stimulate the green economy or fund tax relief for households.

How tempting this would be for the Government, despite their ideological hue.

NHS reforms: Health Tsar resigns

Sir Roger Boyle, the Department of Health's heart tsar, has resigned this week, as it becomes clear that the revised Health and Social Care Bill retains - albeit in carefully chosen language -  many of its most controversial elements. This follows on from the BMA's rejection of the revised Bill.

Jacqueline Davis, co chair of the NHS Consultants' Association, has written an article over at the Guardian's Comment is Free expressing concerns that the supposed 'u-turn' by Lansley was not quite as dramatic as many seem to believe.

The government, meanwhile, continues to peddle misleading information regarding the NHS, clearly in the hope that a revised timetable will enable the reforms to go ahead as originally planned with minimal public opposition, although perhaps not as fast as they would have wanted. Many of the criticisms of the original Bill, supposedly addressed and satisfied after the 'listening exercise' are worth revisiting over the coming months.

BSkyB takeover: 24 hours to respond

It is worth drawing attention to the official Notice of Consultation on the proposed takeover of BSkyB by News Corporation.

It remains unclear whether the government is minded to reconsider their decision to approve the acquisition. Those who think they should - particularly on grounds of media plurality - can respond here.

The NHS: smaller isn't always better

Central to the Cameron project are two key concepts: first, that the state should no longer be the default provider of public services and, second, that the fewer large, hierarchical public sector organisations there are, the better. Better still that the invisible hand of the market determines priorities than central planning.

The NHS reforms, of course, were an attempt to do just that: GPs, clinicians and hospitals are to become ever more autonomous. Previous posts on this blog have discussed the problem this poses for accountability that this approach would bring.

Calum Paton, professor of health policy at Keele University, has penned an article that addresses this issue, amongst others. In it, he makes the very valid point that the very same government that condemns public sector hierarchies ignores the fact that in business the approach is wholly uncontroversial:

"The hardest-nosed businessmen have no problem with accountability upwards within integrated organisations. Ironically, every time the Department of Health or the media calls in a Gerry Robinson or some other troubleshooter, the absence of a clear hierarchy based on accountability is the main diagnosis – not the absence of an elegant quasi-market".

The Mail reaches new depths...

Even by the standards of the Daily Mail, today's story on the tragic death of a girl takes the biscuit. Before the weight of complaints forces them to change the text, here is a screen grab:

A good day to bury news

One of the least surprising political decisions of the year has come to pass, as Jeremy Hunt today provisionally approved News Corporations bid for full control of BSkyB.

The great fear of other media companies - from the BBC to BT to the Telegraph Media Group - is that this will give Murdoch's company the ability to bundle online newspaper subscriptions into Sky packages and thus fatally undermine his competitor, at the same time as securing more power from which he can undermine public service broadcasters such as the BBC and Channel 4. The decision was described as Britain's Berlusconi moment.

That the decision has been passed demonstrates yet again that this government preaches localism, Big Society and the importance of competition when it relates to the public sector, but will conveniently forget all these tenets when it comes to their powerful corporate allies.

Is it a co-incidence that the government chose today of all days to make the announcement? Well, that's up to you to decide...

Universities - an easy target for a Tory revolution

At the end of 2010, the Tories looked set to steam ahead with a market-led revolution in public services, albeit one they failed to mention in their 2010 manifesto.

From health care, to education, to local services and right up to the heart of Whitehall, the government - in the name of deficit reduction - looked set to sweep away the whole concept of 'public' services, and in their place bring a multiplicity of private and voluntary organisations.

But they over-reached themselves. Although reforms roll on in education - albeit at a slower pace and in a different manner than they would have hoped - in other areas reforms have stalled or stopped.

First came the forest sell-off u-turn. This was actually a defining moment - when Cameron would have been realised that if an 'easy target' such as this raised such emotion and opposition, then his NHS and public services plans would be in trouble.

And yet he continued - as recently as February he was pushing his plans to effectively end the presumption that the state should be the preferred provider of public services - and he backed Andrew Lansley's NHS plans until it was clear that opposition was too strong.

Both of these culminated in u-turns of sorts. The Public Services White Paper is almost half a year late, and appears to be a shadow of what was originally conceived. Meanwhile, even after a humiliating u-turn, what remains of the Health and Social Care Bill is witnessing continued opposition.

But there is one area where the government have clearly got their way - and it is a case study of how easy it is for a right-wing party to achieve its goals when a sector is divided and fails to command widespread sympathy with the general public.

The privatisation of higher education

The HE White Paper, released yesterday, is in essence a bit of a mess. It's an attempt to try to tackle the frankly hysterically ill-conceived funding changes that the government has introduced in the most hapless fashion. In simple terms, families will have to take on more debt to pay for universities that are less secure and - the icing on the cake -  the cost to the Exchequer (through the student loans system) will be higher under the new regime than the last.

So more debt for individuals and more debt for the government.

But the HE White Paper is a mess for another good reason. It is - rather like Lansley's original Health and Social Care Bill - an attempt to turn into practical policy a hugely ideological plan: namely privatisation and deregulation, at all costs. Furthermore, it's an attempt to put into a practical policy a plan to achieve this without explicitly stating so.

So - new private providers of HE, fewer barriers to overseas companies entering the market, a shift from public funding for education to private tuition fees and even proposed changes to the term 'university' and what it means and entails.

But why havs this succeeded whereas Andrew Lansley plans appears to have been thwarted? Well,quite simply for two main reasons:

Divide and rule

First, the HE sector is divided. There is the Russell Group - the research-intensive institutions - for many of whom higher tuition fees are welcome. It will give them the ability, or so the argument goes, to compete with other global research-led institutions, particularly in the United States. Amongst this group include a select number of institutions who profess little or no interest as to whether they educate any UK students, or offer benefits to their local communities.

Then, at the other end of the spectrum, there is the post-1992 group of institutions, who have been the recipients of most of the growth in students from lower socio-economic groups. They stand to lose badly from any system that may dissuade such students from attending universities. They are also the recipients of the ire of the certain breed of Tory politician that act like walking Daily Mail editorials - of which, alas, there are a great deal.

In between these two groups are a wide variety of institutions, with their own missions and agendas. And it is precisely this diversity in institution type - and agendas - that has given the Tory Party the perfect opportunity to divide and rule.

An unpopular cause

It is these reactionary views -  which permeate society - that provide the second reason for the Tory triumph in this area. The last government may have succeeded in expanding the opportunities for hundreds of thousands more to go to university, but failed to counter-balance the cliched views of universities (promoted relentlessly by the mainstream media) that they aren't that important - not like schools and hospitals.

These views are well-versed: universities are full of feckless, work shy-students studying on 'Mickey Mouse' courses; the last government encouraged too many people from the lower rungs of society to go into higher education when they should have been fixing dodgy plumbing, or repairing cars; and, for a section of the political right, universities are a bastion of liberal-left ideology, full of future bureaucrats promoting health and safety or environmental legislation, or academics teaching about multiculturalism, or lecturers promoting left-wing economics.

It is this lack of broad public support - one that that NHS continues to enjoy - that made the HE sector a prime target for a genuine revolution, and one that has apparently rolled over so easily. So, from Michael Gove's plans to take teacher training out of university hands (and thus, he hopes, to release the teaching profession from their left-wing, liberal mind-set) to this new White Paper, the dismantling and privatisation of an internationally-renowned sector begins.

BMA rejects revised Health and Social Care Bill

So, after what Cameron may have thought was a done deal, the amended Health and Social Care Bill is in trouble again, with the British Medial Association's annual conference calling for its withdrawal.

How the Liberal Democrats - their members, not leadership - respond will be crucial.

OECD: Slow the rate of spending cuts

In a significant development, the Chief Economist from the Organisation for Economic Co-operation and Development (OECD) has advised Osborne to start revising his spending cuts as their impact on economuc growth becomes clear.

This view has been supported in recent weeks by large falls in consumer confidence and poor figures for household spending and business investment.

Interesting that the OECD, which has been a supporter of austerity-heavy budgets across the continent, is now revising their view. This, of course, will come of little or no surprise to the high-profile experts who have been warning for some time of the folly of the sledgehammer approach to tackling public deficits, such as the Nobel-prize winning economists Paul Krugman and Joseph Stiglitz.

Krugman calls the Osborne approach "expansionary austerity" - the idea that dramatic spending cuts can 'free' business to grow the economy. In the past he has attacked this "delusional" approach:

"Slashing spending in the face of high unemployment is a mistake...Why not slash deficits immediately? Because tax increases and cuts in government spending would depress economies further, worsening unemployment. And cutting spending in a deeply depressed economy is largely self-defeating even in purely fiscal terms: any savings achieved at the front end are partly offset by lower revenue, as the economy shrinks".

Krugman has also pointed out that Osborne's last budget made assumptions that as state deficits would be cut, private debt would rise rapidly:

"The only way the economy can avoid taking a hit from government cuts is if private spending rises to fill the gap — and although you rarely hear the austerians admitting this, the only way that can happen is if people take on more debt. So we have the spectacle of a government that inveighs against the evils of debt pinning all its hopes on an assumption that over-indebted households will dig their hole even deeper. All in all, it’s quite a spectacle. It would be funny, except that millions of people will suffer the cost of this folly".

UPDATE FRIDAY 27 MAY:

The Guardian has picked up this theme today in its editorial.

Clegg: the NHS is our red line

He may have supported Lansley's Health and Social Care Bill in its original form, but one angry conference and an electoral battering later, and Nick Clegg is now all over the media attacking Tory plans for the NHS.

The Liberal Democrats want substantive changes to the role of Monitor - to ensure it isn't a force for the promotion of competition. It is, apparently, the Lib Dem's elusive red line.

Whether it will work, it's hard to say. The Tories, previously staring at a growing gap in the polls with Labour have recently recovered ground. They may be a little over-confident, considering they are currently maintaining (at best) a vote share that failed to win them the last General Election, but this may result in a certain degree of intransigence in their dealings with their weaker Lib Dem partners.

Meanwhile it's left to an Tory ex-minister, Stephen Dorrell, to rightly focus on one of the longest problems with health care provision in the UK - the lack of co-ordination between social care and health care...something that Lansley's aim of fragmenting the service will only make much, much worse.

No-wonder rumours are abound that Dorrell may be in line for Lansley's job.

Majority of Britons believe NHS to be amongst the best in the world

After a well-documented delay, the Government has finally - reluctantly - released the latest NHS public satisfaction data.

Amongst its crucial findings are that satisfaction with the service remains very high, only little behind the record highs seen last year -  with (unfortunately for the Government) 70% happy with how the NHS is currently run and 73% of those that have used the service satisfied with their experience.

In addition, 66% expressed the view that the NHS was amongst the best in the world (a figure that was even higher when posed in 2010):



http://www.dh.gov.uk/en/MediaCentre/Statements/DH_126747


Following on from the recent YouGov polling showing that almost half of Britons rate the NHS as the best system in the developed world - and other recent research findings - it demonstrates the mountain that Cameron is going to have to climb if he tries to force through Lansley's plans without major changes.

TaxPayers' Alliance 'pro-cuts' rally draws about ten people

A heavily-trailed pro-cuts rally, backed by a motley crew of groups including UKIP and the ubiquitous TaxPayer's Alliance drew a crowd to Westminster so small that they were probably outnumbered by the pigeons, and certainly by random passers-by.

Nice to know that a UK Tea Party has precisely zero chance of success this side of the Atlantic. As you can see below, it was about as busy as Jim Davidson's latest tour:  

Chair of NHS 'listening' exercise: competition-led provision may destroy services

After the hammering the Liberal Democrats received in the local elections, their newly strident tone on the NHS reforms (which, let's not forget, they had supported mere months earlier) looks likely to derail Lansley's vision for a quasi-free market health system.

However, if Lansley and other members of the Tory Party had hoped that they could ignore Lib Dem pressure and ensure that the listening exercise would be a pause and not much more, then today's news that the man chairing the consultation process, Steve Field, has attacked the original proposals as having the potential to "destroy essential services" will not be welcome.

He is, of course, correct - a free-market, competition-led approach to health care provision would both fragment the health service in this country and has been demonstrated to be an approach that will result in a system that is less fair and - crucially - less efficient.  

Are the Tory Party finally awakening to public opposition to mass privatisation?

After the leaked memo earlier this week that suggested that the Government is having cold feet with its plans to sell off just about everything, one of the pioneers of this ultra neo-liberal approach has decided to put on the brakes as well.

Last year, this blog drew attention to the desire by Suffolk County Council to use the budget crisis to fulfil their Thatcherite dreams. Well, it appears that they are now having second thoughts. In an eerily similar process to Cameron's 'listening exercise' on the NHS, Suffolk have announced what they have termed a 'period of 'reflection'.

The key question is this: are the Tories really rethinking their plans, or is this an attempt to turn down the political heat for a while (particularly until after today's elections)?

If they are reconsidering, then why? Is this the influence of the apparently resurgent left-wing of the Liberal Democrats? Or is it a sudden realisation, in the wake of the NHS reform debacle, that the public aren't prepared to sit back as quiety as Cameron hopes while a Conservative Party that failed to win the last general election dismantles public services without a mandate, all in the name of deficit reduction?

Oh. There is a third option, which that the senior Tories have suddenly grown a conscience... but that's the least plausible of all.

Finally - a decent AV campaign video

Witty, clear and - best of all - not full of the kind of misleading guff that has afflicted both official campaigns to date, this pro-AV video is worth a watch. Sadly, with the weight of the Tory Party, major donors and its press allies ranged against it, probably too little too late.

Why Osborne's austerity-addiction will cost us dear

Etonmess is back from a break overseas and has noticed that the economic news hasn't got any better.

An article in the Financial Times asks if Osborne's right-wing monetary policies are making the situation worse, suggesting that the approach of shifting debt held by the state 'most creditworthy entity in the economy' onto the individual may well be precisely the wrong thing to do (and, it wouldn't be unfair for this blog to suggest, pretty hypocritical given previous comments by the Chancellor and his PM).

This, of course, is a long-time theme of the economist David Blanchflower, who offers this typically intelligent dissection of a recent set of comments by Fraser Nelson:

"Cutting too deeply and too quickly as this government is doing, compromises growth. Investing in the infrastructure and giving firms incentives to invest and hire in the long run will lower the deficit. A growing economy generates revenues. As Larry Summers said at Bretton Woods the whole idea of an expansionary fiscal contraction is 'oxymoronic'. The empirical evidence from the real world, rather than Nelson's made up one, is that austerity in the depths of a recession doesn't work. In the US when a similar policy was implemented in the 1930s it plunged the economy into a double-dip recession".

Why Osborne's comparison with Greece is wrong

And, for good measure, this paper Paul De Grauwe of the University of Leuven, which neatly explains why Osborne's repeated argument that the UK must cut or "be like Greece or Spain" is bunkum.

"In a nutshell the difference in the nature of sovereign debt between members and non-­members of a monetary union boils down to the following. Members of a monetary union issue debt in a currency over which they have no control. It follows that financial markets acquire the power to force default on these countries. This is not the case in countries that are not part of a monetary union, and have kept control over the currency in which they issue debt. These countries cannot easily be forced into default by financial markets".

Poll: British people think the NHS is now better than the competition

YouGov has published this poll that demonstrates that the years of investment in the NHS may have finally impacted on general public perceptions of the standard of health services in the UK.

In the mid 2000s, academic research demonstrated a disconnect ('perception gap') between patients' (service users') improving view of the NHS and those of the public at large, who may not have had recent experience of the service, which tended to be more negative.

However, this most recent YouGov poll found that almost half of respondents believe that health care services in the UK are better than those in other developed countries, compared to only a quarter who believe otherwise. Clearly, the cumulative impact of improving standards and impact on patient experience has managed to overcome the media portrayal of the service, which remains overwhelmingly negative.

Coupled with recent research on standards in the NHS and surveys on patient satisfaction with the NHS, it shows the mountain that Lansley and Cameron have to climb in persuading the public that their health care reforms are borne out of necessity rather than ideology.

Dentists join the queue of professionals opposed to the 'Big Society' NHS

This blog has posted before about the hidden (and not so hidden) dangers of Cameron's push for public service staff to form autonomous mutuals.

As mutuals they would run the risk of becoming less accountable to service users, less efficient and more open to corruption. To add to this is a bigger risk: in the free market vision that the Tory Party has as its endgame, they would almost certainly lose the battle for contracts to large private companies. Mutualisation can therefore be seen as a staging post - more acceptable to a sceptical public - for the real aim of the privatisation of public services. The hope, from the political right, is that taking smaller steps will make the logical next step to an open free market of for-profit providers of health, education and other exiting services more palatable.

Well, Andrew Lansely - currently enjoying the kind of reaction that other Government ministers can expect as this 'Big Society' project expands into other parts of public services - can add dentists to the list of people whose view of mutualisation is not far removed from the argument posted above.

The British Medical Association, meanwhile, puts it well:

‘It is hard to see how the NHS can operate effectively if lots of bits of it are in private hands – even if they are those of former employees....New mutuals could quickly find themselves in conflict with each other and at risk of being out-competed by private healthcare giants. The consequence could be financial and operational chaos.'

In government, the Lib Dems are revealing their inner contradictions

Evan Harris, one of the leading left-of-centre Liberal Democrats behind the recent challenges to the Governments NHS reforms, has launched this critique of what he described as the 'Orange book brigade' and their views on the health care reforms.

In his article for Liberal Democrat Voice, Harris addresses some of the key (and misleading) attack lines that Norman Lamb has used against the NHS, including the (oft-repeated) statistics on heart disease survival rates that were criticised by the British Medical Association.

In his piece he states that politicians should be 'honest enough to explain to the public that effective but expensive treatments can only become available on the NHS when there are increases in real terms spending. I hope that the Lib Dems, when economic circumstances allow, will always give the public the option of voting for more NHS spending through fair taxation'.

Norman Lamb himself appears to lie somewhat in between two factions of the Lib Dem Party (his own 'Blairite' position is clearly distinctive from that of Clegg and Cameron). On one side, you have the likes of Evan Harris - and probably the majority of grass roots members - that are broadly of the centre-left.

On the other side, you have those such as David Laws, who in terms of their views on taxation and the economy are indistinguishable from most Tory MPs. An article he wrote for the Independent back in 2002 gives an interesting glimpse into the kind of future government he was later to become a part of. During the article he writes:

"We make a profound error when we try to pretend that funding is the source of all the problems in our public services...As a party, we have not, I fear, been leaders in securing the consumer interest. We do not, for example, consider how the public can be more closely connected to the health services they receive, for example, through a more social insurance based model".

Other examples of this strand of thinking can be found amongst those such as Julian Astle from CentreForum, who castigates the 'Old Labour' wing of the Liberal Democrats, adding that 'the Lib Dem-Conservative coalition is pressing ahead with the most radical reforms to our public services since they were founded', which he describes as 'a testament to the political leadership of Nick Clegg and the intellectual leadership of David Laws'.

It is entirely reasonable to think that a fair number of the 'Orange Book' tendency on the right of the Lib Dems would have joined Cameron's (more socially liberal) Tories had they existed when they entered politics. In other words, you have a collection of people in Clegg's party (and probably Nick himself) whose main objection to the Tories of old was their social illiberalism, rather than their right-wing economic policies.

In opposition, the Liberal Democrats could gloss over these inherently different political viewpoints - although its long been acknowledged that they have campaigned on different platforms depending on the audience and on geography. In government, with practical policies to implement, these contradictions are becoming more and more evident.

NHS: Clegg makes some ambiguous demands

Lansley's reforms: now in Clegg's hands?

The signs aren't great. What has been billed as a 'listening exercise' on the NHS looks worryingly like an attempt to delay in the hope that pressure on the Government over the proposed reforms ebbs away.

The Guardian has, quite rightly, pointed to the recent communication by NHS Chief Executive David Nicholson, in which he said this:

"It will not have escaped your attention that the NHS has been the subject of considerable debate in Parliament and the media. My message to you is simple: whilst we cannot help but be interested in these debates, especially when they potentially affect our own futures, we must not allow ourselves to be diverted from our core purpose and responsibilities in the year ahead".

For those who were hoping the massive opposition from across the health professions might have persuaded the Government to drop their reform programme, it doesn't look particularly positive, even with the Prime Minister's warm words (particularly as Cameron's 'consessions' seem to basically involve continuing with the same proposals, but at a slightly slower pace).

However, it looks like the Liberal Democrats might be finally waking up from their post-election slumber. Nick Clegg - up until now looking very out of step with his own party on this - has now issued this ultimatum to his Conservative partners:

• quality not price should drive competition;
• services should not be commissioned by family doctors alone;
• GP consortia if unprepared, should not go ahead in 2013;
• the NHS constitution principles must be protected;
• GPs need to work together with councils.

These are all welcome suggestions - but are the least that could be expected given the pressure that Clegg has felt from his grass roots supporters. In fact, it could equally be concluded that Clegg is trying to satisfy his party members but by conceding the minimum possible. He did, after all, allow the existing Bill to get through the Commons intact until the Sheffield Lib Dem conference vote forced his hand.

 

If these are as far as they go, Clegg's suggestions aren't enough. The silence on one issue is almost deafening: privatisation. Nowhere does he oppose one of the central problems that so many people have with the Health and Social Care Bill - that they will allow private companies to take over NHS commissioning services, and grant them even more of service provision.

 

Asking that "services should not be commissioned by family doctors alone" or that GPs "work together with Councils" are potentially not much stronger than the 'concessions' Lansley has been promising. Private companies could still be the beneficiary of outsourced commissioning work. Private providers could still massively increase their influence throughout the service. 

 

This, ultimately, is the 'red line' that Clegg is going to have to address. His own party members reflect the views of the majority of the British people on this one: allowing the privatisation of the National Health Service isn't something that will command support in the country, no matter how many Tory MPs and their media allies want it.

 

It also is a useful indicator (particularly coupled with the forest privatisation fiasco) just how difficult it will be for Cameron to undertake his far-reaching plans to facilitate the outsourcing of all other core public services. If the PM had thought that the principle of a genuine 'public' sector was one he could quietly drop, then he almost certainly doesn't now.

Labour releases critique of Health and Social Care Bill as nurses vote 'no' to Lansley's reforms

In the wake of the Royal College of Nursing passing a vote of no-confidence in Andrew Lansley, Labour have produced a detailed document highlighting the key flaws of the NHS reform bill as it currently stands.

It is telling just how badly the reforms have progressed to date that, with the full use of the civil service (or, 'enemies of enterprise', if you prefer) to help it, the Government have managed to produce a fairly weak riposte to the charges laid at their door.

The truth is Government have - as the outcomes of the elections of 2001 and 2005 must have underlined to the Tory leadership - forgotten that the electorate isn't as right-wing as its press likes to believe. They are simply not willing to countenance the privatisation of the NHS. And they aren't willing to buy the line that giving private companies control over delivery of services and allowing for the outsourcing of health commissioning to private companies is somehow not the same as privatisation.

It is, and people know it.

Tory voters want to tax the rich, increase the minimum wage.. and regulation on unpaid internships

Towards the end of last year, a poll demonstrated overwhelming levels of support for higher taxes on wealthier people, an increased minimum wage, better rights for temporary workers and more taxes on the banks amongst the general public. Interestingly, in each case, this included the significant majority of Tory voters.

Well, yesterday a YouGov poll demonstrated that Conservative voters are also supportive of better rights for interns. It found that the majority of supporters of all the three main parties supported the payment of at least the minimum wage for interns and government intervention to regulate internships. It also found a clear majority believed that internships give an unfair advantage to those with wealthy parents:

 © YouGov 2011