Wednesday, 21 September 2011

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.

Tuesday, 20 September 2011

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.

Sunday, 18 September 2011

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.

Wednesday, 7 September 2011

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:

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

Monday, 5 September 2011

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.

Sunday, 4 September 2011

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?

Thursday, 1 September 2011

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.