111 and Labour's synthetic rage over NHS Direct
So the government under Labour piloted a new scheme
This was a scheme to replace NHS Direct with a new 111 non-emergency number.
Quoting from this:
In the future, it could become the single number for non-emergency services, including NHS Direct.
Ministers did know
Health Minister Mike O'Brien said: "Patients have told us that they need clear, easy advice on how to find healthcare quickly when it's less urgent than 999 and I am delighted that Ofcom has allocated 111 for these purposes.
"This will be particularly useful outside of GP surgery hours and for people who are away from home."
Now Labour seem to be against it
The plan has provoked an angry reaction from Labour, with shadow health secretary Andy Burnham using it as evidence of what he claims is the government's intention to "dismantle" the NHS.
He said: "The health secretary's statement will stun people across the NHS.
"It is yet more evidence that Andrew Lansley is on a vindictive mission to break up the NHS, ruthlessly dismantling services before alternatives are in place."
Mr Burnham told the BBC that the government had shown "arrogance" and acted in a "cavalier" way by choosing to scrap NHS Direct without consulting the public.
is to that dreadful case in Manchester.
It does appear that it would have been possible absent adoption targets to have kept the elder child with her birth mother.
The Emergency Budget and the IFS report
The "new" IFS report repeats substantially what they said at the time of the Emergency Budget.
Firstly from a tax perspective the budget is progressive. It in fact is more progressive than Labour because of the CGT increases.
Where the debate exists is on the treatment of benefits. The biggest factor is whether the change from RPI to CPI should be considered to be regressive or not.
The above chart shows that recently CPI inflation has often been higher than RPI inflation.
The biggest distinction currently arises from using a geometric mean rather than an artithmetic mean for averaging price increases. Then come various housing issues some of which are encountered by some claimant households.
My view is that we should have a measure to monitor inflation for claimant households. I raised this in the house and the government have agreed to look at this.
Some things such as energy costs hit claimant households harder than other households. That is why this needs to be looked at.
However, I do not think it is reasonable for the IFS to analyse these changes as regressive because they may result in lower benefits for some people than would otherwise be the case. That would imply that anything that puts up benefits is progressive.
What we actually need to do is to deal with the poverty trap. That cannot be done by simply increasing benefits which deepens the trap.
We need to protect those people who are prevented from working through disability. We also need to protect those people who have retired (and the triple lock on the state pension does that).
However, we need to encourage those who can work to work. To me that is the progressive way out of poverty. Reducing the poverty trap does have oosts, but it is a better route for people than simply increasing benefits beyond what household costs are increased by.
Panorama and the William Ward Case
The William Ward case was an exceptional case in a number of ways. However, Panorama have really missed the key points.
Most mothers facing a case like this one would not only have lost their son to adoption, but also lost subsequent children.
Firstly, they were allowed to have the grandparents supervising. That is rare.
Secondly, they were allowed a second medical opinion. That also is rare.
What would normally have happened would have been that baby William would have been put with foster carers and limited contact (perhaps three times a week if they were lucky) would have been the option.
What needs to be looked at in respect of this case is, however, more complex than presented in the programme.
Firstly, we should not attack experts who offer opinion merely because the judge does not agree with it. Experts have to offer their viewpoint.
Where the real problem lies is in the interface between medical opinion and legal certainty. Medical opinion is often not that certain. There must be proper review of all medical evidence to enable it to be tested for truth.
The issue of spiral and metaphyseal fractures and similarly the SBS triad absent physical damage are areas where there is not sufficient certainty to warrant life changing decisions.
We also need to do a systemic risk review for how cases are managed. The criminal law remains a good deterrent. There comes a point at which additional supervision does not reduce the risk. These are the issues that often cause substantial problems and a misallocation of resource.
Furthermore the medical profession have to move away from the assumption that unexplained injuries equate to child abuse. It may be child abuse and it may be something else.
Finally the conflict of interest on experts with pet theories who can make massive incomes by hawking them around in the secret family courts has to be recognised. If only expenses were paid then there would be less of a conflict of interest.
It was good to have a further review of procedures in the family courts, but the programme was some way off recognising how bad the system can really be or identifying real solutions.
There are quiet a few comments
on the BBC website about this story.
Childrens Commissioner on experiences of Safeguarding
The Childrens Commissioner has published a good report
looking at the experiences of the safeguarding system from a family perspective.
There are some strong quotations in the report and it is surprising that it has not had any press.
One parent described how a male social worker had been allocated to
her daughter who had been sexually abused by her ex-partner and
was terrified of men. This mother had specifically asked for a female
social worker to be allocated.
“They just don’t listen. They don’t want to hear what you say.”
This issue puzzled the families, and they felt they never got a clear
answer about it and so were left with the conclusion that:
“It’s another way of controlling us.”
“They can leave and never come back, and you might never know, but
as soon as you say, this is not working, I want someone new, they
don’t like it.”
Victoria Ward and Panorama
The link is to a Panorama
programme tonight about a family court case.
This case was unusual because the Ward's were allowed to get a second opinion. Normally the parents are refused a second opinion and lose the case.
It should also be noted that quite large expert fees are paid to those people who diagnose child abuse in children. Those fees are generally not available if people don't think that the children have been abused. This creates a major conflict of interest which I have raised with the GMC.
If anyone thinks that is a fair and just system I am amazed.
The Children will be heard (forced adoption)
This is another case of an adoption that reverses as soon as the children get old enough. There will be a lot more of these.
Couple took cash for 'loaning adopted girls to paedophiles'
This sort of story reported in the Daily Mail makes one wonder about the reliability of the assessment processes used by local authorities.
Whether there will be a serious case review or not is unclear. I think there should be some inquiry.
There is nothing really key about 100 days. It is a purely arbitrary point at which to assess a government.
However, one key assessment is what the interest rate is on government debt. The figures from Bloomberg today are:
UK (10 year) 3.037
Ireland (10 year) 5.236
Greece (10 year) 10.692
Germany (10 year) 2.353
That affects in the long term how much money is available for public services. Labour's strategy of don't cut so much in the short term leads to larger cuts in the Long term.
In the mean time the Coalition government is working to make the UK a nicer place to live. The banning of demanding money with menaces (aka car clamping on private land) is a good example of that. Yes people may still have to pay penalty charges, but the behaviour of so many clamping operations has been totally unacceptable.
The Audit Commission
I must admit that when I looked in detail recently at one of the Audit Commission's inspection I saw an inspection where the conclusions had been identified before the inspection started.
A good way of saving money, therefore, is to stop such ludicrous inspections from even starting.
PFI is it value for money?
PFI costs a lot as the BBC have found (hat tip Bob Piper
) - see link.
The government claim it is value for money. The problem is that it is not.
It is only calculated as being value for money by using an adjustment to the alternative public sector procurement cost. This is called optimism bias.
I have explained this a number of times. The last time in the house was hereWe have a similar problem with the funding costs of private finance initiatives. The great difficulty is comparing all the figures involved in what is called optimism bias. I asked the Government what the optimism bias figures were for a number of different PFI projects, and they came back with a wide range of figures. Let me explain a bit about optimism bias, for those hon. Members who are not aware of it. When a PFI project is put together, there is an assumption that, if it could be done through the public sector, it would be done through the public sector, so it must therefore be done in the most cost-effective way. A calculation is made of what the public sector project would have cost, but an optimism bias is then added to it, on the assumption that the public sector calculation is optimistic and therefore too low. That is then compared to a PFI cost without an optimism bias.
The interesting thing is that people are told to pick their own optimism bias, and if the optimism bias is such that undertaking the project through the public sector is cheaper, they must do it through the public sector, but there is no money for that so it will not go ahead. Inevitably, people pick an optimism bias figure that means that the PFI looks cheaper, when it is not. Such things have been going on substantially around the country. Although the clear line of sight project is a positive move, we need to go further.
Legal aid proposals for family division
There is a lot of wailing going on about the legal aid proposals. Some of it may be valid.
However, given that most firms of solicitors merely roll over when facing care proceedings against their clients I see a lot of the money as being simply wasted.
Furthermore given that legal aid is from time to time refused for parents who wish to contest proceedings I wonder what it is all about.
Good News for KE VI Sheldon Heath Academy
I understand that capital is now to be released to rebuild Sheldon Heath as the KE VI Sheldon Heath Academy.
I hope that this is not as part of BSF. If it isn't then we should be able to get the school rebuilt a lot faster.
BSF is dreadfully slow and inefficient as a process.
International Miscarriage of Justice
There is an important extract from John Waters' storyThrough the evolution of media custom and practice, however, a situation has developed whereby the very mention of “childcare proceedings” or “family law” is enough to have media lawyers and editors running for cover. Even though it is very often abundantly clear that the only purpose being served by a blanket suppression of information is the protection of judges, lawyers, State agencies and professionals, media practitioners continue to impose an interpretation of the in camera rule that implicitly assumes these outcomes to be legitimate.
This applies to the irish rules, however.#
He goes on to saySuch interpretations of the legal situation are grossly inimical to the interests of democracy.
Something deeply ugly is happening at the heart of our society and the manner of its governance in the most intimate areas of human life.
If social workers from a foreign jurisdiction are enabled to run whooping and high-fiving from an Irish courtroom because they have been permitted to snatch the child of a blameless Irish mother, is it not time we asked what is happening?
The media offers the only forum in which such questions can be put. Media practitioners therefore have a sacred duty to take their courage in their hands and shine harsh searchlights on those who are empowered to intervene in the intimate lives of citizens to a close-to-absolute degree.
If we cannot report on such matters, why bother reporting anything?
Does it matter whether the economy functions?
Why should we care who sits in Leinster House?
Whatever happened to “publish and be damned”?
Are we journalists or entertainers?
How seriously do we take our role in democratic society?
Are we concerned with the public consequences of the events we write about, or simply seeking adequately interesting material to fill space and time to shift “product”?
Unless journalists and editors are prepared to address these questions, we may as well pull the blinds down on the enterprise of journalism and leave the protection of our democracy to the bloggers and tweeters, who at least have the excuse of having no responsibility for what happens to human freedom.
A bit more on the financial position
Consituents remain interested in the situation for the country hence I am going to repost and update a posting I made on 23rd July (on The Stirrer forum).
The financial crisis had really four components. Three were international and one national. The international ones were
1. CDOs (the credit crunch issue - causing a big hole in banks' balance sheets). This is the issue that causes all the fuss about banks and bonuses as people were basically making money out of thin air. This is also the mistake of the ratings agencies.
2. The illiquidity of the land market and associated bubble. This has a cycle that is often international, but can be local (as was the case in Sweden). That has a knock on effect on the capital of lending institutions. It runs on about a 15 year cycle with the previous periods being 89-92 and the mid 1970s. Because it ran for slightly longer the fall back was higher.
3. Oil prices. Jumps in oil prices cause recessions. Energy affects economic activity. The calculation as to how much energy is needed for each pound of GDP is called the energy intensity of GDP.
Then nationally there is the question as to how "prudent" the government is with the public finances.
What is interesting in this situation is that the varying policy responses in different countries can to some extent be tested against each other.
You can see in this that Labour's strategy placed the UK in the same category as Ireland, Italy, Greece, Portugal and Spain rather than France and Germany.
The bank customer rescue (which did not bail out the owners of the banks viz the shareholders) was an international requirement although it raises questions about the comparative merits of bank regulation.
Then you have various demand management measures.
The big mistake people think in considering the coalition's policy is to think that in some ways it is not neo Keynsian. The proposals are to reduce the deficit, not to pay back debt. The objective is to ensure confidence in the government's (UK's) solvency. That is necessary to keep interest rates down. Ireland is having to issue debt at about 5.5% at the moment. Our 10 year rate is more like 3.5%.
On a trillion pounds of debt that difference in interest rate is £20 bn a year. A big sum to find from the cuts that Labour would be forced to bring in as a result of their having lower market confidence.
It is important that people remember that having a higher deficit also leads to higher interest rates not just a higher principal upon which interest is calculated.
In terms of the ideological "size of the state" issue. Government spending at the end of the cuts will be around the same as at the end of Tony Blair's government in 2007. I haven't managed to get the precise figures on this, but will at some stage.
Hence the govenment's financial strategy is simply a rational approach to deal with reality not an ideological drive towards a smaller state.
To be fair to Alistair Darling it appears from Mandelson's memoirs that he understands this.
Hence it is quite clear that Labour's financial strategy would result in greater cuts to public services than will be implemented by the coalition government.
David Cameron's comments on Council Housing
I am not that happy about his comments about council housing. There is a complex issue about housing and how we manage a spectrum of different types of tenancies and ownerships.
Housing is a very important foundation for families. People with disabilities often have their properties specifically adapted.
I think it is important to give people some security. I am actually unhappy about forcibly removing people from their homes for under occupation although I reocgnise that we should encourage people to downsize.
The local housing allowance scheme does encourage people to downsize when they don't need such a large property.
This is an area where considerable discussion is needed before putting proposals forward in legislation.