John Hemming's Web Log John's Reference Website
Monday, January 31, 2011
  Labour's myths about NHS proposals
Labour myths answered

Myth: There is next to nothing of Lib Dem policy in this huge top-down reorganisation:

Absolutely not true.
The Liberal Democrat manifesto promised that new social enterprises would be created to deliver NHS services, that all types of providers – NHS, voluntary, or independent sector – would be free to deliver, the scrapping central, top-down targets, and cutting back on unnecessary administrative costs . Abolishing SHAs, increased competition, stronger local democratic input in the NHS and greater integration between health and social care are also all Liberal Democrat policies explicitly set out in our manifesto.

1. GP commissioning

“[We will ensure] that local GPs are directly involved in providing out-of-hours care.” (page 43, Liberal Democrat manifesto)

2. Provider-side reform

“[We will put] front-lime staff in charge of their ward or unit budgets, and [allow] staff to establish employee trusts giving them real involvement and a say over how their service is run.” (page 42, Liberal Democrat manifesto)

3. Any Willing Provider

“[We will reduce] centralised targets and bureaucracy, replacing them with entitlements guaranteeing that patients get diagnosis and treatment on time. If not, the NHS will pay for the treatment to be provided privately.” (page 42, Liberal Democrat manifesto)

“[We will give] Local Health Boards the freedom to commission services for local people from a range of different types of provider, including for example staff co-operatives, on the basis of a level playing field – ending any current bias in favour of private providers.” (page 42, Liberal Democrat manifesto)

4. Choice

“[We will give] every patient the right to choose to register with the GP they want, without being restricted by where they live, and the right to access their GP by email.” (page 43, Liberal Democrat manifesto)

5. Reorganisation

“We will cut the size of the Department of Health by half, abolish unnecessary quangos such as Connecting for Health, and cut the budgets of the rest, scrap Strategic Health Authorities and seek to limit the pay and bonuses of top NHS managers so that none are paid more than the Prime Minister.” (pages 40-41, Liberal Democrat manifesto).

6. Targets / bureaucracy

“[We will reduce] centralised targets and bureaucracy.” (page 42, Liberal Democrat manifesto)

“We will cut the size of the Department of Health by half, abolish unnecessary quangos such as Connecting for Health, and cut the budgets of the rest, scrap Strategic Health Authorities and seek to limit the pay and bonuses of top NHS managers so that none are paid more than the Prime Minister.” (pages 40-41, Liberal Democrat manifesto).

7. Social enterprises

“[We will allow] staff to establish employee trusts giving them real involvement and a say over how their service is run.” (page 42, Liberal Democrat manifesto)


Myth: The reforms open up all parts of the NHS to private health companies:

Unlike the last Labour Government, we aren’t setting an arbitrary percentage of services that must be run by the private sector, with guaranteed volume levels and higher prices. Instead, any willing provider means that patients will be able to choose on the basis of quality, but without guarantees for providers. Private providers will not be able to “cherry pick” services. The less complex the procedure, the less someone-including in the private sector-will be paid. Unlike Labour, we won’t rig the market in favour of the private sector. That’s why Monitor has been given the powers of an economic regulator to prevent anti-competitive behaviour.


Myth: The legislation seriously restricts openness, scrutiny and accountability both the public and to Parliament.

This couldn’t be further from the truth. Under Labour the right of local authorities to scrutinise local health services was restricted to public healthcare providers. Where as before there were limitations on where the scrutiny could go under our changes scrutiny will now, for the first time, be able to follow the NHS pound by allowing local authorities to scrutinise private providers.

Local govt will no longer just be an observer when it comes to health commissioning. Instead they will be responsible for shaping local health services through Health and Wellbeing Boards, which will inject real democratic legitimacy into the NHS for the first time in almost 40 years.

GP consortia will be public bodies with a range of legal duties including adhering to the ‘Nolan principles’ of good governance and ensuring public and patient engagement.

The Secretary of State and the Department of Health will continue to retain overall accountability for the NHS. The Secretary of State will set a ‘mandate’ for the NHS Commissioning Board which sets out key priorities and outcomes for the NHS, this will be produced annually and will be subject to consultation and reporting to Parliament; our aim is to make political accountability more transparent ensuring that Ministers will no longer be able to micromanage the system in the way the last Government did.


Myth: Conservative ideology of full market competition is at the heart of this NHS reorganisation:

Not true.
Our manifesto included a commitment to commission services “on the basis of a level playing field” (p. 43). That is exactly what the ‘Any Willing Provider’ model allows for. We want patients to be able to choose to be treated wherever they want to be – whether it’s an NHS hospital, or one in the voluntary or private sectors. This is because more choice will lead to better care for patients. But we don’t want to set a target for the amount of private sector involvement in the NHS – unlike Labour – and unlike Labour we won’t pay the private sector any more than we would pay the NHS.


Myth: The BMA describe the changes as ‘extremely risky and potentially disastrous.

This is effectively the same position the BMA has held on NHS reform for years. It should not be forgotten that the BMA opposed the original creation of the NHS in 1948. It is a sad truth that the Labour Party, which once had interesting ideas on the NHS, now aligns itself with the opponents of modernisation. However, the Labour Party does seem confused about whether it is the principles or the implementation it objects to:
John Healey's speech to The King’s Fund: 19/01/11
“The general aims of reform are sound – greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes – and are common ground between patients, health professions and political parties.
 
Saturday, January 22, 2011
  The Cootes Family back in Suffolk
This is an Anglia TV story about the Cootes Family that went to live next door to Sam Hallimond in Los Monterisinos.

Sam and Vanessa have now got their son with him in Spain, but his previous daughter is lost to them in the English adoption system.
 
Thursday, January 20, 2011
  TEQs launch event
The link is to videos of Tuesday's TEQs launch event.
 
  A pay freeze for public sector workers has to include MPs
I cannot believe the SSRB has said that MPs should have a pay increase. That is clearly nonsense. MPs are public sector workers and have to be covered by the pay freeze.
 
Wednesday, January 19, 2011
  Education Maintenance Allowance (EMA)
The issue of EMA has been debated today in the House of Commons. No-one is saying that the system should not change.

The difficulty is working out what proportion of EMA is spent on unnecessary things. It is clear that many students rely on it for transport, but not all of them.

What I have been doing is working with the 6th form Colleges in Birmingham to try to find out what is essential.

Only when we have that information can we judge how much money should be in the replacement scheme.
 
Sunday, January 16, 2011
  The human misery behind the statistics
The link is to a story in today's Sunday Telegraph.
In recent months, I have reported on many disturbing examples of how our system of “family protection” has gone horribly off the rails, but none is more bizarre than this week’s. As usual, I am legally barred from identifying the mother at the centre of this case or giving many other details, but she is in her mid-thirties, has various academic qualifications and some time back returned to England after 10 years working in America. There, among other things, she had worked as a counsellor in Guantanamo Bay, but what she saw there led her to start a new career as a financial adviser.

In September 2009, after a difficult pregnancy, she gave birth to a daughter, by an old friend with whom marriage was not possible. Two months later, she was sitting on her mother’s windowsill, dressed in a coat and hat ready to go out, when she fell, snatching at a curtain in a vain attempt to save herself.

She woke up in hospital, paralysed from the neck down. Soon afterwards, a nurse handed her a phone. It was a social worker from the local council, to tell her that her daughter – who was being looked after by her sister – was to be placed in care and put up for adoption within six weeks. “I was so paralysed,” she says, “that I couldn’t wipe the tears from my eyes.”


The link is to this story. This is what "concurrent planning" is about.
 
Saturday, January 15, 2011
  Ed Milliband, Lib Dems and Coalition
The real problem with Ed Milliband's approach to Lib Dems is that it ignores those aspects of the coalition policy which are simply a rational approach to reality with him trying to pretend they are ideological.

There is no uncertainty about the underlying need to reduce the size of the structural deficit. This can easily be quantified and we now also have the Office of Budget Responsibility to look at this. We can monitor the interest rates on sovereign debt and it is very clear that the overall financial envelope of government policy is not something where there are real alternative options.

There is, additionally, a more ideological question as to the size of the state. This of often measured in terms of the proportion of the GDP which is spent by the state.

After the cuts the state will still be spending over 40% of GDP. Historically this is higher than the first two Blair governments. Hence ideologically from this aspect the proposal about the same (and possibly a bit more statist) than Blairism.

Hence the Labour position is transparently not based in a proper understanding of reality.

Labour almost bankrupted the country and the worst aspect of this is that they do not recognise that. Hence they cannot be trusted.

In Birmingham we face some real challenges maintaining public services in the context of reducing resources. It is possible, but not by attempting to hold back the tide of changes like King Cnut - a la Labour Party.

Labour wish that things were different. I wish that things were different, but at least I recognise that they are not and we have to get on and deal with the situation.
 
  Bullying of Constituents and Contempt of Parliament
Today in parliament has picked up on the issue of Bullying of Constituents. It is about 10 minutes in here.
 
Friday, January 14, 2011
  Social workers accused of "penguin mentality"
The link is to the story in the Birmingham Mail today. This is where a Birmingham politician (not me) has said:
“It’s what I call the penguin complex among social workers. They live in a different continent to the rest of us, like Antarctica, and at the slightest criticism they all go into a huge huddle, turning their backs and shield each other.”

(Len Clark)

In part the rest of society is to blame by tending to look for a scapegoat when things go wrong. However, things will not improve if people do not respond to suggestions for change other than by resisting it.
 
Wednesday, January 12, 2011
  TB and Birmingham
Sadly someone has now died from TB in a Birmingham School. The school was one in Yardley, but the majority of children at that School are not from Yardley.

Birmingham as a whole qualifies for having the option of a TB vaccination in school as do the HOB and BEN PCT areas although not the South Birmingham Area.

Since 2005 I have been calling for an extension of TB vaccination as an option at school. More recently the Council has come on side on this and I am hoping that this will change in the near future.
 
Thursday, January 06, 2011
  Refuse Collection and Equal Pay in Birmingham
There is a lot of confusion about the issues behind the industrial action by Refuse Collectors in Birmingham.

What is clear is that there have been problems collecting the rubbish.

The background to the issue is Single Status and the Pay and Grading Review. Most of the pain in this process arose from the need to cut some people's pay to fit the overall pay scale.

Initially the Refuse Collectors were "assimilated" part way up the grade. However, legal action was taken against the council which declared that this particular proposal was unlawful. Hence the council has been forced to cut the pay of the refuse collectors.

The alternative is to increase the pay of everyone working for the City Council by around £4,000. That is because the system of pay grades include the vast majority of council employees and it is not possible to have a separate scheme.

The comparison made was between Refuse Operatives (Bin Men) and Canteen Workers (Dinner Ladies). Personally I have worked as a Night Cook in a Hospital. Personally I think Refuse Collecting is a job that should pay more given the demands. However, the law says otherwise.

The pay reduction went through in 2010.

So, we have had Christmas, lots of Snow and a strike. The initial strike had no effect because it was on a day when rubbish would not be collected. There also has been "working to rule". That means that the Refuse Collectors will not do overtime to clear up the mess. The Council, however, does have agency staff and casuals who are working to clear the rubbish as well.

I am not surprised that the Refuse Collectors are protesting. I have some sympathy with their situation, but the council does have to follow the law. I do not support the industrial action.

There are also other actions being taken which are not at all acceptable. The photos of bin bags below are ones I took with my mobile phone just after a refuse collecting truck had gone down this road.

In other words they have deliberately decided not to pick up all the rubbisn in that road. They are supposed to collect it from frontages and not only if it is on the road. However, if you look at the photos you will see that the rubbish is really quite close to the road in any event.

There also have been small groves missed out.
IMAG0127
IMAG0126
Rubbish piles just after a refuse collection truck has been down the road.
 

Click Here for access to higher resolution versions of the photos The license for use allows use of the photos by media as long as they are attributed.

better brent chart

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