Announce a new ring-fence and 2% real terms budget increases paid for by welfare cuts. Labour won't be able to do that.
Plus Wales. The government need to make a big play of NHS Wales which is controlled totally by Labour and has had deep budget cuts compared to an effective real terms freeze in England.
Really though it is defeat from the jaws of victory for Cameron here, he had it nailed, even the waxworks picture of himself in the famous billboard advert got the message across, "I can be trusted on the NHS". He then allowed Lansley to reorganise it after promising not to allow such a thing, and while £3bn spent is a drop in the ocean over a five year spending period for the NHS (less than 1%), the reputation damage incurred was all self-inflicted. Worse still the Lansley reforms essentially amounted to primary care trusts being renamed to GP commissioning bodies, with the staff and management paid off and rehired on new terms with the same but different job titles.
The problem is that even when Burnham is accused of mishandling the NHS, even when the Tories were the only party to ring-fence NHS spending, even when the issues with the Welsh NHS are available; Labour are still are more trusted on the NHS.
Cameron needs to decontaminate with some some kind of bold public gesture. Maybe ask Juncker to nominate Lansley as the next Commissioner For Dying By Firing Squad.
Mr. Hopkins, preconceptions about each party's strengths are very hard to budge. Labour has Health and Education, the Conservatives have Defence, Law & Order and (now) the Economy.
A better strategy might be to ignore the NHS and play a straight bat where necessary, and instead raise the 'hard' issues on which the blues have a seemingly natural advantage in the mind of the voter.
Is your very question not precisely the problem? The whole debate seems to have become one about how to protect the NHS. We need a debate how best to serve patients with a limited health budget. The NHS is part of the problem. It needs to be broken up or privatised or somehow made to feel the winds of competition. But it's a monolithic Stalinist monster. How do we move to a consumer rather than a producer driven debate?
The problem is that even when Burnham is accused of mishandling the NHS, even when the Tories were the only party to ring-fence NHS spending, even when the issues with the Welsh NHS are available; Labour still are more trusted on the NHS.
So how do the Tories get their message across?
It might be the Conservatives are never able to out perform Labour on the NHS but simply to limit the damage electorally.
The NHS isn't the silver bullet for Labour or a stake through the heart of the Conservatives.
Is your very question not precisely the problem? The whole debate seems to have become one about how to protect the NHS. We need a debate how best to serve patients with a limited health budget. The NHS is part of the problem. It needs to be broken up or privatised or somehow made to feel the winds of competition. But it's a monolithic Stalinist monster. How do we move to a consumer rather than a producer driven debate?
It's already been broken up, it's now a regulated market with heavy political intervention. There are hundreds of buyers and sellers. NHS is now a brand rather than an organisation. The Government is desperate to avoid a winter crisis, so they're throwing cash at health economies on the condition that they operate on anyone who's waited 16 weeks for an operation this summer. A transparent attempt to stop the 18 weeks target being broken, because they know a bad winter could knock the whole thing over before the election
Maybe Labour's lead on the NHS is not a cause of their lead in the polls but a result: people say they trust Labour more on the NHS because they want to vote for them but can't actually think of any reason to do so. The economy? No. Employment? No. Welfare? No way. Immigration? Certainly not. Ah yes - the NHS.
The other factor is that with a lead on the NHS Labour have an overall polling lead of around 2-4% nationally, if the Tories are able to make a big play of Wales and a new ringfence (if they go for one) then it erodes Labour's advantage. Labour's NHS strength is already priced into the polls, where I think there is still some economic recovery yet to factor in as wages post taxes and benefits are still rising relatively slowly and will not rise quickly until the end of the third quarter this year. A continued economic recovery and any weakening of Labour's NHS strength will turn a 2-4% national polling lead into a 2-3% deficit, which would still make Labour the largest party in terms of seats, but only by a whisker and with a real democratic deficit if they don't win the popular vote.
Is your very question not precisely the problem? The whole debate seems to have become one about how to protect the NHS. We need a debate how best to serve patients with a limited health budget. The NHS is part of the problem. It needs to be broken up or privatised or somehow made to feel the winds of competition. But it's a monolithic Stalinist monster. How do we move to a consumer rather than a producer driven debate?
Your answer is why Labour will always have the NHS trump card. The NHS is much more efficient at providing health than the models you suggest. The very mention of nhs and privatise in the same sentance drives votes to Ed. Even though Alan Milburn is the architect of the Provider model that set the nhs off on the slippery slope
Is your very question not precisely the problem? The whole debate seems to have become one about how to protect the NHS. We need a debate how best to serve patients with a limited health budget. The NHS is part of the problem. It needs to be broken up or privatised or somehow made to feel the winds of competition. But it's a monolithic Stalinist monster. How do we move to a consumer rather than a producer driven debate?
Your answer is why Labour will always have the NHS trump card. The NHS is much more efficient at providing health than the models you suggest. The very mention of nhs and privatise in the same sentance drives votes to Ed. Even though Alan Milburn is the architect of the Provider model that set the nhs off on the slippery slope
Bullshit on the efficiency point. Spot-on on the political perceptions thereof point. I blame lefty scaremongering.
If you think things are bad in England, come check the NHS out in Wales.
There is genuine, growing anger about services here in Wales. Our local surgery, for instance, is now an absolute mess (I've known nothing like it, it's changed so much across my lifetime (36); I feel sorry for the people who work there - you can't get an appointment for toffee).
Trouble is for the Tories, I doubt many Welsh people even realise that it's run by Labour.
''The very mention of nhs and privatise in the same sentence drives votes to Ed.''
100% correct. But perhaps people are open to certain procedures being 'spun off' from the public purse??
Like cancer services in Cumbria already are being. Next time you get a referral, ask what your options are, in lots of cases you can go private. The political rhetoric around the NHS is well out of date
I doubt many Welsh people even realise that it's run by Labour.
The Welsh conservatives should be much more aggressive and much more imaginative here. They can take the fight to labour's ground! what are they waiting for??!!? They can start saying
'Why go over the border??? vote conservative....and get English services here!!!
Education is also in a parlous state. Labour are desperately slashing all points of comparison between England and Wales to hide the schools catastrophe.
Most people (by definition, or there would be riots) have a good experience with the NHS. We have had five years of Tory/Cons oversight and so most people will presumably have had five years of good NHS experiences.
The danger for Lab is that if they bang on about how dreadful or imperiled it is under the Tories most people will look to their own experiences and say to themselves: nah, it's been fine.
Good graphics, but if the government is able to neutralise the NHS at any election, it is surely this coming one.
No chance I suggest you look at the latest set of accounts from your local acute hospital. Over half of acute providers are in perilous financial health. Only surviving and by DH emergency bail outs. The pothole fund whereby nhs allocation is given to councils and not reinvested in health and athe stupid mechanism whereby acutes only get paid 30% cost for all extra A&E attendances will push many acutes over the edge. Anyway I am at cricket and haven't got time to explain to people like you who don't get what damage the Tory reforms to the nhs are doing.
But the Tories can't neutralise the NHS. Because of the crazy and stupid Lansley restructuring the news is going to continue to get worse.
So the ideologues hope, but in fact satisfaction with the NHS is near an all-time high. It peaked in 2010, fell sharply in 2011 (presumably because of the papers being full of doom and gloom about it), and has since recovered somewhat:
In only two of the past 30 years (2009 and 2010) have satisfaction levels been greater than those recorded in 2012 and 2013. ... The proportion of people who are dissatisfied with the NHS overall is also low by historical standards. When we look at net satisfaction levels – that is, the number of people who are satisfied minus the number who are dissatisfied – the net difference between satisfaction and dissatisfaction in 2013 remains the third highest since 1983 at 38 per cent
Once again you offer no answers as to what you would do with the children of someone who has been refused benefits under your regime. They have themselves and a family to feed. How do you think they do so if they have neither a job nor benefits?
To be honest given what has being revealed over the last few days and continues to be revealed, speculation on the election based on polls such as these has the feel of two people in a pub on 2nd September 1939 speculating on who would win the 1942 world cup.
The NHS is run so well in Wales that people in my income bracket get zero money from child tax credits but as many free prescriptions as I fecking well like.
I have a houseful of asthma inhalers if anyone wants some.
Lansley reforms are coming home to roost. Give CCG(GPS basically)all the money and let them decide whether to invest it with GPS in primary care or spend it in a&E. Guess where it goes complete conflict of interest. Your local hospital will almost certaintly be falling over as we speak. Anyway Derbyshire are 139-3 and sun is out in beautiful queens park
His ideas (right or wrong) were rather mangled and diluted/amended to try and keep the Lib Dems (and maybe some blue backbenchers) onside.
Of course, that doesn't mean the end result isn't a steaming pile of horse manure anyway.
Also worth mentioning Labour's bloody awful failure at renegotiating GP terms. Alan Johnson's a very likeable chap, but as a negotiator he was bloody useless.
But the Tories can't neutralise the NHS. Because of the crazy and stupid Lansley restructuring the news is going to continue to get worse.
Indeed. Worse for the Tories is that the reason the news is getting worse is because we have an ageing population and finances are stretched, but it will be very easy for Labour to plant the worsening service firmly at Lansley and the Tories' door.
From what I can tell the reality is that the reforms amounted to a £3bn rebranding exercise and the operational differences pre and post reforms are non-existent.
Once again you offer no answers as to what you would do with the children of someone who has been refused benefits under your regime. They have themselves and a family to feed. How do you think they do so if they have neither a job nor benefits?
Yes I did. I did it by pointing out you were using a strawman argument
I said that if someone we unable to work and wasn't looking for a job then they wouldn't have been getting JSA anyway so it wouldn't be being taken away
If someone is getting JSA they are signing every other week to declare they are able to work and therefore they get dole. Your mother of three wouldn't be doing this would she? Because she is unable to work
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
If Labour came up with the best, most workable, most plausible immigration plans ever they'd still trail the Conservatives on the issue. The NHS is like this in reverse, the reality for better or worse barely matters - Labour will pretty much always have a lead on it.
The important to me and my family are things that the person can control
The important to the country are things only the state should control
Completely wrongheaded to dismiss the latter for scoring more than the former, in fact it's probably more likely to get people to vote if the country score is higher
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
That was meant to be the upside ofthe Lansley reforms. Then we got micromanagement from Hunt, who phones Trusts up personally
But its record up to 2010 in the UK - and in Wales since - really is nothing they should be proud of.
The problem for the Tories is that simply responding "Wales and Stafford" doesn't resonate. And, of course, there's a lot that Cameron said before GE2010 that'll be chucked back at him.
There were three mega-mistakes: appointing Lansley in the first place, then allowing him to black-ball the LD Norman Lamb as number 2 and then letting him move on with his "reform" plan in 2010.
The LD message for GE2015 will be that you can't trust LAB with the economy or the Tories with the NHS.
Most people (by definition, or there would be riots) have a good experience with the NHS. We have had five years of Tory/Cons oversight and so most people will presumably have had five years of good NHS experiences.
The danger for Lab is that if they bang on about how dreadful or imperiled it is under the Tories most people will look to their own experiences and say to themselves: nah, it's been fine.
Seems I need to remind Conservative supporters as well as the likes of BenM that plaudits or brickbats are owed to the Coalition.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Someone did, or at least tried to:
Q: What is the independent NHS Board?
A: The Tories have long called for an independent board to run the NHS, accountable to the Health Secretary.
Unfortunately this got a bit watered down when the LibDems got cold feet and ganged up with Labour to damage the reforms which they'd jointly proposed with Lansley a few months earlier.
The problem for the Tories is that simply responding "Wales and Stafford" doesn't resonate.
Not so sure about that. Of course they need to keep repeating it, ad nauseam, to get the message through, but they are doing that. Luckily Ed Miliband is giving them every opportunity to do so.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
The £3bn isn't really a big deal for the Tories, it's what Labour can try and paint the £3bn as. It's one thing for Labour to try and say the whole NHS is crumbling because Lansley wasted £3bn (it isn't and that wouldn't be why anyway), but the Tories don't really have a retort to that charge regardless of how big a lie it is.
As I said below, the Tories would do well to keep the ringfence or even extend it to guarantee 2% real terms budget increases over the next 5 year spending period paid for by welfare cuts.
The other major issue, and this strikes to the core of 30 years of poor policy by Tories and Labour, is not enough money is spent on preventative care and there isn't enough done within the education system to teach young people the health benefits of a balanced diet, it should start in primary school, modern parents clearly aren't up to the job given how many young kids I see with their parents in McDonalds and KFC on the way home from work so it is an area where the state will have to step in. Obesity, heart disease, high cholesterol, stroke, diabetes and heart attacks are all preventable problems in 9/10 cases, but we spend too much on saving people from within an inch of death rather than ensuring they don't get there in the first place. That is a structural and policy issue though and both parties are at fault.
Poking around the Halifax House Prices Index website, I have noticed that they do provide a regional breakdown of price rises in a supplementary Excel table. The data is not current, but shows price rises as an index based at 100 in 1983 and updated to end 2013.
Looking at the figures it shows that in no region is the index higher than its peak in 2007, but range of falls from peak go from -40 in Greater London to nearly -500 in Northern Ireland.
Here is a summary using 5 year breaks ranked left to right by 2013 index level:
Halifax House Prices Index - Historical Regional Variations
============================================================ GR. SOUTH SOUTH WALES EAST UK LONDON EAST WEST ANGLIA Index Index Index Index Index Index ------------------------------------------------------------ 1983 100.0 100.0 100.0 100.0 100.0 100.0 1988 245.3 232.4 217.6 162.3 248.9 184.8 1993 192.0 186.4 185.9 204.5 193.2 202.1 1998 272.3 244.2 226.4 220.2 224.4 233.7 2003 563.3 483.8 477.7 397.2 465.0 429.1 2008 705.3 588.6 583.2 579.4 600.8 585.9 2013 737.2 591.0 565.8 557.3 551.1 547.0 ------------------------------------------------------------ Peak 777.6 636.9 641.9 640.7 637.3 635.9 Fall -40.4 -45.9 -76.1 -83.4 -86.2 -88.9 ============================================================ UK WEST EAST YORKS NORTH NORTH SCOT N. MIDL. MIDL. & HUM. WEST LAND IRE. Index Index Index Index Index Index Index Index ------------------------------------------------------------ 1983 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 1988 184.8 185.8 187.0 155.0 149.0 136.7 139.7 126.7 1993 202.1 219.1 208.3 228.3 219.3 206.3 196.4 151.7 1998 233.7 250.0 229.9 229.8 220.4 211.2 209.8 235.6 2003 429.1 460.7 457.5 395.6 366.3 370.6 274.5 340.3 2008 585.9 591.9 582.0 580.0 558.3 547.2 478.2 679.2 2013 547.0 540.7 539.2 527.3 501.9 496.8 400.5 368.9 ------------------------------------------------------------ Peak 635.9 640.4 632.4 640.5 596.8 601.8 488.2 844.5 Fall -88.9 -99.7 -93.2 -113.2 -94.9 -105.0 -87.7 -475.6 ============================================================ Note: Peak = 2007 Prices, Fall calculated at end 2013 Prices
This adds weight to my speculation that reluctance to realise a nominal loss on resale of property is probably the main reason for low transaction volumes since the recession.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Isn't that what the Tories originally proposed, but then everyone started screaming about democratic oversight
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Not quite true to say that Cameron and Lansley's multi-billion Top Down Reorganisation achieved nothing.
It allowed profiteering private companies to cream off even more vast sums from stretched NHS budgets at the expense of taxpayers and patients.
Private companies like this
Private health care firms with Tory links have been awarded NHS contracts worth nearly £1.5billion.
Circle Health landed £1.36billion worth of health service work after several of its investors gifted about £1.5million to the Conservatives.
And Care UK has contracts worth another £102.6million. Its chairman John Nash was made a peer after boosting Tory coffers by £247,250.
Most people (by definition, or there would be riots) have a good experience with the NHS. We have had five years of Tory/Cons oversight and so most people will presumably have had five years of good NHS experiences.
The danger for Lab is that if they bang on about how dreadful or imperiled it is under the Tories most people will look to their own experiences and say to themselves: nah, it's been fine.
I'm sorry but I totally disagree. On the contrary, I would suggest that such is the collective brainwashing that the NHS is a national treasure, that even people who have had horriffic experiences on the NHS still feel that their experience is the exception and that the rest of the service must be great. Patients who've suffered are also often quick to blame 'underfunding' or 'staff shortages' -both of which are patently untrue. I've seen this in my own friends -one of whom has a grandfather who had a serious (but not life-threatening) operation in a local hospital. I gently advised her from the beginning that it was not a good place to be and to get him in and out asap. What happened? Obviously he got multiple infections, and died within a couple of weeks, not even recognising his family -a man who had not had a sick day in his life. Is she embittered toward the NHS? Not a single bit; she makes no connection between the two, and thinks the NHS is wonderful -and I am certainly not going to be insensitive enough to discourage her.
The bottom line is, until the money flows up from the patient (whether from their own pockets or via a Government endowment of some kind) rather than down from on high, the NHS will continue to be a national disgrace. You hear a lot about privatisation of the NHS, but outsourcing is not privatisation. It's privatising the wrong part. It's the demand end that needs to be privatised not the supply.
@MikeP - Ah, glad you brought that up. Since Andy Burnham set up the process which culminated in Circle Care being signed up to run Hinchingbrooke Hospital, it has been transformed for the better.
Lord Ashcroft: "The most interesting difference between my weekly telephone poll and the most frequently published online polls is not the levels of “volatility”, which are comparable, but the consistent differences in the combined share of the two main parties.
At the 2010 general election, Labour and the Conservatives together received 67 per cent of votes in Great Britain. Over the life of the ANP, YouGov and Populus have consistently found the combined two-party scores to be higher than this, and often above 70 per cent. The ANP, meanwhile, along with telephone pollsters ComRes and ICM, have found lower combined totals in some cases closer to 60 per cent."
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
Maybe Labour's lead on the NHS is not a cause of their lead in the polls but a result: people say they trust Labour more on the NHS because they want to vote for them but can't actually think of any reason to do so. The economy? No. Employment? No. Welfare? No way. Immigration? Certainly not. Ah yes - the NHS.
I think that Labour will almost invariably lead on health, as the Tories will on law and order and immigration.
The swing issue is the economy. The Tories also lead on employment, something which would once have unthinkable.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Obesity, heart disease, high cholesterol, stroke, diabetes and heart attacks are all preventable problems in 9/10 cases, ...
An outrageously silly claim (except about obesity, where the score must be close to 10/10), as a moment's googling will confirm.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Obesity, heart disease, high cholesterol, stroke, diabetes and heart attacks are all preventable problems in 9/10 cases, ...
An outrageously silly claim (except about obesity, where the score must be close to 10/10), as a moment's googling will confirm.
You are really saying that genetic predisposition accounts for more than 10% of people in these cases? That's a bold claim. Poor diet and sedentary lifestyles are the leading cause of chronic illness.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Not quite true to say that Cameron and Lansley's multi-billion Top Down Reorganisation achieved nothing.
It allowed profiteering private companies to cream off even more vast sums from stretched NHS budgets at the expense of taxpayers and patients.
Private companies like this
Private health care firms with Tory links have been awarded NHS contracts worth nearly £1.5billion.
Circle Health landed £1.36billion worth of health service work after several of its investors gifted about £1.5million to the Conservatives.
And Care UK has contracts worth another £102.6million. Its chairman John Nash was made a peer after boosting Tory coffers by £247,250.
If you are going to have a go at changes why not have a go at them from the perspective of the patients not the people paid by the system.
You have a go at Circle, for example, but are they not the people who took over a failed, never mind failing, hospital and turned it round to the satisfaction of patients and staff alike.
Please, how about thinking about the NHS from the patient experience. After all if Hitchinbroke hospital was doing such a fantastic job then Labour, Labour mark you, would not have decided that it needed to be put out to tender. FFS, if even Andy "staffs" Burnham thought that something had to be done it must have been dire.
Just try and think of it in these simple terms, the NHS exists not for its employees, it exists for the patients.
But its record up to 2010 in the UK - and in Wales since - really is nothing they should be proud of.
The problem for the Tories is that simply responding "Wales and Stafford" doesn't resonate. And, of course, there's a lot that Cameron said before GE2010 that'll be chucked back at him.
There were three mega-mistakes: appointing Lansley in the first place, then allowing him to black-ball the LD Norman Lamb as number 2 and then letting him move on with his "reform" plan in 2010.
The LD message for GE2015 will be that you can't trust LAB with the economy or the Tories with the NHS.
Not sure about that and your conclusions are at odds with expert systematic analysis.
For example, the Kings Fund published a paper in May on productivity in the NHS. Their core conclusion was as follows:
The unprecedented slowdown in the growth of NHS funding in England since 2010 required the NHS to pursue the most ambitious programme of productivity improvement since its foundation. It has broadly risen to the challenge, with pay restraint, cuts in central budgets, and the abolition of some tiers of management producing significant savings.
The Kings Fund also found that quality of care, service levels and patient satisfaction have all improved under the Coalition government with much due to the success of the Lansley reforms.
The Kings Fund's concern is that there is a limit to the extent to which productivity improvements can be realised without loss of service levels or a deterioration in clinical outcomes. Once this limit is reached, there will be a need to increase NHS funding as a proportion of GDP if it is to meet known future demands.
The solution to this lies in managing an economy so that it optimises growth at the same time as keeping total government spending falling as a percentage of GDP. This should allow spending on health to increase as a proportion of total spend.
In other words the approach and achievements of Osborne in managing the economy effectively are the most feasible means of supporting the NHS's future funding needs.
The problem the Conservatives have with the NHS are with communications not management of the service.
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
That's fair. The NHS in Luton is poor. Mental health services everywhere are diabolical. But, the London teaching hospitals are excellent. All, in my experience, of course.
The Kings Fund's concern is that there is a limit to the extent to which productivity improvements can be realised without loss of service levels or a deterioration in clinical outcomes. Once this limit is reached, there will be a need to increase NHS funding as a proportion of GDP if it is to meet known future demands.
I am willing to bet that we are nowhere near anything like that limit. The experience of the private sector has been that you can systematically improve productivity year after year after year. What tends to happen is that you go for the obvious things first (in the NHS, this might be rationalising inefficient procurement), but, as you keep at it, you find further savings which you didn't initially know were possible.
In all the various dealings which I've had with the NHS, it's always been clear that the organisation is not efficient, in myriad different ways - some small, some bigger.
That's not to say that there aren't lots of demographic and other pressures, of course.
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
That's fair. The NHS in Luton is poor. Mental health services everywhere are diabolical. But, the London teaching hospitals are excellent. All, in my experience, of course.
It just shows how personal experience differs.
A good friend of mine earlier this year had several days experience of Luton and Dunstable Hospital some ten years since his last in-patient treatment. He couldn't believe the transformation for the positive compared to the rotten experience he had previously endured.
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Obesity, heart disease, high cholesterol, stroke, diabetes and heart attacks are all preventable problems in 9/10 cases, ...
An outrageously silly claim (except about obesity, where the score must be close to 10/10), as a moment's googling will confirm.
You are really saying that genetic predisposition accounts for more than 10% of people in these cases? That's a bold claim. Poor diet and sedentary lifestyles are the leading cause of chronic illness.
That's not what you said. Stroke and heart attacks are not obviously counted among chronic illnesses, and "leading cause" does not equate to "cause of 90% of cases".
And to suggest that "genetic predisposition" and lifestyle factors are the only two competing causes of illness is a prize false dichotomy. People get ill because they just do.
Here's a claim by a body with a vested interest in ramping up avoidability, that one third of heart disease and stroke deaths might be preventable.
No it bloody well isn't, well, not universally so.
I am very pleased to hear you are getting good treatment. Why don't you have have a go at Mr Bigjohnowls, he's the one running the English NHS down.
Fair go, Mr. Taffy's, but I did say that the English NHS was a Curate's Egg, I have my fair share of horror stories from my diverse hospital stays (when I was in hospital for the first time, except for injures, in early 1998 my GP came to visit me, he told me, "You need to get out of here, old boy, or you'll end up dead").
As for taking on Big John, he is just spouting his beliefs as far as I can see and there is no point in tackling a man on his beliefs - mud wrestling a pig and all that.
Anyway my daughters college lecturers are going on strike tomorrow one day before their 8 week summer holiday begins. They are very hard done by. Can you imagine having an 8 week holiday from work and coming back to no work backlog, no emails to answer, just starting afresh. I do think sometimes people need to appreciate that maybe they in fact have quite a nice job.
The NHS most certainly is not crap,most of my working life I went private,but now use the NHS. After a lifetime of excessive outdoor pursuits my body finally rebelled,I have had 4 A&E visits,about 15 GP visits,and about 20 outpatient visits in the last year,thankfully I am now nearly fixed and returning to my outdoor pursuits. I have nothing but praise for the service I have received. My other experience is in looking after a young friend who had a bone marrow transplant,I regularly drive him to Christies for treatment,the staff are exemplary,and the cost of the treatment must be about £1000/visit,he has 4 trips a month. The bone marrow transplant is enormously complex and expensive,be thankful we have the NHS.
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
That's fair. The NHS in Luton is poor. Mental health services everywhere are diabolical. But, the London teaching hospitals are excellent. All, in my experience, of course.
It just shows how personal experience differs.
A good friend of mine earlier this year had several days experience of Luton and Dunstable Hospital some ten years since his last in-patient treatment. He couldn't believe the transformation for the positive compared to the rotten experience he had previously endured.
Last year, they operated on me for appendicitis. Initially, my GP diagnosed it as food poisoning. As I got worse, I got an appointment with the emergency GP at the hospital, who diagnosed it correctly, and e-mailed the surgery to operate on me immediately. They never got the e-mail. 24 hours later, I was running a very high temperature, with no operation in sight. My wife made a massive fuss, and an operation was booked for the evening. Then, I was told they had had to cancel my operation, due to the man before me having a heart attack, in the operating theatre! (as well as filling me with confidence, that's a huge breach of confidentiality. ) I was finally operated on 36 hours after the GP said it was an emergency.
I did get to experience morphine injections, which are wonderful.
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
That's fair. The NHS in Luton is poor. Mental health services everywhere are diabolical. But, the London teaching hospitals are excellent. All, in my experience, of course.
It just shows how personal experience differs.
A good friend of mine earlier this year had several days experience of Luton and Dunstable Hospital some ten years since his last in-patient treatment. He couldn't believe the transformation for the positive compared to the rotten experience he had previously endured.
Last year, they operated on me for appendicitis. Initially, my GP diagnosed it as food poisoning. As I got worse, I got an appointment with the emergency GP at the hospital, who diagnosed it correctly, and e-mailed the surgery to operate on me immediately. They never got the e-mail. 24 hours later, I was running a very high temperature, with no operation in sight. My wife made a massive fuss, and an operation was booked for the evening. Then, I was told they had had to cancel my operation, due to the man before me having a heart attack, in the operating theatre! (as well as filling me with confidence, that's a huge breach of confidentiality. ) I was finally operated on 36 hours after the GP said it was an emergency.
I did get to experience morphine injections, which are wonderful.
I'm reconciled to the fact that I'll probably end my days in the Luton & Dunstable or in the ambulance on the way.
Creating the narrative that the NHS is in serious trouble is Labour's last throw of the dice to try and win in 2015.
First up, too far too fast & economic disaster. Failed as Osbo actually didn't actually cut very much at all and fixed many of the basic's.
Next up, cost of living crisis. Failed as the economy races ahead.
Now its NHS crisis time, in the hands of those evil Tories, brought forward from the planned time on Labour's planning matrix as the first 2 economic story lines have bombed out.
Trouble is the NHS in England is getting better. Hunt does actually focus on patient outcomes. Sure parts of the system don't like it as they have to work better i.e. the unions & doctors, so they moan, but overall it is improving. The contrast with Wales is clear and a real problem for Miliband whenever he raises the NHS.
Labour have had advantage on the NHS politically for ages, but they've had to go on it far too early as their lead attack issue. Cameron & Co have months to neutralise the narrative and I wouldn't be at all surprised if come May 2015 the Tories are actually ahead on the NHS.
Unless there's some mega heat wave this summer that starts killing off old folk like they had in France a few years ago, there's no way the NHS will be an issue in the summer. In Labour's ideal world, we will have a terrible winter 2014/5 with lots of flu around and the system gets massively overloaded (as they hoped for last winter), so they can attack Cameron with current stats and events. Going now on the NHS is just too soon and they won't be able to sustain a credible narrative.
I'm not surprised Labour are having a mini boost of a couple of points, but it ain't going to last.
After a lifetime of excessive outdoor pursuits my body finally rebelled,I have had 4 A&E visits,about 15 GP visits,and about 20 outpatient visits in the last year,thankfully I am now nearly fixed and returning to my outdoor pursuits.
May I respectfully ask why after self-inflicted injury whilst voluntarily engaged in "lifetime of excessive outdoor pursuits" you think it's fair that taxpayers pay for you to be repaired ... for a return to doing the same lifestyle-choice "outdoor pursuits"?
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
That's fair. The NHS in Luton is poor. Mental health services everywhere are diabolical. But, the London teaching hospitals are excellent. All, in my experience, of course.
It just shows how personal experience differs.
A good friend of mine earlier this year had several days experience of Luton and Dunstable Hospital some ten years since his last in-patient treatment. He couldn't believe the transformation for the positive compared to the rotten experience he had previously endured.
Last year, they operated on me for appendicitis. Initially, my GP diagnosed it as food poisoning. As I got worse, I got an appointment with the emergency GP at the hospital, who diagnosed it correctly, and e-mailed the surgery to operate on me immediately. They never got the e-mail. 24 hours later, I was running a very high temperature, with no operation in sight. My wife made a massive fuss, and an operation was booked for the evening. Then, I was told they had had to cancel my operation, due to the man before me having a heart attack, in the operating theatre! (as well as filling me with confidence, that's a huge breach of confidentiality. ) I was finally operated on 36 hours after the GP said it was an emergency.
I did get to experience morphine injections, which are wonderful.
I'm reconciled to the fact that I'll probably end my days in the Luton & Dunstable or in the ambulance on the way.
I think it was the emergency GP and my wife who saved my life. In between his diagnosis, and eventually seeing a consultant, there was a wait of 4 hours. I felt so shattered, that I just wanted to go home to bed, but my wife wouldn't let me.
@Sean_F "I did get to experience morphine injections, which are wonderful." Yes totally agree,I once got rescued after a fall in the mountains and they gave me the air and gas mix used normally for childbirth,wonderful stuff,much better than alcohol. Morphine was for an intolerable back injury,and again wow,it works.
After a lifetime of excessive outdoor pursuits my body finally rebelled,I have had 4 A&E visits,about 15 GP visits,and about 20 outpatient visits in the last year,thankfully I am now nearly fixed and returning to my outdoor pursuits.
May I respectfully ask why after self-inflicted injury whilst voluntarily engaged in "lifetime of excessive outdoor pursuits" you think it's fair that taxpayers pay for you to be repaired ... for a return to doing the same lifestyle-choice "outdoor pursuits"?
Quite happy to pay,always went private for most of my life,also on the very few occasions I have needed rescue etc,I have always paid a large donation to those involved. I don't smoke,am not obese,have made very few demands on the NHS apart from this one problem. If I did not enjoy my outdoor pursuits I would much less healthy. Anyway got to go,off out climbing.
Lord Ashcroft: "The most interesting difference between my weekly telephone poll and the most frequently published online polls is not the levels of “volatility”, which are comparable, but the consistent differences in the combined share of the two main parties.
At the 2010 general election, Labour and the Conservatives together received 67 per cent of votes in Great Britain. Over the life of the ANP, YouGov and Populus have consistently found the combined two-party scores to be higher than this, and often above 70 per cent. The ANP, meanwhile, along with telephone pollsters ComRes and ICM, have found lower combined totals in some cases closer to 60 per cent."
"My wife made a massive fuss, and an operation was booked... "
Now that just rings so true. Time after time I have found with the NHS if someone with sufficient backbone and who is sufficiently articulate says, "Excuse me, but ...", then a lot of different options suddenly become available. I do wonder sometimes if some of the early death rates are not due to people actually passively accepting what their quacks say.
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
That's fair. The NHS in Luton is poor. Mental health services everywhere are diabolical. But, the London teaching hospitals are excellent. All, in my experience, of course.
It just shows how personal experience differs.
A good friend of mine earlier this year had several days experience of Luton and Dunstable Hospital some ten years since his last in-patient treatment. He couldn't believe the transformation for the positive compared to the rotten experience he had previously endured.
Last year, they operated on me for appendicitis. Initially, my GP diagnosed it as food poisoning. As I got worse, I got an appointment with the emergency GP at the hospital, who diagnosed it correctly, and e-mailed the surgery to operate on me immediately. They never got the e-mail. 24 hours later, I was running a very high temperature, with no operation in sight. My wife made a massive fuss, and an operation was booked for the evening. Then, I was told they had had to cancel my operation, due to the man before me having a heart attack, in the operating theatre! (as well as filling me with confidence, that's a huge breach of confidentiality. ) I was finally operated on 36 hours after the GP said it was an emergency.
I did get to experience morphine injections, which are wonderful.
I'm reconciled to the fact that I'll probably end my days in the Luton & Dunstable or in the ambulance on the way.
I think it was the emergency GP and my wife who saved my life. In between his diagnosis, and eventually seeing a consultant, there was a wait of 4 hours. I felt so shattered, that I just wanted to go home to bed, but my wife wouldn't let me.
My last visit to hospital was for appendicitis (many moons ago now) but my experience was vastly different to yours. Went to see the Doc first thing Monday morning, told him what was wrong, a chopper down to RAF Akrotiri and on the table - 4 hours start to finish.
Most people (by definition, or there would be riots) have a good experience with the NHS. We have had five years of Tory/Cons oversight and so most people will presumably have had five years of good NHS experiences.
The danger for Lab is that if they bang on about how dreadful or imperiled it is under the Tories most people will look to their own experiences and say to themselves: nah, it's been fine.
I'm sorry but I totally disagree. On the contrary, I would suggest that such is the collective brainwashing that the NHS is a national treasure, that even people who have had horriffic experiences on the NHS still feel that their experience is the exception and that the rest of the service must be great.
The polling data is pretty clear - most people by a large margin have positive experiences from the NHS, and IIRC most people think it's got a bit worse under the Coalition. It was noticeable last week that when Miliband asked all the questions on the NHS, people here said "Ah, yeah, home issue, a bit desperate to fall back on that".
You might be right that people who do have horrid experiences think they must be an exception, just as people who don't get burgled think they've been lucky, not that burglary is now relatively rare. But it's difficult to argue that people aren't (a) broadly satisfied (b) very interested (c) somewhat concerned about the trend and (d) inclined to think Labour is more unambiguously in favour of improving it. We can argue about whether they're right, but that's a separate issue.
The Kings Fund's concern is that there is a limit to the extent to which productivity improvements can be realised without loss of service levels or a deterioration in clinical outcomes. Once this limit is reached, there will be a need to increase NHS funding as a proportion of GDP if it is to meet known future demands.
I am willing to bet that we are nowhere near anything like that limit. The experience of the private sector has been that you can systematically improve productivity year after year after year. What tends to happen is that you go for the obvious things first (in the NHS, this might be rationalising inefficient procurement), but, as you keep at it, you find further savings which you didn't initially know were possible.
In all the various dealings which I've had with the NHS, it's always been clear that the organisation is not efficient, in myriad different ways - some small, some bigger.
That's not to say that there aren't lots of demographic and other pressures, of course.
I agree. The NHS in its current structure must be near impossible to manage.
But Lansley's reforms have [deliberately and dishonestly] been portrayed as an unnecessary expense and distraction. In reality they are making a significant difference by moving responsibility for change (on commissioning) to clinicians which moves decision making one step closer to user need. This alone is worth all the investment, disruption and political capital spent.
A similar move to embed culture change into the NHS to achieve continuous and incremental productivity improvement and cost saving is needed. Future NHS needs will not be met solely out of productivity improvement but looking to increased funding is not the sole answer either. The competitive pursuit of profit is probably the best known means of ensuring continued cost control and innovative process, but this is not, in its full blown form, a current option for the NHS.
Cameron needs to search his cabinet and back benches for another ex. SDP reformer to take on this brief in the next parliament. Hunt is excellent as a placebo but I am not convinced he is right as a radical cure.
NHS. Without some sort of reliable statistics one falls back on anecdote. Over 40 yrs and more I have seen the hospital in Bedford go from a somewhat dingy and low spirited place to a bright spirited one with generally helpful care. And personal treatment of me and mine has generally been very good. Now we hear routinely of threats of closure of this and that, or of the whole shebang. I don't believe that's going to enhance the Tory chances. Maybe the fact that we are a marginal seat might work to our advantage. I don't know.
Most people (by definition, or there would be riots) have a good experience with the NHS. We have had five years of Tory/Cons oversight and so most people will presumably have had five years of good NHS experiences.
The danger for Lab is that if they bang on about how dreadful or imperiled it is under the Tories most people will look to their own experiences and say to themselves: nah, it's been fine.
I'm sorry but I totally disagree. On the contrary, I would suggest that such is the collective brainwashing that the NHS is a national treasure, that even people who have had horriffic experiences on the NHS still feel that their experience is the exception and that the rest of the service must be great.
Lord Ashcroft: "The most interesting difference between my weekly telephone poll and the most frequently published online polls is not the levels of “volatility”, which are comparable, but the consistent differences in the combined share of the two main parties.
At the 2010 general election, Labour and the Conservatives together received 67 per cent of votes in Great Britain. Over the life of the ANP, YouGov and Populus have consistently found the combined two-party scores to be higher than this, and often above 70 per cent. The ANP, meanwhile, along with telephone pollsters ComRes and ICM, have found lower combined totals in some cases closer to 60 per cent."
I read that. I think Ashcroft plays a straight bat. The grey goddess of chaos and randomness is powerful.
I think I've mentioned this on more than one occasion. It's a huge disparity between pollsters and one that must be considered going forward.
On topic, we don't really have a National Health Service - we have a National Sickness Service. Concepts of promoting good public health and health education were the first casualties of economic cutbacks.
Most people don't use the NHS unless they are ill or know someone who is ill. In East Ham, I either see Dr Patel or Dr Singh (this may come as no surprise). Dr P wears a double-breasted three-piece suit which at least means if I visit on the way to the office I don't feel overdressed.
Cameron needs to search his cabinet and back benches for another ex. SDP reformer to take on this brief in the next parliament. Hunt is excellent as a placebo but I am not convinced he is right as a radical cure.
Hunt is excellent as a very political health minister - which is what is needed at the moment, whilst the Lansley reforms bed down. For nitty-gritty incremental improvement, I'd go for Hammond. But mostly, it's a question of letting the NHS get on with it, and bringing in efficient private providers like Circle to give the rest of the NHS something to aspire to.
"Labour’s problem is not just that the torrent of invective occupies air time and column inches that it could be using to popularise its agenda. It is much more fundamental than that. By persistently echoing (and amplifying) the media’s groans about politicians’ failings, the party is undermining voters’ residual faith in the political process. Why, bombarded by assertions of the venality and untrustworthiness of politicians, should ordinary folk not conclude that a steady-as-she-goes vote for the Tories (or indeed a protest vote for UKIP) is a safer option than Mr Miliband’s grand plans to re-engineer the British economy? Labour is not so much cutting off its nose to spite its face as sticking its entire head into a wood chipper. To paraphrase its leader, it can do better than this."
" we don't really have a National Health Service - we have a National Sickness Service. Concepts of promoting good public health and health education were the first casualties of economic cutbacks"
Hey, Mr. Stodge, see what you are getting at but when I am lying on the trolley at death's door I need some people who are going to fix me up not give me a lecture on good public health. A thousand words on the disadvantages of consuming too much sugar maybe worthwhile but if I am about to conk out through renal failure it may not be the best treatment.
When dosh is tight are you, you Mr. Stoge, going to tell Mrs. Smith she is about to become Widow Smith because the money that could have saved her husband has been spent on telling teenagers not to drink coca-cola and the like?
Cameron needs to search his cabinet and back benches for another ex. SDP reformer to take on this brief in the next parliament. Hunt is excellent as a placebo but I am not convinced he is right as a radical cure.
Hunt is excellent as a very political health minister - which is what is needed at the moment, whilst the Lansley reforms bed down. For nitty-gritty incremental improvement, I'd go for Hammond. But mostly, it's a question of letting the NHS get on with it, and bringing in efficient private providers like Circle to give the rest of the NHS something to aspire to.
Yes.
I must say I grow fed up of articles saying the NHS is bad news for the tories. Maybe it is, but how relevant is it compared to other issues? How relevant is any of it when it comes to persuading those people who are persadable when it comes to voting? If the govt, as is their duty, put pressure on teachers to perform and likewise on NHS staff, then all this sizeable group of people might well take umbridge and vote labour or whoever. Its the same with the entire public service. And people not in the public service might complain the govt are not tough enough!
But over and above all this some people - a lot of people - will make a more reasoned judgement.
Cameron needs to search his cabinet and back benches for another ex. SDP reformer to take on this brief in the next parliament. Hunt is excellent as a placebo but I am not convinced he is right as a radical cure.
Hunt is excellent as a very political health minister - which is what is needed at the moment, whilst the Lansley reforms bed down. For nitty-gritty incremental improvement, I'd go for Hammond. But mostly, it's a question of letting the NHS get on with it, and bringing in efficient private providers like Circle to give the rest of the NHS something to aspire to.
I was being slightly tongue-in-cheek on the SDP reformer proposal, but it does highlight that Lansley was not the radical, free-market reformer portrayed by disaffected Lib Dem bloggers, the Labour party and 2010 LD deserters to the left of both.
I also have great respect for the soft spoken Hunt who is thriving in his damage limitation and improved communication role at Health. Where next for him? Education?
Agree too on Hammond, who would be perfect for the role you describe.
Comments
Plus Wales. The government need to make a big play of NHS Wales which is controlled totally by Labour and has had deep budget cuts compared to an effective real terms freeze in England.
Really though it is defeat from the jaws of victory for Cameron here, he had it nailed, even the waxworks picture of himself in the famous billboard advert got the message across, "I can be trusted on the NHS". He then allowed Lansley to reorganise it after promising not to allow such a thing, and while £3bn spent is a drop in the ocean over a five year spending period for the NHS (less than 1%), the reputation damage incurred was all self-inflicted. Worse still the Lansley reforms essentially amounted to primary care trusts being renamed to GP commissioning bodies, with the staff and management paid off and rehired on new terms with the same but different job titles.
So how do the Tories get their message across?
http://blogs.spectator.co.uk/isabel-hardman/2014/07/exclusive-hopeless-warsi-resists-david-camerons-fight-against-extremism/
On-topic: is the NHS a serious issue, in terms of deciding votes?
Obviously if Yes wins Scotland will become critical as a political/foreign policy area, but otherwise the economy would still seem to be top dog.
A better strategy might be to ignore the NHS and play a straight bat where necessary, and instead raise the 'hard' issues on which the blues have a seemingly natural advantage in the mind of the voter.
The NHS isn't the silver bullet for Labour or a stake through the heart of the Conservatives.
The Government is desperate to avoid a winter crisis, so they're throwing cash at health economies on the condition that they operate on anyone who's waited 16 weeks for an operation this summer. A transparent attempt to stop the 18 weeks target being broken, because they know a bad winter could knock the whole thing over before the election
What else is there??
This is what makes Wales potentially so toxic, and why Welsh MPs are desperately trying to get Cameron off their backs.
Spot-on on the political perceptions thereof point.
I blame lefty scaremongering.
There is genuine, growing anger about services here in Wales. Our local surgery, for instance, is now an absolute mess (I've known nothing like it, it's changed so much across my lifetime (36); I feel sorry for the people who work there - you can't get an appointment for toffee).
Trouble is for the Tories, I doubt many Welsh people even realise that it's run by Labour.
100% correct. But perhaps people are open to certain procedures being 'spun off' from the public purse??
Next time you get a referral, ask what your options are, in lots of cases you can go private.
The political rhetoric around the NHS is well out of date
The Welsh conservatives should be much more aggressive and much more imaginative here. They can take the fight to labour's ground! what are they waiting for??!!? They can start saying
'Why go over the border??? vote conservative....and get English services here!!!
Education is also in a parlous state. Labour are desperately slashing all points of comparison between England and Wales to hide the schools catastrophe.
But they can't stop PISA....
The danger for Lab is that if they bang on about how dreadful or imperiled it is under the Tories most people will look to their own experiences and say to themselves: nah, it's been fine.
Anyway I am at cricket and haven't got time to explain to people like you who don't get what damage the Tory reforms to the nhs are doing.
In only two of the past 30 years (2009 and 2010) have satisfaction levels been greater than those recorded in 2012 and 2013.
...
The proportion of people who are dissatisfied with the NHS overall is also low by historical standards. When we look at net satisfaction levels – that is, the number of people who are satisfied minus the number who are dissatisfied – the net difference between satisfaction and dissatisfaction in 2013 remains the third highest since 1983 at 38 per cent
http://www.kingsfund.org.uk/projects/bsa-survey-2013/satisfaction-nhs-overall
I'm not sure if there are any more recent figures, but, overall, despite the best hopes of Labour, this doesn't seem a toxic issue.
Meanwhile, in Wales...
Once again you offer no answers as to what you would do with the children of someone who has been refused benefits under your regime. They have themselves and a family to feed. How do you think they do so if they have neither a job nor benefits?
I have a houseful of asthma inhalers if anyone wants some.
http://qmr.kingsfund.org.uk/2014/11/data
You can cherry-pick some where things have got a bit worse but others have got better.
I'm not suggesting the NHS in England is good. It's crap.
What I'm saying is that its worse in Wales under labour, which will always be mentioned as soon people like you start wailing.
Do you work in the NHS?
@Foxinsox of this parish does, and he seems to think it is a decent improvement on what went before
From my perspective, all I hear is complaints that the central pharmacists aren't buying sexy new drugs anymore.
His ideas (right or wrong) were rather mangled and diluted/amended to try and keep the Lib Dems (and maybe some blue backbenchers) onside.
Of course, that doesn't mean the end result isn't a steaming pile of horse manure anyway.
Also worth mentioning Labour's bloody awful failure at renegotiating GP terms. Alan Johnson's a very likeable chap, but as a negotiator he was bloody useless.
From what I can tell the reality is that the reforms amounted to a £3bn rebranding exercise and the operational differences pre and post reforms are non-existent.
@Foxinsox of this parish does, and he seems to think it is a decent improvement on what went before
From my perspective, all I hear is complaints that the central pharmacists aren't buying sexy new drugs anymore.
He does not work in secondary care then
But its record up to 2010 in the UK - and in Wales since - really is nothing they should be proud of.
I said that if someone we unable to work and wasn't looking for a job then they wouldn't have been getting JSA anyway so it wouldn't be being taken away
If someone is getting JSA they are signing every other week to declare they are able to work and therefore they get dole. Your mother of three wouldn't be doing this would she? Because she is unable to work
Yup. £3bn down the drain, recreating what we had previously. Every few years the NHS wastes vast amounts of cash restructuring into a model it has tried before. Sadly this won't be the last of ministerial meddling. Ideally someone would pass a law that prevented ministers from faffing about with it and left any strategic management to experts.
Best to try and neutralise I think for the CONs.
The important to me and my family are things that the person can control
The important to the country are things only the state should control
Completely wrongheaded to dismiss the latter for scoring more than the former, in fact it's probably more likely to get people to vote if the country score is higher
There were three mega-mistakes: appointing Lansley in the first place, then allowing him to black-ball the LD Norman Lamb as number 2 and then letting him move on with his "reform" plan in 2010.
The LD message for GE2015 will be that you can't trust LAB with the economy or the Tories with the NHS.
Q: What is the independent NHS Board?
A: The Tories have long called for an independent board to run the NHS, accountable to the Health Secretary.
http://www.telegraph.co.uk/health/healthnews/8550618/QandA-Andrew-Lansleys-NHS-reforms-explained.html
Unfortunately this got a bit watered down when the LibDems got cold feet and ganged up with Labour to damage the reforms which they'd jointly proposed with Lansley a few months earlier.
The point is that Labour can't use its trump card of being the saviour '24 hours to save the NHS' any more, given its royal f8ck ups in Wales.
NHS Wales is like Kryptonite for the party. Just like education.
Labour can';t attack on these issues any more. They haven't earned the right.
My impression - although he has never said - is that he is a hospital based consultant. I could be completely wrong, of course.
As I said below, the Tories would do well to keep the ringfence or even extend it to guarantee 2% real terms budget increases over the next 5 year spending period paid for by welfare cuts.
The other major issue, and this strikes to the core of 30 years of poor policy by Tories and Labour, is not enough money is spent on preventative care and there isn't enough done within the education system to teach young people the health benefits of a balanced diet, it should start in primary school, modern parents clearly aren't up to the job given how many young kids I see with their parents in McDonalds and KFC on the way home from work so it is an area where the state will have to step in. Obesity, heart disease, high cholesterol, stroke, diabetes and heart attacks are all preventable problems in 9/10 cases, but we spend too much on saving people from within an inch of death rather than ensuring they don't get there in the first place. That is a structural and policy issue though and both parties are at fault.
@taffys
Poking around the Halifax House Prices Index website, I have noticed that they do provide a regional breakdown of price rises in a supplementary Excel table. The data is not current, but shows price rises as an index based at 100 in 1983 and updated to end 2013.
Looking at the figures it shows that in no region is the index higher than its peak in 2007, but range of falls from peak go from -40 in Greater London to nearly -500 in Northern Ireland.
Here is a summary using 5 year breaks ranked left to right by 2013 index level:
Halifax House Prices Index - Historical Regional Variations This adds weight to my speculation that reluctance to realise a nominal loss on resale of property is probably the main reason for low transaction volumes since the recession.
It allowed profiteering private companies to cream off even more vast sums from stretched NHS budgets at the expense of taxpayers and patients.
Private companies like this
Private health care firms with Tory links have been awarded NHS contracts worth nearly £1.5billion.
Circle Health landed £1.36billion worth of health service work after several of its investors gifted about £1.5million to the Conservatives.
And Care UK has contracts worth another £102.6million. Its chairman John Nash was made a peer after boosting Tory coffers by £247,250.
www.mirror.co.uk/news/uk-news/fury-tory-party-donors-handed-3123469
The bottom line is, until the money flows up from the patient (whether from their own pockets or via a Government endowment of some kind) rather than down from on high, the NHS will continue to be a national disgrace. You hear a lot about privatisation of the NHS, but outsourcing is not privatisation. It's privatising the wrong part. It's the demand end that needs to be privatised not the supply.
http://www.cambridge-news.co.uk/News/How-quality-of-care-at-Hinchingbrooke-Hospital-has-been-declared-best-in-England-after-it-was-placed-in-hands-of-private-firm-Circle-20140522115615.htm
It's a great Labour success story.
Why are the Left so shy about celebrating it?
"The most interesting difference between my weekly telephone poll and the most frequently published online polls is not the levels of “volatility”, which are comparable, but the consistent differences in the combined share of the two main parties.
At the 2010 general election, Labour and the Conservatives together received 67 per cent of votes in Great Britain. Over the life of the ANP, YouGov and Populus have consistently found the combined two-party scores to be higher than this, and often above 70 per cent. The ANP, meanwhile, along with telephone pollsters ComRes and ICM, have found lower combined totals in some cases closer to 60 per cent."
http://www.conservativehome.com/platform/2014/07/lord-ashcroft-the-ashcroft-national-poll-so-far.html
"I'm not suggesting the NHS in England is good. It's crap"
No it bloody well isn't, well, not universally so.
What with my kidneys, such as they are, and my eyes, I am a heavy user of the English NHS and it the bits I use it are damn good and damn site better than they used to be. Its not perfect, not by a long way and it has some dreadful pockets of awfulness still in it, and I have seen a few. The English NHS is not crap, its just like the Curate's egg.
The swing issue is the economy. The Tories also lead on employment, something which would once have unthinkable.
Charles, I think you are correct
I am very pleased to hear you are getting good treatment. Why don't you have have a go at Mr Bigjohnowls, he's the one running the English NHS down.
Charles, I think you are correct
And then up pops an independent report stating that the NHS under the evil Coalition is ranked first among 11 western nations :
http://www.independent.co.uk/news/uk/uks-healthcare-ranked-the-best-out-of-11-western-countries-with-us-coming-last-9542833.html
If you are going to have a go at changes why not have a go at them from the perspective of the patients not the people paid by the system.
You have a go at Circle, for example, but are they not the people who took over a failed, never mind failing, hospital and turned it round to the satisfaction of patients and staff alike.
Please, how about thinking about the NHS from the patient experience. After all if Hitchinbroke hospital was doing such a fantastic job then Labour, Labour mark you, would not have decided that it needed to be put out to tender. FFS, if even Andy "staffs" Burnham thought that something had to be done it must have been dire.
Just try and think of it in these simple terms, the NHS exists not for its employees, it exists for the patients.
For example, the Kings Fund published a paper in May on productivity in the NHS. Their core conclusion was as follows:
The unprecedented slowdown in the growth of NHS funding in England since 2010 required the NHS to pursue the most ambitious programme of productivity improvement since its foundation. It has broadly risen to the challenge, with pay restraint, cuts in central budgets, and the abolition of some tiers of management producing significant savings.
The Kings Fund also found that quality of care, service levels and patient satisfaction have all improved under the Coalition government with much due to the success of the Lansley reforms.
The Kings Fund's concern is that there is a limit to the extent to which productivity improvements can be realised without loss of service levels or a deterioration in clinical outcomes. Once this limit is reached, there will be a need to increase NHS funding as a proportion of GDP if it is to meet known future demands.
The solution to this lies in managing an economy so that it optimises growth at the same time as keeping total government spending falling as a percentage of GDP. This should allow spending on health to increase as a proportion of total spend.
In other words the approach and achievements of Osborne in managing the economy effectively are the most feasible means of supporting the NHS's future funding needs.
The problem the Conservatives have with the NHS are with communications not management of the service.
In all the various dealings which I've had with the NHS, it's always been clear that the organisation is not efficient, in myriad different ways - some small, some bigger.
That's not to say that there aren't lots of demographic and other pressures, of course.
A good friend of mine earlier this year had several days experience of Luton and Dunstable Hospital some ten years since his last in-patient treatment. He couldn't believe the transformation for the positive compared to the rotten experience he had previously endured.
And to suggest that "genetic predisposition" and lifestyle factors are the only two competing causes of illness is a prize false dichotomy. People get ill because they just do.
Here's a claim by a body with a vested interest in ramping up avoidability, that one third of heart disease and stroke deaths might be preventable.
http://www.cardiovascularbusiness.com/topics/practice-management/one-third-heart-disease-stroke-deaths-potentially-preventable
As for taking on Big John, he is just spouting his beliefs as far as I can see and there is no point in tackling a man on his beliefs - mud wrestling a pig and all that.
Not only that he is Big John:
https://www.youtube.com/watch?v=RN3exiuyQJc
After a lifetime of excessive outdoor pursuits my body finally rebelled,I have had 4 A&E visits,about 15 GP visits,and about 20 outpatient visits in the last year,thankfully I am now nearly fixed and returning to my outdoor pursuits.
I have nothing but praise for the service I have received.
My other experience is in looking after a young friend who had a bone marrow transplant,I regularly drive him to Christies for treatment,the staff are exemplary,and the cost of the treatment must be about £1000/visit,he has 4 trips a month. The bone marrow transplant is enormously complex and expensive,be thankful we have the NHS.
I did get to experience morphine injections, which are wonderful.
First up, too far too fast & economic disaster. Failed as Osbo actually didn't actually cut very much at all and fixed many of the basic's.
Next up, cost of living crisis. Failed as the economy races ahead.
Now its NHS crisis time, in the hands of those evil Tories, brought forward from the planned time on Labour's planning matrix as the first 2 economic story lines have bombed out.
Trouble is the NHS in England is getting better. Hunt does actually focus on patient outcomes. Sure parts of the system don't like it as they have to work better i.e. the unions & doctors, so they moan, but overall it is improving. The contrast with Wales is clear and a real problem for Miliband whenever he raises the NHS.
Labour have had advantage on the NHS politically for ages, but they've had to go on it far too early as their lead attack issue. Cameron & Co have months to neutralise the narrative and I wouldn't be at all surprised if come May 2015 the Tories are actually ahead on the NHS.
Unless there's some mega heat wave this summer that starts killing off old folk like they had in France a few years ago, there's no way the NHS will be an issue in the summer. In Labour's ideal world, we will have a terrible winter 2014/5 with lots of flu around and the system gets massively overloaded (as they hoped for last winter), so they can attack Cameron with current stats and events. Going now on the NHS is just too soon and they won't be able to sustain a credible narrative.
I'm not surprised Labour are having a mini boost of a couple of points, but it ain't going to last.
"I did get to experience morphine injections, which are wonderful."
Yes totally agree,I once got rescued after a fall in the mountains and they gave me the air and gas mix used normally for childbirth,wonderful stuff,much better than alcohol.
Morphine was for an intolerable back injury,and again wow,it works.
I don't smoke,am not obese,have made very few demands on the NHS apart from this one problem. If I did not enjoy my outdoor pursuits I would much less healthy.
Anyway got to go,off out climbing.
"My wife made a massive fuss, and an operation was booked... "
Now that just rings so true. Time after time I have found with the NHS if someone with sufficient backbone and who is sufficiently articulate says, "Excuse me, but ...", then a lot of different options suddenly become available. I do wonder sometimes if some of the early death rates are not due to people actually passively accepting what their quacks say.
BTW, your good lady sounds a peach.
You might be right that people who do have horrid experiences think they must be an exception, just as people who don't get burgled think they've been lucky, not that burglary is now relatively rare. But it's difficult to argue that people aren't (a) broadly satisfied (b) very interested (c) somewhat concerned about the trend and (d) inclined to think Labour is more unambiguously in favour of improving it. We can argue about whether they're right, but that's a separate issue.
But Lansley's reforms have [deliberately and dishonestly] been portrayed as an unnecessary expense and distraction. In reality they are making a significant difference by moving responsibility for change (on commissioning) to clinicians which moves decision making one step closer to user need. This alone is worth all the investment, disruption and political capital spent.
A similar move to embed culture change into the NHS to achieve continuous and incremental productivity improvement and cost saving is needed. Future NHS needs will not be met solely out of productivity improvement but looking to increased funding is not the sole answer either. The competitive pursuit of profit is probably the best known means of ensuring continued cost control and innovative process, but this is not, in its full blown form, a current option for the NHS.
Cameron needs to search his cabinet and back benches for another ex. SDP reformer to take on this brief in the next parliament. Hunt is excellent as a placebo but I am not convinced he is right as a radical cure.
Without some sort of reliable statistics one falls back on anecdote.
Over 40 yrs and more I have seen the hospital in Bedford go from a somewhat dingy and low spirited place to a bright spirited one with generally helpful care. And personal treatment of me and mine has generally been very good.
Now we hear routinely of threats of closure of this and that, or of the whole shebang. I don't believe that's going to enhance the Tory chances.
Maybe the fact that we are a marginal seat might work to our advantage. I don't know.
On topic, we don't really have a National Health Service - we have a National Sickness Service. Concepts of promoting good public health and health education were the first casualties of economic cutbacks.
Most people don't use the NHS unless they are ill or know someone who is ill. In East Ham, I either see Dr Patel or Dr Singh (this may come as no surprise). Dr P wears a double-breasted three-piece suit which at least means if I visit on the way to the office I don't feel overdressed.
"Labour’s problem is not just that the torrent of invective occupies air time and column inches that it could be using to popularise its agenda. It is much more fundamental than that. By persistently echoing (and amplifying) the media’s groans about politicians’ failings, the party is undermining voters’ residual faith in the political process. Why, bombarded by assertions of the venality and untrustworthiness of politicians, should ordinary folk not conclude that a steady-as-she-goes vote for the Tories (or indeed a protest vote for UKIP) is a safer option than Mr Miliband’s grand plans to re-engineer the British economy? Labour is not so much cutting off its nose to spite its face as sticking its entire head into a wood chipper. To paraphrase its leader, it can do better than this."
Hey, Mr. Stodge, see what you are getting at but when I am lying on the trolley at death's door I need some people who are going to fix me up not give me a lecture on good public health. A thousand words on the disadvantages of consuming too much sugar maybe worthwhile but if I am about to conk out through renal failure it may not be the best treatment.
When dosh is tight are you, you Mr. Stoge, going to tell Mrs. Smith she is about to become Widow Smith because the money that could have saved her husband has been spent on telling teenagers not to drink coca-cola and the like?
You might both consider a PB function at Luton & Dunstable Hospital in your final days.
I'm sure PB would give you a hell of a send off .....
Oopps .... should I have mentioned "hell"
I should have said a heavenly experience and for old time sake a "Coalition of PB's Finest"
Mike has banned me from PB's functions, anyway I wouldn't be seen dead in Luton .... so to speak !!
I must say I grow fed up of articles saying the NHS is bad news for the tories. Maybe it is, but how relevant is it compared to other issues? How relevant is any of it when it comes to persuading those people who are persadable when it comes to voting?
If the govt, as is their duty, put pressure on teachers to perform and likewise on NHS staff, then all this sizeable group of people might well take umbridge and vote labour or whoever. Its the same with the entire public service.
And people not in the public service might complain the govt are not tough enough!
But over and above all this some people - a lot of people - will make a more reasoned judgement.
I also have great respect for the soft spoken Hunt who is thriving in his damage limitation and improved communication role at Health. Where next for him? Education?
Agree too on Hammond, who would be perfect for the role you describe.