The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
As we’re talking about Ireland, my students thought it was an Irish joke when I told them that the GDP figures for last year were a forecast. (p.s. I did the OECD forecasts for Ireland and UK in the mid-70s.)
There needs to be a serious conversation involving all medical and political parties about the future of the NHS, probably a Royal Commission. It's abundantly clear that serious reform is needed which is currently politically impossible.
And it is likely to remain so.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Surely we should expand that to all activities where people knowingly make a choice that is likely to impose extra costs on the rest of us?
So, if you're speeding and are in an accident. Or if you choose to go mountain climbing and have an accident.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Did they take the drugs voluntarily or were they slipped into their drinks?
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
I can, and do, book appontments with my GP on-line. And, incidentally request repeat prescriptions, which are then transmitted electronically to the local pharmacy. I can’t book more than one appointment any time, though, although I could, I suspect book one manually with the receptionist, and, as far as preceriptions are concerned, if I want anythjing much before it’s due, it’s refused and I have to visit the surgery and explain to the staff why I need it early...... usually because I’m off on holiday.
This is basically what a CAB report found. Can you imagine if Amazon ran their business like this...you can only buy one product at a time, you can't buy things well in advance, etc etc etc.
The booking system, including the bar, seems fair enough to me. Not comparable with Amazon at all. Why would anyone want to request multiple appointments?
As far as requesting prescriptions too frequently is concerned, in my last couple of jobs I spent a lot of time trying to control over-requesting and over-prescribing, so while I get irritated now and then I can see the sense of it. My only serious grumble is that the local CCG considers that people on regular medication should not take more than two weeks holiday at a time! When one goes off for a month every so often that can cause ‘discussion’!
Re multiple appointments...if you have a condition that needs to be managed at regular intervals e.g. Many of those on warfarin, need an INR test every x weeks.
In those situations, it would be much more efficient for all concerned if a patient could log on a schedule say the next x visits.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Surely we should expand that to all activities where people knowingly make a choice that is likely to impose extra costs on the rest of us?
So, if you're speeding and are in an accident. Or if you choose to go mountain climbing and have an accident.
Only if you want to massively complicate things and get nothing at all done so you can sit and moan about how bad the NHS is forever
If you can prove the person was injured whilst speeding, by all means charge them. An accident doing a hobby is fair enough to be treated for free, we are allowed hobbies
But my contention is that A&E is overcrowded at weekend nights because of drinking and drug taking rather than Speeding and mountain climbing
I am surprised that someone with no apparent qualifications in art history or museums or design or curatorship can end up with one of the best jobs in the Museum world.
I guess all those young graduates wanting jobs in museums and galleries will find it reassuring that you can get your foot through the door without prior experience.
What struck me was no experience in management of large organizations or any kind of large budget?
I reckon either he will need a #2 who knows what they are doing... Or we will soon see one of the big 4 arriving and explaining what he should already know.
Presumably that is the full time job of the #2, whilst the #1 gets on with the important job of glad handing donors and people wanting to lend collections, and chatting up politicians and select committees about budgets. Rather like the difference between a minister and a permanent secretary
Glad handing donors will be the responsibility of the huge Development Office. Of course, the Director will be expected to oil around donors, but that is hardly a full-time occupation requiring the services of someone paid 160 k.
All previous directors of V&A have had either an impressive track record in academic art history, or experience in museumship, for example, in staging important or influential exhibitions.
Tristram Hunt seems to have had a modest academic career in a not very relevant area of political history (Engels, Victorian urban history).
Of course, the appointments committee may have decided to look at the job from a new perspective -- though it is curious that such speculative appointments normally do involve the hiring of the very well-connected.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Surely we should expand that to all activities where people knowingly make a choice that is likely to impose extra costs on the rest of us?
So, if you're speeding and are in an accident. Or if you choose to go mountain climbing and have an accident.
Only if you want to massively complicate things and get nothing at all done so you can sit and moan about how bad the NHS is forever
I'm just saying we should be logically consistent. If we're going to charge people for being pissed and injuring themselves (which is legal), then it seems odd not to also charge also for people who injure others by speeding (which is illegal).
I am surprised that someone with no apparent qualifications in art history or museums or design or curatorship can end up with one of the best jobs in the Museum world.
I guess all those young graduates wanting jobs in museums and galleries will find it reassuring that you can get your foot through the door without prior experience.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
@Moniker: I suspect the cost of living in Northern Ireland is a lot lower than in England, hence that article.
The World Bank link I posted shows the PPP adjustments by country, and their methodology is - I believe - pretty sound.
Ireland never *feels* rich to me, not in the way that Central London does, or most of Switzerland, or the Californian Coast, or parts of Tuscany, Provence, Bavaria or Singapore...
But going by the stats it should feel richer than Hong Kong!
At best (the affluent bits of Dublin, or the southern coast), it feels about as rich as Edinburgh, or the Devon riviera.
That's using my S K Tremayne "feels rich" Rich-o-Meter (patent pending), and it's served me well in the past. I remember visiting Ireland BEFORE the crash and thinking, hold on, this is meant to be one of the richest countries in the EU, with property prices like Monaco, something is very wrong. And it was.
Ireland shouldn't feel any richer than the average for the UK, because it isn't any richer than the average for the UK. And the average for the UK includes Stoke-on-Trent, Sunderland, and lots of places where a one bedroom flat costs less than half a million pounds.
Nevertheless, it has gone from being a lot poorer than the UK in the mid 1980s, to being about the same as us today. During a time when our exports have increased 6-fold, theirs have increased 30-fold. Productivity per hour worked has gone from 40% less than us, to 10% more than us. It has been an enormous success story, largely based around deregulation and low taxes.
The Republic of Ireland does have the advantage of not being constrained by EU regulations, restrictive trade arrangements, unlimited immigration and an inflexible currency union.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
Financial services seems to be the only industry that generates serious wealth de novo. Oil and gas are depletable resources (although each year not as depletable as we were told the last)
The Kuwaits of the world are presumably in there but don't feel wealthy because either the GDP calculation is made on citizens/permanent residents, and excludes guest workers, or because of huge wealth disparities, with the vast majority on low wages and the fruits of the oil and gas concentrated on the 5-20% of the population who are citizens.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Surely we should expand that to all activities where people knowingly make a choice that is likely to impose extra costs on the rest of us?
So, if you're speeding and are in an accident. Or if you choose to go mountain climbing and have an accident.
Only if you want to massively complicate things and get nothing at all done so you can sit and moan about how bad the NHS is forever
I'm just saying we should be logically consistent. If we're going to charge people for being pissed and injuring themselves (which is legal), then it seems odd not to also charge also for people who injure others by speeding (which is illegal).
If you can prove they were speeding at the time of injury when they arrive (which you cant) then do it.
As you cant we might as well try to make improvements that are possible and practical. I don't really see why we should be logical and consistent actually/
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
If you can promise the NHS an extra £350 million per week, 52% will vote for a turd wrapped in a Union Jack.
@Moniker: I suspect the cost of living in Northern Ireland is a lot lower than in England, hence that article.
The World Bank link I posted shows the PPP adjustments by country, and their methodology is - I believe - pretty sound.
Ireland never *feels* rich to me, not in the way that Central London does, or most of Switzerland, or the Californian Coast, or parts of Tuscany, Provence, Bavaria or Singapore...
But going by the stats it should feel richer than Hong Kong!
At best (the affluent bits of Dublin, or the southern coast), it feels about as rich as Edinburgh, or the Devon riviera.
That's using my S K Tremayne "feels rich" Rich-o-Meter (patent pending), and it's served me well in the past. I remember visiting Ireland BEFORE the crash and thinking, hold on, this is meant to be one of the richest countries in the EU, with property prices like Monaco, something is very wrong. And it was.
Ireland shouldn't feel any richer than the average for the UK, because it isn't any richer than the average for the UK. And the average for the UK includes Stoke-on-Trent, Sunderland, and lots of places where a one bedroom flat costs less than half a million pounds.
Nevertheless, it has gone from being a lot poorer than the UK in the mid 1980s, to being about the same as us today. During a time when our exports have increased 6-fold, theirs have increased 30-fold. Productivity per hour worked has gone from 40% less than us, to 10% more than us. It has been an enormous success story, largely based around deregulation and low taxes.
The Republic of Ireland does have the advantage of not being constrained by EU regulations, restrictive trade arrangements, unlimited immigration and an inflexible currency union.
Oh wait...
Its also been a massive net contributor to the EU budget for over 40 years.
I can, and do, book appontments with my GP on-line. And, incidentally request repeat prescriptions, which are then transmitted electronically to the local pharmacy. I can’t book more than one appointment any time, though, although I could, I suspect book one manually with the receptionist, and, as far as preceriptions are concerned, if I want anythjing much before it’s due, it’s refused and I have to visit the surgery and explain to the staff why I need it early...... usually because I’m off on holiday.
This is basically what a CAB report found. Can you imagine if Amazon ran their business like this...you can only buy one product at a time, you can't buy things well in advance, etc etc etc.
The booking system, including the bar, seems fair enough to me. Not comparable with Amazon at all. Why would anyone want to request multiple appointments?
As far as requesting prescriptions too frequently is concerned, in my last couple of jobs I spent a lot of time trying to control over-requesting and over-prescribing, so while I get irritated now and then I can see the sense of it. My only serious grumble is that the local CCG considers that people on regular medication should not take more than two weeks holiday at a time! When one goes off for a month every so often that can cause ‘discussion’!
Re multiple appointments...if you have a condition that needs to be managed at regular intervals e.g. Many of those on warfarin, need an INR test every x weeks.
In those situations, it would be much more efficient for all concerned if a patient could log on a schedule say the next x visits.
Agree, but such conditions are often managed day to day by another health professional .... nurse or pharmacist. And I assume that reception staff can override the block if needed. After all, by definition,, the patient is in the surgery. The surgery I use doesn’t use the system for flu vaccination, for example, and my regular injections appear on the screen as ‘nurse appointments’ and don’t affect medical ones. TBH, while I’m sure there could be some improvements here and there, the system seems reasonable. Reception staff can, of course, book one in as a result of phone calls, personal visits etc. if necessary.
Interesting discussion. For the purposes that most people use ("Would I like to live there?" "Do people there feel rich?"), median income is vastly better than average GDP per head. If inequality is rampant, a place can have huge GDP per head but most people can be poor while a few people live in luxury - cf. oil and mining oligarchies. For the purpose of spotting whether there's a big "left behind" segment, it may even be best just to look at incomes for the lowest quartile.
Interesting discussion. For the purposes that most people use ("Would I like to live there?" "Do people there feel rich?"), median income is vastly better than average GDP per head. If inequality is rampant, a place can have huge GDP per head but most people can be poor while a few people live in luxury - cf. oil and mining oligarchies. For the purpose of spotting whether there's a big "left behind" segment, it may even be best just to look at incomes for the lowest quartile.
Median income by PPP would probably be a good place to start.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
If you can promise the NHS an extra £350 million per week, 52% will vote for a turd wrapped in a Union Jack.
Weren't you a Labour member when it was using promises of extra NHS money to get people to vote for a turd wrapped in a red flag.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
Interesting discussion. For the purposes that most people use ("Would I like to live there?" "Do people there feel rich?"), median income is vastly better than average GDP per head. If inequality is rampant, a place can have huge GDP per head but most people can be poor while a few people live in luxury - cf. oil and mining oligarchies. For the purpose of spotting whether there's a big "left behind" segment, it may even be best just to look at incomes for the lowest quartile.
The places (both countries and within countries) which tend to win those 'best places to live' awards tend to be affluent and with little inequality rather than the richest but with high inequality.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
If you can promise the NHS an extra £350 million per week, 52% will vote for a turd wrapped in a Union Jack.
Weren't you a Labour member when it was using promises of extra NHS money to get people to vote for a turd wrapped in a red flag.
Yeah, a lot of people were suckered by that and came to regret it too.
Overall the NHS was better until Milburn started the wrecking process.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Surely we should expand that to all activities where people knowingly make a choice that is likely to impose extra costs on the rest of us?
So, if you're speeding and are in an accident. Or if you choose to go mountain climbing and have an accident.
Only if you want to massively complicate things and get nothing at all done so you can sit and moan about how bad the NHS is forever
I'm just saying we should be logically consistent. If we're going to charge people for being pissed and injuring themselves (which is legal), then it seems odd not to also charge also for people who injure others by speeding (which is illegal).
If you can prove they were speeding at the time of injury when they arrive (which you cant) then do it.
As you cant we might as well try to make improvements that are possible and practical. I don't really see why we should be logical and consistent actually/
If you mean get the person who caused the accident by speeding to pay for any treatment, then yes I agree,
I see Ladbrokes are taking the rare step of offering doubles on the by-elections. Seeing as many of the same dynamics affect both races (chiefly, is Corbyn really toxic in Labour seats or not so bad) I think that's rather generous. I particularly like the 5/2 on Labour holding both seats, but the 13/8 on them losing both isn't too bad for the same logic as above.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
@Moniker: I suspect the cost of living in Northern Ireland is a lot lower than in England, hence that article.
The World Bank link I posted shows the PPP adjustments by country, and their methodology is - I believe - pretty sound.
Ireland never *feels* rich to me, not in the way that Central London does, or most of Switzerland, or the Californian Coast, or parts of Tuscany, Provence, Bavaria or Singapore...
But going by the stats it should feel richer than Hong Kong!
At best (the affluent bits of Dublin, or the southern coast), it feels about as rich as Edinburgh, or the Devon riviera.
That's using my S K Tremayne "feels rich" Rich-o-Meter (patent pending), and it's served me well in the past. I remember visiting Ireland BEFORE the crash and thinking, hold on, this is meant to be one of the richest countries in the EU, with property prices like Monaco, something is very wrong. And it was.
Ireland shouldn't feel any richer than the average for the UK, because it isn't any richer than the average for the UK. And the average for the UK includes Stoke-on-Trent, Sunderland, and lots of places where a one bedroom flat costs less than half a million pounds.
Nevertheless, it has gone from being a lot poorer than the UK in the mid 1980s, to being about the same as us today. During a time when our exports have increased 6-fold, theirs have increased 30-fold. Productivity per hour worked has gone from 40% less than us, to 10% more than us. It has been an enormous success story, largely based around deregulation and low taxes.
The Republic of Ireland does have the advantage of not being constrained by EU regulations, restrictive trade arrangements, unlimited immigration and an inflexible currency union.
Oh wait...
Its also been a massive net contributor to the EU budget for over 40 years.
Oh wait...
It's possible to view UK and Irish membership of the EU, since 1973, as simply a way for the UK to funnel tens of billions to Ireland, without getting any of the credit. That said, given the tragic history intertwining the two countries, it was maybe the right thing to do.
Now that Ireland is a fully developed country, practically equal in personal wealth to Britain, we can depart the EU, our task complete.
Its interesting that Great Britain has a population almost ten times the size of Ireland while having an area not much more than twice the size.
The comparison between England and the Republic is even more extreme.
That suggests that either Ireland is still somewhat underdeveloped or that England is too overdeveloped for its own good.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
If you can promise the NHS an extra £350 million per week, 52% will vote for a turd wrapped in a Union Jack.
Weren't you a Labour member when it was using promises of extra NHS money to get people to vote for a turd wrapped in a red flag.
Yeah, a lot of people were suckered by that and came to regret it too.
Overall the NHS was better until Milburn started the wrecking process.
Change in organisations usually costs more, takes longer and realises fewer benefits than was predicted.
The NHS was not set up to deal with the things it has to deal with now. It was a free service to stop poor people dying unnecessarily. It was not a drop in centre for the same drunks and illegal drug users to be patched up time and again.
Now that it has to dal with thing s such as that, as well as our imported, massive population, it can no longer be done for free, so the answer is simple
a) Strip it back so it only does essentials (and is able to distinguish between deserving and undeserving)
b) Charge
Just out of interest... who are the deserving and the underserving?
People who turn up in A&E pissed out of their heads or high on drugs are undeserving of free treatment (if they are proven to have been attacked then obv they don't have to pay)
Surely we should expand that to all activities where people knowingly make a choice that is likely to impose extra costs on the rest of us?
So, if you're speeding and are in an accident. Or if you choose to go mountain climbing and have an accident.
Only if you want to massively complicate things and get nothing at all done so you can sit and moan about how bad the NHS is forever
I'm just saying we should be logically consistent. If we're going to charge people for being pissed and injuring themselves (which is legal), then it seems odd not to also charge also for people who injure others by speeding (which is illegal).
If you can prove they were speeding at the time of injury when they arrive (which you cant) then do it.
As you cant we might as well try to make improvements that are possible and practical. I don't really see why we should be logical and consistent actually/
Indeed, is the tax code logical and consistent? Are fines for misdemeanours and felonies consistent? Are criminal sentences?
Life, laws and regulations are full of inconsistencies. Trying to remove them would result in us doing nothing else.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
This also shows the difficulty of negotiating with so many countries on the other side who all want their own thing.....
But it's a two way street. If they are going to insist on something like that, they will have to compromise, significantly, elsewhere. Like giving the City passporting rights, or allowing restrictions on Free Movement.
Honestly I think that demand isn't far off being a deal breaker for TM... Surely enough of her party will surely totally resent the idea of European politicians influencing tax rates...
The Republic of Ireland does have the advantage of not being constrained by EU regulations, restrictive trade arrangements, unlimited immigration and an inflexible currency union.
Oh wait...
Hmmm...
1. Ireland was not terribly well-off when it entered the EEC-as-was, so was showered with cash. As distinct from a certain other country which was always a net contributor, even when suffering from galloping inflation, huge industrial unrest and visits from the gnomes of Zurich (except for one single year, which just happened to be the one when it held a referendum on leaving - quelle surprise.) 2. It may be best not to make jokes about Ireland's membership of the currency union. It suffered a large spike in unemployment and emigration (as well as a steeper loss of GDP during the Great Recession than the UK did) as a result of the straitjacket and the runaway property boom that it created. It is still in a process of recovery, and will be paying off all those bailout loans for decades. 3. The population density of the Republic of Ireland is around 70 people per square km, compared to over 400 in England. They have a bit of a way to go to catch us up. 4. Ireland's competitiveness has been largely based on its rock bottom corporate tax rates, which the EU has never much liked. If and when the central authorities get the power to start harmonising taxes then that will be one of the first things to go. 5. Anyway, there is perhaps only limited value in discussing Ireland as an example, given that it is committed to a fundamentally different path to the UK: the logical endpoint of the European project is its abolition as a sovereign state. A single European state is the aim of the EU, and indeed some form of federation with a common government, treasury, taxation, debt and system of fiscal transfers needs to be built if the aforementioned currency union is to be made to work properly. FYI, Ireland had 15% of the seats at Westminster before the Irish Free State was created, whereas the Republic of Ireland has 1.5% of the seats in the European Parliament. So, that worked out really well for them.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
If you can promise the NHS an extra £350 million per week, 52% will vote for a turd wrapped in a Union Jack.
Weren't you a Labour member when it was using promises of extra NHS money to get people to vote for a turd wrapped in a red flag.
Yeah, a lot of people were suckered by that and came to regret it too.
Overall the NHS was better until Milburn started the wrecking process.
Change in organisations usually costs more, takes longer and realises fewer benefits than was predicted.
And the NHS has had more than it’s fair share of re-organisations. At least Hunt hasn’t tinkered with his predecessors botch-up of non-hospital health.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
This also shows the difficulty of negotiating with so many countries on the other side who all want their own thing.....
Exactly. We won't be negotiating with a single entity; we'll be negotiating with 27 entities all looking out for their own interests and all with the power of veto. It'll be a Herculean task to reach agreement on even the most trivial issues. This is why Brexit will have to be either Brexit-in-name-only, or complete withdrawal. Anything else is impossible to negotiate under such circumstances.
@Moniker: I suspect the cost of living in Northern Ireland is a lot lower than in England, hence that article.
The World Bank link I posted shows the PPP adjustments by country, and their methodology is - I believe - pretty sound.
Ireland never *feels* rich to me, not in the way that Central London does, or most of Switzerland, or the Californian Coast, or parts of Tuscany, Provence, Bavaria or Singapore...
But going by the stats it should feel richer than Hong Kong!
At best (the affluent bits of Dublin, or the southern coast), it feels about as rich as Edinburgh, or the Devon riviera.
That's using my S K Tremayne "feels rich" Rich-o-Meter (patent pending), and it's served me well in the past. I remember visiting Ireland BEFORE the crash and thinking, hold on, this is meant to be one of the richest countries in the EU, with property prices like Monaco, something is very wrong. And it was.
Ireland sh success story, largely based around deregulation and low taxes.
The Republic of Ireland does have the advantage of not being constrained by EU regulations, restrictive trade arrangements, unlimited immigration and an inflexible currency union.
Oh wait...
Its also been a massive net contributor to the EU budget for over 40 years.
Oh wait...
It's possible to view UK and Irish membership of the EU, since 1973, as simply a way for the UK to funnel tens of billions to Ireland, without getting any of the credit. That said, given the tragic history intertwining the two countries, it was maybe the right thing to do.
Now that Ireland is a fully developed country, practically equal in personal wealth to Britain, we can depart the EU, our task complete.
Its interesting that Great Britain has a population almost ten times the size of Ireland while having an area not much more than twice the size.
The comparison between England and the Republic is even more extreme.
That suggests that either Ireland is still somewhat underdeveloped or that England is too overdeveloped for its own good.
Well part of the reason for all that is The Famine. Which kinda speaks for itself.
But the population of England compared to that of Ireland was a ratio of under 2:1 in 1800 and still only 6:1 in 1900. Its now about 10:1.
That is a big demand from them, and we will expect something equally big in return, as I say.
More importantly, perhaps, this shows how a Hard, chaotic Brexit really isn't in the interests of Europe, any more than it is us. As Barnier admitted yesterday, cutting off European access to the City, just like that, would have severe, destabilising and maybe explosive effects on EU businesses and governments.
Similarly, as the Dutch have realised, if Britain crashes out with no agreement in place, that might damage the UK - but it also allows us Brits to do exactly what we want in taxes, workplace rights, everything, attracting lots of businesses from them.
It really is in the interests of both sides to fudge a deal, so I expect a deal will be fudged.
Well quite. Two issues of concern for EU:
1. London is the de facto financial capital of the EU and of the Eurozone, and provides most of the services (particularly with respect to debt financing) that keep it going round. These cannot be readily replicated anywhere else, simply by banks upping sticks and moving some of their offices to the continent. 2. If there's no deal at all, then the Tories might just exploit the weakness of the Opposition to turn Britain into a gigantic Singapore. Germany and Scandinavia might be able to cope with that but I wouldn't give much for the chances of Italy under such circumstances, let alone France.
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
It's quite possible a Royal Commission would find that the NHS is simply the wrong approach to health care. But no way would the public accept that, they believe in the myths, and think that all the NHS needs is more money.
If you can promise the NHS an extra £350 million per week, 52% will vote for a turd wrapped in a Union Jack.
Weren't you a Labour member when it was using promises of extra NHS money to get people to vote for a turd wrapped in a red flag.
Yeah, a lot of people were suckered by that and came to regret it too.
Overall the NHS was better until Milburn started the wrecking process.
Change in organisations usually costs more, takes longer and realises fewer benefits than was predicted.
And the NHS has had more than it’s fair share of re-organisations. At least Hunt hasn’t tinkered with his predecessors botch-up of non-hospital health.
Indeed.
How many government ministers (or business chief executives for that matter) feel the need to change things around just so that they can be seen to 'do something'.
And when you have a new person in charge every two to four years you can easily get a continuous change process with never any end result.
I am surprised that someone with no apparent qualifications in art history or museums or design or curatorship can end up with one of the best jobs in the Museum world.
I guess all those young graduates wanting jobs in museums and galleries will find it reassuring that you can get your foot through the door without prior experience.
Much as people might want to knock him, academically he looks well suited to the role to me.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
This also shows the difficulty of negotiating with so many countries on the other side who all want their own thing.....
Exactly. We won't be negotiating with a single entity; we'll be negotiating with 27 entities all looking out for their own interests and all with the power of veto. It'll be a Herculean task to reach agreement on even the most trivial issues. This is why Brexit will have to be either Brexit-in-name-only, or complete withdrawal. Anything else is impossible to negotiate under such circumstances.
How to Completely Miss The Point.
What this news shows is that the Europeans are getting worried. They've realised that we have cards to play, too. There will almost certainly be a deal.
You're still making the same mistake of treating the Europeans as a homogeneous block. Yes, many may be getting worried. But they're worried about different things and each country will have its own desired outcome. We won't be able to move for red lines. That is the point.
I see Ladbrokes are taking the rare step of offering doubles on the by-elections. Seeing as many of the same dynamics affect both races (chiefly, is Corbyn really toxic in Labour seats or not so bad) I think that's rather generous. I particularly like the 5/2 on Labour holding both seats, but the 13/8 on them losing both isn't too bad for the same logic as above.
I find it extraordinary that Ladbrokes thinks Labour losing both is more likely than Labour winning both.
Then what are the odds for Labour losing one of the two ?
Mr. Surbiton, I do wonder if we're underestimating the residual strength of Labour's brand, despite Corbyn.
There's no equivalent of the SNP south of the border. Lib Dems start from too low a base, UKIP's receding and the Conservatives can't leap in the same way because they're the Government and already have a majority.
Macao, second on the World Bank list, feels like a complete shit hole most of the time. The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany) 2. Oil and gas helps.
3. Being a centre of tax avoidance while being surrounded by large rich countries helps.
This also shows the difficulty of negotiating with so many countries on the other side who all want their own thing.....
Exactly. We won't be negotiating with a single entity; we'll be negotiating with 27 entities all looking out for their own interests and all with the power of veto. It'll be a Herculean task to reach agreement on even the most trivial issues. This is why Brexit will have to be either Brexit-in-name-only, or complete withdrawal. Anything else is impossible to negotiate under such circumstances.
How to Completely Miss The Point.
What this news shows is that the Europeans are getting worried. They've realised that we have cards to play, too. There will almost certainly be a deal.
You're still making the same mistake of treating the Europeans as a homogeneous block. Yes, many may be getting worried. But they're worried about different things and each country will have its own desired outcome. We won't be able to move for red lines. That is the point.
The UK will not get what it wants but nor will every EU nation, both sides will have to compromise. Of course May has the card that if an Eastern European nation tries to block then the UK can slash military support for the Baltics against Putin and if a Western European nation tries to block the UK will impose heavy tariffs on all its exports to the UK
Comments
(p.s. I did the OECD forecasts for Ireland and UK in the mid-70s.)
Can you imagine what would happen if, as seems likely, such a process would recommend a wholesale reorganisation of provision, based around the consolidation of GP services into large polyclinics, more resources for social (especially elderly) care, and large teaching hospitals and specialist units? There are way, way too many people who treat their local mid-sized district general hospital as a holy and inviolable sanctuary. Any proposals for mass downgrades and closures will result in deafening howls of rage from every corner of the country - regardless of how compelling the evidence for such action may be.
So, if you're speeding and are in an accident.
Or if you choose to go mountain climbing and have an accident.
Macao, second on the World Bank list, feels like a complete shit hole most of the time.
The tiny petro-States (Kuwait, Brunei, Qatar) don't feel particularly well off. Or rather, they are full of people earning pennies.
There are three places that feel genuinely wealthy in the top ten: Luxembourg, Switzerland, and Singapore.
My two lessons from perusing the GDP per capita numbers are:
1. Smaller is better. There are no countries with more than 10m people in the top ten, and only three in the top 20 (the US, Saudi Arabia, and Germany)
2. Oil and gas helps.
In those situations, it would be much more efficient for all concerned if a patient could log on a schedule say the next x visits.
If you can prove the person was injured whilst speeding, by all means charge them. An accident doing a hobby is fair enough to be treated for free, we are allowed hobbies
But my contention is that A&E is overcrowded at weekend nights because of drinking and drug taking rather than Speeding and mountain climbing
All previous directors of V&A have had either an impressive track record in academic art history, or experience in museumship, for example, in staging important or influential exhibitions.
Tristram Hunt seems to have had a modest academic career in a not very relevant area of political history (Engels, Victorian urban history).
Of course, the appointments committee may have decided to look at the job from a new perspective -- though it is curious that such speculative appointments normally do involve the hiring of the very well-connected.
https://www.theguardian.com/commentisfree/2017/jan/09/barack-obama-legacy-presidency
Oh wait...
The Kuwaits of the world are presumably in there but don't feel wealthy because either the GDP calculation is made on citizens/permanent residents, and excludes guest workers, or because of huge wealth disparities, with the vast majority on low wages and the fruits of the oil and gas concentrated on the 5-20% of the population who are citizens.
As you cant we might as well try to make improvements that are possible and practical. I don't really see why we should be logical and consistent actually/
Oh wait...
TBH, while I’m sure there could be some improvements here and there, the system seems reasonable. Reception staff can, of course, book one in as a result of phone calls, personal visits etc. if necessary.
http://www.gallup.com/poll/166211/worldwide-median-household-income-000.aspx
https://www.theguardian.com/politics/2017/jan/14/netherlands-will-block-eu-deal-with-uk-without-tax-avoidance-measures
This also shows the difficulty of negotiating with so many countries on the other side who all want their own thing.....
Overall the NHS was better until Milburn started the wrecking process.
Maybe donate all speeding fines to the NHS?
LOL at the politicians that think they have all the cards.
The comparison between England and the Republic is even more extreme.
That suggests that either Ireland is still somewhat underdeveloped or that England is too overdeveloped for its own good.
Life, laws and regulations are full of inconsistencies. Trying to remove them would result in us doing nothing else.
1. Ireland was not terribly well-off when it entered the EEC-as-was, so was showered with cash. As distinct from a certain other country which was always a net contributor, even when suffering from galloping inflation, huge industrial unrest and visits from the gnomes of Zurich (except for one single year, which just happened to be the one when it held a referendum on leaving - quelle surprise.)
2. It may be best not to make jokes about Ireland's membership of the currency union. It suffered a large spike in unemployment and emigration (as well as a steeper loss of GDP during the Great Recession than the UK did) as a result of the straitjacket and the runaway property boom that it created. It is still in a process of recovery, and will be paying off all those bailout loans for decades.
3. The population density of the Republic of Ireland is around 70 people per square km, compared to over 400 in England. They have a bit of a way to go to catch us up.
4. Ireland's competitiveness has been largely based on its rock bottom corporate tax rates, which the EU has never much liked. If and when the central authorities get the power to start harmonising taxes then that will be one of the first things to go.
5. Anyway, there is perhaps only limited value in discussing Ireland as an example, given that it is committed to a fundamentally different path to the UK: the logical endpoint of the European project is its abolition as a sovereign state. A single European state is the aim of the EU, and indeed some form of federation with a common government, treasury, taxation, debt and system of fiscal transfers needs to be built if the aforementioned currency union is to be made to work properly. FYI, Ireland had 15% of the seats at Westminster before the Irish Free State was created, whereas the Republic of Ireland has 1.5% of the seats in the European Parliament. So, that worked out really well for them.
1. London is the de facto financial capital of the EU and of the Eurozone, and provides most of the services (particularly with respect to debt financing) that keep it going round. These cannot be readily replicated anywhere else, simply by banks upping sticks and moving some of their offices to the continent.
2. If there's no deal at all, then the Tories might just exploit the weakness of the Opposition to turn Britain into a gigantic Singapore. Germany and Scandinavia might be able to cope with that but I wouldn't give much for the chances of Italy under such circumstances, let alone France.
How many government ministers (or business chief executives for that matter) feel the need to change things around just so that they can be seen to 'do something'.
And when you have a new person in charge every two to four years you can easily get a continuous change process with never any end result.
Then what are the odds for Labour losing one of the two ?
There's no equivalent of the SNP south of the border. Lib Dems start from too low a base, UKIP's receding and the Conservatives can't leap in the same way because they're the Government and already have a majority.