Charge more than a tenner if the costs outweigh the savings. Make it £100
It's not a stupid idea. A&E is abused by people who brought their injuries on themselves, I have spoken to several NHS staff who think it should no longer be free of charge
"people who brought their injuries on themselves"
When I fractured my elbow last year whilst out hiking, I essentially brought the injury on myself: I was doing a hobby and stupidly slipped through lack of caution. Should I have been charged for the A&E ? How about a friend who shattered his collarbone last year whilst training for an Ironman (he tried bunny-hopping onto a kerb on his racing bike) ?
Why are drinking or drugs the only ways someone can 'bring' an injury on themselves?
Being slightly more serious: a problem is that it's easy to see scenarios where it is hard to argue with you: someone's been absolutely stupid and hurt themselves whilst the worse for wear. The difficulties comes in the less obvious scenarios, and that's where the costs would come in.
Yes I agree that is an arbitrary system, and people will find examples where it seems unfair. But I am trying to find ways of easing the strain on A&E... I didn't say that drinking and drug taking were the 'only' things people do that bring harm in themselves,but I chose those two as I think it feels morally more right to ask those people over someone who was enjoying a healthy hobby. I think we should discourage drunkenness and drug taking and not walking and ironman training. I have been in A&E myself twice through drunkenness and had 27 stitches in my head, 3 in my knee plus two new front teeth! It was my fault and I should have paid!
A half-serious question: is there a mechanism for donating?
I also wonder if it's not looking at the right thing. When I was seriously ill a year ago, the ambulance service (yes, the much-maligned East of England one) and Addenbrokes A&E were superb. Absolutely first class.
The problems mostly came immediately afterwards; when I was moved out of A&E and onto the wards. Is the bottleneck not in the NHS, but the parts of the hospital and support services that people move onto after A&E ?
(I am not a doctor, so I might have the roles and responsibilities incorrect).
@paulhutcheon: UK Labour: imposes whip to vote for Article 50 Scottish Labour: imposes whip to vote against Article 50
The UK Labour Party is reflecting the democratic will of the UK people. The Scottish Labour Party is reflecting the democratic will of the Scottish people.
English & Welsh MPs of any party who vote against triggering Article 50 are sticking two fingers up at the people.
Nonsense, you can accept the result but not the process.
Those voting against are opposing and undermining the result, not accepting it. The only way for MPs to show their acceptance of the Leave result is to expedite the triggering of Article 50.
After that, they can argue about detail, and hold a vote on the 'Deal or No Deal?' terms of leaving.
Mr. Meeks, I fear you're overlooking a supposedly neutral umpire wading into partisan political matters because it suits your perspective.
I think Trump's an oaf and his executive order ill-conceived and unjust, but that doesn't mean the Speaker of the House of Commons suddenly has permission to be a player rather than a referee.
Mr. rkrkrk, the footage yesterday was instructive. The Speaker got cheers and applause, from one side of the House, and stony silence from the other. That's not speaking for the House. It's speaking for the Opposition.
Mr Dancer, the Speaker isn't a neutral umpire. He speaks for the House. He evidently believes that he has done so on this occasion.
Yet he was happy to allow other speeches by other leaders guilty of far worse than Trump - why so?
Presumably he believed that the House wished those speeches to go ahead.
There is an argument to be made - I express no view on it either way - that the leader of the free world should be held to a higher standard than tinpot dictators.
Anyway, the whole debate about foreign patients, self-inflicted injuries and missed appointments is a complete sideshow. What's driving up the costs of the NHS is a steadily ageing population.
Charging patients for bungee-jumping may make voters feel better but it does the square root of f all towards dealing with the underlying problem.
The underlying problem is the undying problem. We can now take a notional patient and fix most things now bar the brain - but at huge cost in surgery and ongoing medication. And everyone expects to be that nominal patient under the NHS.
It is an area where no politician will wade in. But at some point this century, I expect we are going to be taking a radically different view on quality of life and end of life. Are we really going to have the state look after 5 million dementia patients? 10 million?
There's going to need to be a proper debate about end of live care and control as well. I think living wills and allowing someone to have control over their life and the right to end it is needed.
Absolutely. We can agree to live together, get married, have children - but we can't agree to assist each other die if the one wants that. If my wife were to be in huge pain, house-bound, a mere shadow of her former vibrant self, I would respect her wish if she wanted to die. Even though that may mean jail time for me, to help bring that about.
Similarly, if I were to become aware that the rest of my lifetime was being lived under dementia, I would want to have a bit of time to tick off a few bucket list items while I could still appreciate them - but then I want to check out. I don't want somebody stepping in and saying my judgment was clouded, so they are going to decide for me that I will spend twenty years in a home, surrounded by similar broken people. No, I want my wishes respected - and I want to check out. Painlessly, surrounded by my nearest and dearest, in a warm, loving setting. At home, not in Switzerland.
This whole area has to be revisited, and profound change embraced. I will have huge respect for the first politician prepared to stick their head above the parapet on this subject.
"Nick Boles, who is currently fighting cancer, leaves hospital today to vote on the Article 50 bill:
“Today, on my own initiative, I am coming out of hospital to support the government on the Article 50 bill. I have spent the last week receiving my third round of chemotherapy for the cancer that was discovered last October. I feel pretty grim and will have to go back to hospital after I have voted. But I want to come to Parliament to represent my constituents on this important bill and do my bit to ensure that it is passed without amendment.”
Mr. Meeks, I fear you're overlooking a supposedly neutral umpire wading into partisan political matters because it suits your perspective.
I think Trump's an oaf and his executive order ill-conceived and unjust, but that doesn't mean the Speaker of the House of Commons suddenly has permission to be a player rather than a referee.
Mr. rkrkrk, the footage yesterday was instructive. The Speaker got cheers and applause, from one side of the House, and stony silence from the other. That's not speaking for the House. It's speaking for the Opposition.
Mr Dancer, the Speaker isn't a neutral umpire. He speaks for the House. He evidently believes that he has done so on this occasion.
Yet he was happy to allow other speeches by other leaders guilty of far worse than Trump - why so?
Presumably he believed that the House wished those speeches to go ahead.
There is an argument to be made - I express no view on it either way - that the leader of the free world should be held to a higher standard than tinpot dictators.
So Trump should be held to a higher standard than Bercow?
Mr. W, the Speaker is meant to be neutral. He's waded straight into Foreign matters. It's clearly unacceptable.
When the time comes for a replacement, MPs will now be considering each potential successor's partisan political perspective. Because Bercow's decided the Speaker can opine on diplomatic affairs without the approval of a majority of the House following a vote, and without consulting the Lord Great Chamberlain or the Lords Speaker.
He's politicised what's meant to be a neutral role.
You are completely misreading the issue.
Bercow gave an answer within his remit. The fact that it is inconvenient to the government or their policy isn't relevant. The Speaker exercised his authority just as firmly as he does when Black Rod has the door to the Chamber of the House of Commons shut in his face.
There is a reason why the Speaker enjoys elevated precedence. At times the government and wider public should be reminded of it.
Mr. Meeks, I fear you're overlooking a supposedly neutral umpire wading into partisan political matters because it suits your perspective.
I think Trump's an oaf and his executive order ill-conceived and unjust, but that doesn't mean the Speaker of the House of Commons suddenly has permission to be a player rather than a referee.
Mr. rkrkrk, the footage yesterday was instructive. The Speaker got cheers and applause, from one side of the House, and stony silence from the other. That's not speaking for the House. It's speaking for the Opposition.
Mr Dancer, the Speaker isn't a neutral umpire. He speaks for the House. He evidently believes that he has done so on this occasion.
Yet he was happy to allow other speeches by other leaders guilty of far worse than Trump - why so?
Presumably he believed that the House wished those speeches to go ahead.
There is an argument to be made - I express no view on it either way - that the leader of the free world should be held to a higher standard than tinpot dictators.
I wonder what the actual view of the house was on the predient of China, and POTUS making speeches to parliament.
Did Bercow speak for the house, or did he believe he spoke for the house. I wonder how votes on the respective speeches would go.
I wonder if Bercow has fallen into the trap of believing a noisy minority is in fact a majority, when it is not.
@paulhutcheon: UK Labour: imposes whip to vote for Article 50 Scottish Labour: imposes whip to vote against Article 50
The UK Labour Party is reflecting the democratic will of the UK people. The Scottish Labour Party is reflecting the democratic will of the Scottish people.
English & Welsh MPs of any party who vote against triggering Article 50 are sticking two fingers up at the people.
Nonsense, you can accept the result but not the process.
Those voting against are opposing and undermining the result, not accepting it. The only way for MPs to show their acceptance of the Leave result is to expedite the triggering of Article 50.
After that, they can argue about detail, and hold a vote on the 'Deal or No Deal?' terms of leaving.
Take Daniel Zeichner (no, please do). He was robustly pro-EU during the run-up to the referendum, and represents an area that voted heavily for remain. AIUI he voted against A50.
For him to vote for A50, he would not only be misrepresenting his own views, but also those of the majority of his constituents.
Fortunately there are relatively few MPs in that sort of position; but they should be free to vote for what they think is right. If enough constituents disagree they'll suffer at the next election.
Charge more than a tenner if the costs outweigh the savings. Make it £100
It's not a stupid idea. A&E is abused by people who brought their injuries on themselves, I have spoken to several NHS staff who think it should no longer be free of charge
"people who brought their injuries on themselves"
When I fractured my elbow last year whilst out hiking, I essentially brought the injury on myself: I was doing a hobby and stupidly slipped through lack of caution. Should I have been charged for the A&E ? How about a friend who shattered his collarbone last year whilst training for an Ironman (he tried bunny-hopping onto a kerb on his racing bike) ?
Why are drinking or drugs the only ways someone can 'bring' an injury on themselves?
Being slightly more serious: a problem is that it's easy to see scenarios where it is hard to argue with you: someone's been absolutely stupid and hurt themselves whilst the worse for wear. The difficulties comes in the less obvious scenarios, and that's where the costs would come in.
Yes I agree that is an arbitrary system, and people will find examples where it seems unfair. But I am trying to find ways of easing the strain on A&E... I didn't say that drinking and drug taking were the 'only' things people do that bring harm in themselves,but I chose those two as I think it feels morally more right to ask those people over someone who was enjoying a healthy hobby. I think we should discourage drunkenness and drug taking and not walking and ironman training. I have been in A&E myself twice through drunkenness and had 27 stitches in my head, 3 in my knee plus two new front teeth! It was my fault and I should have paid!
A half-serious question: is there a mechanism for donating?
I also wonder if it's not looking at the right thing. When I was seriously ill a year ago, the ambulance service (yes, the much-maligned East of England one) and Addenbrokes A&E were superb. Absolutely first class.
The problems mostly came immediately afterwards; when I was moved out of A&E and onto the wards. Is the bottleneck not in the NHS, but the parts of the hospital and support services that people move onto after A&E ?
(I am not a doctor, so I might have the roles and responsibilities incorrect).
Depends what time of the week you get ill I guess.
My Dad was in hospital recently and all if the staff I spoke to said people should have to pay. Abuse of A&E was their major bugbear. I'm no expert, just trying to think of ways the NHS could be better
Mr. Meeks, I fear you're overlooking a supposedly neutral umpire wading into partisan political matters because it suits your perspective.
I think Trump's an oaf and his executive order ill-conceived and unjust, but that doesn't mean the Speaker of the House of Commons suddenly has permission to be a player rather than a referee.
Mr. rkrkrk, the footage yesterday was instructive. The Speaker got cheers and applause, from one side of the House, and stony silence from the other. That's not speaking for the House. It's speaking for the Opposition.
Mr Dancer, the Speaker isn't a neutral umpire. He speaks for the House. He evidently believes that he has done so on this occasion.
Yet he was happy to allow other speeches by other leaders guilty of far worse than Trump - why so?
Presumably he believed that the House wished those speeches to go ahead.
There is an argument to be made - I express no view on it either way - that the leader of the free world should be held to a higher standard than tinpot dictators.
Which is tantamount to saying that we should let tinpot dictators get away with behaving badly, and indeed be rewarded for such, because they don't know any better, where as Mr Trump went to a good university in a modern country so he should know better.
As others have quoted: May it please your majesty, I have neither eyes to see nor tongue to speak in this place but as this house is pleased to direct me whose servant I am here; and humbly beg your majesty's pardon that I cannot give any other answer than this is to what your majesty is pleased to demand of me.
You're missing the point. The Speaker speaks for the House. He evidently believed he did so with majority support. He seems to have been correct in his belief (and perhaps he took advance soundings before opining). If so, he has correctly interpreted the House's direction to him as their servant.
It's not up to the Speaker to 'interpret' the mood of the House and then say something (or at least, something controversial). It's for the House to *tell* the Speaker what its view is and for the Speaker to *report* it.
Otherwise, the Speaker would effectively be nothing more than a mouthpiece of - or even a member of - the government.
Well that's not right either. In Britain's imperfect system, the executive has far more influence over the legislature than is healthy but not all members of the governing party in the House of Commons are part of the executive. Some will actively not seek such a role. Some will be wanting to be critical friends. Their interests are not necessarily those of the executive and often will be diametrically opposed to them. And it seems strange for you to be making this suggestion precisely when the Speaker has acted inconveniently to the executive.
The government seems to have overlooked some important niceties when wanting to curry favour with President Trump. Did it occur to no one to check whether this invitation was one that Parliament was willing to endorse?
Whether or not the government has behaved appropriately doesn't impact on the debate as to whether the Speaker has, and he hasn't.
There might be a case that the government should have consulted more widely. I might well have some sympathy with that criticism and it might well be valid for Bercow to voice that view. If he his a role in the process has been overlooked then he has a legitimate grievance that he can air. That's not what's happened. What has happened is that the Speaker made an overtly political speech and one which divided the House on partisan lines to boot. That's simply not acceptable.
In any case, does anyone even know whether Trump was invited to speak in the Palace of Westminster? Because if it's simply a case of opposition MPs creating a mood to ensure that such an invitation was impossible then it's even less responsible of Bercow to get involved.
Mr. Meeks, I fear you're overlooking a supposedly neutral umpire wading into partisan political matters because it suits your perspective.
I think Trump's an oaf and his executive order ill-conceived and unjust, but that doesn't mean the Speaker of the House of Commons suddenly has permission to be a player rather than a referee.
Mr. rkrkrk, the footage yesterday was instructive. The Speaker got cheers and applause, from one side of the House, and stony silence from the other. That's not speaking for the House. It's speaking for the Opposition.
Mr Dancer, the Speaker isn't a neutral umpire. He speaks for the House. He evidently believes that he has done so on this occasion.
Yet he was happy to allow other speeches by other leaders guilty of far worse than Trump - why so?
Presumably he believed that the House wished those speeches to go ahead.
There is an argument to be made - I express no view on it either way - that the leader of the free world should be held to a higher standard than tinpot dictators.
Which is tantamount to saying that we should let tinpot dictators get away with behaving badly, and indeed be rewarded for such, because they don't know any better, where as Mr Trump went to a good university in a modern country so he should know better.
There's no test Trump could win approval from - he knows his base and they aren't Guardian readers.
No, not the entire cost. I'd say anyone in A&E over the DD limit or under the influence of illegal drugs pays a tenner
Yes but what about my taxi example where you're over the limit but have done the responsible thing, and end up in A&E through no fault of your own..
A rare and awkward counterexample but I'd like to know your view on it :>
A&E is the wrong place to start. Society has a moral duty to provide immediate care.
I suspect people are think more about heavy smokers with lung cancer or obese people wanting gastric bypasses
Agree whole-heartedly. Emergent/acute care should be available as of right in a civilised society. The debate should be around how chronic, non-acute or 'elective' treatment is delivered; the big problem for the NHS right now (IMHO) is that the facilities providing care are too heavily over-lapping on these two broad categories.
@david_herdson That's one reason why I'm far from convinced the government will give a nod and wink. They need to avoid his active opposition at this precise moment, while Brexit is still live - but if they delay past this week the moment to dump him over Trump will pass.
If they play, they must win this time.
I doubt they would win. Bercow might be a cackhanded egomaniac, but he probably has too much sympathy on this. The optics of throwing out the Speaker to placate Trump would be terrible.
Which is why I'm sceptical that it will happen, unless backbenchers push it beyond the point of no return - but if they do, I agree that the PR would be bad. Still, better bad short-term PR than a hostile Speaker for 3-4 years (and after seeing off a second attempt to unseat him, he would be overtly hostile).
But yes, I think the plan will be to find some better opportunity to bring him down.
@david_herdson That's one reason why I'm far from convinced the government will give a nod and wink. They need to avoid his active opposition at this precise moment, while Brexit is still live - but if they delay past this week the moment to dump him over Trump will pass.
If they play, they must win this time.
I doubt they would win. Bercow might be a cackhanded egomaniac, but he probably has too much sympathy on this. The optics of throwing out the Speaker to placate Trump would be terrible.
Which is why I'm sceptical that it will happen, unless backbenchers push it beyond the point of no return - but if they do, I agree that the PR would be bad. Still, better bad short-term PR than a hostile Speaker for 3-4 years (and after seeing off a second attempt to unseat him, he would be overtly hostile).
But yes, I think the plan will be to find some better opportunity to bring him down.
I think that has to be the right option. If no further comment is made, the posturing little twerp is denied the oxygen of additional publicity, which he seemingly craves.
It may also embolden him to even more rash acts of self-aggrandisement, at which point the story becomes "the Speaker is removed because he's an embarrassment" rather than "the Speaker is removed because he opposed the Government".
I find that very depressing but I seem to remember that it was somewhat staged. Am I correct, or miss-remembering?
BBC3 isn't known for its right-wing bias.
Yes Plato, I know but I recall some debate about programme at the time but it's too long ago and I've slept since then - and lost a few brain cells
TBH, everything a teeny bit critical of Islam is rubbished.
I posted the Afflect video a day ago - his reaction to fellow lefties was epic. His ego /opinion just shut out any alternative opinion/facts. He's a smart guy who wasn't listening-just outraged believer.
His body language is so angry. He's beyond reasoning with.
The reaction to Trump — it lacks the rigour of a response — has followed the grammar of identity politics. I am appalled. You are not appalled enough. We are virtuous. They are racists. This is all well and good but achieves nothing beyond giving the speaker a warm glow of virtue.
Racist is bit passe.
2016: Your a racist 2017: Your a white supremacist 2018: ?
2018: You're a nazi/Hitler 2019: You're worse than Hitler.
Electoral bias in the electoral college system continued:
Question: Are the safe/swing states under or overweight:
GOP swing states underweight by 10 (Note includes Ohio & Iowa) Dem swing states overweight by 6 GOP safe states overweight by 12 Dem safe states underweight by 8
Comments
I also wonder if it's not looking at the right thing. When I was seriously ill a year ago, the ambulance service (yes, the much-maligned East of England one) and Addenbrokes A&E were superb. Absolutely first class.
The problems mostly came immediately afterwards; when I was moved out of A&E and onto the wards. Is the bottleneck not in the NHS, but the parts of the hospital and support services that people move onto after A&E ?
(I am not a doctor, so I might have the roles and responsibilities incorrect).
After that, they can argue about detail, and hold a vote on the 'Deal or No Deal?' terms of leaving.
There is an argument to be made - I express no view on it either way - that the leader of the free world should be held to a higher standard than tinpot dictators.
“Today, on my own initiative, I am coming out of hospital to support the government on the Article 50 bill. I have spent the last week receiving my third round of chemotherapy for the cancer that was discovered last October. I feel pretty grim and will have to go back to hospital after I have voted. But I want to come to Parliament to represent my constituents on this important bill and do my bit to ensure that it is passed without amendment.”
https://order-order.com/2017/02/07/nick-boles-leaves-hospital-to-make-article-50-vote/
Bercow gave an answer within his remit. The fact that it is inconvenient to the government or their policy isn't relevant. The Speaker exercised his authority just as firmly as he does when Black Rod has the door to the Chamber of the House of Commons shut in his face.
There is a reason why the Speaker enjoys elevated precedence. At times the government and wider public should be reminded of it.
Did Bercow speak for the house, or did he believe he spoke for the house. I wonder how votes on the respective speeches would go.
I wonder if Bercow has fallen into the trap of believing a noisy minority is in fact a majority, when it is not.
For him to vote for A50, he would not only be misrepresenting his own views, but also those of the majority of his constituents.
Fortunately there are relatively few MPs in that sort of position; but they should be free to vote for what they think is right. If enough constituents disagree they'll suffer at the next election.
My Dad was in hospital recently and all if the staff I spoke to said people should have to pay. Abuse of A&E was their major bugbear. I'm no expert, just trying to think of ways the NHS could be better
I suspect people are think more about heavy smokers with lung cancer or obese people wanting gastric bypasses
https://www.youtube.com/watch?v=jaCYiBT5EVI
There might be a case that the government should have consulted more widely. I might well have some sympathy with that criticism and it might well be valid for Bercow to voice that view. If he his a role in the process has been overlooked then he has a legitimate grievance that he can air. That's not what's happened. What has happened is that the Speaker made an overtly political speech and one which divided the House on partisan lines to boot. That's simply not acceptable.
In any case, does anyone even know whether Trump was invited to speak in the Palace of Westminster? Because if it's simply a case of opposition MPs creating a mood to ensure that such an invitation was impossible then it's even less responsible of Bercow to get involved.
But yes, I think the plan will be to find some better opportunity to bring him down.
NEW THREAD
It may also embolden him to even more rash acts of self-aggrandisement, at which point the story becomes "the Speaker is removed because he's an embarrassment" rather than "the Speaker is removed because he opposed the Government".
I posted the Afflect video a day ago - his reaction to fellow lefties was epic. His ego /opinion just shut out any alternative opinion/facts. He's a smart guy who wasn't listening-just outraged believer.
His body language is so angry. He's beyond reasoning with.
https://www.youtube.com/watch?v=vln9D81eO60
2019: You're worse than Hitler.
Question: Are the safe/swing states under or overweight:
GOP swing states underweight by 10 (Note includes Ohio & Iowa)
Dem swing states overweight by 6
GOP safe states overweight by 12
Dem safe states underweight by 8