politicalbetting.com » Blog Archive » Three Score and Ten? Has the NHS reached the end of its natura
politicalbetting.com » Blog Archive » Three Score and Ten? Has the NHS reached the end of its natural life?
On July 5th the NHS marks its 70th birthday, and the occasion will be marked by a significant financial injection as a means of life support by the Conservative government. This should keep it breathing for a while yet, but like any ageing process we should consider whether the condition is terminal, and what the objective of continued treatment is. Is the NHS a model of health care fit for the 2020’s or are there better ways of organising it in the modern world?
Comments
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NHS forever. Always first !0
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Thank you for a real anaylsis of the NHS.
It has to be taken out of party politics and given a cross party mandate for it to survive. TM offering 20 billion extra a year and Corbyn saying he will pay more as he did today is just not the answer0 -
surby said:
I have implemented the GDPR and appointed a Data Protection Officer to create and write the paperwork, questionnaires. Apart from that, nothing has changed !Nigelb said:California passed its own, slightly more sensible version of GDPR last week:
http://money.cnn.com/2018/06/28/technology/california-consumer-privacy-act/index.html
Its ISO 9001 all over again.0 -
If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?0
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My rule of thumb is: If your personal data handling such that you can't easily answer GDPR queries then your data handling is bad and you should feel bad.surby said:surby said:
I have implemented the GDPR and appointed a Data Protection Officer to create and write the paperwork, questionnaires. Apart from that, nothing has changed !Nigelb said:California passed its own, slightly more sensible version of GDPR last week:
http://money.cnn.com/2018/06/28/technology/california-consumer-privacy-act/index.html
Its ISO 9001 all over again.0 -
We don't want the Irish system.williamglenn said:If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?
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An excellent thread header by Dr Fox.
I would suggest though that one thing we do need to do is look at European systems - particularly the French - and how they introduce private money into their National Health service. Whilst a significant proportion of the service is provided by the private sector in France (whilst generally remaining free at the point of delivery), that private sector is far more constrained than we are used to in the UK. Drug costs, treatment costs and service quality are all very tightly regulated and private companies go into health care not because it will make them vast sums of money per se but because it will provide a steady, predictable income over a long period. This is the way we should be looking at private provision of health services in the UK rather than the awful US system.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.0 -
The NHS is also a victim of increasing inequality, as that means its funding is increasingly reliant on a smaller number of people.
Somehow the great mass of the population need to become richer, so that everyone can contribute more to the NHS.0 -
F1 ... Mercedes demonstrating yet again their inability to strategise on the fly.0
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I was under the impression the Irish system was almost as bad as the NHS. Better to take the opportunity to reform both systems along the lines of France or Germany.williamglenn said:If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?
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are you proposing a trial separation?williamglenn said:If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?
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Jeremy wouldn't like that but he is a dinosaurRichard_Tyndall said:An excellent thread header by Dr Fox.
I would suggest though that one thing we do need to do is look at European systems - particularly the French - and how they introduce private money into their National Health service. Whilst a significant proportion of the service is provided by the private sector in France (whilst generally remaining free at the point of delivery), that private sector is far more constrained than we are used to in the UK. Drug costs, treatment costs and service quality are all very tightly regulated and private companies go into health care not because it will make them vast sums of money per se but because it will provide a steady, predictable income over a long period. This is the way we should be looking at private provision of health services in the UK rather than the awful US system.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.0 -
Disclaimer: I know nothing about the Irish system.Richard_Tyndall said:
I was under the impression the Irish system was almost as bad as the NHS. Better to take the opportunity to reform both systems along the lines of France or Germany.williamglenn said:If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?
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Hunt or CorbynBig_G_NorthWales said:
Jeremy wouldn't like that but he is a dinosaurRichard_Tyndall said:An excellent thread header by Dr Fox.
I would suggest though that one thing we do need to do is look at European systems - particularly the French - and how they introduce private money into their National Health service. Whilst a significant proportion of the service is provided by the private sector in France (whilst generally remaining free at the point of delivery), that private sector is far more constrained than we are used to in the UK. Drug costs, treatment costs and service quality are all very tightly regulated and private companies go into health care not because it will make them vast sums of money per se but because it will provide a steady, predictable income over a long period. This is the way we should be looking at private provision of health services in the UK rather than the awful US system.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.
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I agree but you'd be hard pressed to find many politicians of influence (of any hue but the redder, the less likely) to publicly promote the concept. Who would hold the buggers to account when the only measures most voters are allowed to consider are cost and "how does it affect me"? Corbyn will doubtless be disappointed to have to discontinue reading out his Doubting Thomas letters, real or otherwise.Big_G_NorthWales said:Thank you for a real anaylsis of the NHS.
It has to be taken out of party politics and given a cross party mandate for it to survive. TM offering 20 billion extra a year and Corbyn saying he will pay more as he did today is just not the answer0 -
It is similar to the NHS with a nationally directed system operated by the HSE (health service executive) - with hospitals run mostly by the HSE and some by charities often linked to the Catholic Church. The one big difference is that unless your household family income is below 15k euro (and thus aren't eligible for the famed medical card) you have to pay 75 euro per night stay in hospital, 50 euro to see a GP and 100 euro to go to casualty even for kids aged over 7 and the elderly.Richard_Tyndall said:
I was under the impression the Irish system was almost as bad as the NHS. Better to take the opportunity to reform both systems along the lines of France or Germany.williamglenn said:If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?
Like the NHS it's good and bad in parts - overcrowded A&Es but some facilities top notch. A lot of people do go private though.
But it's not really a model we would want to reform into - it's the NHS with extra charges and some private provision.0 -
Thanks, Dr Fox.
The truth is that the NHS was formed in a past age. We have changed massively from the late 1940s: rationing has gone, the death penalty was itself dealt a deathly blow, homosexuality is legal, and TV and communications are everywhere. The world has moved on, but the NHS remains an iceberg drifting towards the Equator.
The 'ageing' problem can be solved by evolution, not revolution. Work out the core principles, the current and future (< twenty years) demand, and how best to fulfil that demand within those principles.
Unfortunately, there are too many on the left who treat the NHS as something that cannot be altered (except when they are doing the altering). Worse, there are many when the NHS and its staff matter more than outcomes and patients - witness the current Manchester Mayor's views on the Stafford scandal. This is an evil.
Likewise, those who look to America and want to reform the NHS in that manner - ignoring the core principles - are equally wrongheaded, although less numerous.
I agree with Mr G below: it needs to be taken out of party politics. However that won't happen as long as Labour believe that the NHS is an electoral winner for them. And in the meantime the NHS will drift on until it finally melts into nothingness. And that would be a tragedy.
In addition: we have to be cleverer in the use of technology: and the NHS is terrible when it comes to trying new medical technology, with hundreds of little fiefdoms. There are also non-technological enhancements that can be made, e.g. to reduce A&E visits.0 -
Mercedes couldn’t organise a pregnancy on a council estate.Nigelb said:F1 ... Mercedes demonstrating yet again their inability to strategise on the fly.
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Many thanks for this Doctor Foxy.
A real joy to publish this.0 -
Do they moonlight as Brexit negotiators?TheScreamingEagles said:
Mercedes couldn’t organise a pregnancy on a council estate.Nigelb said:F1 ... Mercedes demonstrating yet again their inability to strategise on the fly.
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FPT
If the withdrawal agreement cannot be the reason to create the conditions needed for border checks, how do you expect to agree a withdrawal agreement which creates a border?Richard_Tyndall said:
And again misreading. 'Does not authorise' is not the same as 'prevents'. Either side can impose border restrictions if they chose to do so. They simply can't use the December agreement as a reason to do so.williamglenn said:http://www.legislation.gov.uk/ukpga/2018/16/section/10/enacted
The EU Withdrawal Act does not authorise the UK to:
...create or facilitate border arrangements between Northern Ireland and the Republic of Ireland after exit day which feature physical infrastructure, including border posts, or checks and controls, that did not exist before exit day and are not in accordance with an agreement between the United Kingdom and the EU.
So no technology on the Irish border or new checks or controls of any kind.0 -
No - one thing they can do is plan in advance. If they’d been doing Brexit we’d already have a deal.FrancisUrquhart said:
Do they moonlight as Brexit negotiators?TheScreamingEagles said:
Mercedes couldn’t organise a pregnancy on a council estate.Nigelb said:F1 ... Mercedes demonstrating yet again their inability to strategise on the fly.
They are simply incapable of reacting to the unexpected.
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Girls are banned from wearing skirts at 40 secondaries across England as schools opt for gender-neutral uniforms to cater for transgender pupils
http://www.dailymail.co.uk/news/article-5906031/Girls-banned-wearing-skirts-40-schools-insist-gender-neutral-uniforms.html
I don't understand this approach. Why not simply say trousers, skirts and shorts are all acceptable uniform options (for either sex).
I am sure there are girls who would choose to wear trousers, especially during winter, but might prefer skirts in the summer.0 -
Good afternoon. Thanks for the article Dr Foxy.
That was the worst bit of defending I've seen for a long time in the Spain / Russia match.0 -
Just got back from a family lunch with some fellow Brexiteers. The general mood when discussing Europe was one of resignation; the government has no leverage without ‘no deal’ preparation, but they are manifestly not doing it, and it is probably now too late. The only real solution to the Irish border that will let us have our own trade policy is reunification.
While we are all hard Brexiteers in principle, we agreed that a no deal Brexit with no preparation would be utterly irresponsible. If all May can get is CU and SM with no U.K. input on rule-making, we need a second referendum.0 -
I think it's about avoiding a debate about skirt lengthFrancisUrquhart said:Girls are banned from wearing skirts at 40 secondaries across England as schools opt for gender-neutral uniforms to cater for transgender pupils
http://www.dailymail.co.uk/news/article-5906031/Girls-banned-wearing-skirts-40-schools-insist-gender-neutral-uniforms.html
I don't understand this approach. Why not simply say trousers, skirts and shorts are all acceptable uniform options (for either sex).
I am sure there are girls who would choose to wear trousers, especially during winter, but might prefer skirts in the summer.0 -
Excellent. Thanks @Foxy
The issue is that there are several questions which get muddled up. Some are rightly intensely political, others really shouldn’t be. It’s not helpful by some on the left who see the the NHS as a massive political weapon so oppose any reform with screams of “45 mins to save the NHS” or some such crap.
In an ideal world you could have a series of Royal Conmissions (too big for one) which should operate sequentially
Starting from the basic principal that adequate healthcare should be universally available
(1) what is the remit (ie treatment vs prevention, how much elective stuff). Are we preserving life at all cost or how should we integrate into hospice movement?
(2) for a given budget of X what is the best way to deliver? (Eg DGH vs A&E retail vs convalescence vs centres of excellence etc)
(3) should it be one size fits all?
The question of money is one for politics but hopefully we can all agree we want the best health outcomes for the money available
(The other question is whether it’s just too big to manage. I’ve beem wondering recently whether we should switch the government structure from function to client based. So - for instance - you’d combine pensions/social care; education/child benefit etc. Ultimately people in different stages of life have different needs but should have a holistic service provided by the state)0 -
France does spend more on health than we do, and not just because of insurance. The French government spends more as well. Most advocates of moving to European models do not tell us how much more money they'd spend; this is surprising because if you did want to convince voters to change then promising extra funding would be a powerful carrot -- ask Boris! The American system might be awful but one strength is innovation. I don't know if it can be measured but I'd expect most new treatments to come from the US.Richard_Tyndall said:An excellent thread header by Dr Fox.
I would suggest though that one thing we do need to do is look at European systems - particularly the French - and how they introduce private money into their National Health service. Whilst a significant proportion of the service is provided by the private sector in France (whilst generally remaining free at the point of delivery), that private sector is far more constrained than we are used to in the UK. Drug costs, treatment costs and service quality are all very tightly regulated and private companies go into health care not because it will make them vast sums of money per se but because it will provide a steady, predictable income over a long period. This is the way we should be looking at private provision of health services in the UK rather than the awful US system.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.
ETA: what surprises many is the American government spends more on health than ours, even in what you'd think is the most market-oriented system in the world.0 -
In which you would vote Remain?RoyalBlue said:While we are all hard Brexiteers in principle, we agreed that a no deal Brexit with no preparation would be utterly irresponsible. If all May can get is CU and SM with no U.K. input on rule-making, we need a second referendum.
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I had some mates round yesterday for drinks and made some canapés with the Labneh that I'd made the night before (sourdough crispbread smeared with garlic and herb Labneh topped with spring onion and half a yellow cherry tomato).
These were extremely popular and everyone wanted know how I made the cream cheese. Being a bit drunk I did a demonstration, and made almost a litre of it. All were shocked at how easy it is to make.
This morning I woke up to find a litre of Lebanese garlic cream cheese in my fridge and thought I ought to use it up. I went to tesco (in a new record 113mpg!) and got the ingredients to make mini moroccan spice lamb burgers, flatbreads and a chilli, radish and red onion salad to garnish.
Luckily these are delicious, as I've made enough to feed a football team so I'll be eating them for lunch all next week!
I like the header, but I think the nhs is here to stay. And grow. If we're going to have it, it ought to be coordinated and incorporated with social care.0 -
Pretty much my view, albeit coming from squarely the opposite direction. The Brexit promised will not be on the table. The government will hopefully, post-Chequers, decided on which of the irreconcilables to junk - likely this will be a certain notion of sovereignty as we are are unwilling to leave the customs union and may also need to concede certain elements around FOM.RoyalBlue said:Just got back from a family lunch with some fellow Brexiteers. The general mood when discussing Europe was one of resignation; the government has no leverage without ‘no deal’ preparation, but they are manifestly not doing it, and it is probably now too late. The only real solution to the Irish border that will let us have our own trade policy is reunification.
While we are all hard Brexiteers in principle, we agreed that a no deal Brexit with no preparation would be utterly irresponsible. If all May can get is CU and SM with no U.K. input on rule-making, we need a second referendum.
If, with these compromises known, we still wish to Leave, then at least we will do so with eyes wide open - but we need a Vote on the Deal to ratify the government’s policy.0 -
Because banning is easier for teachers than allowing choiceFrancisUrquhart said:Girls are banned from wearing skirts at 40 secondaries across England as schools opt for gender-neutral uniforms to cater for transgender pupils
http://www.dailymail.co.uk/news/article-5906031/Girls-banned-wearing-skirts-40-schools-insist-gender-neutral-uniforms.html
I don't understand this approach. Why not simply say trousers, skirts and shorts are all acceptable uniform options (for either sex).
I am sure there are girls who would choose to wear trousers, especially during winter, but might prefer skirts in the summer.0 -
But how was your parking?JonnyJimmy said:I had some mates round yesterday for drinks and made some canapés with the Labneh that I'd made the night before (sourdough crispbread smeared with garlic and herb Labneh topped with spring onion and half a yellow cherry tomato).
These were extremely popular and everyone wanted know how I made the cream cheese. Being a bit drunk I did a demonstration, and made almost a litre of it. All were shocked at how easy it is to make.
This morning I woke up to find a litre of Lebanese garlic cream cheese in my fridge and thought I ought to use it up. I went to tesco (in a new record 113mpg!) and got the ingredients to make mini moroccan spice lamb burgers, flatbreads and a chilli, radish and red onion salad to garnish.
Luckily these are delicious, as I've made enough to feed a football team so I'll be eating them for lunch all next week!
I like the header, but I think the nhs is here to stay. And grow. If we're going to have it, it ought to be coordinated and incorporated with social care.0 -
If the government needs statutory authorisation for customs checks on our Borders, then it would be incorporated into a Finance Act.williamglenn said:FPT
If the withdrawal agreement cannot be the reason to create the conditions needed for border checks, how do you expect to agree a withdrawal agreement which creates a border?Richard_Tyndall said:
And again misreading. 'Does not authorise' is not the same as 'prevents'. Either side can impose border restrictions if they chose to do so. They simply can't use the December agreement as a reason to do so.williamglenn said:http://www.legislation.gov.uk/ukpga/2018/16/section/10/enacted
The EU Withdrawal Act does not authorise the UK to:
...create or facilitate border arrangements between Northern Ireland and the Republic of Ireland after exit day which feature physical infrastructure, including border posts, or checks and controls, that did not exist before exit day and are not in accordance with an agreement between the United Kingdom and the EU.
So no technology on the Irish border or new checks or controls of any kind.0 -
I agree. It is vital that the final settlement is explicitly supported by the electorate, rather than be categorised as a ‘Tory Brexit’.Gardenwalker said:
Pretty much my view, albeit coming from squarely the opposite direction. The Brexit promised will not be on the table. The government will hopefully, post-Chequers, decided on which of the irreconcilables to junk - likely this will be a certain notion of sovereignty as we are are unwilling to leave the customs union and may also need to concede certain elements around FOM.RoyalBlue said:Just got back from a family lunch with some fellow Brexiteers. The general mood when discussing Europe was one of resignation; the government has no leverage without ‘no deal’ preparation, but they are manifestly not doing it, and it is probably now too late. The only real solution to the Irish border that will let us have our own trade policy is reunification.
While we are all hard Brexiteers in principle, we agreed that a no deal Brexit with no preparation would be utterly irresponsible. If all May can get is CU and SM with no U.K. input on rule-making, we need a second referendum.
If, with these compromises known, we still wish to Leave, then at least we will do so with eyes wide open - but we need a Vote on the Deal to ratify the government’s policy.0 -
You agree that this can only happen in the case of No Deal? A deal which includes any form of MaxFac on the Irish border cannot happen unless the legislation is amended?Sean_F said:
If the government needs statutory authorisation for customs checks on our Borders, then it would be incorporated into a Finance Act.williamglenn said:FPT
If the withdrawal agreement cannot be the reason to create the conditions needed for border checks, how do you expect to agree a withdrawal agreement which creates a border?Richard_Tyndall said:
And again misreading. 'Does not authorise' is not the same as 'prevents'. Either side can impose border restrictions if they chose to do so. They simply can't use the December agreement as a reason to do so.williamglenn said:http://www.legislation.gov.uk/ukpga/2018/16/section/10/enacted
The EU Withdrawal Act does not authorise the UK to:
...create or facilitate border arrangements between Northern Ireland and the Republic of Ireland after exit day which feature physical infrastructure, including border posts, or checks and controls, that did not exist before exit day and are not in accordance with an agreement between the United Kingdom and the EU.
So no technology on the Irish border or new checks or controls of any kind.0 -
What a surprise - Selmayr being an arse again:
https://www.theguardian.com/politics/2018/jul/01/brexit-eu-accused-of-making-false-aid-funding-claims0 -
I didn't use the accelerator at all in the car park, and only used my brake once to stop precisely between the lines in a carefully chosen spot right next to the trolley park which I was able to drive both into and out of without reversing.JosiasJessop said:
But how was your parking?JonnyJimmy said:I had some mates round yesterday for drinks and made some canapés with the Labneh that I'd made the night before (sourdough crispbread smeared with garlic and herb Labneh topped with spring onion and half a yellow cherry tomato).
These were extremely popular and everyone wanted know how I made the cream cheese. Being a bit drunk I did a demonstration, and made almost a litre of it. All were shocked at how easy it is to make.
This morning I woke up to find a litre of Lebanese garlic cream cheese in my fridge and thought I ought to use it up. I went to tesco (in a new record 113mpg!) and got the ingredients to make mini moroccan spice lamb burgers, flatbreads and a chilli, radish and red onion salad to garnish.
Luckily these are delicious, as I've made enough to feed a football team so I'll be eating them for lunch all next week!
I like the header, but I think the nhs is here to stay. And grow. If we're going to have it, it ought to be coordinated and incorporated with social care.
So pretty good 0 -
One thing that strikes me from both fly-on-the wall documentaries and attending outpatients is that there are some fairly simple improvements that could be made, such as labelling cupboards so staff can find equipment more easily, and better signposting so patients (especially this one) don't get lost in a maze of corridors.0
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What herbs do you recommend ?JonnyJimmy said:
I didn't use the accelerator at all in the car park, and only used my brake once to stop precisely between the lines in a carefully chosen spot right next to the trolley park which I was able to drive both into and out of without reversing.JosiasJessop said:
But how was your parking?JonnyJimmy said:I had some mates round yesterday for drinks and made some canapés with the Labneh that I'd made the night before (sourdough crispbread smeared with garlic and herb Labneh topped with spring onion and half a yellow cherry tomato).
These were extremely popular and everyone wanted know how I made the cream cheese. Being a bit drunk I did a demonstration, and made almost a litre of it. All were shocked at how easy it is to make.
This morning I woke up to find a litre of Lebanese garlic cream cheese in my fridge and thought I ought to use it up. I went to tesco (in a new record 113mpg!) and got the ingredients to make mini moroccan spice lamb burgers, flatbreads and a chilli, radish and red onion salad to garnish.
Luckily these are delicious, as I've made enough to feed a football team so I'll be eating them for lunch all next week!
I like the header, but I think the nhs is here to stay. And grow. If we're going to have it, it ought to be coordinated and incorporated with social care.
So pretty good0 -
Chris Grayling is determined to ensure the Tories don’t win any Northern marginals.
https://twitter.com/helenpidd/status/1013350207545839622?s=21
I bet Grayling does strategy for Mercedes F1 on the side too.0 -
Raikkonen about to give up a place, I think.0
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Just catching up on the last thread to read of references having been made to WW1. This reminds me that I wrote a pretty nice cryptic clue yesterday.
World War One is chaos whatever the result (3,4,2,4)
And after a few beers came up with this
A bit tutti-frutti, psychoactively (5)0 -
This is a disgrace.Nigelb said:Raikkonen about to give up a place, I think.
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I'm still experimenting! For this batch I used fresh mint and chives. It's really very nice with the lamb.Nigelb said:
What herbs do you recommend ?JonnyJimmy said:
I didn't use the accelerator at all in the car park, and only used my brake once to stop precisely between the lines in a carefully chosen spot right next to the trolley park which I was able to drive both into and out of without reversing.JosiasJessop said:
But how was your parking?JonnyJimmy said:I had some mates round yesterday for drinks and made some canapés with the Labneh that I'd made the night before (sourdough crispbread smeared with garlic and herb Labneh topped with spring onion and half a yellow cherry tomato).
These were extremely popular and everyone wanted know how I made the cream cheese. Being a bit drunk I did a demonstration, and made almost a litre of it. All were shocked at how easy it is to make.
This morning I woke up to find a litre of Lebanese garlic cream cheese in my fridge and thought I ought to use it up. I went to tesco (in a new record 113mpg!) and got the ingredients to make mini moroccan spice lamb burgers, flatbreads and a chilli, radish and red onion salad to garnish.
Luckily these are delicious, as I've made enough to feed a football team so I'll be eating them for lunch all next week!
I like the header, but I think the nhs is here to stay. And grow. If we're going to have it, it ought to be coordinated and incorporated with social care.
So pretty good0 -
I thought we were discussing a No Deal situation.williamglenn said:
You agree that this can only happen in the case of No Deal? A deal which includes any form of MaxFac on the Irish border cannot happen unless the legislation is amended?Sean_F said:
If the government needs statutory authorisation for customs checks on our Borders, then it would be incorporated into a Finance Act.williamglenn said:FPT
If the withdrawal agreement cannot be the reason to create the conditions needed for border checks, how do you expect to agree a withdrawal agreement which creates a border?Richard_Tyndall said:
And again misreading. 'Does not authorise' is not the same as 'prevents'. Either side can impose border restrictions if they chose to do so. They simply can't use the December agreement as a reason to do so.williamglenn said:http://www.legislation.gov.uk/ukpga/2018/16/section/10/enacted
The EU Withdrawal Act does not authorise the UK to:
...create or facilitate border arrangements between Northern Ireland and the Republic of Ireland after exit day which feature physical infrastructure, including border posts, or checks and controls, that did not exist before exit day and are not in accordance with an agreement between the United Kingdom and the EU.
So no technology on the Irish border or new checks or controls of any kind.
If a deal is agreed, then customs checks will be dealt with in the deal, and in the legislation that puts into place..0 -
Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/10134070737265336320 -
"Trump's mother being Scottish will help us get a good trade deal."
Oh...
https://twitter.com/ddale8/status/10134268044624158720 -
Oh I am quite happy to say how much we need to spend as it is, to me at least, an unpolitical position.DecrepitJohnL said:
France does spend more on health than we do, and not just because of insurance. The French government spends more as well. Most advocates of moving to European models do not tell us how much more money they'd spend; this is surprising because if you did want to convince voters to change then promising extra funding would be a powerful carrot -- ask Boris! The American system might be awful but one strength is innovation. I don't know if it can be measured but I'd expect most new treatments to come from the US.Richard_Tyndall said:An excellent thread header by Dr Fox.
I would suggest though that one thing we do need to do is look at European systems - particularly the French - and how they introduce private money into their National Health service. Whilst a significant proportion of the service is provided by the private sector in France (whilst generally remaining free at the point of delivery), that private sector is far more constrained than we are used to in the UK. Drug costs, treatment costs and service quality are all very tightly regulated and private companies go into health care not because it will make them vast sums of money per se but because it will provide a steady, predictable income over a long period. This is the way we should be looking at private provision of health services in the UK rather than the awful US system.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.
ETA: what surprises many is the American government spends more on health than ours, even in what you'd think is the most market-oriented system in the world.
According to the World Health Organisation total UK expenditure on health care in 2015 was $4,356 per person. That includes both public and private provision.
By comparison French expenditure per person was only $4,026.
However Canadian ($4,508), German ($4,592) and Dutch ($4,746) spending per person were all higher than the British. The US is ludicrously high ($9,818) when you consider the state of their health care.
Obviously I would expect these have al increased since 2015.
The French have better health care provision than the NHS for lower per capita spending but I would suggest we should be looking to have German or Dutch levels of spending combined with French (or German or Dutch) systems.
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Thanks Brendan. Sounds like both countries should be looking to continental European systems.brendan16 said:
It is similar to the NHS with a nationally directed system operated by the HSE (health service executive) - with hospitals run mostly by the HSE and some by charities often linked to the Catholic Church. The one big difference is that unless your household family income is below 15k euro (and thus aren't eligible for the famed medical card) you have to pay 75 euro per night stay in hospital, 50 euro to see a GP and 100 euro to go to casualty even for kids aged over 7 and the elderly.Richard_Tyndall said:
I was under the impression the Irish system was almost as bad as the NHS. Better to take the opportunity to reform both systems along the lines of France or Germany.williamglenn said:If Ireland were reunified, how would they go about integrating the Northern Irish NHS into the health system of Ireland, and would this provide any useful lessons for NHS reform to create a more European style system?
Like the NHS it's good and bad in parts - overcrowded A&Es but some facilities top notch. A lot of people do go private though.
But it's not really a model we would want to reform into - it's the NHS with extra charges and some private provision.0 -
The withdrawal agreement comes first, and will be an international treaty. Based on the current state of play, if there is a withdrawal agreement it will have to include the backstop.Sean_F said:I thought we were discussing a No Deal situation.
If a deal is agreed, then customs checks will be dealt with in the deal, and in the legislation that puts into place..
Incidentally this ties in with @RoyalBlue's argument that it is in the Tory party's interests for a second referendum. May said "no British PM could agree to a customs border between NI and GB". If the withdrawal agreement implies that this could be a future consequence of Brexit, then she will have to seek some kind of mandate from the people and the best way to do it is a referendum on the deal.0 -
More needs to be spent. More needs to be expected of individuals. Less should be provided in some areas. None of this will be popular.0
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The DfT and Network Rail have really screwed future large-scale rail enhancements. It's clear no-one has any idea how much such upgrades to existing lines will cost.rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/10134070737265336320 -
Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.0
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Good afternoon, everyone.
F1: very exciting race. Also, very green. Ironically, the only bet I made that didn't end up green was the one I tipped in an article. But still very pleased.
Will try writing the post-race tosh but many things occurred so I may well omit something by accident.0 -
Mr. Eagles, it's just dumb. Grayling can find £2bn to bugger Stonehenge with a tunnel, but nothing to keep promises on electrifying northern rail lines.0
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The reality of the policy is every bit as bad as the optics.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
Grayling is solid oak between the ears, but he is being allowed to perpetuate this nonsense by an aimless and powerless prime minister.0 -
1-1 at half time is a surprise, especially as the Spanish 1 was surely the oddest own goal in recent history.0
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Indeed. I said it on here previously, if we're going to spend money on trains and high speed rail then we should start from the top, two lines coming down from Newcastle (via Leeds) and Liverpool (via Manchester) down to Birmingham should be done first, then do the Birmingham to London link afterwards. Politically it makes a lot more sense than spending £40bn+ on more rail infrastructure in the south. Economically it's probably marginal either side, I don't see the economic case for HS2 in general but we should at least make some kind of political capital from it.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
0 -
Would be laughable if it didn’t indicate a delusional complacency about Tory prospects at the next election.Nigelb said:
The reality of the policy is every bit as bad as the optics.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
Grayling is solid oak between the ears, but he is being allowed to perpetuate this nonsense by an aimless and powerless prime minister.
The Tories, by being so crap across so many dimensions, are enabling Corbyn-ism, and putting the country’s future at risk. Like the Bourbons, the post-Cameron Tories have learned nothing and forgotten nothing.0 -
This is an insane decision. We can find £20bn for the NHS, but not some hundreds of millions to improve a rail link between two major cities?rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/1013407073726533632
Pathetic.0 -
https://www.the-tls.co.uk/articles/public/brexit-politics-george-walden/Gardenwalker said:
Would be laughable if it didn’t indicate a delusional complacency about Tory prospects at the next election.Nigelb said:
The reality of the policy is every bit as bad as the optics.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
Grayling is solid oak between the ears, but he is being allowed to perpetuate this nonsense by an aimless and powerless prime minister.
The Tories, by being so crap across so many dimensions, are enabling Corbyn-ism, and putting the country’s future at risk. Like the Bourbons, the post-Cameron Tories have learned nothing and forgotten nothing.
The spectacle of such a talented yet leaderless nation stumbling blindly towards an unmapped future, tapping its stick fearfully as it goes, inspires sadness, shame and pity. As penury and not so splendid isolation loom, the question becomes, who are the patriots now?0 -
The optics on this as the North faces rail chaos are beyond belief. Maybe Grayling is a Jezza convert and is now a deep sleeping agent?RoyalBlue said:
This is an insane decision. We can find £20bn for the NHS, but not some hundreds of millions to improve a rail link between two major cities?rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/1013407073726533632
Pathetic.0 -
Oh, stop your whining.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
If you hadn't noticed, the main reason for the timetable failure on Northern Rail at the end of May was Network Rail's inability to deliver similar upgrades. So the 'desolate north' has been getting a heck of a lot of upgrades: perhaps not as much as you want, or even deserve, but they are happening.
As a good Conservative, I'd have thought you were not keen on writing blank cheques for upgrades - as we have seen happen on the GWML electrification, and we saw on the WCML upgrade a decade ago.
To give you an idea of the scale of the problem, the GWML program was costed at about £1.3 billion. A few months ago its costs were £3.2 billion. The WCML upgrade program was about a tenfold increase in costs, and was reduced in scope and delivered very late.
I'd prefer a reduced electrification scheme over a number of years, but such upgrades also rely on new stock, and the new stock is needed much sooner.
So, what would your upgrade program be?0 -
Well we all lost money on that race...0
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Personally I think HS2 needs to be built, but I see no point to the Southern part of HS2 unless it links directly into St Pancras and can run international trains to the continent.MaxPB said:
Indeed. I said it on here previously, if we're going to spend money on trains and high speed rail then we should start from the top, two lines coming down from Newcastle (via Leeds) and Liverpool (via Manchester) down to Birmingham should be done first, then do the Birmingham to London link afterwards. Politically it makes a lot more sense than spending £40bn+ on more rail infrastructure in the south. Economically it's probably marginal either side, I don't see the economic case for HS2 in general but we should at least make some kind of political capital from it.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
0 -
OECD has France on higher per-capita expenditure in France: $4,600 vs $4,200 in 2016.Richard_Tyndall said:
Oh I am quite happy to say how much we need to spend as it is, to me at least, an unpolitical position.DecrepitJohnL said:
France does spend more on health than we do, and not just because of insurance. The French government spends more as well. Most advocates of moving to European models do not tell us how much more money they'd spend; this is surprising because if you did want to convince voters to change then promising extra funding would be a powerful carrot -- ask Boris! The American system might be awful but one strength is innovation. I don't know if it can be measured but I'd expect most new treatments to come from the US.Richard_Tyndall said:An excellent thread header by Dr Fox.
I would suggest though that one thing we do need to do is look at European systems - particularly the French - and how they introduce private money into their National Health service. Whilst a significant proportion of the service is provided by the private sector in France (whilst generally remaining free at the point of delivery), that private sector is far more constrained than we are used to in the UK. Drug costs, treatment costs and service quality are all very tightly regulated and private companies go into health care not because it will make them vast sums of money per se but because it will provide a steady, predictable income over a long period. This is the way we should be looking at private provision of health services in the UK rather than the awful US system.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.
ETA: what surprises many is the American government spends more on health than ours, even in what you'd think is the most market-oriented system in the world.
According to the World Health Organisation total UK expenditure on health care in 2015 was $4,356 per person. That includes both public and private provision.
By comparison French expenditure per person was only $4,026.
However Canadian ($4,508), German ($4,592) and Dutch ($4,746) spending per person were all higher than the British. The US is ludicrously high ($9,818) when you consider the state of their health care.
Obviously I would expect these have al increased since 2015.
The French have better health care provision than the NHS for lower per capita spending but I would suggest we should be looking to have German or Dutch levels of spending combined with French (or German or Dutch) systems.
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
It may be that it depends on the small print as to what is classified as health spending.
0 -
Costs on such projects are so out of control that no-one knows how much it would cost.RoyalBlue said:
This is an insane decision. We can find £20bn for the NHS, but not some hundreds of millions to improve a rail link between two major cities?rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/1013407073726533632
Pathetic.
If you still want to go ahead on that basis, fair enough. But be aware that others will want their pet projects that you disagree with to go ahead as well on a similar basis.0 -
The investment required for a new East-West route doesn’t begin to compare with HS2, and I would guess the economic returns would be superior - let alone the social ones.MaxPB said:
Indeed. I said it on here previously, if we're going to spend money on trains and high speed rail then we should start from the top, two lines coming down from Newcastle (via Leeds) and Liverpool (via Manchester) down to Birmingham should be done first, then do the Birmingham to London link afterwards. Politically it makes a lot more sense than spending £40bn+ on more rail infrastructure in the south. Economically it's probably marginal either side, I don't see the economic case for HS2 in general but we should at least make some kind of political capital from it.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
0 -
COME ON RUSSIA
in a strictly football context you understand0 -
NonsenseJosiasJessop said:
Oh, stop your whining.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
If you hadn't noticed, the main reason for the timetable failure on Northern Rail at the end of May was Network Rail's inability to deliver similar upgrades. So the 'desolate north' has been getting a heck of a lot of upgrades: perhaps not as much as you want, or even deserve, but they are happening.
As a good Conservative, I'd have thought you were not keen on writing blank cheques for upgrades - as we have seen happen on the GWML electrification, and we saw on the WCML upgrade a decade ago.
To give you an idea of the scale of the problem, the GWML program was costed at about £1.3 billion. A few months ago its costs were £3.2 billion. The WCML upgrade program was about a tenfold increase in costs, and was reduced in scope and delivered very late.
I'd prefer a reduced electrification scheme over a number of years, but such upgrades also rely on new stock, and the new stock is needed much sooner.
So, what would your upgrade program be?
https://twitter.com/jenwilliamsmen/status/1012603163747192832?s=21
0 -
I can’t cheer for a side with that c**t Sergio Ramos in it nor can I cheer for Russia.
This is France v Argentina all over again0 -
Mr. Sandpit, *cough*
Hedged the Bottas win bet. And may've backed Haas double classified finish. And Raikkonen podium.
The only bet I had that failed was the one I tipped in the pre-race article
0 -
I think that the US system is very innovative, and successful at development of new techniques because of its diverse small business orientation. This is a very expensive system, and one that insurance companies try to contain, but successful on its own terms.DecrepitJohnL said:
France does spend more on health than we do, and not just because of insurance. The French government spends more as well. Most advocates of moving to European models do not tell us how much more money they'd spend; this is surprising because if you did want to convince voters to change then promising extra funding would be a powerful carrot -- ask Boris! The American system might be awful but one strength is innovation. I don't know if it can be measured but I'd expect most new treatments to come from the US.Richard_Tyndall said:An excellent thread header by Dr Fox.
Edit: Oh and I agree we need to pay more. But In would prefer that to be via private insurance than just pumping more tax payer's money in the behemoth.
ETA: what surprises many is the American government spends more on health than ours, even in what you'd think is the most market-oriented system in the world.
I am sceptical about compulsory insurance and the venom from Republicans in repealing Obamacare seems to be confirmation that I am not alone. Perhaps my views have been influenced by seeing too many insurance companies wriggling out of paying fro private patients. The problem of compulsory insurance is that it is still redistributive, and the low risk will nearly always pay far more than they use. At least in the short term.
To satisfy the consumerist society, and for all their Corbynism Millenials are very consumerist, there does need to be self funding as an option. My scheme of individual healthcare savings accounts is designed to circumvent the insurance companies, as spending would be consumer controlled. There is little benefit for swapping a faceless NICE committee for its insurance company equivalent. It would also be a form of saving for social care in retirement, but uunlike pensions could be drawndown for health need during working life.
Any transition from an NHS to a safety net system plus more private sector would have to be a slow one. Both Staff and patients need time to adjust and shift their expectations. Like Brexit transition it needs an agreed direction of travel and no sudden shocks.
Thanks for all the kind comments. I am not sure if my header reads more as an epitaph than the hymns of praise that we will see this week. Like the Curate's egg, the NHS is good in part, but having been involved for half its life I have tasted the rotten parts too.0 -
Tbh, the walk from Euston to St Pancras is short, what we might see is an underground walkway with an "airside" section for transfer passengers coming in from Paris/Brussels. Linking the two together with a piece of railway track will be impractical as two tube lines already run under that piece of space.rottenborough said:
Personally I think HS2 needs to be built, but I see no point to the Southern part of HS2 unless it links directly into St Pancras and can run international trains to the continent.MaxPB said:
Indeed. I said it on here previously, if we're going to spend money on trains and high speed rail then we should start from the top, two lines coming down from Newcastle (via Leeds) and Liverpool (via Manchester) down to Birmingham should be done first, then do the Birmingham to London link afterwards. Politically it makes a lot more sense than spending £40bn+ on more rail infrastructure in the south. Economically it's probably marginal either side, I don't see the economic case for HS2 in general but we should at least make some kind of political capital from it.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
0 -
I would rather Spain fell out of our side of the draw. Go Russia!TheScreamingEagles said:I can’t cheer for a side with that c**t Sergio Ramos in it nor can I cheer for Russia.
This is France v Argentina all over again0 -
Yep I saw the two sets of figures and went with the WHO version as I thought it was probably more accurate. Since I am arguing for more spending anyway - to German or Dutch levels - I didn't think it would be contentious. I would be interested to know why the two organisations have such different figures.DecrepitJohnL said:
OECD has France on higher per-capita expenditure in France: $4,600 vs $4,200 in 2016.
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
It may be that it depends on the small print as to what is classified as health spending.0 -
I am not certain, but I suspect what shows is that as May approached, the TOC started to put more and more effort into gearing up for the TT change. So that would mean more drivers taken off service trains to do training on the electric trains.TheScreamingEagles said:
NonsenseJosiasJessop said:
Oh, stop your whining.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
If you hadn't noticed, the main reason for the timetable failure on Northern Rail at the end of May was Network Rail's inability to deliver similar upgrades. So the 'desolate north' has been getting a heck of a lot of upgrades: perhaps not as much as you want, or even deserve, but they are happening.
As a good Conservative, I'd have thought you were not keen on writing blank cheques for upgrades - as we have seen happen on the GWML electrification, and we saw on the WCML upgrade a decade ago.
To give you an idea of the scale of the problem, the GWML program was costed at about £1.3 billion. A few months ago its costs were £3.2 billion. The WCML upgrade program was about a tenfold increase in costs, and was reduced in scope and delivered very late.
I'd prefer a reduced electrification scheme over a number of years, but such upgrades also rely on new stock, and the new stock is needed much sooner.
So, what would your upgrade program be?
https://twitter.com/jenwilliamsmen/status/1012603163747192832?s=21
EDIT: Though I'm not sure what was going on with short formations.0 -
What purpose does Grayling serve?Morris_Dancer said:Mr. Eagles, it's just dumb. Grayling can find £2bn to bugger Stonehenge with a tunnel, but nothing to keep promises on electrifying northern rail lines.
0 -
And yet you are in favour of the biggest of these projects (HS2) which has already shown its costs are out of control.JosiasJessop said:
Costs on such projects are so out of control that no-one knows how much it would cost.RoyalBlue said:
This is an insane decision. We can find £20bn for the NHS, but not some hundreds of millions to improve a rail link between two major cities?rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/1013407073726533632
Pathetic.
If you still want to go ahead on that basis, fair enough. But be aware that others will want their pet projects that you disagree with to go ahead as well on a similar basis.0 -
Non at allSean_F said:
What purpose does Grayling serve?Morris_Dancer said:Mr. Eagles, it's just dumb. Grayling can find £2bn to bugger Stonehenge with a tunnel, but nothing to keep promises on electrifying northern rail lines.
0 -
Lucky you! Thankfully I lost less money today than I made yesterday.Morris_Dancer said:Mr. Sandpit, *cough*
Hedged the Bottas win bet. And may've backed Haas double classified finish. And Raikkonen podium.
The only bet I had that failed was the one I tipped in the pre-race article0 -
Mr. Sandpit, ha, yeah, it makes a nice change. Glad I hedged the Bottas bet. At that stage he seemed nailed on for a 1-2. But I remain slightly haunted by complacently failing to hedge my Con majority bet at the last election...0
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The way to square the circle is for us to lead healthier lives, via the usual suspects of eating and drinking less, exercising more, and not driving each other mad, as well as not smoking. The Marmot report linked in the header was pretty sound in its proposals.AlastairMeeks said:More needs to be spent. More needs to be expected of individuals. Less should be provided in some areas. None of this will be popular.
There always needs to be a universal service covering emergencies and critical care. These are the parts of healthcare that need central planning. None of us is immune to a sudden major trauma, and it is at those times that the NHS is at its best. A lot of other healthcare is more amenable to fragmentation to generate competition and innovation.
Personally, I hear good things about the Dutch system, but as well as being a nation of thin cyclists they do have the highest social care spend in the EU, I think.0 -
F1: just adding the points to my records, and surprised to discover Leclerc finished ahead of Ericsson, given he was behind very late on. Wonder if there was a late pass.0
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This is interesting. It's been suggested in the past that the problem we are having now is that the generation reaching their 80s are the healthiest group there has been and probably likely to be. You're points about the Dutch keeping fit and spending a lot on social care are probably connected.Foxy said:
The way to square the circle is for us to lead healthier lives, via the usual suspects of eating and drinking less, exercising more, and not driving each other mad, as well as not smoking. The Marmot report linked in the header was pretty sound in its proposals.AlastairMeeks said:More needs to be spent. More needs to be expected of individuals. Less should be provided in some areas. None of this will be popular.
There always needs to be a universal service covering emergencies and critical care. These are the parts of healthcare that need central planning. None of us is immune to a sudden major trauma, and it is at those times that the NHS is at its best. A lot of other healthcare is more amenable to fragmentation to generate competition and innovation.
Personally, I hear good things about the Dutch system, but as well as being a nation of thin cyclists they do have the highest social care spend in the EU, I think.0 -
I am in favour of HS2 (as it currently stands), and am unsure why you think its cost are 'out of control', especially in comparison to the existing network enhancement projects I mentioned.Richard_Tyndall said:
And yet you are in favour of the biggest of these projects (HS2) which has already shown its costs are out of control.JosiasJessop said:
Costs on such projects are so out of control that no-one knows how much it would cost.RoyalBlue said:
This is an insane decision. We can find £20bn for the NHS, but not some hundreds of millions to improve a rail link between two major cities?rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/1013407073726533632
Pathetic.
If you still want to go ahead on that basis, fair enough. But be aware that others will want their pet projects that you disagree with to go ahead as well on a similar basis.
However, it is a very different style of project. Enhancements that do not much touch existing infrastructure are relatively easier to budget: witness HS1 or Crossrail, which kept pretty much to time and cost budget compared to WCML upgrade or GW electrification.
In fact, the problematic parts of Crossrail are turning out to be the places it integrates with Network Rail, hence why Ealing, West Acton and Southall (and others) will be opening late.
I've also said repeatedly in the past that the thing that is most likely to kill HS2 will be Euston, which is a black hole (pun intended).0 -
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Scotland's Andy Murray chickens out, take that Knighthood back.Scott_P said:0 -
Current Eighty year olds had (TB, smog and German bombs excepted!) a healthy child hood with food rather spartan and rationed, and plenty of exercise outdoors. This set them up with good habits for life apart from smoking. I think it quite possible that they will outlive subsequent generations.tlg86 said:
This is interesting. It's been suggested in the past that the problem we are having now is that the generation reaching their 80s are the healthiest group there has been and probably likely to be. You're points about the Dutch keeping fit and spending a lot on social care are probably connected.Foxy said:
The way to square the circle is for us to lead healthier lives, via the usual suspects of eating and drinking less, exercising more, and not driving each other mad, as well as not smoking. The Marmot report linked in the header was pretty sound in its proposals.AlastairMeeks said:More needs to be spent. More needs to be expected of individuals. Less should be provided in some areas. None of this will be popular.
There always needs to be a universal service covering emergencies and critical care. These are the parts of healthcare that need central planning. None of us is immune to a sudden major trauma, and it is at those times that the NHS is at its best. A lot of other healthcare is more amenable to fragmentation to generate competition and innovation.
Personally, I hear good things about the Dutch system, but as well as being a nation of thin cyclists they do have the highest social care spend in the EU, I think.0 -
Cost of HS2 rail link jumps by £8bnJosiasJessop said:
I am in favour of HS2 (as it currently stands), and am unsure why you think its cost are 'out of control', especially in comparison to the existing network enhancement projects I mentioned.Richard_Tyndall said:
And yet you are in favour of the biggest of these projects (HS2) which has already shown its costs are out of control.JosiasJessop said:
Costs on such projects are so out of control that no-one knows how much it would cost.RoyalBlue said:
This is an insane decision. We can find £20bn for the NHS, but not some hundreds of millions to improve a rail link between two major cities?rottenborough said:Wow! The Tories really do want to lose the next election don't they?
https://twitter.com/Andrew_Adonis/status/1013407073726533632
Pathetic.
If you still want to go ahead on that basis, fair enough. But be aware that others will want their pet projects that you disagree with to go ahead as well on a similar basis.
The cost of building the HS2 high-speed rail line between London and north has shot up by more than a fifth to almost £43bn.
https://www.ft.com/content/4acc946c-de84-11e2-b990-00144feab7de
The first major construction contracts for Britain’s new high-speed rail line are set to be awarded on Monday, as a new study estimated that each mile of the initial section will cost over £400m, almost twice the official figure.
https://www.ft.com/content/653c8dd2-6a37-11e7-bfeb-33fe0c5b7eaa
Initial costs for High Speed 2 (HS2) main civil works are coming in around £1bn over budget, New Civil Engineer can reveal.
https://www.newcivilengineer.com/latest/exclusive-hs2-civil-works-1bn-above-target-cost/10031999.article
Would you like me to post more links showing HS2's costs are out of control?0 -
F1: post-race ramble of a very eventful grand prix, and a lot of churn in the standings too:
http://enormo-haddock.blogspot.com/2018/07/austria-post-race-analysis-2018.html0 -
These enhancement projects are not delivered immediately, and there is much disruption whilst they are ongoing.TheScreamingEagles said:
NonsenseJosiasJessop said:
Oh, stop your whining.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
If you hadn't noticed, the main reason for the timetable failure on Northern Rail at the end of May was Network Rail's inability to deliver similar upgrades. So the 'desolate north' has been getting a heck of a lot of upgrades: perhaps not as much as you want, or even deserve, but they are happening.
As a good Conservative, I'd have thought you were not keen on writing blank cheques for upgrades - as we have seen happen on the GWML electrification, and we saw on the WCML upgrade a decade ago.
To give you an idea of the scale of the problem, the GWML program was costed at about £1.3 billion. A few months ago its costs were £3.2 billion. The WCML upgrade program was about a tenfold increase in costs, and was reduced in scope and delivered very late.
I'd prefer a reduced electrification scheme over a number of years, but such upgrades also rely on new stock, and the new stock is needed much sooner.
So, what would your upgrade program be?
https://twitter.com/jenwilliamsmen/status/1012603163747192832?s=21
Also, there were significant disruptions with the stock changes / cascades: AIUI trains that were due to be coming from Scotland not coming due to Hitachi not being able to design windscreens, and the HST remodelling for Scotrail.
There is a major issue here: the failure of Hitachi and others to deliver the new trains and upgraded trains, along with Network Rail's failure to provide enhancements, means that several TOCs don't have the trains they need.0 -
The problems long predate the stock changes and upgrades.JosiasJessop said:
These enhancement projects are not delivered immediately, and there is much disruption whilst they are ongoing.TheScreamingEagles said:
NonsenseJosiasJessop said:
Oh, stop your whining.TheScreamingEagles said:Spend billions on HS2 is fine but a spend a few million on the desolate North is a no no.
If you hadn't noticed, the main reason for the timetable failure on Northern Rail at the end of May was Network Rail's inability to deliver similar upgrades. So the 'desolate north' has been getting a heck of a lot of upgrades: perhaps not as much as you want, or even deserve, but they are happening.
As a good Conservative, I'd have thought you were not keen on writing blank cheques for upgrades - as we have seen happen on the GWML electrification, and we saw on the WCML upgrade a decade ago.
To give you an idea of the scale of the problem, the GWML program was costed at about £1.3 billion. A few months ago its costs were £3.2 billion. The WCML upgrade program was about a tenfold increase in costs, and was reduced in scope and delivered very late.
I'd prefer a reduced electrification scheme over a number of years, but such upgrades also rely on new stock, and the new stock is needed much sooner.
So, what would your upgrade program be?
https://twitter.com/jenwilliamsmen/status/1012603163747192832?s=21
Also, there were significant disruptions with the stock changes / cascades: AIUI trains that were due to be coming from Scotland not coming due to Hitachi not being able to design windscreens, and the HST remodelling for Scotrail.
There is a major issue here: the failure of Hitachi and others to deliver the new trains and upgraded trains, along with Network Rail's failure to provide enhancements, means that several TOCs don't have the trains they need.0 -
You seem to neglect that studies in both the us and netherlands is that lifetime healthcare costs for those that live healthily exceed those that smoke , drink or are obese. That is even before you factor in the tax take reduction from lower sin taxes and higher payouts on pensionsFoxy said:
The way to square the circle is for us to lead healthier lives, via the usual suspects of eating and drinking less, exercising more, and not driving each other mad, as well as not smoking. The Marmot report linked in the header was pretty sound in its proposals.AlastairMeeks said:More needs to be spent. More needs to be expected of individuals. Less should be provided in some areas. None of this will be popular.
There always needs to be a universal service covering emergencies and critical care. These are the parts of healthcare that need central planning. None of us is immune to a sudden major trauma, and it is at those times that the NHS is at its best. A lot of other healthcare is more amenable to fragmentation to generate competition and innovation.
Personally, I hear good things about the Dutch system, but as well as being a nation of thin cyclists they do have the highest social care spend in the EU, I think.0 -
Was that farage in the crowd at the Spain vs Russia footy?0
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No, Dmitry Medvedev.FrancisUrquhart said:Was that farage in the crowd at the Spain vs Russia footy?
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I did wonder. Came back from getting a cold one from the fridge and they quickly flicked to the posh seats and thought that can’t be nige surely.TheScreamingEagles said:
No, Dmitry Medvedev.FrancisUrquhart said:Was that farage in the crowd at the Spain vs Russia footy?
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Don’t go there, the last election was my first try at spread betting and I lost a pile on it. I also had a grand on the Tory majority at 1/4 a couple of days out.Morris_Dancer said:Mr. Sandpit, ha, yeah, it makes a nice change. Glad I hedged the Bottas bet. At that stage he seemed nailed on for a 1-2. But I remain slightly haunted by complacently failing to hedge my Con majority bet at the last election...
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