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Labour now must prove that the NHS is safe in their hands
I’ve lost count of the number of times when the UK Labour Party have stated ‘only 24 more hours to save the NHS’. As somebody who has always voted for Labour in fact since 1992, I take no pleasure in saying that Labour now must prove that the NHS is safe in its hands.
If you believe that the NHS is a cherished institution, or even a ‘sacred cow’, with massive public goodwill, it might seem strange that the Secretary of State for health, Jeremy Hunt MP, plays so fast and loose with junior doctors’ pay. A reason that Jeremy Corbyn MP, the current leader of the opposition and leader of the Labour Party, is so despised, apart from not turning up to gala rugby matches or singing the national anthem, is that he has effectively torn up the rule book. It’s no longer a case of ‘balancing the books’ – and let’s face it Osborne has been dramatically unsuccessful in even doing that – but it’s a case of making sure the customer doesn’t get ripped off from rail privatisation or has a decent living wage.
A favourite line of attack for Progress, the think tank which caters well for Labour believers who believe in modernity, is that ‘money does not grow on trees’. This is of course a full throated lie when you factor in that George Osborne himself got out the printing press recently, and did rather well out of it.
It has been convenient to misquote Liam Byrne MP as ‘there’s money left’ to perpetuate the idea of ‘living within your means’. That is except for the investment bankers who were not living within their means, and had to suffer the indignity of one trillion pound of a State bailout to help subsidise their lavish bonuses and more.
The austerity in the NHS is better known as ‘efficiency savings’, except here money is leaking like a sieve. The Conservative mantra that you need a successful economy is utterly fraudulent when you finally acknowledge that national debt since 2010 has gone through the roof. It also becomes hollowed out when you consider the high number of NHS foundation trusts running a deficit, because they have not been – take a deep breath – given enough money to run the NHS.
This was of course the biggest lie about the word ‘sustainability’ which many came to know as code as ‘we don’t want to afford it’. This means that it became a tough public choice that we didn’t want to afford the pay of nurses or junior doctors, but we could somehow afford the unconscionable loan repayments to the City for shiny new PFI buildings.
The lack of ability of Labour, like the Conservatives, to do something about the private finance debt, not just talk about it in a public accounts committee, is staggering. The current crisis in agency staffing could have been totally avoided with better planning.
Jeremy Corbyn wishes to give an apology for the Iraq War. But this is not the only apology that Labour needs to make over policy, although other apologies are less serious. For ages, Labour peddled the myth that quality between autonomous foundation trusts could be driven up through competition. To acquire ‘foundation trust status’, NHS hospitals had to reach targets, and even if NHS CEOs ultimately failed they could move onto other equally lucrative posts.
To make the financial books balance however, it is sadly the case the legacy was that some Trusts did not run their operations safely. The issue of lack of planning, in an unsocialist way, also is evident in the way in which Labour embraced independent sector treatment centres; the argument ‘to increase capacity to deal with demand’ was an entirely synthetic one, given that the NHS has been increasing significantly in demand since 1946.
So it is quite possible that the election of Jeremy Corbyn as leader of Labour is a stop to ‘more of the same’. This entirely depends on how much Corbyn’s private views are tempered by his shadow cabinet, and Corbyn has tried to bring dissenters into his tent to manage the situation in the same way Abraham Lincoln had many years ago.
To give Burnham credit, there was the beginning of a discussion of bringing health and social care together. Such discussions have nonetheless failed to reconcile how an universal NHS system can be bolted onto a means-tested social care system. The relics of personal budgets, which also have been identified as a practical way of devolving cuts and rationing, continue in policy, and have been furthered rather than extinguished by recent legislation.
Labour itself did much to wreck social care with privatisation, and, whilst we have had relentless cuts in social care funding in recent years which have also affected the way in which the NHS works, the problems started a long time before 2010. But Labour has for me much to prove on the NHS. It’s a long time since ‘the spirit of 45′, but Labour cannot just function as a shrill shroud waving protest party. It needs to have, at last, a sensible debate about all these matters which have been festering for far too long.
An important letter from Andy Burnham (@andyburnhammp) today about the future of health and social care in the NHS
Today I want to start a discussion about the future of health care in Britain. Over the last two and a half years we’ve fought for our NHS and exposed David Cameron’s broken promises. We’ve opposed the Tories’ unnecessary and damaging top-down NHS reorganisation, with nearly 5,000 nurses cut and more patients waiting longer in A&E. And we’ve spoken out against the Tories’ marketisation and fragmentation of healthcare. Labour always has been and always will be the party of the NHS. But in 2015 we’ll inherit a damaged NHS, fragmented by Tory privatisation and cuts – so we need to talk about how we’re going to deliver One Nation Labour health and care in this environment. Our vision is an NHS committed to ‘whole-person care’ – physical health, mental health and social care brought together into a single service to meet our care needs. This is a true One Nation vision ? a health and care system shaped around people, not around the bureaucratic structures and market dogma the Tories have introduced, putting at risk one of our most beloved institutions which binds us together as a society. The Tory way is leading to fragmentation ? making it even harder to tackle these problems. Labour will build a single service, improve patient rights and protect the NHS for future generations. And when money is tight, a single service is cheaper. Untreated mental illness costs the NHS £10 billion each year, and hospital care for people who cannot be discharged because there?s no help at home costs the NHS £4 million a week. Thank you. Andy Burnham
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The situational judgement test: past, present and future
As of this morning, 103 people have taken the BPP Legal Aware Situational Judgement Test.
You can take the test here, if you haven’t done so already.
There has been a small explosion in the research done into ‘situational judgement tests’ (SJT) for employment selection (Weekley and Ployhart, 2006). SJTs present applicants with work-related situations and possible responses to the situations. There are broadly two types of instructions (reviewed by McDaniel et al., 2007). Behavioural tendency instructions ask respondents to identify how they would likely behave in a given situation. Knowledge instructions ask respondents to evaluate the effectiveness of possible responses to a given situation. Tests assessing an individual’s judgement concerning work-related situations have had a long history in the psychological assessment literature (McDaniel et al., 2001). For example, during World War II, Army psychologists attempted to assess the judgement of soldiers (Northrup, 1989). These judgement tests consisted of scenarios with a number of alternative scenarios. Solutions rested on the person’s ability to draw on his common sense, experience, and general knowledge, rather than logical reasoning.
In an influential study by Chan and Schmitt (2002), data from 160 civil service employees were analysed, with a view to demonstrating the validity of the SJT in predicting overall job performance as well as three performance dimensions: task performance (core technical proficiency; problem analysis, written communication, oral communication), motivational contextual performance (job dedication; motivation to perform, motivation to learn, motivation to work hard), and interpersonal contextual performance (interpersonal facilitation; conflict resolution, negotiation, teamwork and co-operation). Chan and Schmitt (2002) also felt that situational judgement tests provided incremental validity over prediction from cognitive ability, personality traits, and job experience.
Previously, Huffcuttt and colleagues (2001) had attempted to elucidate the most suitable construct categories. Their constructs included mental capability, knowledge and skills, basic personality traits, applied social skills, interests and preferences, organizational fit, and physical attributes.Recently, Christian, Edwards and Bradley (2010) argue that many studies have failed, however, to report the constructs actually measured in SJTs. A construct-level focus in the situational judgement test literature is therefore lacking. Christian and colleagues (2001) found that situational judgement tests most often assess leadership and interpersonal skills and those situational judgement tests measuring teamwork skills and leadership skills have relatively high validities for overall performance.
There has been an increasing drive to standardising these tasks. For example, the LR SJT has questions in written format. There is inevitably a difference for oral questions, or SJTs in video format (it is claimed that video SJTs have more subtle nuances involving social cognition or emotional intelligence which can be picked upon). Also, the questions can potentially vary in scenario length (longer scenarios tend to have more detail), and how scenarios are profession-specific (for example, type of firm, law/medicine/business). Finally, the questions can vary in format. In the LR SJT, and for example in the 2010 and 2011 Clifford Chance SJT, you have to pick one best out of the options given. In some tests, rather, you may be required to rank your choices in order of preference.
References
Chan, D, Schmitt, N. (2002) Situational judgment and job performance. Human performance, 15(3), 233-254.
Christian, MS, Edwards, BD, Bradley, JC. Situational judgment tests: constructs assessed and a meta-analysis of their criterion-based constructs. (2010) Personnel Psychology 63: 83-117.
Huffcutt, AI, Conway, JM, ROTH, PL, Stone, NJ.. (2001) Identification and meta analytic assessment of psychological constructs measured in employment interviews. Journal of Applied Psychology 80: 897-913.
McDaniel, MA, Hartman, NS, Whetzel, DL, Lee Grubb III, W. (2007) Situational judgment tests, response instructions, and validity: a meta-analysis. Personnel Psychology 60, 63-91.
McDaniel, MA, Morgeson, FP, Finnegan, EB, Campio, MA, Braverman, EP. (2001) Use of situational judgment tests to predict job performance: a clarification of the literature. Journal of Applied Pyschology 86(4), 730-740.
Weekley, JA, Polyhart, RE. (2006) Situational judgment tests: Theory, management, and application. Mahwah, NK: Erlbaum.
The future of control orders
A friend of mine tweeted this morning: “254,998,923 laptops taken out of hand luggage and then 254,998,923 put back into hand luggage: success or fail?”
On issues of national security, many members of the general public should like to believe that they have an integral influence in matters of national security, the legislators, we all admit, decide upon national policy. Ultimately it is the Home Secretary, Theresa May MP, who is able to propose legislation on the basis of her advisors, the think tanks, the public, the media, the police, the rest of the judicial system, and of course the intelligence services MI5, MI6. Obviously, it is impossible to ignore the raft of events, such as 9/11 and the Mumbai bombing. There is in face a growing notion internationally, irrespective of political affiliations, that in the wake of September 11th, many civil liberties had been curtailed or suspended. There has been historical disagreement concerning how much risk to national security or civil liberties should be taken.
The need to achieve an appropriate balance of these seemingly competing goals was evident. In the USA, lawyers from the Department of Homeland Security, Federal Bureau of Investigation, and the U.S. Army called for aggressive prosecution of the terrorist proven suspects, while lawyers advocating civil liberties argue strongly for the safeguarding of individual rights, lest we cede victory to terrorists through the compromise of principles that define our view of a liberal democracy.
We are surprisingly at one here with the U.S., reflecting a strong entrenchment of our law in European law as a result of the European Communities Act (1972) (as amended), and numerous subsequent treaties. The legal notion of ‘proportionality’ originally developed in European Law, but it has been readily applied in English Law in the House of Lords and Supreme Court. One specific definition of proportionality given by Lord Lowry in the leading British case ‘Brind’, which examined the principle as one that requires a reasonable relation between a decision, its objective and the circumstances of any given case. This concise definition shows how proportionality is a theory that is ultimately intuitive to human nature. A vast majority feel that Labour went too far in the counter-terrorism legislation, which is a massive own goal in that one of the first achievements of Tony Blair was to introduce the Human Rights Act (1997).
In fact, Labour has had terms in coming to terms with their past on crucial matters of civil liberties, in lengths of detention and ID cards. For example, officers used Section 44 of the Terrorism Act 101,248 times but just 506 of those stopped were taken into custody and none on suspicion of plotting terror attacks. Furthermore, Home Office data provide that no terror suspect was held for more than 14 days before being charged, just half the 28-day limit brought in by the last Government. Shami Chakrabarti, of civil rights group Liberty, insisted Section 44 was a “crude and blunt instrument” that was also counter-productive. Shami Chakrabarti further said: “It costs us dearly in race equality and consent=based policing with very little in terms of enhanced security.” I fully agree.
Another bone of contention are ‘control orders’, also introduced under 2005 anti-terrorism legislation. Ministers have to sign an order to place a terrorism suspect under close supervision that some say is similar to house arrest. The orders were introduced after the then Law Lords declared that the previous system of detaining foreign terrorism suspects without trial, or without prospect of deportation, breached human rights. The previous Labour government said it still needed a mechanism, which would allow it to control the lives of some suspects whom it said it could not prosecute because of the rules over the use of secret intelligence in trials.
Control orders were originally introduced as an alternative to putting people in prison, that originally was supposed to not leave individuals suffering from a breach of liberty and personal freedom (1995). Obviously, curtailing this liberty and personal freedom has to be a necessary, balanced and proportional response to a threat of national security, and the Law Lords have thus far said that control records are legal. However, not everyone sees it this way. The issue of control orders, under which terror suspects are placed under “virtual house arrest”, is the one of the most sensitive civil liberties issues for ministers as opposition to Labour’s authoritarian counter-terror policy was seen as part of the glue that made the coalition possible.
Tom Brake MP, the co-chair of the Lib Dem home affairs parliamentary party committee, has said there was no evidence to suggest that control orders were effective in preventing terrorism. The other signatories of the letter, Baroness Sally Hamwee, and Lord Martin Thomas, represent Lib Dem peers. As the English legal system is a system of precedent, I feel that it any changes to the law could be introduced, but it would be their Lordships’ prerogative to decide whether any subsequent changes to the law are legal or not. And I fully trust Lords Hoffman, Neuberger and Baroness Hale, amongst others, to analyze with the legal issues with great precision if or when the time should come.
According to the most up to date figures for January 2010, there are 12 control orders in force – three fewer than a year before. Some 45 people have been subject to the controls since the system was created. Six of the foreign nationals held under the restrictions have been deported. The political situation is messy, as reflected in a rather informal conversation between Baroness Kennedy and Theresa May on the Andrew Marr show this morning. Liberal Democrats have openly warned David Cameron for the first time that any decision not to scrap control orders would jeopardise the coalition’s civil liberties credentials.
Senior Lib Dem backbenchers and peers have also written to Downing Street pressing for the limit on detention without charge to be cut from 28 days to 14 days, arguing that two-weeks is a “wholly adequate” time to bring charges, even in the most complicated cases of multiple terrorist attacks. The intervention from Lib Dem MPs and peers comes after an intense lobbying campaign by the security services. Jonathan Evans, the head of MI5, recently wrote to Cameron saying that he could not guarantee the safety of the public if the control order regime was scrapped. Whitehall officials confirm that MI5 has played its “full part in the debate”. The review of counter-terrorism powers was set up immediately after the general election, with a specific remit to look urgently at the future of control orders and the wider matter of counter-terror measures and programmes.
The home secretary, Theresa May, is thought to have recently supported the retention of control orders as a necessary intervention despite repeated interventions by Nick Clegg, whose Lib Dem manifesto clearly had called for them to be scrapped. It feels as if a pendulum over civil liberties is still in damped smooth harmonic motion, but at least the review and the Supreme Court will help the UK legislature and public reach a stable equilibrium.
