Home » Posts tagged 'independence'
Tag Archives: independence
Two Titanic democratic deficits are colliding: Scotland and the NHS
Two huge democratic deficits are about to collide: what the general public feel about the NHS and the action of governments, and also the government of Scotland.
The Health and Social Care Act (2012) did not have a single clause on patient safety. It did not speak to Mid Staffs.
Remember when David Cameron promised ‘no top down reorganisation’?
It did, however, contain a very nifty clause, distinct from the legislation which had preceded it, providing a massive legal threat to those NHS contracts which did not go out to competitive tender in section 76(7).
It was clear that this legal threat was not innocent at all, as previous experience from the Netherlands had been very costly.
I reviewed back in January 2013 that in the Netherlands, a year previously, competition law authorities fined the national GP association £6.4 million for trying to prevent the same situation as has been allowed to develop in Sweden, rural areas unserved by primary care services (reported in the British Medical Journal).
This legal pincer grip continues to have sharp teeth. Earlier this year, it was reported that a complaint by private healthcare operators had been upheld against Blackpool CCG on the basis of ‘insufficient choice’.
A lot of damage has done in the English health policy in the name of competition and choice. The idea was that competition would drive up quality and drive down costs. Because of the nature of the oligopolistic market, as would be predicted, this has not happened.
This competition policy has been aggressively pimped in the academic journals as a ‘success’ for New Labour’s health policy between 1997-2010, and together with the public private initiative and TTIP formed an unholy mess.
The privatisation of social care in England is well known to have been a disaster, an explosive mixture of austerity, outsourcing and privatisation opportunities and poor employment bargaining.
In England yesterday, the current Prime Minister framed low taxes as ‘a moral decision’. Low taxes means, however, theoretically less money you contribute to the running of public services such as the NHS, and more you can spend elsewhere for example on private health insurance.
And it has all being elegantly through: the ability to take your pension as a lump sum encourages the free movement of capital into private industry too.
The SNP have now got a clear lead in the polls, and the tendency has been for this to be under-reported in England, emphasising instead that the Conservatives and Labour are ‘neck and neck’.
Whatever the claim and counterclaim, Scotland made a clear departure from the English pro-privatisation legislation back in 2011, and is set to complete the current phase of devolution with a Scotland Bill to be presented to parliament later this year.
As a Guardian newspaper report in 2011 revealed,
“The rhetoric may be strident, but Scottish Government ministers at least practice what they preach. Across a whole range of areas, public versus private sector, telehealth, pooling health and social care and streamlining management, the devolved government has adopted a markedly different approach for the NHS in Scotland. And although that health service had long been administered separately from that in England, it was the creation of the Scottish Parliament in 1999 that made this increasing divergence politically possible.”
So a critical question becomes would the SNP be willing to vote on non-Scottish issues such as the NHS?
The answer, as of January 2015, appears to be “yes”.
Sturgeon explains:
“On health, for example, we are signalling that we would be prepared to vote on matters of English health because that has a direct impact potential on Scotland’s budget. So, if there was a vote in the House of Commons to repeal the privatisation of the health service that has been seen in England, we would vote for that because that would help to protect Scotland’s budget.”
In exchange, the SNP viewed in public during the referendum campaign that Scottish independence as producing a sustainable financial budget for the NHS, hence the smirks from Sturgeon when Nigel Farage claimed that Scotland gets a relatively good deal from “the Barnet Formula”.
Labour’s policy is for the NHS to be the “preferred provider”, but only in January 2015 the English NHS achieved its “biggest-ever privatisation of its services in a deal worth up to £780m intended to help hospitals tackle the growing backlogs of patients waiting for surgery and tests.”
But this policy does not go as far as the SNP one. For a start, the Labour policy still retains the failed quasi-market and purchaser-provider split.
The anti-austerity arguments run that if you ease off the rate of austerity then you can encourage consumer-led growth, increasing tax revenues, and encouraging a recovering economy.
The direct parallel of this is the austerity-induced ‘efficiency savings‘ in the NHS, an austerity narrative which has seen some English NHS hospitals running unsafe staffing in the aim of balancing budgets, because neoliberal parties do not wish to entertain funding the NHS properly.
The freeze on pay in nurses, therefore, looks ideologically driven, as opposed to using pay to incentivise performance of staff as in any other industry. Also, national policy appears to give the impression that nurses are immune from any recovery in the economy due to this imposed austerity, which is a crying shame.
Of course, the trade off for a more public NHS in England might be Scottish independence, but some feel the most pertinent moral argument is here that Westminster should not be governing over Scotland anyway if has few or no MPs.
Unbelievably, two democratic deficits have collided: one to do with the NHS and one to do with Scotland.
There’s no point striving for economic integration if we’re sustaining political and social disintegration
When Margaret Thatcher spoke on the steps of Downing Street, about to escalate eleven years of unforgettable government, a New Jerusalem was pictured of a country at ease with itself. Not reliant on any sense of collectiveness, but a group of individuals who could seek and achieve success.
And indeed her star pupil, Tony Blair, was the best product from this era for Thatcher. Ed Miliband later proudly admitted that he ‘believed in’ the sense of aspiration to be inherited from the late Baroness.
Except this nirvana was anything but heavenly. Far from liberalising people, the Hayekian market enslaved working people who did grew further apart from the fruits of their productivity.
Inequality ‘never had it so good’ in governments during Thatcher and beyond. Ed Miliband in his recent speeches for the Labour Party conference has had to refer to ‘responsible capitalism’, citing specifically how consumers’ bills have rocketed due to energy suppliers almost acting like a cartel.
The fact that Rupert Murdoch was backing the ‘No’ campaign was therefore bound to cause disquiet, as was the backing by BP. It seems that all the multinational corporates know which side their bread is buttered on, having been given a strong lead from Barack Obama.
So therefore the idea that Scottish citizens were rejecting the privatisation of the English NHS was a profound embarrassment for the Westminster parties. All parties, especially the current Coalition parties, have vehemently denied that there has been any privatisation in recent years.
The current Government adamantly state that the percentage of private provision in the NHS has gone up from 5% to 6%. Critics of section 75 of the Health and Social Care Act (2012), argued to turbo-boost the outsourcing of NHS contracts through competitive tendering, are continually told about New Labour’s drive towards the growth of independent sector treatment centres.
Tony Benn left people thinking that it did not as such matter which party you now voted for, as they all effectively have become frontmen for globalised multinational corporations. That nobody actually votes for the World Bank or the European Commission legislators led Benn to do a pilgrimage to Strasbourg which he proudly hated.
For Benn, it was more important that a citizen could achieve influence through a single vote in democratic socialism, than to buy influence as part of a lobbying organisation. And of course we see a profound failure of democracy in the springing of the Lansley Act and the “hospital clause” from nowhere.
The spectacle of Miliband, Cameron and Clegg marching up from Westminster to Glasgow made many of my Scottish friends to vote “Yes”. But for them their solidarity has been a reaction to a different ethos being inflicted from above.
Whatever the appearance of economic integrity there might be in the United Kingdom, even with the use of the Pound Sterling in Scotland, or Eurozone avoiding a currency crisis, the victory appears somewhat Pyrrhic if there has been in fact been decades of social and political disintegration.
If Scotland votes to be independent, Labour could end up losing MPs who instead become ‘foreign nationals’. Ed Miliband has a relatively united party behind him, but it is likely that many in the Conservative Party will want to get rid of him.
This is especially likely if Cameron’s party enters the farcical situation of wanting to opt out of Europe having lost Scotland. David ‘Little England’ Cameron would then, even beyond the Labour Party, would become the worst Conservative Prime Minister to have ever existed.
But, if Scotland votes no, then it is possible that the UK general election will occur ‘on time’, i.e. early May 2015. The truth is that, even if Scotland votes yes, it possibly is too much hassle to shift the date of the election pursuant to the Fixed Term Parliament Act.
Then it might become business as usual, where the UK Labour Party promise to halt the privatisation of the NHS. The Conservatives have adopted the position where they wish to deny absolutely any existence of privatisation of the NHS, completely unlike their position on the utilities or Royal Mail. So, presumably, if the Conservatives win the election, the ‘non-privatisation’ of the NHS will continue.
But, in addition to the goal of economic integration, an incoming Labour government does have a hope of political integration with an albeit devolved Scotland. The greatest challenge will, nonetheless, be an England at ease with itself, which does not have different groups of people pitted against each other.
There is much work to be done in English health policy, including review of PFI, the purchaser-provider split, abolition of the Health and Social Care Act (2012), exemption from TTIP, a properly funded health and social care system, and fair pay for NHS staff, as well as implementation of “whole person care”.
If, on the other hand, Whitehall organises a painful ‘conscious uncoupling’ of Scotland and England, that could take up a lot of effort which might be better used up elsewhere.
Vince Cable goes to 'war' with 'The Murdoch Empire'
As one of my bosses used to say, “Things just go from worst to worstest”. Vince Cable’s comments are indeed explosive as he has a very significant quasi-judicial role in this takeover bid from Rupert Murdoch, and he must act in an independent and impartial way, with no conflict of interest.
