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David Cameron is wrong on the NHS corporate restructuring for these reasons



In an interview where David Cameron tried to tell John Humhrys he was wrong, Humphrys identified that Cameron was showing no leadership on the bankers.

The interview can be heard here:
http://news.bbc.co.uk/today/hi/today/newsid_9363000/9363655.stm

David Cameron is wrong about the NHS restructuring for the following:

It is wrong simply to focus on outcomes at the treatment end; much more could and should be done at the diagnosis end (health policy analysts find outcomes useful, but what they’re actually measuring are objective benefits).  Much of the fundamental issue for the next decade will be the early diagnosis of the disease especially cancer, and there needs to be some focus on the efficacy of screening methods at the other end too (e.g.for colon cancer, breast cancer, COPD).

It is no good just talking about length of survival times, because there has to be a proper analysis of the quality-of-life and well being of patients with chronic morbidity including dementia.

The Doctors were not asking for the changes – the BMA is opposed to it, and to my knowledge the Royal College of Physicians shows little interest in it in a very positive direction. The King’s Fund certainly think it is a calamity.

2-3 years is a very short time to produce ‘the biggest reorganisation’ in the first time; it will involve £1.4 bn in the first year. John Humphrys was right to correct the figures that Cameron produced on the basis of actual evidence from the Kings Fund.

Satisfaction is at an all time high now with the NHS – this cannot be divorced from the record spending by Labour in the last parliament.

David Cameron denied the NHS IS getting better. This must means that he thinks that all aspects of it are getting worse. THIS IS A LIE.

John Humphrys asked that the NHS was in fact changing to a Federal Health Service. Cameron saying that there are already regional variations is frankly irrelevant. Humphrys is correct saying that an analogy between GPs and free schools is an extremely poor analogy; I am shocked that David Cameron is idiotic enough even to suggest it.

There’s no point Cameron trade-union bashing, as there are many ordinary nurses, doctors and other health-professionals who are non-Labour members who are highly critical of his insane policy.

If Andrew Lansley is so well respected, why does the whole of RCN disagree with him? The man is not well respected amongst the health professionals.

Dr Shibley Rahman Queen’s Scholar; BA (1st Class), MA, Bachelor of Medicine, Bachelor of Surgery, Doctor of Philosophy, Diploma of the Membership of the Royal College of Physicians (MRCP(UK)); FRSA, LLB(Hons).

Member of the Fabian Society.

BBC R4 Today and the squeezed hard-working non-upper class



Friday morning with John Humphrys is not going to be an occasion Ed is going to forget in a hurry, because of an extraordinarily tough interview on the BBC Radio 4 Today programme.

Ed Miliband’s opening gambit was talking about aspiration, which has indeed been an enduring theme for Labour, certainly during Tony Blair’s time in the 1990s. John wished to pin down Ed on where he precisely he wishes to lead the country, and specific issues, such as the graduate tax and the inequality gap, were discussed, with regards to deficit reduction and fairness. It may seem like quite a sexy concept, “the squeezed middle” like a tube of toothpaste, but actually even the simplest of analyses provides that it is fraught with problems. For example, what are these pressures “squeezing” the middle? Surely not the State, which the Coalition feels is too big anyway.

The interview can be heard here.

John Humphrys – not Ed Miliband – brought up the discussion topic of the “squeezed middle” on the basis of the article he had written in the Telegraph that morning. However, Ed Miliband clearly ran into trouble in defining the “squeezed middle”, which was very heavily reliant on the definition of the middle class. It was nonsense attempting a definition of the “squeezed middle” without defining the middle class, which was a mistake of Ed, thus giving John Humphrys to give the impression that Ed was on an errant fishing expedition. Even his brother David has alluded to the “squeezed middle”, for example in the the 2010 Keir Hardie memorial lecture tonight in Mountain Ash, South Wales. He provided that,

“To reconceive our notion of fairness. In our concern with meeting peoples’ needs we seemed to sever welfare from desert and this led people to think that their taxes were being wasted, that they were being used. When we said fairness, people thought it was anything but. What emerged as a tribute to solidarity, the welfare state, turned into a bitter division. Many of the ‘hard working families’ we wished to appeal to did not view us as their party. We achieved great things but we did not bring people with us, and our motivation appeared abstract and remote.”

The problem was that the definition that Ed (sort of) provided seemed to be 90% of the general public, but when Labour has previously talked about “progressive universalism”, it really has been talking about the aspiration of non-upper class voters who are hard-working; the word ‘middle’ is far too large, but, then again a group of ‘of non-upper class voters who are hard-working ‘ is equally large. It might be better, once Ed has conducted his review, to outline solutions for select groups of the public, such as students who are disenfranchised from Nick Clegg or elderly voters who are worried about the provision of elderly and social care (for example). Like the II.1 class at Universities, this is too large as to provide an idea which voters can address. The criticism of this is that Ed wishes to be ‘all things to all men’, but it would have been helpful had Ed identified which groups of society he was particularly worried about. Maybe, it’s that Ed Miliband feels he doesn’t wish to dash the aspirations of nearly all of the country. I have blogged before on how Labour has been giving the image of protecting the super-rich, and this is dangerous. Obviously, Ed has to give the definition of the “squeezed middle”, having spoken about it so, and even if he alienates some of the “super rich”, I’m afraid.

At first, the “squeezed middle” started off as a fairly innocent parliamentary joke. The Comprehensive George Review saw George Osborne appearing to be perched on William Hague’s knee. The incident gave Ed a good line about Ken being part of the “squeezed middle”. But Cameron responded well by saying that unlike the Labour leader, Clarke has “bottom”. More seriously, making his debut at the Dispatch Box as Labour leader, Ed asked how it was fair for parents with one salary of £44,000 to lose out while those with two salaries totalling more than £80,000 could keep the benefit. Mr Cameron hit back by accusing Ed of expressing concern for the “squeezed middle” to cover the fact that he had been elected with the support of the trade unions. As it happens, however which you define the “squeezed middle” precisely, the benefit changes, which will affect those paying 40 per cent tax from 2013, mean that a three-child family with a single income of £33,000 after tax will lose £2,500 a year, the equivalent of 6p on the basic rate of income tax.

Ed is right in that the “squeezed middle” has become an emergent theme already in his opposition. Ed has has been leader of Britain’s Labour opposition for about a month now, but already he is identified with a cliché: ‘the squeezed middle’, to whom he promised his party’s support. The phrase has enjoyed several years’ currency on both sides of the Atlantic. But its use by Mr Miliband was followed by chancellor of the exchequer George Osborne’s commitment to remove child benefit from the better paid, and then last week by a report from Lord Browne recommending the uncapping of university tuition fees. Politically, one of the key questions about Lord Browne’s suggestion that tuition fees should be raised is how the middle classes react. Will a rise in fees be seen as another burden on those who work hard, play by the rules and are already bearing more than their fair share of the costs of the state? Both measures, together with looming tax rises, are bound to hurt the middle class, and have prompted a surge of debate about its plight. Rightwing commentators argue that prime minister David Cameron is breaching a cardinal principle of Margaret Thatcher by failing to protect “our people”, the aspirational Tory voters. Ministers respond that there is no chance of reconciling those at the bottom of the pile to spending cuts unless pain is seen to be shared across the social spectrum. They were by no means dismayed by cries of suburban anguish about child benefit curbs.

It is possible that Gavin Kelly at the Resolution Foundation has done a much better job. His broad definition is anyone who is “too poor to be able to benefit from the full range of opportunities provided by private markets, but too rich to qualify for substantial state support.” Even something this vague would have helped Ed. Kelly’s analysis shows what a genuinely important political problem the squeezed middle will be in the years ahead. Earnings are flat, and likely to remain so in real terms, while cost inflation is steep especially for healthcare, energy and insurance. House prices have fallen and interest rates are low, but in Britain a mortgage of three times earnings will not buy a home on the edge of a provincial city for even a relatively high-income family on say, £60,000 a year. Kelly calculates that stagnating pay and the rising cost of living will leave these households losing an average of £720 in 2012. That is even before the impact of cuts to tax credits are taken into account. Those who aren’t in the “squeezed middle” – who aren’t “super-rich” – appear to be doing well, and maybe it’s the case that Ed doesn’t want to alienate them either. More and more companies are opting out of offering employees healthcare or final salary pensions. Britain’s average individual earnings are just over £22,000, a pathetically low figure from which to demand that a citizen pays more bills from his own pocket. But that is how things are going to be

However, Ed is in good company in failing to provide a definition of the “squeezed middle”. David Cameron is faring no better than Barack Obama in the vastly difficult task of explaining to his nation, and especially to the “squeezed middle”, where they are going and what is in it for them. He must reconcile people reared in the belief that hard work and prudence will yield comfortable rewards to the new reality of our societies’ diminishing share of global wealth. Finally, Ed must show that he hasn’t forgotten the working classes. Whilst Labour seems to be engaging people in the middle classes, it is dangerous if it writes off the working class in having a share in Labour’s policy.

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