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Some thoughts on Jeremy Hunt



I’m a card carrying socialist. I don’t know whether I’m a Marxist Trot, but my views are in keeping in what most people would view as for the public good but not in a way dictated by markets free or otherwise.

Not that it matters, but I’ve always voted Labour. The defining event for me was in fact going to Margaret Thatcher’s last ever Prime Ministers Questions. I lived mainly in London in 1990, a stone’s throw away from Leicester Square – and I remember the Poll Tax riots and the tail end of the Thatcher government vividly. I remember the politics of the 1980s vividly, as a child, and I committed never to vote Tory again. I fulfilled that promise, as it happens.

It’s well known I’ve spent far longer as a NHS patient, with an adult onset physical disability as a result of meningitis in my mid 30s, than as a practising junior doctor, though I remember my time as a junior doctor with disproportionate affection. Hospitals for me provoke mixed emotions – I survived a six week coma in one, I saw my father have the cardiac arrest team around him before he did in the same hospital as it happens, and it’s one where I have much goodwill for their ‘dementia friendly’ approach given my current interest as an academic physician in dementia predominantly.

I am not a ‘celeb blogger’ – but then again I loathe the media, and the media hate me. I tweeted recently that ‘I don’t believe a word that Jeremy Hunt says’ – this is on the basis of how his legal team had emphasised he had never imposed the NHS #juniordoctors contract despite him saying on numerous occasions he was imposing it.

But the thing to remember for me is that Jeremy Hunt as such does not ‘act alone’. He went into Theresa May’s first cabinet reshuffle expecting to be dropped like a lead balloon – hence the lack of lapel on his jacket – but he emerged happily in situ. So Jeremy Hunt is fallible – he expected to be sacked.

He sincerely believes what he does – which I think is ‘liberalising the market’, ensuring that Mid Staffs never happens again, producing a workforce less dependent on immigration, and so on.

As it happens, I profoundy disagree with his view on the NHS. I dislike the fact he rarely comments on the idea that provider competition has not improved quality in the NHS, how he has a total blindspot for the social care profession, how he seems in total denial about the catastrophic finances of the NHS, how his electronic IT programme is way off track, and so on.

But again I wonder to what extent this lack of trust in him is entirely his fault. For example, I don’t think the BMA acted par excellence, and I myself wondered how on earth these strikes were not impacting on patient quality or safety. But then again if it’s the case that NHS Providers and NHS hospitals can send out strongly worded letters with impunity then that is that.

The General Medical Council don’t appear to wish to comment much on rota gaps, and general morale, or how #juniordoctors might refuse to sign a contract if they feel uncomfortable, and so on. I’m not in fear of the Council, it’s just I have nothing much to do with them. My personal view is that they could have been far more respect and responsive of the patient safety views of doctors, that’s all.

It says in our code of conduct that if we feel uncomfortable about resources we should say so. Some of us have repeated this ad nauseam  – so now what?

I like James Titcombe hugely. I find the story of Joshua incredibly fertile in what we could do for learning from mistakes from the future. But, despite the best will in the world, if Katrina Percy refuses to resign having won once a HSJ award that’s where we are. If I can live with a mistake for the rest of my life, and others don’t, so be it.

I like Deb Hazeldine equally hugely. I can’t even begin to imagine what she feels everyday.

I enjoy my work which is basically advocating for people with dementia. As a carer myself, I am interested in that too. But I know my boundaries. Me ‘hating’ Jeremy Hunt will achieve nothing – he is doing his job albeit with a workforce some of which want to emigrate.

Cuts and low morale I think are a threat to patient safety – but if the General Medical Council feel comfortable with that in their remit, nor with giving proper support to Chris Day’s whistleblowing case, there’s not much many of us can do about it.

I don’t actually ‘hate’ Jeremy Hunt. He MUST, I’m sure, know that the NHS and social care need more money, the workforce largely don’t trust what he says, doctors in India no longer wish to work in the UK whether or not he needs them, and so on.

But it’s Jeremy Hunt – too surreal to fail.

The overall incompetence of Ed Miliband’s opposition should still raise alarm bells
















If you believe in conspiracy theories, Tom Watson’s offering yesterday of a #TrotskyiteTwist was merely a polite way of him chucking in the towel. Like me, Tom has started resorting to posting cute cat pics on Twitter, but #InternationalCatDay might be something to do with that one.

Whatever your views about #Brexit, it’s worth catching Laura Kuenssberg’s documentary on it from earlier this week. And whatever your views about Laura’s reports, I think this documentary was fascinating, and as balanced as could have been given the circumstances. I remember being somewhat surprised at Laura Kuenssberg asking Jeremy Corbyn at the campaign launch himself whether the launch had  been rather ‘lack lustre’, and there were clearly grievances about the degree of commitment from the leaders’ office. But taking the shooting match as a whole, Jeremy Corbyn never struck me more than a 7 out of 10. For him to have pitched it at 10/10 would have been ludicrous. Funnily enough, I don’t think being a lifelong friend of Tony Benn had determined the view of the official Leader of the Opposition. Benn’s views on the 1975 referendum are extremely well known, much in keeping with the contemporaneous Brexit campaign of ‘take back control’. Tony Benn himself apportioned credit to himself for having come up with the idea of giving people a chance to take part in the referendum back in 1968. I think there were two defining factors for Corbyn in his dislike of the European Union (mitigated by his support of protective laws and sense of solidarity). These factors were the pretty awful way in which the European Union had treated Greece, imposing a draconian austerity budget. The other issue Corbyn I think resents is the rôle of EU state aid rules in stopping supporting British industries (say the steel industry which can’t compete with the Chinese dumping of coal.)

The #Brexit decision can of course be interpreted at very many different levels, but the ‘Sunderland roar’ firmly pitches a strand of voters in Labour heartlands who felt a strong disconnect with the views of Westminster. Unlike the Labour PLP, Labour membership contains many people who wanted ‘out’. No matter what reassurances were given about potentially providing extra funding to areas with high flow of immigration (a 2010 manifesto Labour pledge, benefit to the economy),  there is a perception amongst some that politicians were in it for themselves. Doncaster, where are MPs including Ed Miliband, voted in favour of #Brexit (69% leave), so Ed Miliband in endorsing a second ‘review’ referendum vicariously in his support for Owen Smith is effectively signing the political suicide note on his own seat.

I shared somebody else’s graphic on Twitter on August 7th.





































The issue is firmly: Labour needs to come up with a coherent response to globalisation and immigration. Simply shouting at Jeremy Corbyn, or lambasting him over Article 50, is not actually the response desired by many members of Labour. For many, voting ‘out’ was a last resort – and it would be no surprise to people who have zero faith in the parliamentary Labour Party for the response from Westminster to want to assassinate Corbyn politically; quite ironic given that Corbyn might possibly be more in touch with potential Labour voters than the members of his PLP are.

Yesterday, therefore, Owen Smith MP probably needed the news he had just received a glowing endorsement from Ed Miliband MP, as much as he would have needed the news that he has a fresh diagnosis of genital herpes. But herpes he does not have, and Ed Miliband’s endorsement he has. That Ed Miliband feels that his recommendation is in any persuasive is curious, if not frankly delusional. Ed Miliband, Neil Kinnock and Tony Blair all seem to have they have vast influence on the Labour Party, when they haven’t. If you remember Ed Milliband MP’s actual resignation speech on the day after the election on 8 May 2016, you’ll remember a rather childish quip about the launching of the ‘most unexpected cult of Milifandom’. Actually, I don’t care for Abi Tomlinson’s politics in much the same way as I don’t give a stuff about Russell Brand’s youtube video with Owen Jones, but many people felt a profound sense of shock of losing in 2015. It was not just the defeat, but the scale of it. We went down from 41 MPs in Scotland to one – and England’s vote was awful, irrespective of Scotland. So the idea of Miliband lecturing the membership on which way to vote is doubly insensitive, given that he had himself nearly taken the party to destruction.

Ed Miliband MP has of course got a long and distinguished tradition of making terrible YouTube videos, but this was ironically one of his better ones. Ralph Miliband of course might be turning in his grave at Ed’s recommendation – but blood runs thicker than water. Ask Hilary Benn.


In the context of the YouTube video, I replayed to myself his resignation speech. Ed’s tone was generally much more humble in that one, talking about the need for a wide ranging debate within the party to look at what went wrong despite the best efforts of activists. I remember defending Ed to the hilt despite his terrible performances in the TV debate (including tripping over physically), eating that bacon butty, a refusal to reverse the legal aid cuts, and not a peep about PFI. In the video above it is claimed that Owen Smith MP was always having a ‘word in his shell’ about being more radical, but it is well known from the Guardian hustings that Andy Burnham MP’s radical plan for a “national care service” was strangled to death by Miliband and Balls. Burnham said at the time, “I became disillusioned. This party had no vision. This was not the party of Bevan.” Burnham’s reasoning was members of the public, not just Labour voters, did not want to be terrified about future burgeoning social care costs, parallel to how the Clem Attlee government had introduced the NHS to drive out the inequity of having to pay for your own health.

Ed Miliband’s insignificant video also precipitated me to watch the original Jeremy Corbyn leadership videos (from 2015) on YouTube. There’s quite a lot of them. If you get round any irrational hatred of public meetings or rallies, which some happily say should be encouraged as democratising politics, the content of Corbyn’s speeches are interesting. Even if you strongly dislike him, it is hard to disagree with how the Labour Party had lost its way.  There’s one phrase that strikes fear even now: “People like me on the doorstep ended up saying we  were going to offer cuts like the Conservatives, but nicer cuts.” The fundamental proposition that the Conservatives had presented deficit reduction as a necessary book-keeping procedure, rather than call it what it is which is rapid shrinking of the public services, is as true now as it was then. The irony of the continuation of New Labour under Ed Miliband in that the drive to present the opposition as ‘fiscally credible’, they completely failed to address how various factors under Labour’s watch had made the economy less resilient (e.g. under regulation of financial markets, high personal debt, housing boom). And not just this – they allowed the Conservatives to dominate the narrative, when Ed Miliband could have merely rammed home the message that debt under five years of the Tories had far outstripped 13 years of debt under Labour.

But the issue is that it is clearly a lie that the Ed Miliband opposition was simply merely incompetent on economics. Whilst it is now widely accepted as a result of John McDonnell and Jeremy Corbyn that austerity is a political choice not economics-driven decision, austerity was used to drive (it is alleged) disabled citizens to premature deaths, libraries shutting, cuts in the NHS and social care, and so on. Do you remember how Labour also promised to end the ‘something for nothing culture’? The Ed Miliband opposition were incompetent across the board – whether on addressing aggressive tax avoidance, the crisis in lack of social housing, the unconscionable debts of the private finance initiative bankrupting the NHS, the internal market of the NHS crippling the NHS, the abstaining on welfare reforms, and so on. Epitomising this disconnect was Rachel Reeves MP declaring, in an interview in the Guardian, Reeves said: “We don’t want to be seen, and we’re not, [as]the party to represent those who are out of work.”

I have no idea whether Seema Malhotra MP has finally moved out out of her office which she was meant to vacate on her resignation, but I have no intention, despite being a member of the Fabian Society, of attending their fringe events this year in conference. The events list is here. In fact, I’d rather stick hot needles in my eyes, or have my teeth taken out without general anaesthetic. Hopefully Seema Malhotra and the other Fabians will swim happily around their goldfish bowl plotting how next to oust Corbyn.  If you think Twitter is an echo chamber, I strongly suggest you dip your toes into the worlds of the Fabians or the Socialist Health Association. Despite my experience in dementia policy, the Socialist Health Association insist on asking a select few old male stale crusties to present ‘their view’, not the view of their membership, to ‘speak to power’ at places such as the National Policy Forum. I unsurprisingly agree with Jeremy Corbyn that the decision making of policy within Labour currently stinks, and is for wont of a better word totally corrupt and ‘jobs for the boys’. Needless to say I resigned in disgust from the Central Council of the Socialist Health Association who are about as socialist as Ayn Rand or Frederick Hayek.

On some happy news, well done to Andy Burnham MP for being voted in as Labour’s candidate for Central Manchester mayor elections next May – and well done to Kevin Lee, Dr Kailash Chand and Debbie Abrahams too.

Andy has always been supportive of my work, whatever you think of his politics?

well done




























Why I voted for Jeremy Corbyn


My decision to vote for Jeremy Corbyn was not easy. I have learnt to desensitise myself from the hyperbolic shrill of Twitter, and the numbskull hashtag bandwagon campaigns.


First of all, I am mindful that voting for Jeremy Corbyn will be seen by some as a betrayal of the legacy of the Labour Party having made itself electable in the turbulent years in the since the mid 1980s. I should not go so far as to say ‘a pig with lipstick’ could have won the 1997 general election, but I do agree with a sentiment expressed in Liz Kendall’s final speech that Labour did not really have an adequate discussion of what it stands for for a very long time. Whether you agree it or not, there is a perception that Labour to get itself elected is ‘Tory Lite’. This is perceived as huge insult to those who believe in the policies which swept Tony Blair to power in 1997 by some.  But it is the reluctance of those same people to ignore how ineffective we have become in opposition which truly worries me.


Get this. I am physically disabled, and I had to apply three times including a tribunal in Grays Inn Road to get my disability living allowance restored. I found my experience with welfare benefits traumatic, but this cannot have been said to be anywhere as traumatic as those people who took their own lives. Like the MP who spoke elegantly in the debate on assisted dying yesterday, I am loath to say ‘commit suicide’ in the linguistic conflation with the criminal law, such as ‘commit manslaughter’ or ‘commit murder’. I cannot think it is necessary for you to be physically disabled to understand the mental pain which has been brought about by the welfare reforms. but it sometimes feels like it.


When three of the candidates abstained on the welfare reform bill, it really was a massive kick in the groin for me. If anything, Andy Burnham’s explanation of the ‘reasoned amendment’ made it a million times worse. I am not a subscriber to Len McCluskey and UNITE but I felt more than a smidgeon of sympathy when he said he felt like sending Harriet Harman MP the dictionary definition of “opposition”. This single vote was a game changer for me. I had to look very hard to support Andy thereafter. I think his idea to bring together health and social care is much overdue. The reason for this is that the problems in the social care system have a direct effect on the operations of the NHS. But it cannot be ignored by me that Labour did much to bring about the mess of privatisation of social services either. I do not agree with the Foundation Trust policy, introduced by New Labour, as it is my perception that there are NHS Trusts, such as Mid Staffs and Morecambe Bay, which were more interested in their Foundation Trust status than their record on patient safety, and the ability of the clinical regulators to bring anyone to account for clear misfeasance is woefully inadequate. Foundation Trusts, and what has happened, a high proportion of Trusts in deficit in a market gone wrong, is not a legacy of New Labour I can agree with. I am sorry to lay this at the door of Andy Burnham partly, and I would not have minded had it not been for his stance on the private finance initiative (PFI). Andy uses PFI to argue that Labour mended the roof while the sun was shining, but it is shockingly and absorbingly transparently the case that the loan repayments have been unconsionably poor value, as admitted by Margaret Hodges’ committee, something has to be done about it fast. The fact that there are City traders who trade in equity in PFI tells you something about the machinery New Labour put in place over the NHS.


Jeremy Corbyn spoke to my values. I get the fact that he is very old (but that surely should not be a problem unless you are profoundly ageist which I am not?) I think the fact that he disagrees with PFI is a factor, but so is the idea that you invest in people. I remain aghast at how many people seem to think that nurses pay is a trivial idea, mainly from people who have never done had a hard day’s work in the NHS ever. But let me tell you one thing which is very important – nurses’ mental welfare is very important, and rewarding nurses for their difficult job is a step towards that, more useful than yoga classes or whatever the latest out of touch managerial initiative from NHS England is. I think also it IS a problem that Russian oligarchs can buy up new builds in London, and Boris Johnson for example is prepared promote that, at the expense of shoving up house prices in London making social housing in London unaffordable for many. The Blair Twelve, for all their verbal masturbation about how disastrous a Corbyn government will be, have never offered anything constructive on social housing. This is not an issue of “Blairite vs Brownite” for me, it just happens that the abuse from some of those people who have been classified as Blairite has been for me completely unacceptable. Likewise, I think the abuse that Liz Kendall has received is simply disgusting, on account of her standing up for her opinions legitimately.


Economists disagree. I know a reasonable amount of economics, to the point I came top in economics in my own MBA. I think the way people have dismissed a ‘people’s QE’ out of hand distresses me, as it shows that they are more driven by securing their own ideology than potentially helping others in society. It does distress me even more that we have continued with the destruction of delivery of legal aid as we “cannot afford it”. Remember – Sadiq Khan MP, newly elected Labour Mayor candidate – was unable to pledge the reversal of cuts to legal aid when Shadow Justice Minister. And so it goes on. There’s a Labour refusal to say that the £20n efficiency savings, now £30bn, is now unworkable because of the desperate need to hang onto austerity. I have found Yvette speaking too much ‘shrill’ in the debates, and, apart from her interesting anecdote about her Haribos factory, I have found her uniquely uninspiring in the debates. Cooper for example had nothing of interest for me to say on the NHS or social care. And we do know that austerity has failed in numerous jurisdictions – Osborne’s own plans for austerity have failed numerous times, as our national debt has exploded far more than under Labour. Cooper may want to reduce the ‘people’s QE’ as ‘PFI on steroids’ but the way in which Labour implemented QE was itself ‘on steroids’. As Jeremy Corbyn rightly points out, signing up to the Conservatives’ economic plan in 1997 meant us signing up to PFI at the time, and a huge number of contracts were introduced under Labour (even thougjh the Major tenure originally introduced it in 1993).


I think Jeremy Corbyn is a good speaker. He is a Facebook friend. Sure, I ‘get’ the concerns about him potentially leaving NATO and wider foreign policy, but I note that he has never said recently he will definitely leave NATO. For me, he has spoken much sense on the refugee crisis. I expect his Shadow Cabinet to be kept in check by a strong Shadow Foreign Secretary, as I think Hilary Benn MP might be. I as it happens feel that Angela Eagle MP would make an excellent Shadow Chancellor. It’s clear that Scotland rejected Labour. I think the SNP is nationalist rather than socialist, and will do anything to further their nationalist ambitions. But I do think Corbyn does have a chance in speaking to disaffected Labour voters who voted SNP or UKIP recently. I think Corbyn is far from perfect, but he himself has urged the need for a united party, where policy is going to be driven by the grassroots. One of my own personal unpleasant experiences was in the Socialist Health Association where I felt it was impossible to have your contributions valued despite the wealth of experience you can bring. I have no truck with this method of working from the SHA, and I think the whole Labour machine has been like that.


I would like to give Jeremy Corbyn a chance. I am genuinely sorry to those of you who will feel offended by this.

Labour leadership pains: It’s not where you’ve come from, it’s where you’re going to



I must admit that I was taken aback when Gordon Brown quoted a former ‘successful’ Labour Prime Minister thus, “And, in Harold Wilson’s words, Labour is “a moral crusade or it is nothing”. I wasn’t so much amazed that Brown had decided to name drop a Labour Prime Minister who was well known for making policy up on the hoof, and possibly more into style than substance, but the fact that Brown had quoted one of Tony Benn’s favourite quotes ‘of Harold’. To understand the general approach of Jeremy Corbyn, you could do no worse possibly than to watch the film ‘Last Will and Testament’, where like Brown, Benn sets out the historical events which have inspired his quest for social justice. Brown’s penultimate line of conclusion was “And follow what Bevan called that decent instinct to do something that will help the lives of people most in need”, but I think that it is through looking that through this prism you can begin to understand the pain at the lack of efficacy of Labour’s so-called ‘opposition’. For example, Labour has never committed to reversing the destruction of the English legal aid system and the network of English law centres, claiming that such plans would not be possible given austerity. Austerity itself is the reason the NHS is being driven to do ‘more for less’, except the whole world and his dog knows that hospitals get by with the basic of staff on on-call cover, and idea of stretching out existing resources into a seven day way is laughable for most professionals within the service. It is therefore easy for me to understand the immediate popularity of Jeremy Corbyn; that he is defying the neoliberal doctrine, ‘there is no alternative’, with an alternative to austerity. This indeed is not an unelectable formula – look at Scotland (even though one can rightly moot whether SNP policies as actually legislated are particularly left wing). One can argue about whether Corbynomics will work, but the sheer defiance of the ‘there is no money tree’ with quantitative easing is worth raising an eyebrow at least. I have no idea whether Corbynomics is pro-inflationary, but then again no one else unless he or she happens to be an astrologer.


I went up to the Labour Party Conference in 2010 in Manchester. I got to Manchester Piccadilly precisely at the time that they were announcing the Labour Party’s new leader – who was Ed Miliband. Ed Miliband had defied the critics, and had come from nowhere to ‘seal the deal’. This was to much happiness of those who at that stage hated the Blairite wing of the party. I as such do not hate Blairism in the same way that I do not hate any corporates. I do not see Blairism as a social movement, but as a group of some extremely bright people but also some rather sanctimonious disparate people who can see no wrong in Tony Blair. I think many people use Chilcot as an excuse to hate Blair personally rather than a reason, but then again whether the UK went into war legally is a serious issue. I was greeted accidentally by Michael Meacher MP as I entered the ground floor of a pub in 2010 for the Socialist Societies meeting. I asked Michael if he was happy at Ed Miliband’s election: he said, “Not happy – ecstatic.” But he then added, “We’ve got our party back.” And I was to hear this phrase often during conference. And yet he struck me for the remainder of his term as leader that Ed Miliband was never a socialist, but a social democrat. That’s why I thought that the attacks of Red Ed were deeply fraudulent – but clearly not as ridiculous as the bacon butty jibes. When Gordon Brown referred continually to ‘Labour values’, this inevitably was a ‘fist pump’ moment for many, but it is essential to deconstruct whether Labour values, as espoused say by Keir Hardie, have been at the heart of the private finance initiative, where you end up paying for state assets through unconscionable loan agreements, or whether it is particularly Labour values to flog off the State’s infrastructure which you’ve invested in for decades. Lord Mandelson was one of the principal architects of the Royal Mail privatisation, so was it really possible for Labour to ‘oppose’ this when the time came? Is it a Labour value to remain relatively supine about the relative lack of nurses’ wages for many?


What has been incredible for me has been the sheer vitriol aimed at Jeremy Corbyn MP. Representing a different part of North London to the one I’m in, I ‘get’ his views on social housing. When you consider that the Mayor of London, currently Boris Johnson, does not have qualms about selling ‘new buys’ in Paris, making property prices unaffordable for residents of London, you get his point. When you also realise that without any forms of rent controls, landlords are regularly receiving state subsidy to provide accommodation at a huge profit, you see where Corbyn is coming from. However, there are substantial problems with Corbyn’s pitch in various areas, such as possibly exiting NATO. I remain unconvinced whether he really wants the Labour Party to stay in Europe. We all know his ‘friend and mentor’, as indeed he has called him himself, Tony Benn said ‘No Non Nein’ in the original EU referendum. Benn’s socialist reasoning was that he didn’t want everything to be run from unelected people in Brussels, which saw his logical reasoning go into an unholy alliance with the late Enoch Powell’s. But there is a substantial grouping within the Labour Party who do not see Europe as the great competitive nirvana that multinational corporates espousing free movement of capital and labour can do. They see it as a body which does not protect adequately workers’ rights. Corbyn may wish to take the EU negotiations from first principles with Labour. The attack on Labour during the Scottish referendum was that it was indistinguishable from the Tories – the scope for history repeating itself with the EU referendum is there too.


Harriet Harman MP was adamant that Labour should not be opposing for opposing’s sake, and that Labour had to have a moral drive and logic to its opposition. And yet it is Labour which perpetually gives the impression of being utterly toothless and taking it regardless. Its response to the Budget was pretty unmemorable, apart from Chris Leslie for all the wrong reasons. Andy Burnham MP somehow seems to arrived at losing from the clutches of victory, in no way helped by Harman’s stance on the Welfare Reform Bill. Burnham in ‘abstaining’ instead of giving an impression of firm opposition in the form of a ‘reasoned amendment’ which accounted for ‘collective responsibility’ looked instead as if he didn’t give a shit about the devastating effect of welfare cuts, including for the disabled community. Prof Germaine Greer in BBC’s Any Questions unsurprisingly therefore arrived at the conclusion that she expected HM’s ‘Loyal Opposition’ to oppose. There is clearly a feeling now that Labour should not oppose in a long-winged convoluted fashion. It is pretty hard to escape the conclusion that if you want to afford the NHS (not fraudulently articulated fraudulently in neoliberal language as ‘unsustainable’), you have to be willing to pay for it through general taxation. And yet Andy Burnham wants to set up a ‘Beveridge style Commission’ to arrive at this answer. His reasoning for this was presumably because his cherished National Health and Care Service, a great idea which would do much to make a ‘parity a reality’ (one of Burnham’s slogans before he railed against slogans), did not receive its democratic mandate. But there are vast swathes of NHS policy which seemingly do not operate on the basis of a democratic mandate, take for example the suggestion from McKinsey’s of £2 bn or so efficiency savings, or PFI. TTIP is yet another policy arm which, to give him credit, Burnham has been to Europe to oppose. Labour was not in government during the negotiations, but there is a general feeling that Labour did much to put in place the market infrastructure which made subsequent privatisation of NHS relatively easy.


clunking fist

(Cartoon by @BarkerCartoons)


As for Gordon Brown’s ‘Labour values’. where was tub thumbing Brown given the precipitous and disastrous privatisation of social care? It is a honest and settled view of many that social care funding is now on its knee, having not been ring fenced for the last few years. This simple fact makes Cameron’s view that England is the best place to live with dementia frankly delusional. A lot of reasoning behind Labour’s stance has been that it’s been ‘austerity lite’. Whilst socialism does need lots of money to succeed, or as the critics say ‘someone else’s money’, the state infrastructure does need a modicum of investment – even if the return of the investment is later to the City of London, as will inevitably occur when CrossRail or HS3 are flogged off. Tuition fees is another golden example of where a universal right  to higher education has been marred with a requirement of an ability to pay. They say that somebody can easily land himself or herself a £60K debt bill at the end of university education, and I can well believe that. I am grateful for my university education, but equally I understand that university education is not the ‘be all and end all’ (for example we might wish to extend legal apprenticeships). I don’t like the A level system, as it’s my opinion it reflects more how well you’ve been taught than anything else, but there is so much mileage to be gained from my ‘I wouldn’t start from here’ arguments.


I do not happen to agree with the ‘savage’ attacks from the BBC in framing Gordon Brown’s speech as a devastating attack on Jeremy Corbyn MP. For example, Brown quoted Mandela in reference to the notion of the need for hope especially after years ‘in the wilderness’. My interpretation of what Brown was trying to say, albeit with a twang of ‘Don’t blame me if it all goes horribly wrong’, was that any Labour leader must receive the popular vote to get elected in the first place; but once elected it will require a huge effort from all sides to make Government work. I think this is particularly the case for Jeremy Corbyn. At one level, the popularity for him is not the same as left populism, it might be argued, and that the echo chamber Corbynmania and packed out lecture halls are not representative of the Labour voting public at large. We’ve been there before with a heightened sense of optimism, for example Milifandom. You don’t have to go far back in time to get constructive knowledge of polls which have been totally wrong – it could be all the ‘hard entryists’ into Labour do not vote for Corbyn at all, though I have no idea what a million Toby Youngs or Dan Hodges are like. There is a huge risk that Labour is about to enter an extended period of mockery, but you have to remember that Labour had relatively little hope of winning 2020 in any form anyway. Tony Blair is to blame in my opinion definitely for not having done the ‘succession planning’ properly; or you can argue that he is in fact an incredibly successful politician for having pulled the ladder up from underneath him. I think Blair has left in many areas a very formidable legacy as a social democrat, for example LBGT equality, public services reform, devolution, national minimum wage, but the essential problem with all of these policy planks is that we remain utterly clueless about the destination of travel. But the same can be said of Gaitskell or Wilson. But not Attlee – and therein lies some of the trouble.  And as Nye Bevan said, “It’s not where you’ve come from, it’s where you’re going to” – or “If you remain in the middle of the road, you’re bound to get runover.”

Yes, I am getting totally sick of NHS campaigners too


The tragedy about the context to what I am about to say is that the NHS is THE issue of the next election.

Cameron is not a leader. He’s a manager, and not a very good one.

A couple of days ago, the ‘New Economics Foundation’ published an interesting report on how the NHS reforms had been sold on false pretences.

It was an excellent report.

The story starts in the 1980s with full gusto.

Market-based reforms began in the 1980s, when support services were first contracted out, but, according to the report, continued in the 1990s, with the creation of an internal market for clinical services.

The claim  was that increased competition can improve both efficiency and quality of care is a central justification of market-based reforms and the Health and Social Care Act.

The King’s Fund thought it might do too.

But many of us knew this was utter bollocks.

Reams and reams of evidence was published to the contrary, such as on the LSE blogs.

On page 5 of the Report, the experience from Serco makes chilling reading:

“Before pulling out of the Cornwall contract, Serco had replaced clinicians on its out- of-hours service with call-handlers who did not have medical training but followed a computer-generated script. The new system quadrupled ambulances called. Call handlers were then told to make new checks before calling 999 when they received what appeared to be emergency cases, so that managers could cut down the number of referrals they made to the ambulance service. A leaked management email to staff described how they should use their computer system to meet targets set down in the company’s contract on 999 responses.”

Often the NHS discussion goes round and round and round and round and round and round in circles of who started it and who continued it.

On the “private finance initiative” –

“This is a scheme that enables private companies to design, build and operate NHS (and other) facilities, using capital raised through financial markets, and then rent them back under long-term contracts lasting 30 years or more.

First introduced by the Major government, this approach was popular with New Labour, with nearly three-quarters of hospital building schemes funded through PFI between 1997 and 2009.”

And desperate Dan Poulter pulled the same rabbit out of the same that last week.

Labour “started it” with their NHS Competition and Co-operation units. They started it with their “Independent Sector Treatment Centres”.

Except… Labour didn’t start two things in particular.

One – the breach of the “four tests” in reconfiguration, which saw Lewisham win both in the High Court and Court of Appeal.

Second – the legal provision in section 76(7) Health and Social Care Act (2012), from the current Government, of a threat if services do not go to out to competitive tender if there is not a sole bidder.

We saw the same crap last week.

People saying the Clive Efford Bill didn’t go far enough – except nobody said it would abolish the purchaser provider split, PFI, the £2bn funding gap, Foundation Trusts or mutuals, or advance integration of health and care.

NHAP and KONP have gone mute on integrated care and whole person care.

There is absolutely no doubt that the situation where NHS hospitals cannot discharge patients to social care is a situation which cannot carry on.

NHS campaigners seem more concerned about proving how correct they are, than offering constructive thoughts on, say, how to improve wellbeing in long term conditions.

Mid Staffs in some quarters has furthered a toxic atmosphere of malice and retribution, and a culture of fear and nastiness, rather than thinking about how things can improve.

And it has produced a generation of journalists who are the new model jury of the health and care professions.

… except regulation of primary care was not built entirely around Harold Shipman… Harold, under a Tory Government, in case you’re wondering.

No wonder the Staffs area was plunged into a recruitment crisis after all their negative publicity.

GP surgeries are shutting like no tomorrow, and yet Hunt puts pathetic above more pathetic, while some of us are trying to put people before profit.

There will be only one party of Government on May 8th 2015. It might be a temporary Government but we don’t know who it is yet.

UKIP has made utterly contemptible comments about the NHS in the past which are well documented. The idea that Labour can work with UKIP in promoting the NHS is more than disgusting.

So another week and it’s the same old same old tired discussions.

It’s clear to me that some people prefer the foreplay to the actual act.

And it’s entirely all driven by egos. Again.

How badly does Ed Miliband want the job?




Ed Miliband has often remarked that he views his pitch for being Prime Minister being like a job interview. This is not a bad way of looking at the situation he finds himself in, one feels.

The “elevator pitch” is a construct where you’re supposed to sell yourself in the space of a short journey in an elevator. What would Ed Miliband have to do to convince you that he means business?

This question is not, “Would you like to be stuck in a lift with Ed Miliband?”  But that is undoubtedly how the BBC including Andrew Neil, Andrew Marr or David Dimbleby would like to ask it.

On Facebook yesterday, Ed presented his potted ‘here’s what I stand for in four minutes’ pitch.

It’s here in case you missed it.

Presumably advisers have recommended to Ed in interviews that he must look keen to do the job. But presumably there is a limit to looking ‘too keen': i.e. desperate.

Ed being given the job depends on what the other candidates are like: and Nigel Farage, Nick Clegg and David Cameron are not the world’s most capable candidates.

It’s said that most HR recruiters ‘google’ the candidates before shortlisting. Will Ed Miliband survive the stories about him eating a butty? Or being public enemy no. 1?

Does Ed Miliband have issues he wants to bring to the table?

Yes he does: repeal of the loathed Health and Social Care Act (2012), abolition of the despised bedroom tax, a penalty for tax avoidance, and so on.

Will the media give him a fair hearing?


Does Ed Miliband have a suitable background? Well, he got at least a II.1 – this is all anyone seems to care about these days. (I, for the record, think that the acquisition of a II.1 in itself is meaningless, but that’s purely a personal opinion.)

Would Ed take the job if offered it? Yes.

Will he have OK references? Not if you ask Andrew Marr, but if you ask somebody like James Bloodworth, Sunny Hundal, or Dr Éoin Clarke, yes.

Can Ed return something to his stakeholders? Possibly more than David Cameron can return to his. All Ed has to do is to win.

It’s going to be difficult. This general election on May 7th 2015 is incredibly unpredictable. The main factors, apart from Ed Miliband’s two critics, are whether the LibDem vote will collapse, how well UKIP might do, whether Scotland will be a ‘wipeout’, and so on.

But Ed Miliband’s government repealing the Health and Social Care Act (2012) is far more significant than whether he can eat a butty.

Liz McInnes won. Live with it.

Liz Mc

The “thrill of the chase” is the layman’s version of a body of marketing research looking at why humans expend a lot of energy in pursuing a goal which they find rewarding, and yet effortful.

Apart from THE major policy, of pulling up the drawbridge on the torrent of immigration we’re apparently experiencing on an industrial scale, many members of the general public are at a loss to identify a single meaningful policy of UKIP. This is particularly the case in UKIP’s submissions on NHS policy, where scattered offerings do not form a coherent picture.

If anything the policy mutterings of UKIP, which do not in any form constitute a policy, go along the lines of a fundamentally corporatist flavour, ‘making the NHS more efficient’ and ‘laying off the excessive staff’, rather than valuing the workforce, for example many nurses who’ve not benefited from a pay rise for many years.

But it could be that the sheer enjoyment of seeking pleasure ultimately from UKIP matters more than what they wish to do on the NHS.

The ‘scattergun’ nature of UKIP decision-making is of course hugely fraudulent. At one moment, UKIP can offer motherhood and apple pie, such as insisting on an exclusion from TTIP, the hated transatlantic trade agreement. It can then do a volte face at any moment, in the hope that potential voters will have selected in their minds the policies most attractive to them even if they subsequently become redacted. UKIP, also, despite wishing to present a united front, can present polar opposite views to voters who have previously voted Labour like Gillian Duffy from those presented to normally Conservative voters in the South West or East of England.

UKIP is an embarrassment politically. All the criticisms have been well rehearsed elsewhere. The criticisms against Liz McInnes, who has spent the last thirty years working in the NHS, have been utter desperation. The BBC, whose credibility is as embarrassing (and some might say offensive) as a Jeremy Clarkson numberplate in Argentina, would much rather focus on how pathetic UKIP insisted on a recount, rather than mentioning what McInnes might offer her constituents in terms of her wealth of experience on valuing staff in the NHS.

But here’s some sanity from James O’Brien.

In a sense we get the media we pay for, but I for one do not wish to pay an enhanced contribution to listen to the bigoted ranting of BBC domestic news commentators as a form of indirect taxation. The output of the Corporation in domestic news has been for some time worse than pathetic.

It has been worse than getting blood out of a stone in trying to get the BBC to cover the diabolical NHS reorganisation which has so far cost a huge amount of waste in terms of redundancy payments and legal fees for competition experts. Labour has next to no hope in getting a fair crack of the whip when it comes to their flagship policy of combining health and care, which many specialists now feel is long overdue in England. There has to be some semblance of fairness in the BBC’s coverage, such that, for example, it can be difficult to incumbents to increase their majority (a meme rapidly disseminated by the CCHQ ably assisting the BBC). Also, the swing away from the current Coalition in the Heywood & Middleton seat was actually more than thirty percent. Labour’s share of the vote did go up in Heywood and Middleton.

The majority for Liz McInnes might constitute a fewer number of people, but overall votes have been declining. The Conservatives which lost both the seats know their leader David Cameron is a dead duck. I do not particularly like Ed Miliband’s leadership style, but I am truly sickened with the way that the Coalition has incessantly lied about how the deficit was caused unilaterally by Gordon Brown. This sheath of lies has given credence to the shambolic lie of economic credibility by the Conservatives – despite a level of debt which is now exploding out of all control.

In a ‘first past the post’ system, Liz McInnes won. Live with it.

For many, the chase of UKIP will be sufficient escapism, until the moment such voters enter a hospital to be treated by an Asian nurse on the minimum wage who will show the patient excellent professionalism anyway. It is impossible to tell the outcome of the general election of 2015, but it might be worth all the political parties not publishing manifestos but statements of their unnegotiable areas.

If it turns out UKIP does not want to negotiate on its flat-tax for the NHS from UKIP manifestos popping through the letterbox, at a time when NHS funding is a national cause for concern, then we know we do not have to buy any extra toilet paper.

On ‘the thrill of the chase':

Labroo A.A. & Nielsen J.H. (2010). Half the thrill is in the chase: Twisted inferences from embodied cognitions and brand evaluation. Journal of Consumer Research. 37(1), 143-158.

The Tory pitch on the NHS is based on two innocent misrepresentations. They’re huge – like the debt.

A perfect way to annoy nurses is to promise a tax cut for people with the highest incomes ahead of a release from the pay freeze most nurses have endured for the last few years.

I’ve noticed a curious phenomenon when I retweet articles on Twitter. It is not a secret that I am ‘left wing’, whatever that means to the intelligentsia of North London. If I retweet an article from the perspective of how awful this Government, by a left wing ‘seleb’, it won’t be uncommon for people to think ‘nothing to see here, please move on’ . But, if I share something by Fraser Nelson or Isabel Hardman, all hell breaks lose.

Take, for example, the article by Nelson criticising the burgeoning debt burden, published in that well known leftie rag, “The Spectator”. It’s a refreshing honest piece of journalism entitled, “Osborne increases debt more than Labour did over 13 years“. I suspect both Ed Miliband and David Cameron were more prepared for the scenario if Scotland had voted ‘yes’ to independence. Most people I know felt that the story of Ed Miliband’s walk in the park was totally underwhelming. David Cameron, in an outbreak of honesty, meanwhile, let slip that he “resented” the poor. This, for me, represents a clear example the “don’t think of elephants” phenomenon. The harder you try not to think of something, you think of it.

Once, at the Labour Conference held in Liverpool (2011), I asked Jim Naughtie about this famous episode.

Both Naughtie and I burst out laughing. Jim Naughtie is of course not the first person to have dropped a massive clanger. Everyone, including Andrew Neil and Nick Robinson, knows that the pitch by the Tories on tax cuts, when the deficit is being given a second chance to resolve itself, this time by 2018, is a total farce.

I had barely got over the admission that Cameron resented the poor when this suddenly happened.

speech segment

This is a colossal lie, as Sir Andrew Dilnot CBE, Chair of the UK Statistics Authority, has  explained to Chris Leslie MP, the Shadow Chief Secretary to the Treasury, in his letter. The critical paragraph of that letter is this.

Debt Para

Even a PPE graduate from Oxford can begin to get the gist from this graph helpfully provided by Dilnot.

debt graph

Similarly, because of inflationary pressures – including increasing service demands – on the NHS budget, it is difficult to argue that in real terms there has been an increase in funding of the NHS. That one is also colossal lie, as Sir Andrew Dilnot CBE, Chair of the UK Statistics Authority, has  explained to Jeremy Hunt MP, Secretary of State for Health, in his letter here. The critical paragraph of that letter is this.

NHS exercpt

The Conservative pitch logic is as follows: (1) the Tories are trusted on the economy, (2) Labour is trusted on the NHS, (3) Discredit Labour by repeatedly talking about Mid Staffs despite clearly enduring problems in the lifetime of this period of office, (4) Promise tax cuts in 2018 and ‘more for less’ (by citing examples such as falling crime despite budget cuts). But this logic is based on a surfeit of lies and half truths.

It is a curious phenomenon that crime statistics keep on falling across a number of jurisdictions, fitting very nicely with the argument by libertarians for a smaller state. Furthermore, NHS England has reported on poor recent performance, following the time of the Mid Staffs disaster, in the “Keogh Trusts” during the lifetime of this period of a Conservative-led government. Andy Burnham MP does not repeatedly bring up the example of Harold Shipman, a colossal failure of regulation of general practice which happened instead under the lifetime of a previous Conservative government. It’s been repeatedly reported that Labour ‘do not appear to want to be in power despite being on the brink of power’. But, by that token, the Conservatives are behaving as if they realistically do not expect to be the largest party next May, either. The Conservatives-led Government decided not to take up a golden opportunity of regulating clinical professions, handed on a plate by the English Law Commission, in the last Queen’s Speech of this term. The General Medical Council even signalled their disapproval of this. And, as alluded to above, the debt is exploding while NHS demand continues to increase, leaving a ‘funding gap’ which has been brilliantly discussed by ‘The Health Foundation’. Once again, the patriotic Conservative Party have stuck two fingers up at the best interests of the country by currying favour with their high income (and wealthy) backers, instead. The “jam tomorrow” argument from the Conservatives could be fatal to a frank discussion of the need to integrate health and care from the next Government, whoever it is. But, as my late father often used to remind me, “one lie leads to another”.

Time to turn to the “Black Eyed Peas” for inspiration perhaps.

Sorry, sorry, sorry, sorry
Hey, baby my nose is getting big
I noticed it be growing when I been telling them fibs
Now you say your trust’s getting weaker
Probably coz my lies just started getting deeper
And the reason for my confession is that I learn my lesson.

NHS “credibility gap”

The Conservatives have overtaken Labour for the first time since March 2012 in the latest YouGov/The Sun poll.


David Cameron has an inherent advantage in the public perception’s of his leadership qualities, in that he is doing the job every day and being seen to do so on the news. Credibility is an important currency. And Labour has already stated ‘the market went too far’ in the NHS. It is not a secret that many parts of the media try to present Ed Miliband in a negative light. Labour is trusted on the NHS, and the Tories are trusted on the economy; so a rationale strategy for the Tories is to make the link between the country’s economy and the NHS. However, real-terms NHS funding has effectively flatlined for a number of years now, not keeping up with the inflation in the system, and debt under this Government has got out of control.

For example, you’re more likely to get a discussion of the ‘bacon butty’ incident than a discussion of how NHS contracts have been aggressively been promoted to the private sector, or how the Health and Social Care Act (2012) locks in the market.

bacon butty

The Prime Minister often blames this lack of coverage on the era of the rolling news, but conversations in the social media have been very productive in exposing events which the BBC would rather not cover. David Cameron’s segment on the NHS was certainly passionate. Cameron must have been distraught at the closure of the Cheyne Centre which he had once fought to keep alive.

But actions speak louder than words.  When Cameron claims he will protect the NHS he doesn’t say from whom or what he needs to protect it.   He no longer talks about the importance of competition in the NHS and many of the initiatives associated with Andrew Lansley seem to have been quietly forgotten.

If David Cameron had wanted to win the trust of the medical profession, he would not have ambushed them out of nowhere with a ‘top down reorganisation’ which he promised would never happen. The £2.4 bn reorganisation is widely considered to be a tragic waste, when money could have, and should have, been invested in frontline services. The chunk of the speech on the NHS was little consolation to hardworking nurses who’ve witnessed yet another pay freeze, despite the economy’s performance recovering. Nurses, part of the lifeblood of the service, are not immune from the ‘cost of living crisis’, particularly if they are living in London and working in one of the powerhouse teaching hospitals.

A&E targets have been consistently missed during the duration of this period of office by the Conservative Party (and the Liberal Democrat Party).

The current Government need to address what to do about the ‘private finance initiative’. New contracts have been awarded during the lifetime of this Government, and, whilst they were undoubtedly popular under New Labour, their origin is clearly found in the John Major Conservative administration of 1992-1997.

David Cameron, in his conference speech, simply behaved so passionately about the NHS as if the Lewisham debacle had never happened. The current Government even spent money trying to win the case in the Court of Appeal.

GP waiting times have been an unmitigated disaster under this GovernmentThere has been a marked rise in the number of NHS trusts in deficit. Jeremy Hunt is stuck in a time warp. He mentions Mid Staffs at every opportunity. Hunt, completely disingenuously, does not let the failures in culture, quality or management, identified at the CQC, soil his lips. The “Keogh Trusts” were dealt with due to failings which had occurred in the lifetime of and due to this government.

Like the referendum on Europe, promising ‘to protect’ the NHS could be ‘jam tomorrow‘, if the Conservative Party fail to get re-elected. It is either a sign of confidence, or sheer arrogance, that David Cameron and colleagues can hang these uncoated promises in thin air.

The position in an editorial of the Financial Times is clear – and damning:

“But in the bid both to draw a clear dividing line with Labour and reassure the wavering right, they have staked out a fiscal position that is neither sober nor realistic.”

And, hard though it might be to swallow, the Coalition appears to have an ‘edge’ on some key policy areas.

policy edge

Labour would never have been able to get away with such dodgy promises, with their plans for government being watched like a hawk. With the help of the BBC and other supine media outlets, rather, there will be an inadequate scrutiny of these Conservative plans, which hopefully will be better articulated before the time of the election. As such, it does not matter what Labour promises its voters on the abolition of the purchaser-provider split, whole person care, the private finance initiative, reconfiguration of hospitals, GP waiting times, patient safety, and so on, if voters wish to vote for ‘jam tomorrow’.

The hope is that a Secretary of State for a Labour government would be able to untangle the UK government out of TTIP and CETA trade agreements further giving propulsion to neoliberal forces attacking the NHS. There is a hope that health and care finances will be properly funded in the next Government. All parties have arguably failed to have this conversation with the general public thus far.

Some policies of the current Conservative-led administration are incredibly unpopular with Labour voters: e.g. welfare benefits, NHS privatisation, repeal of the Human Rights Act. The feeling of many, currently, is that, while they do not particularly like this Government, they do not wish to vote for Labour which appears to be offering a diluted form of what the Conservative Party is offering. This is not in any way a indictment of the sterling efforts of the Labour Party Shadow Health Team.

But, before Labour attempts to plug the ‘funding gap’, it will need to resolve any ‘credibility gap’ first.



Yesterday we broke the record for most views of the @SocialistHealth blog website

Here are the official figures for the most ‘viewed’ blogposts yesterday (15 June 2014).


My experience of being a sick Doctor 2,286
The Black Report 1980 74
Home 69
Home page / Archives 63
The five core messages of ‘Dementia Friends’ are consistent with the current literature 51
Black Report 6 Explanation of Health Inequalities 50
National Insurance a bad way to pay for the NHS 34
Like Nick Clegg, I was taught by ‘unqualified teachers’ at the same school. His hypocrisy stinks. 27
Black Report 10 Summary and recommendations 24
Aneurin Bevan and the foundation of the NHS 22
Other posts 546
Total views of posts on your blog 3,246


It meant a lot to me having so much positive feedback from people in the #Twitter community on my blogpost which was the first time I’d blogged on my experiences of being a sick doctor in such a public forum.

I reproduce a sample of these tweets here.

It was a really big deal for me to write this, but I wrote it entirely spontaneously this morning. I’ve been churning around these issues every day of my life since waking up from my coma in 2007, and of course on #FathersDay it is impossible to ignore how awful it must have been for my late father.

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