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Will The Libdems Block Cameron's Reforms As Brown Blocked Blair's?

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Will the LibDems block Cameron's public services reforms, as Brown/Old Labour blocked Blair's/New Labour's?

Another 5 years of gridlock? :(

Alan Milburn's (New Labour health secretary, 1999-2003) article in the Telegraph today made me think so.

http://www.telegraph.co.uk/news/politics/8578226/This-NHS-debacle-sets-us-back-a-generation.html

By Alan Milburn

(Alan Milburn was health secretary, 1999-2003.)

10:00PM BST 15 Jun 2011

The Government’s health reforms are the biggest car crash in NHS history. From the outset they were devoid of advocacy and advocates. The screech of skidding tyres has been audible for months. This week, with the publication of the NHS Future Forum report and the Government’s response, the stench of a sharp U-turn has become overpowering. It leaves both health policy and British politics in a very different place.

The temptation to elevate short-term politics above long-term policy proved too much for both David Cameron and Nick Clegg. Cameron has returned to his original strategy of playing safe on the NHS in order to decontaminate the Tory brand. A combination of his own neglect and his Health Secretary’s foolish bout of policy-wonking had put that at risk. It had managed to conflate in the public mind precisely the four words Cameron was desperate to avoid – cuts, privatisation, health and Tory. Clegg has had a different motive: to differentiate his Liberal Democrats from their Conservative Coalition partners by saving the NHS from “Tory privatisers”.

Many in both camps inside the Coalition consider the U-turn a triumph. But it has the makings of a policy disaster for the health service and, maybe in time, a political disaster for the Government.

Everyone knows the NHS cannot stand still in the face of demographic change and medical advance. Reform is a constant necessity. The U-turn slows the pace of reform and dramatically dilutes its impact. GP consortiums that were supposed to be in place by 2013 now have no deadline for their creation. England will have a patchwork quilt of decision-making for years to come. Worse still, GPs’ ability to drive more services out of hospital and into the community has been severely compromised. It is hard to see how the push for £20 billion of efficiency savings will be realised without radical reconfiguration of how local services are delivered.

So how will the NHS books be balanced? By the usual device which policy-makers have deployed every decade or so in the NHS. A very large cheque. It is precisely the situation Cameron and George Osborne were trying to avoid: sorry, George, but the cash you were saving in your pre-election Budget for tax cuts will now have to be spent on a bail-out for the health service.

That is not the worst of the matter. These changes will reverse hard-fought reforms. For decades, the old-style, monolithic NHS has been giving way to a more devolved and diverse health care system. The reforms I introduced as health secretary to create NHS foundation and primary care trusts started the devolution journey. GP consortiums were supposed to complete it. Instead, the Government’s U-turn places real power in the hands of the national NHS Commissioning Board – the daddy of all quangos. The board will control how £60 billion of NHS money is spent in local communities from Darlington to Dartmouth. It is the biggest nationalisation since Nye Bevan created the NHS in 1948. I’m not sure whether he would be laughing or turning in his grave at the prospect of the Conservative Party championing such a policy. Bevan would be equally perplexed to see the Conservatives abandon competition as a driver of NHS improvement. When I introduced private sector providers, some claimed it would be the end of the health service as we had known it. In fact, they strengthened it. Waiting times and death rates both fell faster in areas where new providers were brought in to provide services than where they weren’t.

Andrew Lansley could have quietly built on these advances. Instead, he ineptly promised a privatisation revolution and free-for-all competition. That prompted a furious NHS fightback and the inevitable No 10 retreat. Now the regulator, Monitor, which was to have been charged with promoting competition, will have a duty to promote integration. Words have meaning in the NHS. Every single local decision-maker will read that change as a signal to weaken competition, not strengthen it, and to protect the public sector incumbent over the private or voluntary sector insurgent. The debacle has set back for a generation the cause of market-based NHS reform.

It has also turned the political tables. The promise of the Coalition was that it would go where New Labour feared to tread when it came to public service reform. There would be no no-go areas. In fact, Cameron’s retreat has taken his party to a far less reformist and more protectionist position than that adopted by Tony Blair or even his successor, Gordon Brown. In good part, that is because Cameron feared – rightly – that his party had less public permission to reform the NHS than New Labour ever had. Just as Labour found it hard to reform the military because we enjoyed less public trust on defence policy than the Right, so the Conservatives are finding the reverse is true in spades in education, welfare and health. As this episode proves, reform of the public services in Britain won’t be achieved from the Right: it has to come from the Left. So there is an open goal for Ed Miliband’s Labour Party. The temptation, of course, is for Labour to retreat to the comfort zone of public sector producer-interest protectionism – and there were signs of that in the party’s response to the Government’s U-turn this week. It would be unwise, in my view, for Labour to concede rather than contest the reform territory. It now has an opportunity to restake its claim to be the party of progressive, radical reform. It is only when we are that we win.

Edited by Tired of Waiting

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yep

they've done pretty well so far tho

Gove has rattled thru schools reforms amazingly

concern is over the next election, not just from libdems, but from Osborne too

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yep

they've done pretty well so far tho

Gove has rattled thru schools reforms amazingly

concern is over the next election, not just from libdems, but from Osborne too

Yes,

Was Gove more "discrete"?

Aparently Milburn thinks that should have been Lansley tactic:

"Andrew Lansley could have quietly built on these advances" but noooo... :lol: he started talking about it! :lol:

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Yes,

Was Gove more "discrete"?

Aparently Milburn thinks that should have been Lansley tactic:

"Andrew Lansley could have quietly built on these advances" but noooo... :lol: he started talking about it! :lol:

the NHS is by far and away the most difficult thing to reform, it is notorious for this, and i suspect the most talented tory front benchers knew to steer well clear - looks to me like Lansley got the role cos no-one else applied

it is a shame

politically - can you see how much more interest today's 'Black Wednesday' thread is receiving than this thread - people are tangibly less interested in reforms than they are frightened of instability, on HPC as everywhere else, in political terms tis means the govt could lose the next election over it if they are seen to go too far with the reforms, which IS (in both emotional and real sense) a logical possibility, not all reforms are necessarily good reforms

for what it's worth they seem to be doing well with the housing market, at least they 'get it', although that is much less of a political issue, benefits also, schools; we'll see in the next week what happens. They have forthcoming public sector strikes coming and need to win popular apporval to beat these however.

My guess is that continuing economic weakness is the culprit, and that reforms may get put off until next electoral term when hopefully tories will be revitalised by majority government, they will naturally be lesser, and the NHS will probably remain the behemoth it was, which is a shame.

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the NHS is by far and away the most difficult thing to reform, it is notorious for this, and i suspect the most talented tory front benchers knew to steer well clear - looks to me like Lansley got the role cos no-one else applied

it is a shame

politically - can you see how much more interest today's 'Black Wednesday' thread is receiving than this thread - people are tangibly less interested in reforms than they are frightened of instability, on HPC as everywhere else, in political terms tis means the govt could lose the next election over it if they are seen to go too far with the reforms, which IS (in both emotional and real sense) a logical possibility, not all reforms are necessarily good reforms

for what it's worth they seem to be doing well with the housing market, at least they 'get it', although that is much less of a political issue, benefits also, schools; we'll see in the next week what happens. They have forthcoming public sector strikes coming and need to win popular apporval to beat these however.

My guess is that continuing economic weakness is the culprit, and that reforms may get put off until next electoral term when hopefully tories will be revitalised by majority government, they will naturally be lesser, and the NHS will probably remain the behemoth it was, which is a shame.

Depressing.

I remember some old public "values" research showing that around 60% of UK population has liberal economic views. Pity liberal politicians (also a majority), are spread in all 3 main parties, and all hostages of their illiberal minorities.

Weird.

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Depressing.

I remember some old public "values" research showing that around 60% of UK population has liberal economic views. Pity liberal politicians (also a majority), are spread in all 3 main parties, and all hostages of their illiberal minorities.

Weird.

not the end of the world

Sweden has a much higher rate of public sector spend than the UK, falling rapidly under its conservative govt of the last 7 years or so, and also has a growing and vital economy, the Swedish conservative PM is personal friends with Cameron, and, hopefully, there is always a 2nd tory term to come

you should not discount the real progress made by this government, building on that from the early Blair years

the depths of a deep recession may not be the opportune time for swingeing reform of this scale, maybe we need to wait; even Thatcher didn't get everything done she wanted - do you want another Poll Tax?

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not the end of the world

Sweden has a much higher rate of public sector spend than the UK, falling rapidly under its conservative govt of the last 7 years or so, and also has a growing and vital economy, the Swedish conservative PM is personal friends with Cameron, and, hopefully, there is always a 2nd tory term to come

you should not discount the real progress made by this government, building on that from the early Blair years

the depths of a deep recession may not be the opportune time for swingeing reform of this scale, maybe we need to wait; even Thatcher didn't get everything done she wanted - do you want another Poll Tax?

I know... but it is soooo frustrating. I mean, the majority of the voters and politicians are economically and socially liberal, and yet, minorities can block reforms. Veeery frustrating.

A friend once shouted at the telly: "You can't change policies to suit the morons!"

:lol:

:(

I feel the same.

EDIT:

Edited by Tired of Waiting

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Why cant they just trial it in some (ie tory) areas?

Why's everything all or nothing?

ie Focus on Public transport might be appropriate in London, but not in Milton Keynes, instead we've got Prescotts morass of 'integrated' (should be disintegrating) transport everywhere. A non functional guided busway in rural cambridgeshire, train station car parks prohibitively expensive and so on.

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not the end of the world

Sweden has a much higher rate of public sector spend than the UK, falling rapidly under its conservative govt of the last 7 years or so, and also has a growing and vital economy, the Swedish conservative PM is personal friends with Cameron, and, hopefully, there is always a 2nd tory term to come

you should not discount the real progress made by this government, building on that from the early Blair years

the depths of a deep recession may not be the opportune time for swingeing reform of this scale, maybe we need to wait; even Thatcher didn't get everything done she wanted - do you want another Poll Tax?

Apparently we'll have smaller govt than that bastion of free enterprise the USSR USA come 2015.

http://blogs.telegraph.co.uk/news/neilobrien1/100076120/big-government-in-america-small-government-in-britain-and-germany/

WEO.JPG

FWIW i cant see us shrinking govt, i do see the USA becoming a socialist kleptocratic hispanic state a lot like central and southern america though.

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Apparently we'll have smaller govt than that bastion of free enterprise the USSR USA come 2015.

yep - but the republicans are currently (and have been under messrs Bush) one of the most corrupt statist corporatist conservative parties in the world, they have been terrible

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Apparently he idea that the NHS needed reform was nothing more than political dogma and it was in Milburn's hands that the decline started.

The NHS has been destroyed to allow the private sector into healthcare. In the future, this could well be seen as the most despicable among Blair's Third Way legacies of neo-liberalising the public sector.

Have a read -

http://www.opendemocracy.net/ourkingdom/colin-leys/plot-against-nhs

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Will the LibDems block Cameron's public services reforms, as Brown/Old Labour blocked Blair's/New Labour's?

Another 5 years of gridlock? :(

Alan Milburn's (New Labour health secretary, 1999-2003) article in the Telegraph today made me think so.

http://www.telegraph.co.uk/news/politics/8578226/This-NHS-debacle-sets-us-back-a-generation.html

load of rubbish tbh.

A lot of the proposed NHS reforms seemed to be for the sake of trying to get as much private sector involvement as possible and a bridge to privatising the whole lot.

For example there was no protections against private providers cherrypicking patients and services to offer leaving the gov no choice but to pick up the more costly complicated patients (see royal mail for a perfect, similar, example). The only criteria for the the oversight body was 'competition', not competition as a means to improve quality or services, but just enforcing as much competition as possible with it being the end goal itself. The private sector would have had a field day....

IMO the changes being made are much much better than the original reform proposals.

And looking at 'Andrew lansley's' wiki page its no surprise the original reform proposal came out as it did. Typical fill yer boots freeloading politician.

Edited by alexw

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A lot of the proposed NHS reforms seemed to be for the sake of trying to get as much private sector involvement as possible and a bridge to privatising the whole lot.

link?

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Why would that happen?

demographics mainly. Also total control of the media by corporatist groups, who ridicule and marginalist constitutionalist types and promote statist 'solutions'

We have the same problem's but not quite as bad a two (one) party system where elections are only one with huge amounts of money and airtime.

In short, its what the globalists and bildeburgers want. They'll all bugger off to the far east, and a poorer, more divided and more govt orientated USA will be easier to exploit.

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yep - but the republicans are currently (and have been under messrs Bush) one of the most corrupt statist corporatist conservative parties in the world, they have been terrible

Indeed. Palin is testament to this, as is the Repubs sidelining of Ron Paul, despite his popularity.

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Apparently he idea that the NHS needed reform was nothing more than political dogma and it was in Milburn's hands that the decline started.

The NHS has been destroyed to allow the private sector into healthcare. In the future, this could well be seen as the most despicable among Blair's Third Way legacies of neo-liberalising the public sector.

Have a read -

http://www.opendemocracy.net/ourkingdom/colin-leys/plot-against-nhs

The founder of that site, Anthony Barnett, is the author of "Soviet Freedom" (1988).

The Editor-in-Chief, Dominico Losurdo, wrote "Liberalism: The road from serfdom."

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load of rubbish tbh.

A lot of the proposed NHS reforms seemed to be for the sake of trying to get as much private sector involvement as possible and a bridge to privatising the whole lot.

For example there was no protections against private providers cherrypicking patients and services to offer leaving the gov no choice but to pick up the more costly complicated patients (see royal mail for a perfect, similar, example). The only criteria for the the oversight body was 'competition', not competition as a means to improve quality or services, but just enforcing as much competition as possible with it being the end goal itself. The private sector would have had a field day....

IMO the changes being made are much much better than the original reform proposals.

And looking at 'Andrew lansley's' wiki page its no surprise the original reform proposal came out as it did. Typical fill yer boots freeloading politician.

GPs and patients would buy services. I think that would have been the best way. Very straightforward. Now they've included NHS hospital doctors and nurses in these commissioning boards. This obviously distorts the choice in favour of NHS hospitals.

It shouldn't matter if a provider is private or public, only its quality and cost. GPs and patients should have the right to chose.

"Cherry-picking" would only occur if the NHS hospital had a distorted price lists - charging too much for something and too little for others.

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demographics mainly.

What do you mean?

Also total control of the media by corporatist groups, who ridicule and marginalist constitutionalist types and promote statist 'solutions'

We have the same problem's but not quite as bad a two (one) party system where elections are only one with huge amounts of money and airtime.

In short, its what the globalists and bildeburgers want. They'll all bugger off to the far east, and a poorer, more divided and more govt orientated USA will be easier to exploit.

Sorry, I have no idea what you are talking about.

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The founder of that site, Anthony Barnett, is the author of "Soviet Freedom" (1988).

The Editor-in-Chief, Dominico Losurdo, wrote "Liberalism: The road from serfdom."

Good for them, but the article is written by neither of them and based on a book, by neither of them. Did you actually read it?

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Good for them, but the article is written by neither of them and based on a book, by neither of them. Did you actually read it?

I read more than enough to identify the obsolete and mistaken ideology. For instance:

"The 'Plot' Against the NHS" = they believe in conspiracies, of this size and secret.

"Creating a bridgehead for the private sector" - using military language, and assuming that private providers would be worse than public.

"The shift to an unmanaged market" - health care is never totally unmanaged. Not even in the USA. And even if it were, it would not be as bad as a soviet style centralised command and control state organisation.

"Detaching the clinical workforce from the NHS" - more concerned with the providers than with the patients.

By the way, take a second look there and see how concern they are with the patients/tax-payers.

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Have a read of the article I posted.

by 'link' I implied something reputable or even semi-reputable

a pressure-group's website doesn't count; hell, the guardian or telegraph only half counts but it'd be a start

Edited by Si1

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I find Milburn repulsive - one of the pioneers of NuLab profiteering from legislation he had pushed through

And leftie Frank Dobson does a magnificently factual (abnormally factual by leftie standards) takedown of Milburn's boasts about private sector impact on the NHS

http://www.guardian.co.uk/commentisfree/2011/jun/16/alan-milburn-private-hospitals-nhs

But he is right in some ways. Whatever people thought of them, Lansley's reforms were carefully worked out. One cannot tinker with them (as the NHS Future Forum has done) and expect no harm. The only saving grace is that there may be more spin than substance to the trumpeted changes to reward the child-like Lib Dims with a fake prize to control their tantrums

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And leftie Frank Dobson does a magnificently factual (abnormally factual by leftie standards) takedown of Milburn's boasts about private sector impact on the NHS

http://www.guardian....e-hospitals-nhs

you say factual - but I thought he cherry picked some numbers Gordon Brown style and made an emotive soup out of them

eg

What did the private sector contribute to all these improvements? The most generous answer is "not a lot". Its contribution ranged from 0.07% of NHS patients treated in 2003/4 to 2.14% in 2009/10.

so he is saying that because the private sector currently only do 2% of operations then that's not good enough and means they shouldn't do any more. eh?

And the private sector creamed off straightforward, less-risky operations on patients who were otherwise healthy,

this strikes me as frankly bizarre

leaving the NHS to bear the cost of treating all the rest including complex operations, A&E, emergency beds, intensive care, professional training and long-term care. And for most of this period the private sector got paid 11% more per operation than the NHS got paid for the same operations.

sorry but I thought the private sector creamed off different operations to the NHS itself? And how much is 'most'

So the taxpayer has been getting nine operations for the price of 10.

but again, how much is 'most' and did you factor in NHS pension liabilities?

And that's not all. The private sector got paid for the operations they were contracted to provide but didn't do. Of the £1.78bn paid to the private sector no less than £230m (12.9%) was for operations not carried out.

and whose fault is that????

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