h1

Will NHS chaos be an election issue for Cameron?

September 9th, 2011

Henry G Manson on the health changes

In a speech to the Royal College of Nurses GPs in 2008 David Cameron won applause for his election pledge against “pointless top-down reorganisation that aim for change but just bring chaos.”

Yet ‘chaos’ is surely a considerable risk now. The biggest restructuring of the NHS since it was created, contradictions running throughout the revised Health and Social Care Bill alongside £20 billion of efficiency saving targets. Oh and let’s not forget the real threat of industrial action in the NHS over pensions if the Nursing Times is to be believed.

A number of Conservative-supporting friends are clinicians. In the course of the last week I’ve made a point of speaking with them about what they understand will be the impact of the Governments’ revised health plans. They never shied away from telling me where Labour was getting it wrong. But their attitude was different this time. Among the four, three of them used the word “chaos” or “chaotic” unprompted. The other simply described it was “mad” and that we will be looking forward to his forthcoming retirement as a result.

I’ve never worked in the public sector, but what I do know is that with any dramatic organisational overhaul in the private sector there are inevitably are huge teething troubles even when staff are fully on board. That is still not the case within the NHS.

My sense now is that it will not be ‘privatisation’ in the health service that will alarm voters in 2015, but instead a general sense of ‘chaos’. Given his pre-election pledges, Cameron’s health bill risks making the implementation of his health plans a real election issue.

HenryG Manson @henrygmanson




  • Andy JS
  • Fluffy Thoughts

    Exeunt Omnes @185:

    tim @177

    A completely ludicrous idea.

     

    Wee-timmy is correct: A broken-clock…! :oops:

  • Tim B

    Scott P @198:

    If you’re a fan of course…

     

    If I was, you’re right – I was just pointing out as a public service to those stateside who do not want to spend the entire weekend watching Ground Zero stuff that there is an alternative, even if the Jets are 5 point favorites…

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    196, Mr. B, and F1 and rugby!

  • tim

    200 – I don’t see any reason why drug users would change their voting habits, just their supplier.

  • Oliver

    Fluffy Thoughts @189

    Why not raise personal-allowances whilst putting VAT on food (and other exempt products)? Surely the equalisation of taxes would be a good thing….

    Ignoring anything ideological, reducing income tax isn’t a good way to encourage short-term spending because many people will use the money to save or reduce debts.

    astateofdenmark @190
    That’s a compelling argument against it.

  • Scott P

    203. the Jets are 5 point favorites…

    Ooh, I might have a nibble at that :-)

  • Tim B

    Morris Dancer @204:

    Mr. B, and F1 and rugby!

     

    The Rugby is a) ppv, and b) on mainly in the middle of the night.

    F1 is problematic, depending on how much you spill on PB before I get to see it ;-)

  • Exeunt Omnes

    tim @205

    Are you mean those kind of drugs. Why did you not say so?

  • tim

    209 – Well I obviously didn’t mean the ones that already have VAT on them.

  • MrJones

    “181.Interesting article on policing for less”

    Only skimmed it but one point

    “An operation targeting prostitutes in London did not displace the problem – it solved it”

    It displaced it indoors.

    What the prostitute example shows again is how the cost/benefit for the supplier is different from the consumer and how because of that it’s better to target the user.

    The supplier of prostitution/booze/cigs/whatever gets a high benefit from it so to deter them you need a higher cost which is hard to achieve. The consumer of the product/service gets a smaller benefit so you only need to create a small cost to get them to stop.

    So you don’t have an operation to get street prostitutes off the streets you have an operation to get *their customers* off the streets. If the customers will only turn up if the prostitutes are indoors then the prostitutes will all go indoors.

  • wage slave

    69.

    I get worried when I agree with Mad Nad, but it is true that half the bus queues in Britain could produce a better chancellor than GideO. However her attaks on his personal ‘failings’ sound a bit rich.

    ” I just hope no one else was watching and the shame of having such an immature and tacky Chancellor, is all ours.”

    We all, doubtless recall that Mad Nad’s blog made out to readers that she was mainly resident in her constituency home in Woburn when it was in fact in Chipping Campden, Wiltshire, just down the road from her new boyfriend, Mr Butler.

    Mad Nad has a strange view of ‘honesty’. She says that she was encouraged by the police to make up a lot of the stuff on her blog for security reasons. Funnily enough, no other MP can recall receiving such advice. Perhaps it’s only Nad the jihadists are out to kill? .

    “I don’t lie,” says Mad Nad. “I never, ever lie. And I would defy anyone to go back over my blog and point out a single lie to me.” However, the thing about fact and fiction… “… is perception”. :-(

  • Exeunt Omnes

    tim @210

    Do all “medicines” have Vat on them, including those used in operations such as anaesthetics?

  • wage slave

    193.

    “BERLUSCONI SAYS ECB GAVE ITALY FOUR DAYS TO PREPARE AUSTERITY – BBG”

    How much notice, I wonder, did Silvio give the Bunga Bunga girls that the days of lush living would have to stop? I imagine he’s spending most evenings these days cuddling up to Angela Merkel.

  • tim

    213 – “Drugs, medicines or appliances that are dispensed by doctors to patients for self-administration, are taxable for VAT purposes. “

  • MrJones

    “Perhaps it’s only Nad the jihadists are out to kill?”

    I won’t argue with your general point but people who stick their head out of the trenchs on abortion – either way round – do get a *lot* of death threats.

  • Tim B

    Scott P @207:

    Ooh, I might have a nibble at that

     

    - and the Giants are only 3 point favorites over the Redskins…

  • Andy JS

    It’s very quiet on here tonight. Everyone gone to the pub?

  • Exeunt Omnes

    tim @215

    Thanks, but it did not answer my question. What about hospital stuff>?

  • MrJones

    FPT 120 “If they wanted to be most effective, they would aim at becoming a pressure group and selective stand against Tory candidate who are too Europhile for their taste.”

    That makes a lot of sense.

  • http://twitter.com/PlatoReturns Plato

    http://blogs.telegraph.co.uk/news/edwest/100103979/foreign-nurses-with-poor-english-a-risk-says-lord-winston-but-do-we-actually-need-foreign-nurses/

    It’s curious that in the debate about our need for immigration, one of the most frequently cited examples is the NHS, which, without foreigners, would collapse. During the leadership contest last year Nick Clegg pointed to a local maternity ward which, without foreign staff, would be unable to cope with the large increase in children being born. It never really occurred to anyone to point out that this baby boom is entirely driven by immigration, but thank God anyway for the overseas-born midwives without whom overseas-born women wouldn’t be able to use NHS hospitals.

    Immigration is a difficult subject, sentimentalised by the Left, so when it is combined with the National Health Service, the most sentimentalised of all subjects – criticising it in front of a Labour voter is like questioning the Virgin Mary’s honour to a Pole – its sentimentality increases exponentially. After all, you’ll be told, a third of all doctors are born overseas, and over 30 per cent of NHS staff are foreign.

    But do we actually need foreigners, or that many foreigners, in our health service? It’s a question almost never asked. Yet in the United States, which has a far more diverse work force, only 15 per cent of medical staff come from abroad. Why do we need, proportionally, twice as many?

     

  • http://twitter.com/PlatoReturns Plato
  • MrJones

    150 “And remember she and Warsi destroyed Nick Griffins career.”

    The QT ambush (temporarily) helped the BNP.

  • Andy JS

    “France’s Socialists have yet to come to terms with the modern world”:

    http://www.economist.com/node/21526894

  • MrJones

    223 should have been FPT 150

  • Andy JS

    Nigel Kennedy playing solo Bach pieces on BBC4 at the moment:

    http://www.bbc.co.uk/bbcfour/watchlive

  • http://twitter.com/PlatoReturns Plato
  • Tim B

    Andy JS @218:

    Everyone gone to the pub?

     

    Maybe they’ve forsworn the pub and suddenly caught culture and are listening to Nigel Kennedy instead.

    One can always hope ;-)

  • http://twitter.com/PlatoReturns Plato

    The other day we were discussing the merits of national anthems = here is alternative National Dress ;)

    http://www.telegraph.co.uk/news/picturegalleries/worldnews/8753493/More-Miss-Universe-2011-national-costumes.html

  • tim

    To answer the Ed West article quoted in ignorance at 221.

    Here’s some stats.

    In 1990/91 there were 18,980 “new” nurses entering the UK register from education and
    training in the UK (Fig 1). The annual number of entrants fell year on year to a low of just
    over 12,000 in 1997/8. This decline was a direct result of the significant reductions in the
    number of student places that were funded in UK nurse education in the first half of the
    decade.

    Between 1997 and 2004 the number of nurses employed in the NHS in England rose from 246,000 to 301,000 – as the previous govt had cut back on education places for English nurses these tended to consist of a large numer of overseas nurses, principally from The Philippines, Australia,India and South Africa.

    The number of overseas nurses registering peaked in 2001/2 at 16000 and by 2005/6 was roughly half that.In the same year approximately 8000 nurses moved abroad mainly to Europe,USA Australia and New Zealand, leaving a net inflow of around 4000 per year as the NHS nursing expansion continued.

    Hope that helps.

  • tim

    219 – I think all drugs are VATable but are exempted when administered by a health professional.

  • James

    Henry

    I really don’t think chaos is the correct phrase to use for Dave. There has been chaos in the NHS for years, due to the previous shower in givernment ie. MRSA filthy hospitals, billions wasted on managers instead of nursing staff. Thats chaos for you, any changes being made now can only improve the NHS.
    Anyway an election is nearly 4 years away, why the concern?

  • tim

    Holy of holies, they’re piling in on the Boy.

    @TimMontgomerie
    Tim Montgomerie
    Just watched Osborne’s GQ remarks. A Chancellor should be above Viz-level humour bit.ly/q1ap8f

    Oy, Monty, everyon is entitled to make w@nk jokes for a couple of years after their voice breaks, leave the inbetweener alone.

  • James

    232 Government .. Sorry folks

  • http://twitter.com/PlatoReturns Plato

    BBCRadio4 BBC Radio 4
    On tonight’s panel, Shami Chakrabarti, @benpbradshaw, Stephen Dorell and Sir Simon Jenkins. We’re in St Ives, Cornwall. #bbcaq

  • Lucian Fletcher

    England in danger of royally screwing this up.

  • tim

    232 – You know one reason why the English NHS is more efficient than the Scottish or Welsh?

    Because it isnt undermanaged.

    http://www.kingsfund.org.uk/press/press_releases/leadershipcommission.html

  • James

    233. Tim

    Isn’t it about time you and George got a room.. You seem to spend your life thinking about him.. Get a life man

  • wage slave

    O/T.

    Good evening, PB Bunnies in the electoral jungle. It is good to see some official Tories keeping up the struggle to prove Tereas May Right:

    http://www.thesun.co.uk/sol/homepage/news/3804167/Sir-axed-for-riot-race-web-jibe.html

  • tim

    238 – The Dave n Nadine, George n W@nk show is drawing quite a lot of press comment.

    What does a comparison of the two incidents tell us? First, that Dave can work a room while George can’t. No surprise there. Second, less obviously, that the two men’s sense of humour is similar. There’s a subliminal nastiness there and it’s bound up with class. This isn’t to say that posh people are uniquely nasty: every social group has its own brand of cruelty. But it doesn’t reflect well on the PM and Chancellor that they both resort to their own variety so readily…

    Osborne was attempting to extract a cheap snigger at the expense of his hosts. Dave would understand what he was trying to do. GQ? Vulgar. Good for a laugh. Nadine? Ditto.

    “It’s Darwinian,” a former speechwriter for Cameron told me the other day. “Dave and George basically like laughing at losers.” And people still think of the Tories as the nasty party. Funny, that.

    http://blogs.telegraph.co.uk/news/damianthompson/100104065/the-nasty-party-reveals-its-funny-bone/

  • tim

    239 – “Needless to say I did not mean to use any offensive racist term and was referring to the urban jungle.

    “As for the bunny bit, it was originally animals but I thought people might object to me calling fellow humans this so I chose something I thought was innocuous and also cuddly.”

    Sounds like he’s been taking advice from a certain fiction writing MP.

  • James

    237 Tim

    Read very slowly what you have written .. It makes not one bit of sense!

  • wage slave

    239.

    And some are even nastier:

    “http://www.dailymail.co.uk/tvshowbiz/article-2035324/BBC-Breakfast-girls-blast-Tory-MP-David-Amess-Botox-Jibe.html”

    Doesn’t Mr Amess have an INTERESTING sharp colour differentiation between his toplocks and his sideburns?

  • wage slave

    235.

    “On tonight’s panel, Shami Chakrabarti, @benpbradshaw, Stephen Dorell and Sir Simon Jenkins.”

    The three fellah’s are specialists who can discuss the gorgeous national elf service! :-)

  • Philippe Magnan

    @ Tim B

    How do you feel about Perry’s candidacy?

    Could Romney have fallen into a trap — where he’s got to sound like a Democrat, defending Social Security and scaring the elderly?

    How vulnerable is Perry on the issue of immigration?

  • tim

    243 – Ah yes David Amess, not the sharpest tool in the box.

    Brass Eye aroused controversy because public figures were fooled into supporting fictitious, and often absurd, charities and causes.
    The second episode was called “Drugs” and is one of the most successful. A voice tells viewers there are so many drugs on the streets that “not even the dealers know them all”. An undercover reporter (Morris) asks a purportedly real-life drug dealer in London for fictitious drugs, including Triple-sod, Yellow Bentines and Clarky Cat, leaving the dealer puzzled and irritated. He also asks the dealer if he is the Boz-Boz and says he doesn’t want his arm to feel “like a couple of fortnights in a bad balloon”. Later, Morris dressed as a baby with a nappy on and a red balloon-like hat on his head and again asked for Triple-sod and then says “last time I came here a friend of mine just got triple-jacked over a steeplehammer and jessop jessop jessop jessop jessop”. He explained that possession of drugs without physical contact and the exchange of drugs through a mandrill were legal.
    David Amess, the Conservative Member of Parliament for Basildon, was fooled into filming an elaborate video warning against the dangers of a fictional Eastern European drug called Cake and asked a question about it in Parliament.[1] The drug purportedly affected an area of the brain called Shatner’s Bassoon (altering your perception of time), can give you a bloated neck due to massive water retention (allegedly known in by-then-dissolved Czechoslovakia as “Czech Neck”) and was frequently referred to as “a made-up drug” (a drug, they were told, not made from plants but made up from chemicals).

    Mr. Amess: To ask the Secretary of State for the Home Department what action the Government propose in respect of the import of (a) khat, (b) gammahydroxybutyrate and (c) “cake” to the United Kingdom.

    http://www.parliament.the-stationery-office.co.uk/pa/cm199596/cmhansrd/vo960723/text/60723w10.htm

  • Mike Smithson

    I can see why Guido didn’t take up a nautical career – he’d have been known as Seaman Staines.

  • Philippe Magnan

    FYI — the support for Rick *Ponzi Scheme* Perry amongst Republicans is quite overwhelming.

    From Rush Limbaugh to Hannity to the Wall Street Journal to Natinal Review to the Weekly Standard — many many other influential voices are applauding the political courage of Perry: it’s a gamble that might pay off big.
    One caveat : Perry is expected to offer a more detailed plan on how to curb SS very soon; he’s expected as well to reassure the elderly that a President Perry won’t cut them benefits.

  • Sunil Prasannan

    247. Evening Mike

    And you were criticising my joke from yesterday? :lol:

    Did you hear about the East European who visited Haiti?

    He became a voodoo Pole!

  • Tim B

    Philippe Magnan @245:

    How do you feel about Perry’s candidacy?

    Could Romney have fallen into a trap — where he’s got to sound like a Democrat, defending Social Security and scaring the elderly?

    How vulnerable is Perry on the issue of immigration?

     

    Hi Philippe:

    It’s still early days for me in this campaign – as I said before, I’m just getting into it.

    What I got out of the debate is that Romney has upped his game a lot since the last one, had better zingers, faster come backs, and was generally comfortable.

    I felt that Perry was not comfortable in the debate, as he has been suddenly thrust from the state political scene where he rarely debated into the national one. He’s also vulnerable on the social security being a ponzi scheme charge, and so on.

    I felt Romney came out ahead of Perry. By the way Romney doesn’t defend social security, he wants to reform it.

    Regarding Perry on immigration, I don’t have an opinion yet.

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    Is this the latest line to be used?

    Man makes joke some think amusing, others think not.

    Behold the audacious potency of political philosophy! Tremble beneath the titan of oratory and rhetoric who hurl such mighty attacks like Zeus thundering bolts of lightning towards his foes!

  • tim

    247 – Osborne does seem to be trending furiously at the moment, and is plastered all over the right wing press.

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    Times for tomorrow:

    F1 qualifying at 1pm. I aim to, as usual, watch P3 then offer one or more tips at around quarter past 11.

    9.30am – England versus Argentina.

    2am – Scotland versus Romania [doubt it's worth watching in terms of both time and one-sidedness]

  • another richard

    This comment by HGM is spot on:

    “I’ve never worked in the public sector, but what I do know is that with any dramatic organisational overhaul in the private sector there are inevitably are huge teething troubles even when staff are fully on board. That is still not the case within the NHS.”

    Cameron has made a stupid mistake – NHS reorganisation (assuming that it is necessary) should have been left to a second term.

    It wasn’t a priority and no good could come from it politically.

    What the Conservatives needed to do on health was merely try to make things more efficient and convince people that the NHS was safe in their hands.

    And its very disappointing to see the criticism of HGM.

    The best thing about this site is that you can read a variety of views in both the articles and the comments.

    Which helps those with open mids get a better and wider wiew of the world.

  • oldnat

    tim @252:

    Osborne …. is plastered

     
    Did he go to the pub?

  • tim

    251 – Looking back it’s now obvious that its been a joke all along, all those references to his ‘rock of stability” and the “choppy waters” around his “safe haven” were all for a bet.

  • Tim B

    Mike Smithson @247:

    he’d have been known as Seaman Staines.

     

    with Master Bates and Roger the cabin boy?

  • Tim B

    What the dependably liberal Washington Post thinks of Obama’s ‘Son of Stimulus’ jobs speech…

    http://www.washingtonpost.com/blogs/fact-checker/post/obamas-jobs-speech-deja-vu-all-over-again/2011/09/08/gIQA9amvDK_blog.html?hpid=z1

  • Sunil Prasannan

    257.

    W. Anchor?

  • another richard

    Does anyone know when the FTSE was last higher than the DAX?

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    256, look how tim retreats before me, as a tottering lamb, yet uncertain upon its legs, flees from the roaring might of a hunting lion!

    Tell us, o tim, why you cite the UK as a relatively weak economy when the FTSE and DAX crossed over, when Germany’s borrowing costs exceeded ours for the first time in many a day, when the US lost their AAA credit rating and ours is intact, when the market still has faith in our economy and yet you do not?

    Could it be that your tongue works faster than your brain? Do you make your mind up, give voice and only then scramble for information?

    Why not turn your ceaseless activity to seek out facts, analyse them and then form opinion, coming to conclusions at the end of consideration, not before its beginning?

    Thou art a silly man, tim :P

  • tim

    261 -W@nker.

    St Pauls Educated Mr Osborne taught me that response to your oratory.

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    262, :P

    I forgive you, tim. Matching Morris Dancer, wielder of the Wiffle Stick and Master of Enormo-haddock, in debate is a great task :P

    Will you be watching England tomorrow? It’s a shame it clashes with P3. I’ll probably just watch the end of P3 and otherwise watch the rugby.

  • Tim B

    another richard @254:

    with any dramatic organisational overhaul in the private sector there are inevitably are huge teething troubles even when staff are fully on board. That is still not the case within the NHS.”

     

    The NHS is so huge, old fashioned and complex that re-organising it in any meaningful way would take a decade.

    Working out the process alone would take a couple of years.

  • Philippe Magnan

    Thanks Tim B.

    I’m sensing Perry’s being underestimated : I think his strategist Carney is playing a chess game :sacrificing a pawn or two to trap Romney into losing more ‘conservative ‘ credentials amongst the base.

    Is Perry’s team thinking beyond the daily noise of the media? What’s their medium time range strategy to neutralize Romney?

  • tim

    Actually, as a semi serious aside, its intersting that since the hacking affair the right wing press have been going after Cameron and Osborne in a series of class based attacks.

    It started with Peter Oborne but it seems to have run through the Telegraph, the Mail, Spectator etc – the implication that Cameron and Osborne are posh but a bit common, feral perhaps -discuss.

  • tim

    263 – England vs Argentina?

    I was hoping to find a BNP pub in London to watch it in so I could cheer on Argentina in solidarity with them.

  • Tim B

    Morris Dancer @261:

    Tell us, o tim

     

    That’s it! Following the comments about so many alphabetized Tims, should I let the Holy Grail influence me into changing my handle to Tim the Enchanter? ;-)

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    266, the Telegraph and Mail have never been pro-Cameron, and the Spectator offers many opinions.

    I’m not so sure I detect the same trend, but I rarely read newspapers.

    267, truly, you are a shining wit :)

  • http://thaddeusthesixth.blogspot.com/ Morris Dancer

    268, Mr. B, whilst such a measure would add clarity, I’m not a fan of name changes, as a rule.

    [It baffles me as to why we have such a huge number of tims here. There are also quite a few Richards and Davids, yet only one Morris].

  • Tim B

    another richard @254:

    Which helps those with open mids

     

    My mid couldn’t be more open if it was a hooker’s thighs ;-)

  • Tim B

    Morris Dancer @270:

    yet only one Morris

     

    - named after a car and part of an Elton John song ;-)

  • tim

    George Osborne and Eric Pickles are pushing for planning changes but oppose developments in their own constituencies

    Eric apparently successfully opposed a residential care home for 114 elderly people in Pilgrims Hatch in 2003, saying it would be a “heavy burden” on local services.

    I’m not sure that Erics the man to drive away pensioners with the Heavy Burden defence really, given his planning stance.

    http://www.guardian.co.uk/politics/2011/sep/09/ministers-hypocrisy-over-planning-regulations?CMP=twt_gu

  • Fat Steve

    tim @266:

    It started with Peter Oborne but it seems to have run through the Telegraph, the Mail, Spectator etc – the implication that Cameron and Osborne are posh but a bit common, feral perhaps -discuss.

     
    When everyone can see how hard you’re working, that’s not a good look.
    Trying too hard Tim. Have an early night, really.

  • History Boy

    273. Pilgrims Hatch?

    Is there no limit to the inventiveness of property developers and estate agents?

    It sounds like an ideal place to die.

  • MrJones

    I think the planning thing will come back to haunt the Cameroons because i doubt most of them understand what it means but it will probably take a while before enough people notice the consequences. Same with the energy bills.

    Until then they should be able to cruise on austerity acceptance.

  • Sunil Prasannan

    275. HistoryBoy

    Much older it would seem:

    http://en.wikipedia.org/wiki/Pilgrims_Hatch

  • History Boy

    278. Aaaargh – 12th century property developers. They cast a very long shadow.

  • MrJones
  • http://twitter.com/PlatoReturns Plato
  • Oracle

    A Libyan Islamist has told how he and his family were imprisoned after being “rendered” in an operation MI6 hatched in co-operation with Muammar Gaddafi’s intelligence services. The rendition occurred shortly before Tony Blair paid his first visit to the dictator.

    Sami al-Saadi, his wife and four children, the youngest a girl aged six, were flown from Hong Kong to Tripoli, where they were taken straight to prison. Saadi was interrogated under torture while his family were held in a nearby cell.

    http://www.guardian.co.uk/world/2011/sep/09/how-mi6-family-gaddafi-jail

    Who knows how true all these stories that are coming out, but there are some serious questions that need to be asked just WTF our intelligence services were doing aiding Gaddafi and who told them to do so.

    It is one thing to try to come to agreement with “enemies”, even to turn a blind eye to things (we know all that goes on the world stage), but completely another to be actively assisting them in these alleged ways.

  • Charles

    Exeunt Omnes @219:

    Thanks, but it did not answer my question. What about hospital stuff>?

     

    Hospital stuff would be prescribed as well, so would fall under the same classification

  • MODERATOR

    new thread