An interesting stat in today's Times: NHS funding has leapt from £35 billion when Labour took office to £92 billion in 2007-08. On the surface, I think most people would look at the basic piece of information and say well done New Labour. But as is the reality with many government interventions, the bare statistics do not tell the whole story. What has that £92bn been actually spent on?
Below is a letter to the editor printed in today's Times. It makes very, interesting reading and has been signed by 18 members of the great and the good of the medical world: (I have highlighted some of the key statements)
The Freedom of Information Act 2000 was, at least in principle, a good piece of legislation. It is not perfect and as far as I'm concern had too many ambiguities and exemptions. But all in all it made for a far more open government and public sector. Unfortunately, it seems it has been too successful and there has been for some time a growing force within Parliament to make MPs exempt from the law. This is, as far as I'm concerned, the most open and obvious show of contempt for the electorate I have seen for a long time. What makes them so special that they feel they above the law?
How about this for a health policy? Instead of putting patients in the more cost effective hospital, move them to the ones that are losing loads of money and cost more to run and then close down the more cost effective ones. Well that is the policy in the South East at the moment. Seriously. New hospitals built under PFI have over run so much that they are likely to be in permanent deficit. Not only that, but to close them down now would risk even bigger debts.
It's been reported on the BBC website that the cost of the ID card scheme has risen to £5.31bn. Why can't the government make estimates that are even in the same ball park as the final figures? Every time they value it, the cost seems to rise by another few hundred million. And you just know it isn't going to work when we all have to take them up in 2010 - there are going to be errors left, right and centre - a hacker's dream.
And so to another story of exceptional financial waste and total incompetence of management that only a government oversee. Back in 2000 one of the many, many legacies that Blair wanted to set in place was the city academy programme. So far only 46 of the 400 of these academies have actually opened yet the government has managed to spend £20m on consultants and £28m on project managers!
The countdown continues until the HIPs fiasco hits - everyone knows it's coming but I have all confidence that nothing will be done about it. Currently there are just 57 qualified inspectors for the North East, 76 for Wales, and 152 for London. The Government itself has said it needs at least 7,500 qualified inspectors to carry out the required number of assessments. The Tories have hit out saying that due to the shortage there will be more miles racked up by the few inspectors as they race around the country trying to get to all the houses.
An interesting story today about the British Medical Association and their calls for an independent NHS free from political control - not in keeping with the current poll on PL. The paper includes a broad outline of how they would like to see the NHS run in the future. Firstly they want to see the board appointed by Parliament, comparing their set up to a cross between the BBC and a board run nationalised industry. They would have a constitution setting out rights and responsibilities. It is hoped that by removing the politics from the NHS and day to day tinkering, it will avoid headline grabbing interference and let the professionals get on with the job. It will also allow a more localised service.
Secondly, there is reference to an inevitable "rationing" of services. This goes back to a phrase I first heard less than 12 months ago - providing "core" services. For me this is a minefield - what is a core service? Is an elderly granny with a poor hip part of the core service? Is someone with self inflicted lung cancer part of the core service? Is a new born baby with a 50/50 chance of living a core service? Who is going to define this? As far as I can see, health care is either a core service or it isn't - you don't draw the line a one kidney or age or anything else, surely? It is reported that the list of services provided should be decided through debate between politicians, professionals and the public. Well if that isn't going to be the most controversial impossible debate since we (apparently) solved the Irish question, I'm not sure what is.
Gordon Brown's tax credit scheme. Mr Prudent showing that, once again, he really does not deserve that nickname. Afterall, it is reported today that he is about to write off £2bn as unrecoverable after payments had been made out incorrectly or fraudulantly. That is equivilant to 1p on income tax. So that brilliant budget you did a couple of months ago, Gordon, where you took 2p off income tax (then abolished the lower rate and increased National Insurance contributions) was not only giving with one hand and taking with the other, it was also a waste of time because you've lost 1p in every pound all ready with this numbskull scheme of yours. It could have been 3p in the pound if your department could do some basic accounting. Ministers have already admitted that £5.8bn has been paid to people who should not have received the money! This is incompetence on an NHS scale and this is the man who will be running the country in little over six weeks.
Do I sense a Government climb down over Bingate? In what has become an issue of electoral importance, the fortnightly collections fiasco may have had an impact on the recent local elections. The Government can pour billions of pounds away on an ineffectual health service or go to war with another country based on lies and mis-information yet still keep the electorate onside; but inconvience our every day lives by not collecting our bins and voters will punish you. And punish those councillors they have. The Telegraph today picks up various councils that have introduced fortnightly collections and their opponants have picked up seats.
This may just be a case of putting two and two together and making any number you wish, but it is enough to have got this out of Ruth "Yvette Cooper is more respected than me and everyone knows it" Kelly - "Local councils may decide that the weekly bin collection is one aspect of their policy and they may want to introduce other measures to increase the rate of recycling. That is completely their prerogative. But whatever is done should be done in close consultation with local communities." Ahhh! The consultation word. So it's not a climb down afterall, just a consultaltion to make us all feel like we played a part on the democratic process. Oh well, better keep those bins in for another week then...
One of the worst pieces of privatisation ever embarked on by a government was the Railways Act 1993 under John Major. It was a complex piece of legislation and opposed by just about everyone - including the Labour party. They disliked it so much they promised to renationalise the railways when they got in and the Tory MP and chairman of the Transport Committee at the time, Robert Adley, described it as the "poll tax on wheels".
The proposed split of the Home Office is fast approaching. In a department that has just taken its latest victim with John Reid announcing his retirement from front bench politics at the weekend (nothing to do with the fact the Brown would have pushed him anyway), it has been deemed too difficult a department for one man to run. In the past 6 years, Straw, Blunkett, Clarke and Reid have all failed where many have before them. So, the solution is to split the department up leaving the Home Office to largely tackle terrorism and merge the National Offender Management part with the Department for Constitutional Affairs. This is what has become known by the press as the Ministry of Justice. Brilliant. Not sure what benefit we will be from this, but the Ministry of Justice sounds very Marvel comic. I also can not tell you how much it will cost, because the Government won't tell anyone. However, expect it to be mind boggling large as government estimates (and we all know how short they often come up) suggest.
Traffic Wardens. They have to be, rightly or wrongly, in the top ten least liked people on planet earth. Right up there with estate agents, lawyers and well, MPs probably. I personally can not stand them, though I'm sure as individuals out of that ridiculous "trying to look very official" uniform there are one or two nice ones. After all, they are just doing their job. And, if you follow that logic to it's conclusion, I blame and dislike the councillors even more! And they are only making it worse for themselves.
Big brother really is watching you. From a discrete plane fitted with military spy equipment. Unlike the Big Brother from Orwell's 1984 though, the version of Big Brother the local councils are producing is more of an intrusive, nagging, holier than thou mother in law. Incredibly, spy cameras are being used to monitor the energy efficiency of our homes. This information is then being put on a website, presumably so mobs of green nutters can come and throw stones at your window and sing songs about flowers and the sun gods.
A friend of mine wrote me an email yesterday saying that every time he reads a story on Picking Losers about the NHS it puts him in a bad mood. I promised him I would try and post a positive one as soon as I can. Well, here goes...
From one IT system to another. The MTAS chaos rumbles on and the full reprocussions are going to be felt by the mugs that paid for it in the place - the users and funders of the NHS, you and me. Patricia "only a few weeks left and I'm out of the job" Hewitt has insisted that the system will not be put back up until the DoH is satisfied that all the problems with it have been resolved. And quite rightly, though it doesn't mean that the knock on effects aren't going to create even more trouble. This has led to warnings from consultants that operations could postponed this summer due to a shortage of junior doctors.
"Chaos as Government IT system grinds to a halt". Guess which IT system I'm talking about. MTAS? The Child Support Agency's IT phone system? The NHS's £12bn upgrade system? The criminal records bureau? The answer, of course, could be all of them. However today I'm referring to the latest incredible waste of public money and seemingly unending incompetence of the government when it comes to IT projects that is occurring in our registry offices.
With only days to go before Tony Blair steps down as our leader after 10 years, the debate over democracy is likely to hot up. Watching Hazel Blears bumble her way through five minutes of complete illogical nonsense whilst being grilled be the ever rude and slightly (unintentionally) amusing Jeremy Paxman on Newsnight last night made me begin to think about the issue slightly more than I had previosuly. There were two clear issues raised in this interview that summed up new Labour (and probably the Tories as well).
As predicted, the Home Improvement Packs (HIPs) debate is rolling on and intensifying by the day. The Lords merits committee, chaired by Lord Filkin, published a report on the committee's findings, which concluded "We cannot but conclude that the government has not been able to convince the principal stakeholders in the housing market that their proposals as they now stand are worthwhile or sensible, or are likely to be effective for their declared purposes." In other words they are a complete waste of time and money.
Surprise of the day: Labour party peers were 10 times more likely to get cushty jobs with government quangos than opposition counterparts. Twenty Labour peers to only two Tory and three Lib Dem peers have been handed top public sector posts - some earning up to £200k; though I guess they need the high earning salaries more than the Tories or Lib Dems to pay for their peerage in the first place.