Malcolm Blair-Robinson's Blog, page 126
May 20, 2016
NHS Overspend
There is no wonder that the NHS has overspent because the funding model is mathematically dysfunctional. The problem is obvious. You cannot provide an infinite service with a finite budget. In other words the more patients it helps and who come through its doors, the less it has to spend on each of them. Imagine giving the big supermarkets a fixed budget and telling them to feed the nation for free. Nobody would starve but there would be waiting lists for Marmite.
To run a modern, up to date healthcare system which can offer timely treatment and care to everyone who needs it whenever that need arises, requires funding which expands with demand and is driven by demand alone. Yes there can be a framework and there can be restrictions on quasi-medical services which are more cosmetic than cure. But it cannot be the case that genuine demand restricts supply, causing waiting lists and backlogs as well as over complex management structures, leading to failures and overspend of the type we are now seeing.
Some countries use a part insured or fully insured financial model. We could go that way, but it would be a vote loser because the public prefer direct funding by taxation. That is fine but the taxation formula employed must be fit for purpose and expand to meet increasing costs and demand. The public, which means voters of every party loyalty or none, value the NHS more than any other service in the country. For too long there has been a myth that this is somehow free. It is not and moreover it is expensive to do it properly. Abolition of the irrational quango management system with its Foundations, Trusts and Commissioning Boards would help, as well as banning the iniquity of NHS doctors moonlighting into private practice. But the NHS is still going to cost. A lot. And the taxpayer has to foot the bill. Time for the government and all parties aspiring to replace it, to come clean about that.
May 18, 2016
The Queen’s Speech.
The most remarkable thing about the Queen’s Speech is that at the age of ninety, be-robed and with a heavy crown upon her head she can still make it with a firm voice and faultless delivery. There is no doubt that the Monarch herself is a good deal more remarkable than the stuff she had to read. Because the first majority Tory government since whenever is even more chaotic than the last one under John Major. Whilst Major had to contend with rebellions and insurgencies, Cameron has a cabinet and parliamentary party engaged in a full, declared and open civil war. So far the war has not reached our prisons, so this neutral ground has become the centrepiece of the government’s legislative programme, even though in its present form and led by Cameron it may not survive beyond the end of June.
Only yesterday these prisons were declared in the majority unfit for purpose by the government’s own inspector and are in their worst state of anarchy, violence, drug addiction and murder than for more than 100 years. Whether these latest reforms will fare better than previous attempts remains to be seen. The record is not encouraging. The health service, much reformed, is in serious financial trouble, and its services are declining to lower levels of safety and inefficiency as every day passes; education is approaching a crisis with cuts, re-organisations, exam cock-ups, shortage of places and new teachers leaving faster than they can be replaced; there are problems with the roll out of benefit reforms which are hitting the most vulnerable hardest; power generation is on a knife edge due to a failure to renew capacity; the economic policy appears in tatters with failed forecasts, missed targets and abandoned initiatives; manufacturing is in recession; these are just the obvious headlines which ignore a vast hinterland of confusion and decay.
The most alarming bit of all is that the Tories consider themselves to be doing rather well.
May 17, 2016
Downfall In Downing Street
Set in the mid nineteen nineties, this fast moving thriller lifts the curtain on sex, sleaze and corruption in high places as the long reign of the government totters to an end, following the ousting of the iconic Margaret Thatcher. The novel catches the mood of those times with a host of fictional characters who engage in political intrigue, sex, money laundering and murder, pursued by an Irish investigative journalist and his girlfriend, the daughter of a cabinet minister found dead in a hotel room after bondage sex.
Download £2.08 Paperback 8.99
The Anti-Establishment Vote?
This phenomenon, which started in Greece, is rampaging across the United States propelling Trump onwards and upwards and keeping Sanders in the race although he has lost the nomination but might win the presidency with more certainty than Clinton. It may be the contagion is settling here in the UK as well. This movement does not recognise party nor the verities of politics, it feeds any swing to vote against the governing establishment, the ruling order, the current state of things and whatever has gone before. This would explain why it is, when every detailed economic analysis argues that Brexit would be madness, the polls show Leave either ahead or neck and neck with Remain.
In other words we may be approaching an historically dangerous moment when the referendum campaign ceases to be about the EU and the merits of staying or going and becomes instead a vote against the status quo. People are angry, fed up and they have had enough. Time to kick the system in the teeth?
If they do the subsequent dental bill will come as quite a shock.
May 16, 2016
Vintage Thriller: Paperback or Download
The latest edition of this ever popular psycho-thriller, now in its twentieth year, has a dramatic new cover and is offered for a limited period at the special price of £5.99 paperback and .99p Download. A haunting tale of passion and the paranormal, written in the style of its setting in the 1920s.
A tiny English village slumbers on the Surrey/Sussex borders, but the pastoral exterior hides a number of nightmare secrets.
The return of a young man after a long absence stirs memories of the horrific murder of his mother and uncle years earlier and of an ancient curse delivered upon the family in Napoleonic times. The villagers’ unease grows as the young man embarks upon an affair with the local farmer’s daughter, and a series of mysterious deaths seem to follow in his wake. Full of authentic period detail, this is a tale which will haunt readers long after the last page has been turned.
May 15, 2016
Boris And Hitler
Boris making out that the EU is comparable to Nazi Germany’s conquest of Europe is bordering on the imbecile. Which is odd because Boris is supposed to be a clever man. To try and make out that the democratic and voluntary union of independent nation states for the benefit of trade, peace and human advancement is akin to the Nazi war machine with all its apparatus of genocide and enslavement, is preposterous and causes great offence to all those who suffered and lived through those tumultuous times. Unlike Boris.
This referendum campaign has now sunk into the gutter. We will have to wait and see if there is anybody in the cauldron of bad temper and infighting, which is the present state of the Tory party, capable of picking it up and dusting it down.
May 13, 2016
IMF Brexit Warning: Should We Worry?
In a word yes. With manufacturing in recession, external debt still the second highest in the world and growth slowing, the UK economy is in no position to embark on an economic adventure into the unknown. The IMF is lined up with practically every financial organisation of importance in uttering dire warnings of a Brexit Yes.
The Leave campaign have only themselves to blame for this assault on their credibility, because they have failed to come up with a coherent programme, based on detailed research and credible investigations, which demonstrates a clear alternative which has every chance of working. These Leave people have been plotting for this moment for over a quarter of a century and it is hardly confidence inspiring to find them now clueless, reduced to calling all these world class institutions unreliable and mistaken.
Yet there is a key point which Leave appear to have missed. Most warnings include a sterling devaluation. If this were significant and big enough to damage asset values, increase the cost of imports by a margin that every shopper would notice and make UK manufactured goods cheap in world markets, it might just spark an economic reboot which could lead to prolonged growth and long term prosperity as a trading nation independent of blocks. Maybe the reason they dare not play the card is because the pain of the transformation would be acute. In a country with the highest level of household debt in Europe the pain might difficult for many to bear.
May 12, 2016
The Bank of England Weighs In.
If the central bank of any country warns publicly of the risks inherent in a political course, a rare event, note is always and should be taken. The problem for the Bank of England governor and his senior colleagues is that the government to whom they are responsible is split in half and facing opposite directions in the most perplexing referendum ever held in these islands. Since we have not held many that maybe does not say a lot, but it is certainly the most important issue facing the whole of Europe today.
It is perplexing because of the divergence of opinion on what is a fairly simple question. Is it possible to unravel a trading relationship, political partnership and legal system developed over four decades, with its intertwined financial systems and corporate structures, without causing serious damage to the whole fabric of the economy which may take years to repair? Nobody seems to know the answer, which should cause alarm enough.
In such circumstances only a fool would suppose that the opinion of the Central Bank was a private matter, not to be disclosed to people whose whole lives might be messed up by the wrong move, but whose votes will decide the issue. The Governor of the Bank of England is not the Queen. He is most certainly not above a political move which might damage the economy and it is his duty to comment on the risk. The rest of us have to take the decision. Voting in ignorance for what is increasingly beginning to look like an unprepared flight of fancy, could lead to a very hard landing.
Brexit Thoughts 10: A Tory Civil War
If it is indeed the case that Brexit would destabilise Europe and that it would be a financial disaster with unquantifiable consequences, why on earth are we having this referendum? Surely to call it is madness? Or if it is instead the case that Brexit will bring great benefits in trade and jobs how exactly is this so?
The British public are faced with the extraordinary spectacle of a public contest between the serving prime minister and the man who intends to replace him, each in turn served by followers echoing blood curdling or Utopian prophesies depending on which side they are on, which rather than inform, simply confuse. The root of the difficulty is that this referendum is not really about Europe, it is about two wings of the Tory party, split ever since Thatcher and perhaps well before, finally busting apart and fighting it out.
This is democratically ridiculous. It is like a general election in which one party is fighting against itself from each side. If our economy was as robust as the muddled Chancellor as his fumbling Treasury assert, how is it that our shrunken manufacturing sector is now officially in recession? Is that truly a symptom of a strong economy? Whether it may be better to stay or leave seems to be beyond coherent analysis. What is clear is that with the economy in the state it is, this is no time to fool about with a referendum. It is like playing with petrol in a house already on fire.
