Malcolm Blair-Robinson's Blog, page 37
January 19, 2019
Seeing a GP.
The GP concept is at the heart of a lot of the problems in the NHS. At the beginning, when the NHS was founded, doctors in General Practice did not approve of it and were refusing to join. The Labour government caved in and allowed them to remain independent but under contract to the NHS. This pseudo independence is a bit like having an army part made up of mercenaries. Very useful when the going is tough but not part of the defence structure. The idiotic Commissioning Boards set up by Cameron’s government, supposedly to improve things, made them worse. Some Boards work, some of them don’t but the fragmented nature of the NHS costs billions in the failure of joined up records, planning, and budgeting and, most important, diagnosis. The result is waiting lists and A&E bottlenecks.
The first port of call when feeling unwell should be a combination under one roof of nursing, pharmacy, paramedics and ancillaries such a physiotherapy. Most everyday ailments do not go beyond this skill set. For something more serious the Personal Doctor, not a GP under contract in a separate organisation, but an NHS employee integrated into the whole network, should not only have the ability and resources to treat medically straightforward conditions, but also all the equipment required to arrive at a reliable diagnosis, so the if a referral to hospital is required, it will be to the right specialist.
This would transform what is an office visit of ten minutes time allocation, to a proper medical consultation and diagnosis, putting the patient on the right path from the very beginning to either treatment or hospital referral. In turn the consequential streamlining would cut demands on A&E and reduce waiting lists. But first the nonsense of self employed GPs has to end. General physicians have to be integrated into the NHS team.
January 18, 2019
Trade Deals? There are None
It has now emerged that in spite of promises to ‘replicate’ the more than 50 trade deals the UK has with third countries through membership of the EU, including Japan and Canada, none have been made ready for signature nor are anywhere near being ready by March 29th. Trade deals turn out to be much more complicated than the International Trade Department expected (!).
At the moment, as well as the trade deals with the 50+ we have free trade, freedom of movement of people and capital, the right to live and the right to work, in all or any of 27 countries in the EU, which is the largest single market in the world and the biggest in history.
So if we crash out in the No Deal ecstasy of the nationalist Brexiteers’ dreams on March 29th, we will go from being part of the biggest trading group ever and the greatest personal freedom we have ever enjoyed, to trade deals with nobody and old fashioned travel restrictions we have long ago forgotten.
This has to be stopped. And as for that rubbish about doing what the British People voted for, nobody, NOBODY, voted for that. The British people are not anywhere near as stupid as their politicians.
January 17, 2019
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May Has the Confidence of Parliament: Really?
Not on this Blog’s reading of the facts. The Tory party is terrified of an election in which it fears it would not only lose power, but its nationalist wing believes it might lose Brexit as well. The Government’s life support, the DUP, have only 36% of the votes in NI, are a Leave party in a Remain province and fear what could happen not only to them but also to the Union, on their terms, with the UK. So two political parties cobble together an alliance of opposites to stay in power, but the government they have sustained is entirely dysfunctional and cannot actually govern. All this talk of reaching here there and everywhere and finding consensus is rubbish. As is the notion that a majority will emerge. Something which is not there cannot emerge.
Sooner or later something is going to blow. When it does there will be a big bang. When the dust settles things will have changed. Everything in fact.
January 16, 2019
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Brexit Historic Vote: May Beaten: Now Ask The People
Wow! Yes. Some say the biggest defeat in the history of the Commons. Does it resolve anything? No.
The problem is that we have a flexible unwritten constitution which is now flexing, so what should have happened last night didn’t and what will happen is unclear. There is talk of reaching across the House. Meaning? There is talk of going back to Brussels for tweaks. The unanimous answer from the whole EU, all 27, is forget that until you have AGREED In Parliament what it is you want. And at the moment that seems impossible.
What should have happened last night was that the government make the vote on May’s flagship deal on which she has staked all, a confidence motion. In the old system, which we had up until perhaps the Fixed Term Parliament Act, defeat of the government on a flagship policy would have led to the government falling. But not now. Even a record defeat. The confidence motion comes next. The slippery May knew she would lose her flagship but will win her confidence vote on Labour’s motion. So the total fiasco of a party split so deeply on the main, almost now the only, issue of the day to the point where it cannot govern is, under the new arrangements, going to carry on nevertheless, without direction, policy or purpose. The old system which invested our rather quirky approach to democracy with a world reputation for providing firm government, ends up being unable to offer any form of effective government at all.
In other words before there was a check on putting party survival above the national interest. But not now. Meanwhile people have been saying that parliament will ‘take over’ or ‘take control of the government’. It is now urgent that parliament shows us how it plans to do this. There is of course another way. Ask the people. That is what democracy is supposed to be about.
Hello government! Are you listening? Ask the people. That is the way of democracy.
Hello. Is anyone there?
January 13, 2019
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May’s Mistakes
To stand for election as leader of the Conservative Party was a mistake because Theresa May has neither the imagination nor flexibility for successful leadership in times of division and change.
She tried to build a coalition between two opposing views within the Tory party, when she should have been building a coalition for a sensible Brexit across the House of Commons from like minded MPs from all parties. This would have given her a substantial majority.
She failed to understand, like many others, that the Union would not survive, in the long term, a hard Brexit. First Northern Ireland will link up with the the Republic of Ireland to preserve the Peace Agreement and to remain in the EU, which is what the majority in NI voted for . Later Scotland will peel off to join the EU. Spain has declared Scotland will be welcome.
She also failed to see that to preserve the Union and avoid acute social and economic disruption in the short to medium term, the ‘clean break’ notion of Brexit was undeliverable. Both require the UK remaining in the Customs Union and the Single Market.
She called an election and lost it.
May then made the big mistake of inviting the DUP, a Leave party, out off step with Northern Ireland which voted remain, to be the partners to prop up her government which, because of her other mistakes, was now fatally split on the key issue of the day. During the critical months of negotiation this gave the hard Brexiteers too strong a hand, which when they finally played it, turned out to be much weaker than they thought at every level. This finally showed her attempts to appease them not only futile, but unnecessary.
The outcome of this string of leadership mis-steps is political chaos and a national crisis. May believes she can tough it out, even suffer the loss of the vote for her deal tomorrow, and somehow find a way through to deliver a workable Brexit which will satisfy everybody. That could turn out to be one of the most remarkable ‘leadership from the edge’ success stories ever, or her biggest mistake of all.
