Is world-leading NHS healthcare an affordable proposition?

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Re-posted with kind permission from Progressive Pulse 14th October 2014

Authors:

David Laws, Consultant Anaesthetist, City Hospitals Sunderland NHS Foundation Trust, Sunderland, Tyne & Wear, SR4 7TP

Professor Charles S. Adams, Department of Physics, Durham University, Durham, DH1 3LE

Introduction:

The unquestioned assertion that a highly developed currency-issuing nation cannot afford high quality healthcare [1] is based upon a set of inter-related and almost universally-held false assumptions:
  • Money is in limited supply (as there is no ‘magic money tree’).
  • Taxes fund government spending.
  • Private banks lend out pre-existing savings.
  • NHS spending is a burden on the economy rather than a boost to the economy.

 

1) Money is created ‘out of nothing’ on bank computers

In 1973 the Bretton-Woods international exchange rate system, where currencies were ultimately pegged to the price of gold, was formally ended. Since that time we have used an international fiat monetary system where the value of each currency is determined by the workings of international financial markets. Fiat (Latin: ‘let it be made’) money is created from nothing on the basis of a promise – a promise to deliver goods or services in the future. Only if we believe in these promises and the systems that support them, does money have value.

The following description of the monetary system and its components is highly schematic to aid elucidation of the underlying principles. Money is created either when the government spends or when a bank makes a loan.[2] We can think of government spending and bank loans as the beginning of two interconnected money circuits. The government and bank circuits form the duopoly of money creation, rather like the pulmonary and systemic circulations of the cardiovascular system only in this case the circuits work in parallel. Both circuits are supported by the central bank which creates a unique type of money held within the bank known as electronic reserves (Figure 1). To extend the analogy of the cardiovascular system, the central bank is akin to the heart, individual bank accounts would be equivalent to the capillaries and the wider economy would be the working cells of the body.

The two monetary circuits commingle through banking transactions so bank money and government money become indistinguishable to bank account users. After money is created it flows through the economy and eventually returns to the issuer.

 

Figure 1: Schematic diagram of the monetary system of a sovereign nation. Bank account users cannot distinguish the origin of their deposits.
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2) The government money circuit – taxation removes money from the system

In the government circuit, money is spent into the economy and is effectively cancelled when it returns to the government via the payment of taxes. The collection of taxes is not a prerequisite for government spending as many people assume, but exists at the end of the government money cycle when taxes removed prevent too much money being created. Taxation mainly helps to control inflation and alter peoples’ behaviour in a way that should be beneficial to all. The net result of deficit spending is to leave savings in the form of Government Bonds in the hands of the private sector (Figure 2).

Figure 2: The government spend and tax circuit with a deficit. The difference between spend and tax equals private sector saving and is known as the deficit.

 

Conversely a government surplus (where taxation exceeds spending) would destroy these savings. The superficially sensible idea of running a balanced government budget simply prevents saving in the private sector. This is illustrated in models a) and b) within Figure 3. In a) the government injects money via a fiscal stimulus in year zero. Taxation means that over time all this money is returned. In b) the public choose to save a fraction of their income which leads to the deficit. Savings simply delay the return of money in the circuit. In other words, the private sector is only able to save money because the government supports this activity by running a deficit. The government circuit is leaky by design. For example, people are encouraged through tax breaks to save for their future (e.g. pensions & ISAs). Therefore, the national debt is not what we currently owe but what we currently own.

Figure 3: (a) model which shows that after government spend (fiscal stimulus) if people do not save then all the money comes back as tax, whereas if people save this leads to the deficit (b).

 

3) The private bank money circuit – banks create credit and don’t lend out savings

Most of our money is created in the form of bank loans (credit). When a loan agreement is signed the bank creates a new bank deposit to the value of the loan in the borrower’s bank account. Money is returned to the bank by the repayment of the loan plus interest (Figure 4). Similar to government spending, bank lending influences private sector behaviour but the allocation of money creation is not democratically controlled. The primary purpose of bank lending is to enable individuals and businesses to function and to generate profits for bank shareholders, both over the short and long-term.

Figure 4: The bank circuit where loans concurrently create bank customer deposits and private debt leading to bank profits.

 

Banks must have a licence issued by the government to create money in this manner and aspects of their activities are regulated. However there are no formal economic, social or environmental responsibilities associated with the creation and allocation of bank credit despite the significant influence these decisions have over our lives. Bank credit creation is predominantly distributed towards land (property) and financial asset speculation which dwarfs their support for entrepreneurship. The majority of UK small businesses are actually self-financing.[3]

As the proportion of unproductive private debt increases in an economy a correspondingly increasing proportion of economic output is directed towards servicing this interest-bearing debt. Consequently the private bank money circuit tends to be inherently destabilizing as it drives assets towards the already wealthy making the economy increasingly fragile.

What are the outcomes when the two circuits combine?

If all the money was returned to the issuers the quantity of money would go back to zero (the balanced budget illustrated in Figure 3a). In practice the rate of new money creation is usually higher than the rate of money cancellation and the total amount of money in the economy grows over time to support economic growth (Figure 5). Ideally growth in the money supply should match the growth in economic activity, such that prices remain roughly stable and we maintain confidence in the value of our currency unit. Control of the rate of money creation and destruction in the government and banking circuits are known fiscal and monetary policy, respectively.

Figure 5: UK Money (M4) Supply 1987 – 2017. Source: Bank of England.

 

The money supply increased significantly in the decades prior to the Global Financial Crisis (circa. 2007) primarily through bank credit expansion. In contrast, between 2009 and 2014 net credit was negative.[3] As bank credit creation wavered from 2008 onwards, government deficits rose to prevent a deflationary depression. The actual sector balance data for the UK is shown in Figure 6 and there is similarity with the simple model we presented in Figure 3. Note that the rest of the world is a net saver of UK money (these savings have to be spent in the UK ultimately). Note also that when these three sectors combine, the balance is near zero as this is nothing more than an accounting identity.

Figure 6: UK sectoral balances data from the ONS. The inverse correlation between Private and Public sectoral balances. Private sector savings mirror the public sector deficit as illustrated by the model in Figure 3.

 

Why two circuits?

Why do we need this duopoly of both a government circuit and a banking circuit? Why do we need both fiscal and monetary policy? As money is a collective good, should we transfer all money creation powers to government and demote private banks to the role of intermediaries as some propose? Or could we hand over all money creation to private banks as free-market fundamentalists would prefer?

Put simply, the commercial bank circuit serves private needs while the government circuit serves collective needs. The bank circuit exists to serve individuals and ‘capitalism’, while the government circuit exists to deliver on democratically controlled promises.

Economists often call our collective interests public goods. The failure of the private interest bank circuit to provide public goods is easy to understand by exploring healthcare. The market solution is to cater for the patient offering to pay the most. Even worse, the market may deliberately create a scarcity in order to charge a higher price. A market cannot operate effectively in matters of life and death. Kenneth Arrow a highly-respected pioneer of neoclassical economics and winner of the Nobel Prize in Economics in 1972 wrote ‘the laissez-faire solution for medicine is intolerable’.[4] In situations where competition is not viable, where demand is unlimited like health, and supply delivers societal benefits, then collective democratic control is the optimal solution. The House of Lords Select Committee on the Long-term Sustainability of the NHS report in April 2017 reaffirmed that the principal method of funding the NHS should be via government spending.[5]

What has gone wrong?

The art of economic management is to balance fiscal and monetary policy. An over dependence of one or other is doomed in the long term. The core failure over recent history lies in the inability of politicians and central bankers to regulate the banks and to use fiscal policy appropriately. There now exists UK Department of Health data to support the assertion that government austerity may be the primary underlying cause for the deterioration of health inequality measures in England.[6]

‘In her present condition, Great Britain resembles one those unwholesome bodies in which some of the vital parts are overgrown…and through which an unnatural proportion of the industry and commerce of the country has been forced to circulate, (which) is very likely to bring on the most dangerous disorder upon the whole body politick’. When one considers the unhealthy dominance of the financial sector within the UK and global economy today, it may be surprising to discover that Adam Smith wrote these prescient words in the Wealth of Nations over two hundred and forty years ago.[7]

In a similar vein, using central bank monetary policy alone to rescue the global economy has been misguided. In 1969, the world-famous economist, Milton Friedman said ‘The available evidence . . . casts grave doubts on the possibility of producing any fine adjustments in economic activity by fine adjustments in monetary policy’.[8] More recently, Mark Carney, the Governor of the Bank of England, reinforced this point in his ‘The Spectre of Monetarism’ speech published in December 2016 where he stresses that monetary policy needs to be in ‘better balance with fiscal and structural policies’. [9] The sudden change to no money growth after 2010 in Figure 5 is evidence of the complete failings of recent monetary and fiscal policy.

 

4) NHS spending boosts the wider economy in excess of the money spent

Fiscal policy is very powerful but needs to be carefully managed. The NHS was conceived and built in times of high national debt. This could occur because creation of money is not an inherent constraint. Thanks to the government spend and tax circuit, the NHS nurse, doctor, physiotherapist or pharmacist need not cost anything as long as (they serve a useful purpose and) the money spent on them is also spent. In fact, it is more likely that society will profit through ‘crowding in’ more economic activity through NHS employees’ subsequent spending and a healthier public.

It is estimated that the fiscal multiplier for UK healthcare spending currently lies between 2.5 and 6.1. This means for every £1 spent on the NHS approximately £4 of economic activity results.[10] If you had a cash-back card that gave you £4 back for every £1 spent, you would not cut back on your spending! Only when we reach a position of over supply when NHS staff wait forlornly for patients to present do we reach a point where the multiplier falls to below one. We are, at present, an unsafe distance from a workforce oversupply scenario.

As a sovereign nation, the UK can always afford high quality universal NHS healthcare. Money is essentially an accounting system designed to facilitate our collective activities and development. Fiscal policy needs to be activated to meet the needs of our society as there is now observable failure of the prevailing reliance on monetary policy and preservation of rent-seeking private interests. It is evidently wrong to assert that healthcare access and quality is limited by the availability of money. The constraint, in truth, has never been the potential availability of money, but the desire to resource the NHS appropriately. In the words of John Maynard Keynes, ‘Anything we can actually do we can afford’. [11]

References

[1] Department of Health annual report and accounts 2016 to 2017 https://www.gov.uk/government/publications/department-of-health-annual-report-and-accounts-2016-to-2017 (accessed August 2017)

[2] Money Creation in the Modern Economy. Bank of England Spring Bulletin 2014

http://www.bankofengland.co.uk/publications/Documents/quarterlybulletin/2014/qb14q102.pdf (accessed August 2017)

[3] Bank of England interactive database

http://www.bankofengland.co.uk/boeapps/iadb/newintermed.asp (accessed August 2017)

[4] Uncertainty and the Welfare economics of medical care. Kenneth J. Arrow. The American Economic Review December 1963. http://www.who.int/bulletin/volumes/82/2/PHCBP.pdf(accessed August 2017)

[5] House of Lords Select Committee on the Long-term Sustainability of the NHS. The Long-term Sustainability of the NHS and Adult Social Care Report Published 5th April 2017. p44. https://publications.parliament.uk/pa/ld201617/ldselect/ldnhssus/151/151.pdf (accessed August 2017)

[6] David Buck, King’s Fund  https://www.kingsfund.org.uk/blog/2017/08/reducing-inequalities-health-towards-brave-old-world (accessed August 2017)

[7] Smith, Adam. An Inquiry into the Nature and Causes of the Wealth of Nations. p468-9. Edited by S. M. Soares. MetaLibri Digital Library, 29th May 2007 (accessed August 2017)

[8] Milton Friedman and Walter W. Heller, Monetary vs. Fiscal Policy, W. W. Norton and Company Inc., New York 1969.

[9] ‘The Spectre of Monetarism’. Speech by The Governor of the Bank of England. December 2016. http://www.bankofengland.co.uk/publications/Documents/speeches/2016/speech946.pdf (accessed August 2017)

[10] Does investment in the health sector promote or inhibit economic growth? Aaron Reeves et al. Globalization and Health 2013. https://doi.org/10.1186/1744-8603-9-43

[11] The Collected Writings of John Maynard Keynes. Vol. 27 p270. Activities 1940–1946: Shaping the Post- War World: Employment and Commodities ISBN 978-1-107-65156-2

Dear Philip Hammond, Chancellor of the Exchequer

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A letter to the Chancellor of the Exchequer from Prue Plumridge

I feel I must write to you in response to your speech at the Conservative Conference in which you referred to the medium-term challenge of dealing with the public finances so as not to burden future generations.

Aside from the fact that your government has been promising to deal with the public finances for the past seven years whilst regularly moving the goal posts for achieving it, failed Tory promises show astonishing ignorance about how the state finances work in practice.

Or, is it, perhaps, that you do know but prefer to keep the public in the dark with fake messages about household budgets, living within our financial means, paying down our debts and saving for a rainy day.

You (and George Osborne before you) have abused the trust of the public with your myths and lies about maxing out the credit card and going broke.  Neither of which can happen in a sovereign currency issuing state.  I’m sure you know that really.  In truth, this has suited the pernicious ideology of the Tory government which claimed that Labour overspent and austerity was unavoidable.  Neither was true.  But, as a result, seven years of cuts to public spending have led to rising poverty and inequality through the redrawing of welfare provision and the decimation of public services not to mention the on-going attacks on employment rights and the rise of insecure working and the gig economy.

And, all the time, while you tell us that there is no money for those services upon which we all depend from the NHS, to public infrastructure and services and local government we are witnessing the ongoing transfer of wealth into ever fewer hands and public money being poured into corporate pockets.

Admit it, Chancellor, this exercise has never been about necessity.  It has always been about ideology which can be best expressed in the words of the former head of John Lewis who said recently ‘the only way to provide good public services is to ensure a vibrant business economy’ …… which is not only neoliberal bunkum trading on the lie of discredited ‘trickle down’ but shows how this false narrative dominates the mainstream and infects public understanding.  To quote Richard Murphy from Tax Research on the NHS  (and whilst he doesn’t mention it, public services too)

there is no reason why we should not have health care in thirty years’ time, whatever that care might be…… All we have to do is decide we want it. Then we can pay for it. It will not be a matter of not affording it. It’s just a matter of setting priorities. “

Moving on to your claim that borrowing takes money from the pockets of future tax payers is plain wrong to put it bluntly.

As the economist Professor Bill Mitchell notes “Each generation chooses its own tax rates and that means that the mix of public and private sector involvement in the economy is a political choice”

In this case yours.  Government spending in the form of deficits (assuming of course a government that takes seriously its responsibility for the well-being of the nation) can work on behalf of citizens to create a healthy economy and a fairer distribution of wealth.  This not only helps today’s citizens but also creates investment in public education, public health and other infrastructure which benefits both current and future generations.  Or, of course, it can, as in the case of the Tories and already noted, represent wealth transfer to the already rich and public money leaching into private corporate pockets.  And just to be clear as I can hear you whispering but what about the printing presses, inflation and Zimbabwe I am not suggesting that deficits don’t matter – they do but not in the way you tell us they do.  The fact is that whilst governments are never revenue constrained spending will always be limited by available productive capacity and resources.  And that is what has to be managed.  It should never be about balanced budgets rather it should be about creating a balanced economy.

So, Chancellor, in conclusion, I will finish by saying that a time is coming when you will no longer be able to fool the public into believing your household budget version of the state finances which has claimed that we can’t afford public services, the NHS and the welfare safety net.  They will then understand that you made a choice to deny them the public infrastructure that ensures a healthy economy and the well-being of their families.  They will understand that you played with their lives and their survival.

It is to be hoped that in the near future you will indeed have plenty of time as a shadow minister in her majesty’s government to reflect on where the Tory party went wrong but then again you probably won’t.

Regards

Prue Plumridge

Cameron’s ‘Predator State’ vs Junior Doctors

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RK on social media wrote (with a little editing):

An item on the news, said that teacher assistants were increasingly being used to teach full classes, some up to 30+ hours. PCSO staff are taking over much more of the standard police work and someone I know has just left a job taking bloods on wards, after little training, left alone to do the job on her own… and paid the same wage as a hospital porter.

I believe that by stealth, fully trained, higher waged professionals and semi professionals are being weeded out of many working environments.

Perhaps (just as nurses are taking over some doctor tasks) we will eventually only find the fully qualified in executive positions and barely trained, poorly paid staff will be undertaking most of the work.

Is this part of Hunt’s plans for the NHS, with doctors supervising a collection of underpaid individuals to deliver our health service?

We are fast heading to a worker bee situation, where cost cutting determines a very basic Health Care, Education and security for the masses except for those that can afford to pay. The rich will have the very best of care, education and security… further dividing an already horrendously divided nation.

This constant undermining of skills has been happening in industry for decades, where apprenticeships have ended and Mickey Mouse schemes qualify someone in a trade, after a six week course in a tech college.

It’s the bottom line that always matters most under capitalism. Skill, pride in workmanship, ethical standards of delivery, knowledge of the tasks, are all obstacles in the way of maximising profit. Perhaps that’s why we have so little of our industrial base left.

The argument is always: ” If we can’t be competitive, then we will take our manufacturing abroad to the third world”.

They can’t do that with health, welfare and education, so it has to be de-skilled to make it competitive. It’s also an attack on organised Labour, good pension schemes and secure employment. We all have to live in fear of the sack, or a wage freeze or as Public sector workers have long known, the gradual drip of outside tendering, ripping up of service agreements and eventual wage cuts and overtime payments.

While the working population is under increasing attack, there is a mirror image… one of unbridled growth in profits, bonuses and executive pay, for those that are ruining our nation.

 

I fully recognize the point RK is making and I think most of us could add even more examples of de-skilling of the workforce, whether in the public or private sector. However, he specifically puts the question:

Is this part of Hunt’s plans for the NHS, with doctors supervising a collection of underpaid individuals to deliver our health service?

Dr Bob Gill provides an answer:

The reality is that more qualified staff are being driven out in preparation for the de-skilling that is always part of healthcare privatisation and corporate takeover. For the UK, this is mapped out in the Five Year Forward View by Simon Stevens, the head of NHS England. Stevens used to be an executive of the US based private health care company, UnitedHealth.

http://koshh.org/the-connection-between-the-junior-doctors-contract-and-the-american-corporate-takeover-of-the-nhs

Motions at the BMA conference raised similar concerns that the future training plans could reduce the standards of patient care and safety; that by de-skilling doctors, de facto ‘sub-consultants’ would be introduced who could be paid less, and be subject to more rigid terms and conditions of service; that unacceptable power would be given to local hospital managers to determine training and workforce planning; and limit the career aspirations of many hospital doctors to a sub-consultant grade.

So how does this fit with ‘The Predator State’ of the title?

It is the term used by economist James Galbraith (2008 book) to describe this phase of capitalism in which politicians have colluded with the corporate and financial sectors to privatize public services, using …

‘The state as monopoly collector of taxes and corrupt distributor of the spoils to the private sector.’

This is certainly what is happening to the NHS. Only this week, Richard Branson took over the NHS Children’s Services in Wiltshire. He will be paid by the state for that provision and will doubtless introduce the usual cost-cutting measures to increase its profitability ie reducing the wages bill, weakening union representation and paring the service back as much as possible. Using under or unskilled labour to do the work of a highly trained professional is the obvious way to reduce the wages bill – wages will be the biggest drain on his profits. The UK government will pay Branson for taking on the service (probably with a huge subsidy) and in return, we will get an impoverished service.

So what, where, why?

Aren’t we told that the Tories are all about ‘free-markets’ and competition … but that sounds just like a rigged ‘market’.  How can Richard Branson possibly lose? Just as with the banks and care homes for the elderly, if the private company goes bust or gets fed up, the government will have to step in to pick up the pieces.  In other words, it is yet again …

‘Privatisation of profits and socialization of losses.’

 As Max Keiser pointed out, privatizing health, education and other public services provide great investment opportunities to hedge against more risky speculative ventures. And with another banking crisis predicted for the near future….

So why are the politicians going along with this rip-off of the nation?

Historically, we need to go back to Margaret Thatcher’s election in 1979, and even further back to Hayek on Mount Perelin in 1947.  Put simply, Margaret Thatcher couldn’t bear the Welfare State and wanted Britain to resemble Churchill’s wartime fantasy of pre-WW2…   The Austrian economist Hayek and his book ‘The Road to Serfdom’, offered her a political philosophy and economics that was an intellectual vehicle for her dreams.  The fact that his ideas were so diametrically the opposite of the Welfare State and a mixed economy meant that there were limits to how fast radical dismantling/restructuring could occur without provoking riots.  The ‘Boiling frogs’ strategy was adopted (put frogs in saucepan of cold water and gradually increase the heat – the frogs don’t notice until it’s too late).

The annual release of Margaret Thatcher’s Cabinet papers after the 30y rule confirms all this, and it is notable that this year, Cameron has stopped the release of a majority of the minutes from 1986.

But Margaret Thatcher was egged on and undoubtably manipulated by much bigger vested interests than her dreams of an England fit for Miss Marples and Agatha Christie. The City of London provided experts and consultants who saw the opportunity to return wealth and power to its ‘rightful heirs’ (and themselves) – those who we now call the 1% but more properly should be called the 0.1% or even the 0.001%.

It is highly significant that after the Great Depression, and in that short window of 1945-1979, the rich were not so rich and that has now been reversed back to ‘normal’.

Screen Shot 2016-02-15 at 01.49.36

http://gabriel-zucman.eu/files/SaezZucman2014Slides.pdf

 

Sadly, the LP lost its way in the 80s and bought into the idea that there was no alternative (TINA). Many actually believed in The Third Way. However as Tony Blair said recently, he had seen his role as to build on Margaret Thatcher’s achievements, and ironically, it seems that New Labour politicians continue to believe in ‘the wisdom of the markets’ when it is quite clear that George Osborne and the Republicans in the US do not.

James Galbraith insists that the original Monetarists like Milton Friedman were serious economists but after deregulation, market solutions were abandoned in favour of Crony Capitalism ‘in all important areas of policy-making’.

 For them, [a market solution] now serves as nothing more than an enabling myth, used to hide the true nature of our world. Ironically, only the progressive still takes the call for “market solutions”

http://economistsview.typepad.com/economistsview/2008/05/the-predator-st.html

In other words, we’re being spun a load of economic lies (like austerity, the deficit drama and competitive efficiency) which are intended to persuade us that the impoverishment of the next generation, to benefit the global over-class of super-rich, is unavoidable. And as it happens, we have a government of Old Etonians and aristocrats who belong to that over-class, as do their cronies, friends, relatives and future employers.

‘Cameron himself went to Eton, and the many Old Etonians in his inner circle include Oliver Letwin, minister for government policy; Jo Johnson, head of his policy unit; Ed Llewellyn, chief of staff; and Rupert Harrison, George Osborne’s chief economic adviser.’

http://www.theguardian.com/politics/2014/mar/14/gove-attacks-preposterous-number-old-etonians-cameron-cabinet

“What did the new class… set out to do in political terms? The experience of the past decade permits a very simple summary explanation: they set out to take over the state and to run it — not for any ideological project but simply in the way that would bring to them, individually and as a group, the most money, the least disturbed power, and the greatest chance of rescue should something go wrong. That is, they set out to prey on the existing institutions of the [ ] regulatory and welfare system.”

http://forensicstatistician.wordpress.com/2011/05/23/a-predator-state-the-worst-bits-of-capitalism-communism-and-feudalism/

So where does this leads us with regards to the junior doctors’ contract and Jeremy Hunt?

Jeremy Hunt’s behaviour really doesn’t make any sense if he wants a ‘seven day’ NHS. No-one can imagine that it is feasible, not without more doctors, more hospital porters, nurses, radiographers etc… and expecting 20bn worth of cuts to the NHS budget at the same time? The old adage is that if something doesn’t make sense, ‘Follow the Money’.

After the last 5y of Lansley’s Health and Social Care Bill reorganization and cuts, it is no surprise that hospital doctors feel demoralized, undervalued, over worked and now they are being threatened with a substantial pay cut. Hunt’s imposition of the new contract on the Junior doctors is particularly criticized for driving doctors to work abroad.

Thousands are set to quit the NHS in protest over plans to shake up hours… more than 6,000 requests have been made for the paperwork needed to practise medicine outside the UK.

http://www.mirror.co.uk/news/uk-news/junior-doctors-fleeing-country-after-7367186#ICID=sharebar_facebook

 

Well, the resulting shortage from a mass exodus of doctors would be a perfect reason for using under-skilled staff … and it could be even be spun as unreasonable doctors, disloyally abandoning the NHS.  Hence, the conditions of the NHS could be harmonized with the expectations of private health care providers.  And all who could afford it, would be tempted to go for private treatment… as in the two tier system of the US.

Hunt has good reason to want to upset and alienate the Junior doctors.  It seems all too likely that he would love the awkward squad to go.  Then he can move on to the consultants…

As James Galbraith writes:

There is no common good, no public purpose, no shareholder’s interest; we are the prey and governments as well as corporations are run by and for predators. The “failures” enrich the proper beneficiaries even as they “prove” government is no solution.

 

Fortunately, we’re not told the truth about how the economy really works… and there is no economic reason why a new courageous state could not (in time) restore the NHS to being an improved, truly nationalised service….  And it just so happens that Jeremy Corbyn supports full re-instatement of the NHS.  Fingers crossed.

http://www.nhsbill2015.org/jeremy-corbyn-supports-the-nhs-reinstatement-bill/

 

 

 

https://think-left.org/2012/02/16/the-nhs-and-tina-mrs-thatchers-ideological-anti-democratic-political-legacy/

http://www.taxresearch.org.uk/Blog/2014/05/23/this-mornings-political-landscape-is-a-victory-for-the-cowardly-state/

 

Conservative supporters seem to agree with Jeremy… Corbyn not Hunt

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(Comments gathered from around the web. All positive views of Hunt’s behaviour have been shamelessly ignored but there were hardly any.)

Most embarrassingly for the government, the daughter of former cabinet minister Andrew Mitchell, herself a junior NHS doctor, has called for Jeremy Hunt to be sacked, accusing the health secretary of misusing statistics and alienating “an entire generation of junior doctors”

Then there is increasing criticism from fellow Tory politicians. For example, Dr Dan Poulter MP, who was a health minister until last May and who led the early negotiations on the junior doctors’ new contract in 2014, described Hunt’s decision on Thursday as “a dark day for the NHS and the future of medicine”.

But most vitriolic are ordinary Conservative voters:

Hunt may have won the battle but has certainly lost the war.

When all is said and done, I think Hunt’s behaviour has been appalling and I don’t think we have heard the end of this.

Could anyone really say they would happily argue for Hunt’s imposition of the contract on the doorstep?

I object to the ham-fisted way in which Mr Hunt has conducted the negotiations and his serious misrepresentation of the deal he has imposed on junior doctors.

Patients and the electorate are not going to believe any politician from any party when it comes to what is and is not in the best interests of patient care. They are going to trust the doctors.

Junior doctors had nothing to do with Mid-Staffs and Morecambe Bay and to suggest otherwise is very disingenuous.

Mr Hunt you always sound extremely plausible when I hear you speak and the deal you have offered does not seem bad to me at all. But so many people accuse you of dishonesty that I do wonder if there’s no smoke without fire? If you have been dishonest in the past please ensure that you have learned your lesson and will be straightforward and honest from now. It is the best policy now and always.

Asking doctors to work anti social hours for, in many cases, a net pay cut. The 13% basic award is designed to distract public opinion away from the reduction in special payments.

The new contract seeks to extend anti social hours of working, without increasing staffing levels, but significantly reduced or eliminated special payments.

The BMA offer (rejected by Hunt personally when NHSE apparently thought it ok) was to cut the basic pay rise to 5.6% (from 11) and keep Saturdays as OOH. It was pay neutral. Doctors think working on Saturdays counts as anti-social. Hunt says not. I’m with the doctors on this one.

The NHS is already dangerously over-reliant on locum doctors who are paid ridiculously large amounts compared to junior doctors. Hunt’s action will increase rather than reduce this over-reliance and will increase the number of doctors who emigrate when they qualify, which is already significant, rather than work in the NHS.

A perfectly fair, cost neutral solution, acceptable to NHS employers was vetoed by Hunt. Crass pigheadedness! And for what gain?

A pay deal that leaves more than a few doctors worse off, not as many as the initial proposals, but still enough to be of concern. I have not had to take a pay cut in my career but I wouldn’t wish it on anyone (except perhaps bankers) let alone doctors who have to work weekends, nights and be on call.

Jeremy Hunt should resign now. He’s a disaster for the whole of the U.K., he has alienated an entire profession. He has caused untold harm for years to come as talented young doctors seriously now look elsewhere. Unless this man is thrown out of office, disasters such as these will continue.

A very sad episode this and not good to see these talented hard working people so angry with the government.

Just go Jeremy and do it soon and allow the next minister chance to repair the damage both to the NHS and us politically before it’s too late

Do the decent thing and resign now Mr Hunt.

Had labour done this we on here, quite rightly, would’ve been slaughtering them, the fact it’s actually us that are doing this is all the more painful

Are we trying to install Corbyn in number 10?

A petition calling for a vote of no confidence in Jeremy Hunt has collected over 133 thousand votes in less than 24h. This means that the petition will have to be considered by a Parliamentary committee and has the potential to end up as a debate in the House of Commons.

But let’s not forget that it was a great surprise when Jeremy Hunt was brought in to replace Andrew Lansley (after what another Tory voter called his ‘£3 billion of pointless reorganisation’).  After revelations of Hunt’s dodgy dealings with Murdoch over the failed bid to take over BSkyB, it was expected that he would be quietly dropped not promoted… but there is more …

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(Hat tip Tom Pride)

Jeremy Corbyn, Leader of the Labour Party, responding to Jeremy Hunt’s announcement that he will impose a contract on junior doctors, said: 

“Jeremy Hunt’s decision to impose a contract on junior doctors is provocative and damaging. Rather than helping to resolve this difficult dispute, his action will only inflame it.

“The BMA has continued to table proposals to settle the dispute. The fact that the Health Secretary is now simply trying to impose his will rather than negotiate, demonstrates a lack of confidence in his own arguments.

“We need to recognise the huge contribution junior doctors make and the years of training they go through to look after us. These are people dedicated to our health and our NHS. 

“Patients, doctors, the BMA and the public want an agreed settlement. What is now keeping this dispute going are the actions of the Secretary of State himself.

“More strikes now look likely. If that happens, it will be clear that the blame lies with the government, not the doctors.

“Even at this late stage, I appeal to Jeremy Hunt to go back and negotiate with the BMA.

“This government is reckless with our NHS and is now prepared to put patient care at risk in the service of its self-defeating austerity programme.”

Strange but true… it seems that many Conservative supporters are more in tune with Jeremy Corbyn over this, than they are with Jeremy Hunt and their own government.