1/12/09
Heron's Eye: 12/01/08
"Lady Amos, who was international development secretary and leader of the Lords in Tony Blair's government, has taken up a directorship with an African private equity firm, three months after it received over £15m from a Whitehall agency wholly owned by her former department.
The timing of Amos's appointment was described as "a coincidence" by the Commonwealth Development Corporation (CDC), which approved the cash – amounting to nearly 30% of the funds raised by Travant Capital Partners, based in Nigeria." [Guardian]
Labour's new blog courts best leftwing thinkers on the web
"LabourList.org was controversial even before it was born, with established Labour bloggers complaining at being left out, and Tory bloggers warning that it would be so heavily censored as to be little more than party propoganda." [Guardian]
Peter Mandelson ushers in a virtual New Labour revolution
"The unveiling of Peter Mandelson's avatar in Second Life is part of Labour's push to beat the Conservatives in the political use of new technology, but it also has a symbolic significance. Unlike the rest of Second Life, where people drop a decade or two from their looks or masquerade as animals, Peter Mandelson will actually look like Peter Mandelson. What you see is what you get....
"How independent the blog will be remains to be seen – it has already recruited Brown's former spinster Charlie Whelan – but there is no doubt that there is a gap to be filled in generating unconventional ideas for Labour at a time when almost every policy area is in a state of flux – particularly what on earth can be done to stop the economy from imploding." [Guardian]
Gordon Brown hits back at Tory debt accusations
"Gordon Brown today accused the Conservatives of neglecting the interests of children as he and David Cameron clashed over which party has the best economic policies for Britain.
The Tory leader unveiled a new poster campaign accusing Brown of saddling every new-born baby with a debt of £17,000 because of the mounting level of public sector borrowing." [Guardian]
New babies born with £17,000 debt, claims David Cameron
"Rapidly rising government debt means every baby born in Britain starts life owing £17,000, David Cameron claimed as he launched a new publicity campaign today.
The Tory leader made the claim as his party unveiled a new poster designed to highlight what it calls Labour's "debt crisis".
The poster, which will be displayed at 260 billboard sites across the country, features a photograph of a baby and the slogan: "Dad's nose, mum's eyes, Gordon Brown's debt – Labour debt crisis: every child in Britain is born owing £17,000. They deserve better." [Guardian]
Letter: Filleted statistics
Your leader (8 January) and Marcel Berlins's plea to politicians (Let's stop fighting over the figures in 2009, 5 January) highlight the extent to which criminal justice has become a party political football. In such a fevered climate it can often seem as though statistics have been filleted to expose evidence that a political opponent has gone "soft on crime" rather than to understand what might be effective and in what circumstances. Sadly, the end product of much good work by researchers is to feed the fear of crime and pleas for ever tougher punishments. How else can we explain the lack of attention given to the excellent research into restorative justice, which shows that victims of crime who have such meetings with offenders are far more likely to be satisfied with the process than those who experience the traditional court process? Less than 1% of victims of adult offenders have access to restorative justice." [Guardian]
Gaza crisis is having 'profoundly unhealthy' effect on UK Muslims, minister warns
"The Israeli onslaught in Gaza is having a "profoundly acute and unhealthy" effect on British Muslim communities and "patience is running out", a government minister has said.
The justice minister, Shahid Malik, told the Guardian there was "immense anger" in British Muslim communities over developments in the Middle East. He said: "There is a real feeling of helplessness, hopelessness and powerlessness among Britain's Muslims in the context of Gaza and the sense of grievance and injustice is both profoundly acute and obviously profoundly unhealthy."" [Guardian]
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Grimsdale's Ire: 12/01/09
"Boris Johnson confirmed today that he is preparing to challenge the government in court if it "fails to see sense" and gives BAA the green light to apply for a third runway at Heathrow.
The mayor of London urged the government to reject the plans, as both sides ramped up pressure ahead of the government decision, which is expected soon." [Guardian]
Cameron refuses to rule out Clarke return to shadow cabinet despite noises off from eurosceptic right
"David Cameron has received a stark warning from the Conservative right against bringing the ex-chancellor Ken Clarke back to the frontbenches, with a former minister saying the return of the outspoken Europhile in a year of European elections would "split the party".
The Tory leader is tipped to reorder his frontbench team in the next few days, but over the weekend the former Tory chairman Norman Tebbit said his one-time colleague was too "lazy" for frontbench life, while Stuart Wheeler, the party's biggest donor and a staunch eurosceptic, said he would consider withdrawing funding if Clarke was given a job." [Guardian]
Government 'repeating mistakes' by fighting miners in court
"The government is spending millions of pounds in legal fees fighting the claims of sick miners in a move that lawyers say will recreate the mistakes of the past.
Miners suffering from knee problems and chronic lung disease from inhaling dust on the surface of pits were not included in a previous compensation scheme and are being forced to fight for compensation in the courts." [Guardian]
Haroon Siddique: Prince Harry's racist comments still have the power to divide
"Despite Prince Harry's past misdemeanours and the undistinguished record of his grandfather when it comes to race relations, I was still shocked when I heard that he had used the word "Paki". But what surprised me even more were the attempts to play down the nastiness of the term or to pass it off as a term of endearment.
Listening to a Five Live radio phone-in this morning there were a number of people calling in who suggested that it was a mere abbreviation, of the same ilk as "Brit" or "Aussie" and therefore equally inoffensive. But to make such an argument is to ignore the history of use of the word "Paki" in this country. Growing up in west London in the 1980s it was difficult to escape the insult. I was called a Paki numerous times throughout primary and secondary school, as were Asian classmates – regardless of whether they were actually of Pakistani heritage. Sometimes it was spat out by strangers on the street; at other times it was used by supposed friends registering their anger because I had, for instance, misplaced a pass playing football. Often I would respond with my fists, so hurt and impotent did I feel at the time." [Guardian]
Police squads 'deter ethnic minorities'
"Black and Asian police officers still believe specialist squads are "closed shops", dominated by white middle-aged men and a "canteen culture" of working hard, playing hard and drinking hard, according to a report by the Equality and Human Rights Commission, 10 years on from the Macpherson inquiry.
In a major review of the attitudes of police in England and Wales towards race since the Stephen Lawrence case, the commission reports that ethnic minority officers were put off by perceived "old-fashioned working practices" and felt that robbery, anti-terrorist and firearms units were open only to recruits whose "face fits"." [Guardian]
Redundancy: Don't suffer in silence, says Jon Robins
"It is reckoned that every day this year as many as 1,600 people could lose their jobs. That's 600,000 jobs gone in the next 12 months, according to the Chartered Institute of Personnel and Development. Despite the numbers it is almost impossible not to take redundancy personally. It strikes at our core.
As a society we are increasingly - and some would say unhealthily - work-obsessed. Many of us define ourselves through what we do for a living, so job loss attacks our self image, as well as undermining our personal security and ability to provide for loved ones. Don't underestimate the emotional impact of redundancy; those on the receiving end need to rely on their partners, family and friends for support. Loved ones, in turn, need to be there to provide that support." [Guardian]
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10/28/08
Grimsdale's Ire: 28/10/08
The toilet roll of reason and the burger box of justice
Simon Hoggart takes a light hearted look at how crime and punishment is being questioned in the House of Commons. [Guardian]
Tory thinkers offer lesson in equality
Polly Curtis describes an influential new Policy Exchange report on reforming schools funding. [Guardian]
There's cynicism at the heart of the communities agenda
David Clements makes a concerned critique of the Sustainable Communities Act, suggesting that its motive may be to build political legitimacy rather than promote democracy. [Guardian]
Unions prepare big pay demands to offset food and fuel price rises
“Substantial pay rises are being sought to compensate for sharp increases in energy and food prices, the union-funded Labour Research Department warned last night.” [Guardian]
Child support changes could hit 25% of lone parents, warns charity
"Changes to the way lone parents receive child support could see a quarter falling through the system, a charity warned on the day government reforms come into effect. From this week, separating couples on benefits - who make up 70% of child support claimants - will be encouraged to reach their own arrangements voluntarily, leaving the government's new Child Maintenance and Enforcement Commission to concentrate on those cases where people repeatedly refuse to pay maintenance or regularly default." [Guardian]
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10/27/08
Heron's Eye 27/10/08
Political hypocrisy - don't you hate it?
Michael White analyses the Machiavellian positions that politicians take to appear honest and compares it with historical politicians from the past. [Guardian]
Tories face call to repay Rothschild £1m loan
“The Conservative party faced demands last night to repay a huge loan from a member of the Rothschild banking family made through a company set up with the sole purpose of protecting her anonymity.” [Guardian]
Survey shows George Osborne affair has tarnished Tories
Deborah Summers on how the Oleg Deripaska affair appears to have impacted on the Conservative part’s image. [Guardian]
“A group of economists has attacked the government's Keynesian strategy to spend its way out of the recession as "misguided and discredited". Further big increases in public-sector spending would make the state's role so dominant it would stunt the private sector's recovery, they say in a letter in yesterday's Sunday Telegraph.”[Guardian]
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10/20/08
Heron's Eye: 20/10/08
Labour fails to win poll boost from banking crisis 20/10/08
Gordon Brown is winning praise but not votes for his handling of the financial crisis, according to a Guardian/ICM poll published today. It shows the Conservatives maintaining a double-digit lead, enough for a Commons majority, despite the transformation of the prime minister's reputation at Westminster. [Guardian]
Gordon Brown defends level of national debt 20/10/08
Gordon Brown today defended the level of Britain's national debt – claiming it is "considerably lower" than a decade ago. The prime minister told MPs that it was because the government had repaid so much of its debt in previous years that it was able to borrow more now. [Guardian]
Financial crisis leaves David Cameron with few options 20/10/08
Last week, in an article about what David Cameron and his circle were thinking about the political consequences of the global financial crisis, ConservativeHome reported: "The Tories are not worried about being largely out of the news." [Guardian]
David Cameron is back - but he's storing up trouble for himself with this speech 20/10/08
“Is David Cameron at liberty to attack Gordon Brown's economic record as chancellor and prime minister? Of course he is. That's what we pay an opposition for: to oppose. He also produced a joke I hadn't heard.
Yet to hear some of this morning's talk about breaking the "political truce" during a financial crisis, you'd think he'd done something terrible like push the Brown kids off their tricycles and grazed their tiny knees.” [Guardian]
Salmond blames 'sub-prime minister' for banking disaster 20/10/08
Alex Salmond yesterday blamed Gordon Brown for the economic "calamity" that has forced the government to find £200bn to bail out the UK's banking sector.
The Scottish National party leader accused Brown of "presiding over the biggest economic reverse for a generation", deriding him as the "sub-prime minister". [Guardian]
'Insolvency arc' may influence Scottish poll 20/10/08
Michael White on the effects of the current financial crisis on the SNP’s political fortunes. [Guardian]
Darling invokes Keynes as he eases spending rules to fight recession 20/10/08
The Treasury confirmed yesterday it intends to fast-track spending planned for future years as Alistair Darling signalled that he will use next month's pre-budget report to relax Labour's long-standing fiscal rules to head off the worst effects of the recession.
Over the weekend the chancellor indicated that the government would seek to reflate the economy with a period of targeted spending on large infrastructure projects. Darling said yesterday that the economic thinking of legendary economist John Maynard Keynes was coming back into vogue. [Guardian]
9/30/08
In the Loop: 30/09/08
30th September 2008
"The town of Molfsee near Kiel in the north-western German state of Schleswig-Holstein doesn't want to be filmed by Google for its Street View program, a service that provides 360-degrees street level images via Google Maps.
The leader of the Christian Democratic Union on the town council told the Lübecker Nachrichten that "we are not going to let this happen". The 5,000 inhabitants find the project "extremely alarming" as criminals can plan break-ins more easily. Germany's Federal Commissioner for Data Protection also has major misgivings about Google's plans, according to Der Spiegel." [TheRegister]
Sky told to hand over footy and film rights: Rivals to get access at fair price
Posted in Government, 30th September 2008
"The UK's media regulator Ofcom has told Sky it should offer to sell rights to football games and Hollywood films to other broadcasters at a fair price.
The investigation into pay TV was begun after complaints were made by BT, Virgin, Setanta and Top Up TV. Ofcom reckons that consumers make their choices of which service to go with based on content not the features of different platforms. Big films and live Premiership games are a big draw for viewers and Sky has "market power" in these areas." [TheRegister]
Tories would decentralise NHS IT: Want patient confidence and reined-in data 30/09/08
"An incoming Conservative government would decentralise health service computing and extend competition between suppliers, according to a plan released at its party conference.
The party's NHS Improvement Plan, released on 29 September 2008 by shadow health secretary Andrew Lansley, says the party will replace "Labour's centrally determined and unresponsive national IT system."" [TheRegister]
Secret Service camera bought on eBay: Nikon camera, good nick, includes secret files 30th September 2008
"Today's government data loss shenanigan is a repeat performance of that old favourite - flogging off old kit containing secret information to a random punter through online tat bazaar eBay.
An unnamed 28-year-old delivery man from Hemel Hempstead bought a Nikon Coolpix camera for £17 on eBay. But when he returned from his holiday and downloaded the contents of the camera he found pictures of rocket launchers, log-in details for the Secret Service's encrypted remote computer network marked Top Secret and a hand-drawn diagram linking different, named al-Qaeda cells including individual names and occupations." [TheRegister]
US Congress rubberstamps IP enforcement bill: DoJ suits out, White House czar in 29/09/08
The US House of Representatives on Sunday passed a bill heavily backed by the recording industry that would create an intellectual property enforcement czar position in the White House as well as significantly increase penalties for IP infringement.
The bill passed unanimously through the Senate on Friday after being stripped of a controversial provision that would allow the US Department of Justice to file civil suits against suspected copyright violators on behalf of copyright holders. [TheRegister]
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8/14/08
Heron's Eye: 14/08/08
MP's death leaves Brown facing new SNP challenge in neighbouring
Gordon Brown faces a difficult byelection in his neighbouring
Severin Carrell on the issues facing the Labour party and byelections at the moment. [Guardian]
Gordon Brown is in a "deep hole", placing Labour in a more serious position than other governments that have experienced mid-term blues, a former minister said yesterday. [Guardian]
A powerful coalition of mainstream Labour MPs and leaders of
David Hare anatomised the failure of privatisation in The Permanent Way; in Stuff Happens, he turned a ruthless eye on the double-think and culpable naivety that led to the
A Tory push to win back seats in the north of
"
It was dreary and wet, and slumped in a chair opposite David Cameron was a jobless hoodie: much of the north in a nutshell according to Policy Exchange, until yesterday the Tory leader's favourite thinktank.
"A rightwing thinktank has written off many northern cities as worthless failures and advised their inhabitants to move south at once. In fact, everything about life in the north of
Steve Bell on Policy Exchange’s report on the north of
Young men are shunning work and turning to a life of crime as
One of Gordon Brown's closest allies has joined calls for a windfall tax on oil and energy company profits to pay for measures to alleviate the impact of higher fuel bills on the poor. [Guardian]
Dozens of companies face having to report embarrassing sharp increases in their carbon pollution under government plans to crack down on greenwash. [Guardian]
A former senior civil servant who was responsible for coordinating the government's anti-drugs policy now believes that legalisation would be less harmful than the current strategy. Julian Critchley, the former director of the Cabinet Office's anti-drugs unit, also said that his views were shared by the "overwhelming majority" of professionals in the field, including police officers, health workers and members of the government. [Guardian]
Peter Wilby on the dangerous effects of journalists’ desire for a news story overpowering rational examination in scientific matters. [Guardian]
Martin Kettle prods around Gordon Brown’s brain in order to highlight how Brown’s impression of what is courageous becomes something else when he is unable to change direction on issues. [Guardian]
Police would be given greater powers to conduct surveillance operations on people suspected of crimes such as burglary and vehicle theft under plans the Conservative Party will announce today. [Guardian]
Ministers' plans to hold in secret inquests that are deemed to put national security at risk are expected to face defeat when the House of Lords votes on them this autumn. A cross-party committee of peers, including a former lord chief justice and two former attorney-generals, has told the government that any decision to hold an inquest without a jury must be taken by a judge and not a minister. [Guardian]
Local councils, health authorities and hundreds of other public bodies are to be given the power to access details of everyone's personal text, emails and internet use under Home Office proposals published yesterday. [Guardian]
Ed Vaizey, Shadow Culture Minsiter: “One of Peter Mandelson's enduring political legacies has been a pithy maxim: only when you are bored of what you are saying will the public start to hear you. So at the risk of boring myself, let me respond to the attack on Conservative arts policy by Dominic Cooke, the artistic director of the Royal Court theatre in London (Lurking in the wings, August 6)….” [Guardian]
Heather Stewart on the possible options available to the Chancellor to stimulate the economy. [Guardian]
8/10/08
Heron's Eye: 10/08/08
Unions and MPs back 'dream ticket'
A powerful coalition of mainstream Labour MPs and leaders of
Gordon Brown called yesterday for communities across
The chancellor, Alistair Darling, is prepared to disappoint millions of would-be home buyers by ruling out proposals to revive the housing market, Treasury insiders warned last night. After a chaotic week of claim and counter-claim about Treasury plans to suspend stamp duty for first-time buyers, Darling has hardened his stance against the move, which he believes could cost billions to little positive effect. [Guardian]
After last month's final edition of ITV's The Sunday Programme, its weekly early morning current affairs show, the channel that once produced Weekend World and Walden was left without any specifically political output. It scrapped The Sunday Edition, co-hosted by The Observer's Andrew Rawnsley, at the end of last year, leaving the BBC, which has to cover
Rich-poor education gap wider under Labour, claim Tories
The Conservatives today set out their credentials to become the champions of social equality in a document outlining the education gap between rich and poor, which they claim has widened under the Labour government. [Guardian]
Michael White analyses Nick Clegg’s party leadership and his new direction for the Lib Dem’s tax policy. [Guardian]
The Tories have begun planning for a record-breaking party conference this autumn which will aim to portray David Cameron as a statesmanlike future leader amid signs that the political and corporate establishment is shifting toward the Conservatives. [Guardian]
The
Parents could be offered a seamless system of state-organised childcare from birth to school under proposals being discussed within the government in the battle to win parents' votes. [Guardian]
8/1/08
Heron's Eye: 01/08/08
MPs ordered to pay back money used for 'propaganda'
Five were ordered to repay funds, including three Plaid Cymru MPs, Elfyn Llwyd, Hywel Williams and leader Adam Price, who were each required to give back more than £5,000, and Sidiq Khan, a Government whip, and Malcolm Bruce, Liberal Democrat MP for Gordon, who returned £500.
Separately, Derek Conway, the disgraced former Conservative MP, was asked to return £13,161 after overpaying his student son for working in his office. [Telegraph]
That golden age? It never happened, except in the minds of pessimists
Mark Lawson on how the golden ages of
Blame the rich for feeding the drug industry
Melanie Reid on the hypocrisy within drugs prosecution based on income. [Times]
Clegg Does Realpolitik, Ends Policy of "Equi-Distance"
Guido on the Liberal Democrats positioning themselves to take advantage of anticipated Labour weaknesses in the next general election. [GuyFalkes]
Election spending: Labour shrugs off Electoral Commission reservations
The government today insisted its plans to curb spending outside of an election period – widely seen as an attempt to outmanoeuvre Conservative donor Lord Ashcroft — would not be derailed by the Electoral Commission's "strong reservations" about its proposed reforms. [Guardian]
Scottish Labour leadership: three MSPs line up to replace Alexander
Former Holyrood health minister Andy Kerr will today launch his bid for the Scottish leadership of the Labour party as nominations close at
The leadership and deputy leadership contests were triggered by the resignation of Wendy Alexander, who quit five weeks ago in a row over donations to her leadership campaign last year.
Kerr, the MSP for
Cathy Jamieson, who stood down as deputy leader to pitch for the top job, and the finance spokesman, Iain Gray, have already launched their bids. [Guardian]
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1/28/07
Is The UK’s Current Method of Financing and Distribution of the NHS Sustainable?
Polikowski considered that for most governments, health services policy pursues “three objectives: universal access; affordability; and comprehensiveness of covered benefits”[2] and that universal access is a highly valued principle in most industrialized countries. In the
There are even concerns that the NHS is failing to provide equal access. As Cooper suggests, “there was nothing inherent in the 1946 Act which could have systematically brought equality about.”[13] One of the main reasons was that during the conception of the NHS different parts of the country had significantly different levels of bed and staff, with Powell suggesting that The NHS inherited a very unequal geographical pattern of provision. [14] Similarly, while Klein recognises that there were some efforts to correct the distribution of patient care he still contends that the hospital sector “largely saw an incremental pattern of resource allocation that perpetuated existing inequalities.”[15]Powell even goes as far to suggest that Labour’s 1997 White Paper’s aim to deliver ‘fair access’ will achieve little.[16]
Direct Taxation
One of the major reasons for these issues occurring is the method of health make funding available, as well as to set the right financial incentives for providers, to ensure that all individuals have access to effective public health and personal health care. This means reducing or eliminating the possibility that an individual will be unable to pay for such care, or will be impoverished as a result of trying to do so.” [18]
Following the last Conservative Government the ratio of investment had reached historically low levels, of 7.3% of total expenditure of GDP. To deal with this the Labour Government has implemented a sustained large injection into the NHS, raising the proportion of private expenditure in total (current) expenditure to 8.3% of GDP.[19] However, the expected renaissance of healthcare has failed to materialise leading to commentators to suggest varying changes in the way health care is provided in the
The majority of these criticisms come from libertarian arguments. They believe that the “achievement of freedom requires that individuals are free to make their own choices, constrained by Government only to the minimum necessary extent to provide security and legal systems that protect private property rights and ensure contracts are enforced.”[20] It is assumed that in such a system “individuals will pursue their own interests and those unable to make their way will be cared for by charity, funded by voluntary economic growth and ensure the freedom valued so highly by libertarians.”[21] Despite the increases in funding in the last couple of years the NHS’ finances are still in trouble, with “many trusts reporting deficits and some plainly unable to bring their budgets under control.”[22] Of course there are a number of factors which could help to explain this crisis, such as demographics. However, it is still the case that the centrally funded system in place permits inefficiencies to continue.
Egalitarians who tend to be supporters of the NHS put “equality of opportunity forward as the primary social goal. In such a society all individuals have the right to basic goods and it is for society to define what these basic goods should be. In this world lack of achievement must not be punished and collective mechanisms are needed to ensure all receive care. For egalitarians equalising opportunity may necessarily involve restricting the freedoms of others through taxation and the law”[23]
It has to be remembered that the
Structure of health system financing and provision in four countries p102[25]
For the Government direct taxation makes it easy to control expenditure compared to indirect or national health insurance. This is because they have some degree of delegated discretion in setting contribution rates. The method of funding is seen as an institution by many, making it difficult to reform, with many considering proposals for ‘patient participation in health care financing’ to be “misguided or cynical attempts to tax the ill and/or drive up the total cost of health care while shifting some of the burden out of government and insurer budgets.”[26]
Hypothecated Taxes
Hypothecated taxes have been mooted in the past, in order to make people understand how much the NHS costs. This visibility is assumed to reinforce the opportunity cost of health care and that it is not free and hopefully discourage people from making excessive demands on the system. For libertarians such as
However, the Treasury has deep-seated objections to hypothecated taxes, as if they conceded the principle “then motorists would expect the whole of the taxes they pay to be spent on the roads, not a quarter of it; which drinkers might object that very little of their excise duty they part with goes to deal with problems of alcoholism or drunkenness, and that the duty should be reduced; while peace campaigners may demand to be excused their contribution to the defence budget.”[27]
Local Funding
Just as the Labour Government is decentralising its influence over local health authorities it may be worth considering the possibility of local funding. In
There are concerns that such a system would make it more difficult to redistribute funding between regions in terms of equity. Also the council structure is not developed enough sufficiently to take on such a burden, with councils struggling to justify current budgets to their electorate as a result of funding structures in place. Also,
National Insurance Schemes
The fairness argument put forward by egalitarians has merit but it does not necessarily require the state to pay for an provide all medical care. As
Varying National Styles
Being ranked 4th in terms of performance on health levels
More market based schemes exist in countries like
An interesting mix of these different funding styles exists in the
Private Funding
Critics of NHS funding such as Bosanquet consider that real reform must extend to demand as well as supply: “A more dynamic NHS required a national environment where there are independent sources of funding. Without change in funding, any supply side only reform is likely to run into new problems of rationing as improvements increases the demand for services. The belief that it will be possible both to have reform and continue with taxation as the sole source of funding is unrealistic.”[37]
The perceived advantage of private health organisations is that if care is perceived to be free, people would demand more of it, making demands on trivial conditions. For
There appears to be a benefit from taking some services from the straightjacket of direct funding. As Bosanquet suggests, “although core services will be tax funded there will be many supplementary services at differing levels where they will be an element of co-payment. This is already happening in services such as those for infertility and for services such as physiotherapy.”[39] In the future as newer but more expensive treatments emerge it is unlikely that offering non-critical services free of charge will be efficient or even equitable, given the fact that many people who would be able afford such treatment would be able to receive it without any financial contribution or assessment.
An econometric study by Besley et al for the demand for private health insurance in the
Any enlarged private health care system in the
Pooling
Clearly any regulatory issues regarding the way insurance schemes are implemented. There are concerns over selection behaviour in a more market orientated health care system. Either the health organisations will create a pool of customers with low risk (an example of risk selection) who will contribute but not cause expense, or the high risk consumers will claim more (an example of adverse selection). As a result the WTO warns that any system “becomes a battle for information between consumers (who usually know more about their own risk of requiring health interventions) and the pooling organisation (which needs to know more about consumers’ risks to ensure long term financial sustainability).”[43] This increases costs on the service in order to maintain competitiveness may be significantly larger than the financial benefits from market reforms.
If risk selection predominates and there is weak regulation then the WTO feels that the poor and sick will be excluded. Categories such as the disabled or the elderly would be denied treatment in an unregulated market if they had not saved enough income. At the same time the healthy and young would tend to not need the services for which they had saved. It would be important to create a structure in which “people benefit from mechanisms that not only increase the degree of prepayment for health services, but also spread the financial risk among their members.”[44]
However, it must be remembered that although larger pools offer better economies of scale after a while very large pools (such as the NHS) lose their advantage. This notion of multiple pools existing successfully in an economy without fragmentation is one of the strongest arguments for reducing the scope of the NHS.
Pooling to redistribute risk, and cross-subsidy for greater equity
(arrows indicate flow of funds)[45]
Charging
Currently charging exists for medicine and some medical equipment. It is not a significant source of revenue, with prescription charges only bringing in less than 1% of what the NHS costs.[46] However, the scope for expanding large or lengthy medical interventions is quite controversial but crucial, as it is a key battleground between egalitarian and libertarian policy makers.
Charges have existed since the 1950s on grounds of efficiency, as the need to pay a small amount towards the cost of mechanism helps to deter people from purchasing unnecessary medicine. However, for
There is an equitable element built in to the
Conclusion
There is nothing particularly wrong with the NHS. It is an efficient run service which has passed Polikowski’s standards of universal access, affordability and comprehensiveness of covered benefits. There may be questions over its efficiency but its ability to distribute has been successful despite flaws. Despite an enthusiasm for market based reforms the Labour Government has been focused on improving the NHS and reversing the slide that occurred during the previous Conservative Government. However, this has not been as successful as hoped as the larger budgets have been absorbed by needed wage increases and patients with higher expectations for health care. The new Conservative leader has broken ranks from the traditional party line in support of the NHS. However, the cracks that are appearing in the NHS system are starting to show. There are battle lines appearing over the need for more regional redistribution and increased use of private health care. Despite this the public is relatively content with the current financing mechanism for healthcare and fearful of suitable alternatives, making the financing and principle distribution of the NHS likely to be the same for the foreseeable future.
Appendix
Fairness of financial contribution to health systems in all Member States,
WHO index, estimates for 1997[49]
Overall health system attainment in all Member States, WHO index,
estimates for 1997[50]
Health System Performance in all
Health System Performance in all
[1] The WTO Health Systems: Improving Performance (The World Health Report) 2000
[1] OECD OECD Health Data (OECD, Paris) 2003
[2] p. 133–142. Polikowski, M. & Santos-Eggiman, B. How comprehensive are the basic packages of health services? An international comparison of six health insurance systems (Journal of Health Services Research and Policy), 2002
[3] P7 Powell, P and Exeworthy, M Equal Access to Health Care and the British National Health Service (Policy Studies, Vol 24, No1), 2003
[4] p4 Powell, P and Exeworthy, M Equal Access to Health Care and the British National Health Service (Policy Studies, Vol 24, No1), 2003
[5] p2 Marchand, M and Schroyen, F Can a Mixed Health Care System be Desirable on Equity Grounds? (Scand J of Economics) 2005
[6] p294
[7] p294
[8] p1 Maynard, A and Sheldon, T Funding for the National Health Service (York Health Policy Group, Department of Health Sciences, University of York) 2002
[9] OECD OECD Health Data (OECD, Paris) 2003
[10] p293
[11] p293
[12] p293
[13] Cited in p4 Powell, P and Exworthy, M Equal Access to Health Care and the British National Health Service (Policy Studies, Vol 24, No1) 2003
[14] p4 Powell, P and Exworthy, M Equal Access to Health Care and the British National Health Service (Policy Studies, Vol 24, No1) 2003
[15] Klein, R. The New Politics of the NHS (4th edition.
[16] p4 Powell, P and Exworthy, M Equal Access to Health Care and the British National Health Service (Policy Studies, Vol 24, No1) 2003
[17] The WTO Health Systems: Improving Performance (The World Health Report) 2000
[17] OECD OECD Health Data (OECD, Paris) 2003
[18] p93 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[19] OECD Health Data (OECD, Paris), 2006
[20] p281 Harrison, T Alternative Funding Models (The Future of the NHS, XPL Publishing), 2006
[21] p281 Harrison, T Alternative Funding Models (The Future of the NHS, XPL Publishing), 2006
[22] p293
[23] p281 Harrison, T Alternative Funding Models (The Future of the NHS, XPL Publishing), 2006
[24] p293
[25] p102 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[26] p287 Harrison, T Alternative Funding Models (The Future of the NHS, XPL Publishing), 2006
[27] p295
[28] p294
[29] p297
[30] p297
[31] p294
[32] The WTO Health Systems: Improving Performance (The World Health Report) 2000
[33] p298
[34] p301
[35] p301
[36] p300
[37] p311 Bosanquet, N and Haldenby, A The Case For Pluralism (The Future of the NHS, XPL Publishing), 2006
[38] p296
[39] p311 Bosanquet, N and Haldenby, A The Case For Pluralism (The Future of the NHS, XPL Publishing), 2006
[40] Besley, T., Hall, J. and
Waiting Lists Matter?, (Journal of Public Economics), 1999
[41] P3 Marchand, M and Schroyen, F Can a Mixed Health Care System be Desirable on Equity Grounds? (Scand J of Economics) 2005
[42] p3 Marchand, M and Schroyen, F Can a Mixed Health Care System be Desirable on Equity Grounds? (Scand J of Economics) 2005
[43] p104 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[43] OECD OECD Health Data (OECD, Paris) 2003
[44] p99 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[45] p100 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[46] p297
[47] p288 Harrison, T Alternative Funding Models (The Future of the NHS, XPL Publishing), 2006
[48] p297
[49] p188 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[50] p196 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[51] p199 The WTO Health Systems: Improving Performance (The World Health Report) 2000
[52] P200 The WTO Health Systems: Improving Performance (The World Health Report) 2000






