Saturday, 17 July 2010

Hand all that junk in at the door.............

As readers know I have been keeping an eye on the coalition negotiations going on in the Netherlands. It does appear that the 'purple' coalition favoured by our friends in D66 is now a serious runner. This would bring together VVD the (market) liberals who are the biggest party with Labour, D66 the (social) liberals and the left Greens. The various parties do seem to have kept their conversations private but there is an feeling of momentum about events.

I was interested in the 'off stage' advice of the former Labour leader Ms Ter Horst:

She.... reveals herself to be anything but a fan of new media at cabinet meetings. “A new PM should ban twitter, text messages and internet – insist that all that junk be handed in at the door.”

She sound like my own MP-speaking of whom locals may not have realised that John is asking for advice-altho I would send it via twitter given he and Ms Horst  appear to have similar views on the role of new media. John is heading up the LibDem backbench health committee and has written in Lib Dem Voice:

John Pugh MP asks for Lib Dem members’ feedback on health issues

As part of the empowerment (sorry about the cliche!) of ordinary members it might be useful if you let us in the Westminster village know how you react to unfolding coalition policy.
I’m tasked as Co-Chair for the Backbench Health Committee to ensure that distinctive Lib Dem policy on health goes into the Coalition Government equation.
So I have decided to seek party members’ views on the much-reported Health White Paper – especially from those who have a bit of hands on experience of the NHS.
Please post here or alterantively e-mail me at
The issues are not insignificant, with the perennial issues of cost, efficiency and accountability being thrown into the melting pot by another proposed NHS restructuring. All feedback gratefully received.
With most spending/commissioning power of the NHS scheduled to be handed to consortia of GPs, Primary Care Trusts face oblivion. It would be good to know how ordinary party members feel – specifically:
  • Is the NHS ready for another structural upheaval/reform?
  • How will GPs cope with their new role?
  • And are we going to get a local NHS which is more accountable to the citizen and tax payer?
  • Will the NHS work better for the patient without PCTs and Regional Health Authorities?
  • Can we make progress without these changes ?
Well a number of thoughts do occur -given I appear to be part of your target audience some of which have already been made-there are over 50 comments contributed to John's posting already.

Firstly it should be said such an initiative is welcome especially if it looks at where we go from here so that we have a robust and credible policy of our own for the next election. I do wonder a tad about the questions which some may think are a little leading and reveal maybe certain assumptions which may not be universally held.

John proposed in the last parliament a short term fix to the problem of the democratic deficit which so undermines the legitimacy of PCTs- namely that they should have their budgets signed off by the local authority. I note the White paper goes further and as the has pointed out by the BBC's Nick Robinson-and LDV has picked it up:

The proposals for a re-organisation of the NHS included a fundamental and little-noticed change from those contained in either the Conservative manifesto or the coalition agreement. The government now plan to give councils a major new strategic health role, examining the purchasing decisions of GPs and fitting them together with their plans for public health and social care. For the Lib Dems, this represents an important injection of democracy into the new health market. For the Tories, it allows them to propose the abolition of primary care trusts altogether instead of, as originally discussed, having to hold elections to them.

One of the real problems that New Labour had with Health was their capitulation to special interest in the Health service. This is most fully illustrated with their botched new contracts with GP's  so it is important that our policy is driven more by those who use the services as opposed to pandering to the 'producer interest'. There are only so many GP's who can emigrate to Canada . So I'm with the person who commented : I hope “those who have a bit of hands on experience of the NHS” includes patients as well as professionals.

I have always been a keen advocate of individual health budgets and that will inevitably mean breaking down some of the vested interest groups as patients choose other providers for their care and treatment. There are still far too many barriers in the way which prevent users getting the service -not least of all is the tariff paid to in house providers. A little more of a level playing field is needed so the system acts in the patients interest. I recall a pamphlet by Prof Nick Bosanquet  produced back in the 1980 for the SDP which graphically illustrated the distortions that occur.

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