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An interesting topic. A bit of a side issue, but one question I have is doesn't the move towards ever increasing localisation mean that there will be more of a postcode lottery about what services you can get. I am a big believer in localism, but in areas such as health, do we think the public would ever accept different levels of service provision? You only have to look at the moral outrage expressed in the Mail when one PCT offers a service that another does not.

"""With a Conservative government, spending on public services will rise.""
Oh dear, Mr Cameron seems to believe that the present level of public spending is delivering what is required. It's not. And someone really ought to tell him that the tired old mantra: ""We will share the proceeds of growth between lower taxes and more public spending."" is becoming less and less convincing as we watch public expenditure burn up our taxes and give little in return.

I think the "sharing" mantra works reasonably well - you have to remember how long it takes these things to resonate with voters, as opposed to politicos like us.

And he hasn't said how he's going to share it - presumably as the dynamic effects of the right tax cuts kick in there will be more recipts thus leading to more scope for returning our money to us.

You only have to look at the moral outrage expressed in the Mail when one PCT offers a service that another does not

If you mean Herceptin..........read this


Personally, I think the "sharing mantra" is a good idea.

to quote from a Your Platform piece:

"Let us take the example of the projected growth in tax revenue between now and the end of the current Parliament as a simple example. GDP is projected to rise by £150Bn a year and the tax on this will amount to 39% in total - after taking into account whole economy inflation (using a "GDP deflator") the extra annual tax will amount to around £50Bn a year...."


On a 50-50 split tax cutters would be delighted to have a pot of £25 Bn of tax cuts to play with.

And yes, spending on public services would still increasing.

I don't see why the "postcode lottery" is necessarily a bad thing.

If localism really does mean anything, it means that organisations in different parts of the country will be free to try out different policies.

Some will succeed better than others. Some will decide that performing more effectively in one field makes it acceptable to perform less effectively in another.

In my head I 100% agree with you Sean, but it wouldn't work politically. I remember frothing with joy at the Community Charge when it was introduced -- finally, I thought, rubbish councils would be found out and hounded from office, because everyone had a stake in making sure they were efficient. If only. It just didn't work. "The country" will never allow gross distortions over access to certain forms of healthcare and in a country as small as this one, nor should it. It does strike me as just wrong that certain chronic diseases, which aren't that prevalent (vis a vis something like the flu) should be treated by some authorities but not by others.

How I think localism could work though: why don't we ask people within an area to vote to establish their own priorities for health spending, subject to nationally determined base services which would be funded centrally? Thus authorities could determine, subject to local ballot, what health topics should be prioritised with the money left over after they have delivered the care set down by national governance from a body such as NICE. Some authorities might consider that assistance for sufferers from mental illness required top prioritisation, for example, while this may not be such an important issue in other areas (not because the prevalence, being lower in the latter area implies that the disease doesn't require treating, only that there isn't such a strain on the health budget due to the lower prevalence there).

I am hoping that the party will rediscover something of Liam Fox's passion for treating mental health as a serious issue. I haven't read the report from IDS, and I wonder if it dealt at all with this topic? Perhaps it's just where I live, but I believe that the closure of community hospitals for the treatment of sufferers of mental illness was, with hindsight, a terrible mistake, and I hoped that our party could champion a more enlightened view on this, if only to differentiate ourselves from the gaol-as-therapy view of our current administration.

PS and of course there should be elections for a borough's health officer, to ensure appropriate democratic comeback if the nationally determined base services aren't administered properly, a la all the ridiculous scandals we labour under at the moment.

"To empower - and, yes, to fund - more social organisations in the work they do."

Oh dear, this is where things go wrong in an otherwise good idea. We don't want charities to become dependant on state handouts.

The point about the voluntary sector is that people give voluntarily. Taxation is not voluntary. I pay tax becausr the law tells me to, I'd rather keep a larger proportion of it and decide which charities I want to spend it on.

Furthermore, the only way to roll forward the frontiers of society is to shrink the state. Trying to do it the other way round will just maintain the status quo.

Both Labour and Conservatives are trying to achieve 2 contrary things, if you have local determination of policy then there will be variations across the country, if you want to standardise things across the country then this takes power away from local people towards central government - there is a choice.

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