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The danger with this is that Cameron is creating two tiers of frontbenchers. those who are secure in their jobs and those who Cameron won't confirm will be in their positions when he's interviewed.

It certainly is wise for David Cameron to want a level of continuity for cabinet posts. Labour's regular games of musical chairs have made a mockery out of government.

I would ask Andrew Lansley to make a promise to restore NHS dentistry for those who cannot afford the exorbitant fees that dentists charge these days. I paid 45 pounds just for a check-up, that I was informed was for just a basic check-up, a couple of 'chats' about advanced oral hygiene could be added to bump the price of the consultation up to 130 pounds. Seeing as I already know how to brush and floss I skipped the 'chats'.

Those on low incomes simply cannot afford the cost of dentistry and need access to an NHS dentist. Poor dental health can lead to wider health problems, so this is a matter of necessity. A Conservative promise to bring back NHS dentistry would be a big vote winner.

I think a politically unpartisan listener to Today this morning would have been both reassured and impressed by Cameron's interview. In fact he did successfully underline the difference between Labour and Conservative policies - skilfully attacking Brown in the process - by repeated references to Labour's 'top down' approach and making a clear distinction between centralised targets and devolved decision making based on outcomes. His commitment to Lansley as Health Secretary gave out the clear message - we are a government in waiting with an impressive team in place. I agree the interview was lazy (and surprisingly soft) but Cameron rose to the occasion without the spur of tough questions.

What's important here is that David Cameron is talking about a decentralised but still National NHS. This is exactly what professionals and industry want to hear and it puts clear blue water between the Conservative Party and the Labour, who have, under Gordon Brown and David Nicholson, begun their re-centralisation by stealth.
Yesterday's reference to locally held medical records was also a welcome step in the right direction. I would want to see something more radical though: personally held electronic medical records with access granted by the individual, and where parents have the authority over their children's medical records unless the child is 'at-risk'. Literally putting health back into the hands of the individual!

Why does he need to say this? If he was actually thinking about what he was saying then he would know that it was a stupid mistake by him that could hurt the morale of the other Cabinet members. By implication all current frontbenchers would be Government frontbenchers in the light of an election victory. He didnt need to say this. Idiot...

Julia Manning, yes, a parent should have the right to know if a daughter under sixteen is using contraception or even about to have an abortion. I feel it is wrong that GPs are allowed to keep information on children away from their own parents.

don't you read the news, there are 4 NHS's
which one will he run?

"Why does he need to say this? If he was actually thinking about what he was saying then he would know that it was a stupid mistake by him that could hurt the morale of the other Cabinet members. By implication all current frontbenchers would be Government frontbenchers in the light of an election victory. He didnt need to say this. Idiot..."

Despite your eloquent way of expressing it, I disagree. He specifically said two people are safe. Those two people just happen to be in the positions that people most worry about. Are the Conservatives going to run the health service well? Are the Conservatives going to run the economy well?

We need to show that people can trust us to run their services and these are two positions that we need to be strong on if we want to win the election. With stability in these positions, we will have two cabinet ministers with great knowledge in their departments and well crafted policies.

I think he is right to make it explicit that we're not all about re-shuffles. He's not going to upset those delicate flowers in the cabinet: he's not said they're on their way out. I'm sure they can cope with it to be honest...

Tony Makara at 09.24 gives the lie to Nulab's continual mantra "The NHS, free at the point of use". Absolute nonsense but another point that the tories do not hammer home sufficiently.

On another tack, I hope that Andrew Lansley and his shadow Health team saw the three excellent programmes a year ago (and the follow-up just before Christmas) which showed Gerry Robinson carrying out a review of Rotherham Hospital. It was riveting and showed again that despite the oodles of our cash paid into the NHS, if it is not managed properly you get very poor value for money.

If they did not see the programmes, they should look at them now. Gerry Robinson might be a Labour donor and supporter but we can learn from his example (perhaps he should run the NHS, he obviously would like to).

Perhaps the NHS could be hived off and run by Royal Charter like the BBC (but better).

"Funded by taxpayers but managed by professionals"

Tony Makara [January 03, 2008 at 09:24] may have a particular gripe with dentistry, but I entirely agree that dentistry is a major area of inequality in health provision. The poor people have been truly let down.

What even more significant is that not only are middle classes now being stung by high charges, the situation has deteriorated over the past decade of this government.

The licensing, contract and activity pricing are in need of major revamp.

No one was expecting Lansley or Osborne to be moved anyway so giving these public votes of confidence is just giving the impression of favoritism. Davis and Gove havent been given such glowing praise and yet they represent the Home Office and education/families.

They do indeed represent those. But we're already well trusted on home affairs and Gove is new to Education and families.

The public need to be able to trust someone seen as a good chancellor, and making it clear that he's being trained for the job is very sensible. In Health, Tories traditionally aren't trusted; but by promising that someone that actually can be trusted will be the first Health Secretary makes us look strong.

It's not favouritism at all. If any of them really do get worried because two out of twenty-odd are in crucial positions for Tory growth, they shouldn't really be in politics.

This is crass.

Next time David Davis/ Alan Duncan/ Theresa Villiers are on the radio or TV they'll be asked "Are you keeping your job or doesn't Mr Cameron have faith in you like he has faith in Andrew Lansley?"

Cameron's comment about Lansley seems perfectly sensible.

Have you noticed how the BBC, and the likes of Marr and Toynbee, have started talking about "Election 2010" as if it was a given?
Have they been tipped off by No.10 that Brown is going to take it to the wire, or are they just doing more of his dirty work for him, sending out a subliminal message that Cameron can huff and puff all he likes, but nothing will happen for at least another 2 years?

Cameron can huff and puff all he likes, but nothing will happen for at least another 2 years?

And more to the point the public can huff and puff but Brown has no intention of taking any notice. Sounds like a surefire tactic to blow up in nulabs faces. Like most of Brown's tactics. At that rate by the time 2010 comes around the electorate will be desperate to get rid of him.

What has Nanny Lansley done to deserve this assurance? He has been "captured" by the health service lobbyists - like Ainsworth has been captured by the environmentalists. Lansley has given them what they want - a NHS corporation, i.e. quango, that is unaccountable to the Health Secretary or the Chancellor. Reformers should always be suspicious when the professionals "respect" a Conservative politician.

Contrast Lansley's timid policies with the radical local schools policy of Michael Gove. You won't hear the education unions saying how much they respect Gove. Conservatives must fight the vested interests, not give into them and entrench their position.

"At that rate by the time 2010 comes around the electorate will be desperate to get rid of him".

I hope - and think - Oscar Miller at 12.11 that by the end of 2008 Labour MPs will be fed up with Brown and decide to change him well before the election, because unless he improves radically he is going to lead Labour to a big defeat.

Some of that from MM is correct, but it's also an unfair post.
My own view is the NHS should be more of a mix of public and
private management, like in Holland, France, Australia, and New Zealand.

But, for political reasons, the Tories have had to be very wary of this, and
were so under Margaret Thatcher who ordered John Moore not to go to far with changes he wanted in 1987/88.

No one person has decided this. To be level with Labour on the NHS is quite a turn up for the books compared to 1997 when it would be about 40 points behind.

At least Andrew Lansley has a close interest in the subject, and I hope some reforms will be possible.

There's not much point in total defeat at the polls because the public won't trust us with the NHS - because we'll be in opposition, and there'll be no chance of doing anything atall.

Andrew Lansley is a "safe pair of hands" where a Conservative safe pair of hands is crucial. The NHS is so large with the best will in the world a government can only carry out limited change in 4/5 years so it's no good talking about radical solutions which the electorate have demonstrated they don't want anyway.

However, a problem with Lansley and so many Conservative "safe pair of hands" is that he is poor at communicating to the public (as opposed to industry insiders). There should be a deputy shadow Secretary of State who can get messages across, Labour are shameless it making politics out of the NHS and we need to keep up. (Bear in mind that our health services generally, dominated by the NHS, appear to be among the worst in the western world.)

David Belchamber, if Labour turf brown out by oct 2008 it would be interesting to see what the line-up of, New New New Labour would be. How about David Milliband as prime minister, Ruth Kelly as chancellor, Yvette Cooper as home secretary and David Blunkett making yet another comeback as minister without portfolio?

Tony at 18.43. It would be fun to pick their team for them; I actually think Hilary Benn is one to watch.

Apropos, we clearly differ for once, as I rate Frank Field and would like him and Kate Hoey to come over to us. Can you expand on your remarks about him? You are not taking a remark out of context, are you?

I suggest Tony (and others who've had problems with Dentistry) join Denplan.

£20 a month and it covers all eventualities. Cheaper than House Insurance and just as important.

As Conservatives we should support sensible, efficient and affordable private provision.

Maybe the NHS should pay the subscription fees of the poorest who can choose an organisations (like Denplan) for their healthcare??

GC - re your suggestion of Denplan.
I read that you consider a £20 per month Dental charge sensible and affordable, consider this:

If you earned £6.50 per hour for a 35 hour week this would be like paying an extra 8.8% on top of your NI contribution. Even on £10 per hour/35 hpw this equates to an extra 5.7% insurance contribution.

Or do you consider someone earning £10 per hour the poorest?

David Belchamber, on the subject of Frank Field I don't like the way he seems to think that a good percentage of those on benefit are freeloaders. That type of Alan B'Stard thinking belongs to the 1980s and not the 21st century. It is the sort of thing that put so many people off the Conservative party and unfortunately New Labour were happy to carry on the abuse once they took power. I agree with the idea of welfare reform and I'm not against a proper method of testing to ensure that the right people are on the right benefits, but I find all the nasty language aimed at single mothers and the disabled is unnecessary and distasteful.

IDS and the social policy group have done a fantastic job in taking a serious look at poverty and social breakdown. Such work wins hearts and minds and votes. Yet such brilliant work can be undone very quickly by any Conservative MP who starts to go on about benefit scroungers. If the Conservative party wants to make headway in deprived areas it has to ditch completely the rhetoric about people milking the benefits system. Yes, get on with welfare reform and help people back into work, but do it quietly without all the negativity. I look forward to seeing David Cameron's proposals on welfare reform. I'm excited by the promise of real training for the unemployed. The future Conservative government must take a positive line on welfare reform and put the case that it is to help people. All the 'Bene-hate' must stop. It only damages the party's good intentions.

On the matter of Labour defections I believe the most Conservative of the Labour bunch is actually Ruth Kelly, who seems to not quite fit into the Labour jigsaw. One thing I do like about Ruth Kelly is her opposition to abortion, something I feel very strongly about. I agree that Benn could carry support, probably as a middle ground compromise candidate. Benn seems to be good at just getting on with his job. He seems more 'old school' rather than the usual sickly breed of career-politician that Labour has produced in the Blair/Brown years.

Graham Checker, on the matter of dental charges. I'd like to see all check-ups made free to all citizens regardless of income. As a public service to stay on top of the nations health. Many health problems can be detected a dental check-up and it would encourage good oral hygiene.

Now that NHS dentistry has disappeared and private consultations have become so expensive many problems relating to oral health are going undetected. Even someone working is unlikely to want to fork out 100 pounds a year for two check-ups if his/her teeth appear to be in good order, yet a condition like oral cancer may go undetected because of this. So free check-ups would be highly beneficial to the health of the nation.

a-tracy, can you explain your maths please?

Andrew Lansley will be only responsible for the English NHS - but that the one that matters in gaining a majority. The NHS is increasingly a major factor in any party's ability to win an election. That's because the average age of the voting population is around 47 years old - and health matters most to the older voters (and to mothers with young children)

IMHO those approaching their 60's and old and retired don't want to be hear about insurance funded services, radical change; they are on pensions or looking at funding their retirements, they have paid their taxes & NI. They want to hear that they will be cared for efficiently and well, will not be subject to hospital acquired infections, that they will not be forced to sell their homes.

IIRC about 35% of voters are 55+, with around 20% 65+. These voters have a higher propensity to vote - meaning that in elections this age group probably accounts for close to 45% of voters.

Doesn't mean that we cannot look to evolution of the NHS, to greater localisation, to greater choice of provision but messages such as we offered in the late 80's and early 90's about need to cut costs in NHS, about rationing through the market will drive away the very voting age groups that are most likely to support us.

The politics of an ageing population are with us and Andrew Lansley's approach seems to me to suit these times.

"messages such as we offered in the late 80's and early 90's about need to cut costs in NHS, about rationing through the market will drive away the very voting age groups that are most likely to support us"

Ted, very true. The NHS is a poisoned chalice and its best to just run it as a straight public service. As you say older voters are more set in their ways and don't want to hear about radical change in what is a national institution. On the subject of hospital superbugs I wonder if patient visits might be a contributory factor? When a hospital is open to all manner of visitors, all walking in with all manner of bugs, wearing all manner of dirty footwear and the like, it surely can't help matters. Perhaps the culture of hospital visits needs to be taking into consideration?

Ted - a deliberate error! Whats £20 per week/£20 per month between friends.

However, someone on 6.50 for a 35 hour week earns 227.50 per week, or 11830 per annum; the NI allowance is 4524 per annum.
So 11830 pa less NI free 4524 = 7306 @ 11% national insurance, the bill is 803.66 = 6.8% of gross earnings, the suggested dental insurance bill is 240 pa which adds 2%. So a total insurance premium = 8.8% from your gross income. (I knew I'd worked out that 8.8% cost before).

I know people who earn approx £18,000 pa who can't afford the dental insurance out of their net income after tax, ni, pension, council tax and all other expenditure so they simply don't go to the dentist any longer and one chap had his tooth extracted rather than a root canal done.

"The NHS is a poisoned chalice and its best just to run it as a straight public service." Sorry, Tony, this counsel of despair overlooks the fact that it is one of the worst-run, least accountable and least efficient healthcare systems in the EU, despite having vast sums of money lavished on it. Lansley is claiming that he can run this sacred cow better than his predecessors but why should we believe him? All Health Secretaries have made similar unfounded claims going back to 1948. The NHS simply doesn't deliver comprehensive healthcare free at the point of need. Perhaps Ted can introduce us to some of the French and German pensioners who are dying in the streets because of the iniquitous social insurance systems in those countries. I know of none and suspect that Ted doesn't either.

Michael McGowan [January 04, 2008 at 13:24], I am not sure if there are other doctors writing in these blogs, but you are quite right in alluding to the fact that the conditions and rules that are managerially generated and ultimately the result of flawed policies are the biggest hindrance to nurses and doctors wanting to their their best for their patients.

My colleagues will tell you of incompetent management, the vast amounts of waste and a incessant flow of unnecessary policy changes. The fact that the NHS functions at all (albeit with pockets of effectiveness and quality) is due especially to the dedication of those who work in it and make it work against the odds, rather than appropriate policies. At times, some of my colleagues have either to fight against management or defy silly strictures to ensure care is not compromised.

As for Party policies, I am not sure whether there is a lack of courage to introduce appropriate policies or a lack of imagination and common sense in the approach to the indifferent realities.

I qualified thirty years ago, and I have witnessed the progressive decline in overall quality due mainly to the shift of influence and responsibility for medical services and nursing care from professionals to managers and politicians.

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