PMQs: Cameron raises crisis in the NHS

Moments of agreement: All the party leaders paid tribute to Richard Palmer, the latest British fatality from Iraq.  They also welcomed the Speaker, Michael Martin, back from an angioplasty operation.

NHS in debt crisis: The NHS was the subject of David Cameron's first four questions.  He cited Sir Derek Wanless' acknowledgement that he had not expected so much recent NHS spending to be swallowed by staff pay.  A report yesterday suggested that GPs could earn up to £250,000.  Tony Blair asked if David Cameron wanted to cut the pay of NHS staff?  Tony Blair did his usual thing and quoted a long list of statistics of alleged NHS improvements in the Tory leader's own constituency.  Come to my constituency, David Cameron pleaded, and visit the hospital for the mentally ill that is earmarked for closure.  He also invited the Prime Minister to help find an NHS dentist.  He's more likely to see Lord Lucan riding Shergar, he joked.

Manufacturing job losses: Mr Cameron's second set of questions focused on the closure of the Peugeot factory at Ryton.  The issue was not raised by Labour MPs from the Coventry area.  Did the Prime Minister agree, he asked, that the best use of government money was in training for new jobs rather than futile efforts to save the lost jobs?  Mr Cameron also said that the highest burden of taxation in British history was part of the reason why manufacturing output had fallen under Labour.  Tony Blair replied that the British economy was fundamentally healthy with the highest rates of employment in the G7.

Iran: Both Ming Campbell and Michael Meacher asked Tony Blair to rule out military action against Iran.  Tony Blair said that noone was talking about invading Iran but at a time when the President of Iran was threatening to wipe Israel off the face of the map, this was not a time to show any weakness.

Unanswered question of the day: A Plaid MP, Elfyn Llwyd, asked Tony Blair why his fundraiser-in-chief Lord Levy had asked a donor to lend £1.5m rather than give £1.5m.  Tony Blair said something irrelevant about people wanting to give to Labour being a good thing.

Comments

[Richard]

The only crisis in the NHS is its continued existence. When it was founded back in the 1940s the primary justification was that a state-controlled system would be more efficient. This has since been proven to be a myth.

[CCHQ Spy]

"Mr Cameron also said that the highest burden of taxation in British history was part of the reason why manufacturing output had fallen under Labour."

And what is Mr C going to do about this level of tax...?

Sweet FA.

In a terrible example of supply-side illiteracy, stability is promised before tax cuts.

Was it Tacitus who said "they created a desert and called it stability"?

[Bobby Lawson]

I think you are being slightly unfair, Osborne has said that he is willing to cut business taxes and offset them against the environment. This may not sound like much but you have to remember the tight situation that the public finances will be in by the next election. Remember that Cameron is campaigning left to govern right and that whatever his vague character you will still be more likely to get tax cuts under the Tories than Labour!

[Richard]

According to the OECD:

Between 1960 and 1996 countries with Governments that spent less than 25% of GDP experienced economic growth of 6.6%

Between 25 and 29 the figure was 4.7%

Between 30 and 39 the figure was 3.8%

Between 40 and 49 the figure was 2.8%

Between 50 and 59 the figure was 2%

Over 60 the figure was 1.6%

Go figure.

[Account Deleted]

While Governments which raise tax do tend to have slower growth the picture is not quite as simple as you state.

Countries which are poorer within the OECD tend to have higher growth and lower tax burdens as the services of health and education take up a lower share of GDP in poorer nations, and the idea of welfare for the citizens of these nations does not exist as people have nothing to lose and so don't want the gov to protect them (in the way even the US has to).

Also you haven't stated whether your figs are per capita. Where are they from?

Also, if we rounded anyone up over the age of 60 and burnt them we might have higher productivity and growth rates but on the other hand...

The idea tax is all is shown by the fact African Governments, hardly known for their amazing record on growth have tax ratios of around 15-20%, compared with much higher ratios amongst faster growing developed nations.

None of this is meant to deny tax cuts overall as a good thing in general, and something to aim at, but they are not the holy grail of politics...

Taxes, when used wisely on education and infrastructure probably boost growth. It is only when they are wasted (which is all too often) they are a drag on growth.

[Jack Stone]

Will people never learn.If the party was stupied enougth to go into the next election promising to privatise the NHS you would not only say goodbye to any hope you had of winning the election you would probably be able to fit the parliamentary party into a taxi after the election.
If you want to win you have got to start talking about how the party can improve public services within the public sector and how we can use any extra money to improve and reform the public services not use money for tax cuts.
If the party goes down that old route of tax cuts and privatisation we will be doing Labour`s job for them.

[John Hustings]

"Taxes, when used wisely on education and infrastructure probably boost growth."

Is there any evidence that all the money spent on education is growth-producing?

[Rick]

Richard - when the Emergency Medical Service was founded in WWII the bulk of the bed capacity was in the North so battlefront wounded could be treated after the German invasion.

When the NHS was formed in 1947-8 the private sector hospitals were essentially bankrupt. One of the big problems was collecting on bills from the sick and deceased.

The hospitals were in many cases municipal - Bradford operated the first Municipal Hospital in Britain - in 1922. Many of them were former workhouses as is St James in Leeds.

The NHS must now treat casualties from Iraq since John Major abolished the Military Hospitals and Medical Service, and a high proportion of paramedics and doctors are in Iraq since they are TA Reservists providing medical care to troops.

There is no end of people talking through their hat on the NHS, they have no real experience of other systems - go try the US where medical insurers now run such an oligopoly that the AMA wants Anti-Trust investigations.

No country can afford medical care which is why every country is cutting back.The US spends 16% GDP on healthcare and still has the world's highest infant mortality of any advanced country and bankrupt hospitals, plus pensioners who cannot afford drugs. General Motors, the world's largest industrial corporation just reported a $10.000.000.000 LOSS due in no small part to the cost of retirees medical cover and pensions.

Today Blair floored Cameron on the NHS in a way he would not have floored Davis or Hague. Too many Tories are simply uninformed on the NHS or just plain ignorant and they get tediously boring because they have no idea how it functions inside. It is suboptimal for staff - but go read a few of their Blogs and see what is really happening.

Labour had The Big Conversation but pulled all the NHS Sections as staff made clear what was going wrong. It was not much better after the mess Keith Joseph created in the Heath Government or Thatcher unleashed. Government has a real penchant for snake oil salesmen from McKinsey, Bain, and the assorted "experts" peddling studies designed around Shell Oil structures.

When the NHS can refuse to treat a patient, turn away HIV+ individuals, refuse to admit a pregnant woman, refuse to operate on a patient likely to die, and a GP can purge his list of the sick, depressed, or delusional, the addicted and the obese..............................then healthcare costs will fall and demand for healthcare will have the predictability of selling bras in Marks & Spencer rather than the cascade of human misery that cascades into A&E which seems to be overloaded with Ecstasy-popping, Coke-snorting, Alcohol-swilling deadbeats more than anyone would care to imagine

[James Maskell]

Completely missed PMQs (assumed it was still Easter recess). Shall fit it in with Council meeting tonight.

[Richard]

"the idea of welfare for the citizens of these nations does not exist as people have nothing to lose and so don't want the gov to protect them (in the way even the US has to)."

It is unfortunate that democracy often brings with it a growing state sector - people vote for free health and education but in doing so increase the tax burden. This is why I have found the most compelling arguments against democracy tend to come from libertarians who do not believe 51% of people should be able to deprive the other 49% of their wealth.

"Also you haven't stated whether your figs are per capita. Where are they from?"

Here: http://www.brusselsjournal.com/node/510

"go try the US where medical insurers now run such an oligopoly that the AMA wants Anti-Trust investigations."

The US system is hardly a model of private enterprise. It involves a great deal of subsidy and regulation:

http://www.mises.org/fullstory.aspx?Id=1749
http://www.catostore.org/index.asp?fa=ProductDetails&method=cats&scid=33&pid=1441272

[Richard]

"Will people never learn.If the party was stupied enougth to go into the next election promising to privatise the NHS you would not only say goodbye to any hope you had of winning the election you would probably be able to fit the parliamentary party into a taxi after the election."

I am not calling for total privatisation because I accept it would lose us an election. However, recent polls have shown increasing public sympathy for a less statist-system based around the European model (although that model also has flaws).

Anyway, isn't your name Michael?

[Clare Lewis]

You mention in your introduction that no Labour MP's from Coventry mentioned Ryton. The Ryton plant is not in a Coventry constituency. It is in the Rugby and Kenilworth constituency (MP Mr. Jeremy Wright, Con) who was standing to be called by the speaker until DC used it in his 2nd set of questions, when he sat down. Fantastic communication between leader and backbencher there........

[Rick]

All the party leaders paid tribute to Richard Palmer, the latest British fatality from Iraq.

Can we mention that he was Lieut.Richard Palmer of The Royal Scots Dragoons and not merely "Richard Palmer" British civilian contractor ?

[Rick]

However, recent polls have shown increasing public sympathy for a less statist-system based around the European model (although that model also has flaws).

No doubt it needs a lot of change but I don't think one political party should be doing such things. There should be wide consultation with all parties involved inside and outside Parliament. Change in the NHS has never been consensual but always some for of machismo which founders.

The German and French healthcare systems are in crisis. Go read the German press about how they are trying to change healthcare funding which is crushing small businesses and recall that a large proportion of those with no health insurance in the US are self-employed small businessmen for whom the individual healthcare premium often exceeds their incomes.

Privatisation is moving apace in the NHS already - NHS Logistics was sold to a US group but I bet few people on this Blog know anything about it. The Govt plans NHS to be an insurance provider with US companies running hospitals and contracting on the HMO model in the USA.

The Treasury wants to keep the revenue streams from NHS "insurance" premia just as it wants the income from pension contributions - it intends however to outsource the Cost side to private/voluntary groups so it can sit on a pile of cash and fund itself.

[Margaret]

Commission stalled Peugeot’s UK expansion plans as British taxpayers build new plant in Slovakia 19-04-2006

The European Commission has stalled £188m of extra investment in Peugeot’s Ryton plant in the UK, while simultaneously conducting its longest ever inquiry into state aid. At the same time it has been using cash supplied by British taxpayers to subsidise the building of the Trnava plant in Slovakia, U K Independence Party transport spokesman Mike Nattrass MEP said today (19.4.06).
Mr Nattrass said that Peugeot had submitted a request for state aid in December 2002, which the British government had referred to the European Commission. In what the DTI described as the ‘longest case to win approval’, a decision was not forthcoming until early 2005, by which time Slovakia was on the brink of accession to the European Union. The Commission has approved E105m of state subsidy for the Trnava plant.
Mr Nattrass continued: “Effectively British taxpayers have subsidised the export of their own jobs while the Commission dragged its feet over a decision which could have saved the livelihoods of thousands of my constituents.
“Peugeot was seeking state aid for Ryton in order to manufacture its replacement for the 206 range of vehicles. Had the Commission acted in a timely fashion and permitted the aid package requested, Peugeot would have invested £187 million in the West Midlands, and the future of the plant would have been secure.
“Instead, the Commission has decided that Trnava deserves the jobs more than Coventry, with the British Government nothing more than a helpless bystander. This is the second time in less than a year that this has happened to British car-making, after the Commission halted any plans for state aid to Rover.
“How can our democratically elected parliament at Westminster have given the unelected European Commission the power to play god with British workers jobs?”

[Esbonio]

I am afraid I have to agree with Rick again and in a particular regarding the failure to afford Lieutenant Palmer his rank.

[matt wright]

Rick, absolutely totally spot on. Well done. Yes we can learn from the private sector and the NHS can be run much, much better but you cannot run hospitals as a true business in a commercial competitive model. What are politicians going to do when hospitals close down? Are penisoners going to travel hundreds of miles to get treatment? As you say in the US many old people can't get treatment or it costs crippling amounts,

Matt

[Annabel Herriott]

I would like someone to do some really serious research on NHS Managers. Background, were they just moved sideways because they were getting in the way where they were, how many new desks/carpets/curtains/whatever they get, what about their CARS??? Are they just bean counters, or are they actually achieving anything? how do they equate human beings with business plan s, because clinical stuff is subjected to this sort of evaluation now. I could go on, and on, and on, but I would blow a fuse. Even when DC asked 4 pertinant and reasonable questions, all he got back was a stream of meaningless AND fudged statistics. AND our leader kept his cool, unlike TB who continues to morph into Jack Nicholson going mad (The Shining )

[Annabel Herriott]

Oh, and how many Managers at gawd knows how many quid per annum would you have to lose to retain the nurses currently facing redundancy???? Not many, I bet! What is it? 50 grand + lease car, these days???

[Richard]

"As you say in the US many old people can't get treatment or it costs crippling amounts,"

See the links in my above post. The US system is not truly consumer-driven.

[Rick]

The US system is not truly consumer-driven.

Noone can afford a consumer-driven healthcare system - we do not have a consumer-driven housing system - budgets constrain choice.

Now what budget limits shall we impose on the sick and unwell ?

My US insurance used to have a once-in-a-lifetime cap on coverage for any treatment above $250.000 - after that you were uninsurable for the second operation.

I prefer medical opinion to consumer-driven

[Rick]

We have an area of medical provision that is purely consumer-driven - it supplies Ecstasy, Cannabis, Cocaine, Crack, Crystal Meth, Amphetamines to those who pay directly for as much as they can afford - these are all powerful medical substances which some consume to excess, others overcome the budget constraint through crime to raise the funds, and whatever need the consumption creates ie addiction is driven by consumer choice and consumer need.

Medical provision is unlike any other product - make the wrong choice and you are not around to regret it. Remember Karen Ann Quinlan ? she liked aspirin and Coca-Cola and she never came out of her coma - her choice had consequences for others.

[Oberon Houston]

I am still very concerned at the low quality opposition we have presented to Government policy - especially regarding the NHS. Brown does not look upon it as something to concentrate on to improve the health of people in Britain. He sees it as a huge political bludgeon that he can use to gain power, batter the Tories and maintasin power. The proof of this is in the disgracefully irresponsible way he has developed policy for the NHS - and the current mess it is in. Que for Tony to enter the fray with a self created crisis to deliver an empassioned speech on. Que for Brown to turn his attention to Education. Meanwhile our NHS is in dissaray, Schools have a raft of policy designed to deny us power at the next GE and not to improve the education of our kids...... and what has Her Majestys Hon. Opposition do for 8 years? Not much.