Tag Archives: opinions

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Health and social care

For many years and under many governments the UK has puzzled over the relationship between social care and the NHS. All governments would like a seamless transition from the one to the other for patients who need both. All have looked at whether some administrative or management reform would make all the difference. No-one so far has come up with a perfect solution.

Some now say the answer is to put social care under the control of the NHS. Others say the local NHS in each area needs to work more closely alongside the Council’s social service department. There are concerns that the boundaries do not work well, with some Councils not moving quickly enough to provide social care placing greater strains on hospitals with elderly patients.

It is tempting to think we could reorganise to remove any boundaries between different public bodies providing services. Then maybe the unified budgets would lead to more optimal outcomes for both patient and taxpayer. However, it is difficult to see how you can avoid a boundary. If you put social care into the NHS you just shift the boundary to the one with Council provided care homes and sheltered housing. If you transferred local NHS control to Councils you would find it much more difficult to get benefits from national NHS policies, purchasing power and hospital planning. There would be a bigger tension between national and local NHS, with all the money coming from the national level.

As someone who has thought a lot about this problem as a former government adviser and someone helping with past Manifestoes there is no easy answer. I conclude it is best to start from what we have, and build in incentives and requirements for good conduct by both the NHS and local social care.What we want is a wide range of provision, with choice and capacity available for each different and often difficult case.

Someone in social care needs access to a good GP and or to a hospital Consultant for a worrying condition. Admission to hospital when needed is not normally a problem. Decent supervision of an elderly person should enable better management of any medical condition without emergencies or alarms in many cases.

Discharging an elderly person from hospital requires appraisal of their needs and prompt and helpful action by social services, housing and other relevant departments. This is where local accountability and Councillor supervision should wish to shine.

Promoted by Fraser McFarland on behalf of John Redwood, both at 30 Rose Street Wokingham RG40 1XU

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The world recovery will be fine

There are many fears and alarms expressed about the state of various economies around the world. The curious thing is in recent years none of these has come true. The world economy has continued to grow at a modest pace, with contributions from all the advanced countries led by the US and UK growth rates. China too has kept a steady growth of over 6% going, with many critics claiming it is about to end. This year we may also get some turnround in Brazil and less of a drag from the oil and commodity based economies which suffered in recent past years from low oil and commodity prices.

The background with the Euro area continuing to create extra money and buying up sovereign bonds, Japan doing the same, and the persistence of ultra low interest rates outside the USA, is favourable for more growth. It is true there has been an uptick in US, UK and Euro area inflation this year. This owes much to the higher oil price, aided by some Chinese price rises on exported goods to reflect the higher input prices they are paying for energy and raw materials. This may well abate later this year, as oil and commodity prices have been weaker recently. Higher inflation has not so far impeded reasonable growth in consumer spending in all these affected areas.

Mr Trump’s new found ability to get a Healthcare reform through the House of Representatives means he may be able to get through some reflation as well. He still has to get the Healthcare Bill through the Senate, who may wish to amend it and cause difficulties. Getting some kind of healthcare reform through is an important first step prior to tax cuts which will be easier to achieve if healthcare reform delivers some expenditure savings. Serious tax cuts in the USA would power more growth, which would benefit the rest of us as well.

Promoted by Fraser McFarland on behalf of John Redwood, both at 30 Rose Street Wokingham RG40 1XU

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Fanciful figures

This week we saw a couple of sets of fanciful figures intrude on the debate. There was Labour’s 10,000 police at £30 a year salary, hastily adjusted to £8000 a year, still way below what we normally pay our officers. Then there was the FT’s take on the EU bill for the UK leaving the Union, at Euro 100bn.

The first sets of numbers were mistakes, and have been adjusted upwards as much Labour spending will need to be to make it realistic. £300 m a year is nearer the mark.

The second story that the UK owes up to Euro 100 bn is just silly. There are no legal obligations to pay beyond the sums we owe for our regular contributions over the next twenty two months before we leave. If they want a political deal on money, then of course they would need to knock off our share of the assets. I don’t see that is a sensible or attractive way to proceed for them. They should just accept the Treaty that allows for no special bill.

The UK should continue to be friendly, outward going and positive about it all. We should continue to stress the great deal we are proposing for our future relationship. Free access to our market for all their exporters. Guarantees for all their citizens living and working in the UK. Continued large UK contributions to the defence, security, research and culture of Europe.

Stable and strong leadership is needed by the UK, to be optimistic but to be firm in resisting silly proposals that have no basis in law or political reality.
The EU disobliging briefings sound as if they are coming from people who suddenly realise their negotiating strategy of pressurising a member state into seeing it their way is not going to work. The EU thought the UK would want to stay in the Single market Custom Union. They could then seek to charge us for that. It was always a silly assumption, as the UK clearly wants to make its own free trade agreements with the rest of the world which means leaving the Customs Union. The UK was also clear it wanted to stop paying the money. It is the Commission who are most worried about the loss of the UK’s contributions, as it’s their budgets and salaries that will suffer.

The way countries pay to trade with other reluctant countries is via tariffs. If the EU wants to put tariffs up against us, it can only do so to a limited extent under WTO rules.It would be a lot cheaper than the bills we are hearing about. In return we can impose more tariffs on them given the nature and volume of their exports to us. That is why I have always thought it likely in the end they will want tariff free trade. It is, of course, always possible they wish to self harm. However, it seems it is more the EU Commission that favours a tough approach as the harm is to the member states, not to the Commission itself. The member states are more likely to wake up to the harm it could do their export companies and especially their farmers and want a more sensible approach.

If the EU seriously thinks we need to give them money to be able to sell them goods presumably they would need to give us money to sell us goods. I can’t see that idea catching on.

Promoted by Fraser McFarland on behalf of John Redwood, both at 30 Rose Street Wokingham RG40 1XU

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The French debate

The debate between Le Pen and Macron was by all accounts fiery, personal and intense. There may have been less policy detail than some wanted, but the big divides over policy were nonetheless clear.
They both are running as anti establishment candidates who want change. That is more difficult for Mr Macron as he was until recently a Minister in the socialist government. Agreeing with his opponent that unemployment is too high and new economic measures are needed, he had to deal with why he had not done that as Economy Minister. He now wishes to liberalise the labour market, making it easier for companies to take on people. Madame Le Pen for her part wants to place barriers on the movement of people into the country and workforce, and to protect French trade and jobs by direct intervention. She was asked repeatedly for more detail of her measures and how they were supposed to work. They put the respective cases for a global and EU based approach versus a protectionist France first approach.
They differed strongly on the Euro and EU membership. Mr Macron is fully committed, and stressed the central importance of belonging to the Euro in his vision of the world. Mrs Le Pen argued that the Euro is the bankers’currency, not the currency of the people. She wants a French currency again.
Madam Le Pen attacked the powerful role of Germany in the EU and jibed that either way in this Presidential election France will be governed by a woman – herself or Mrs Merkel. Either when elected as President will need to construct a majority of representatives in the Parliament to help implement their programmes, which will make the Parliamentary elections most important after the choice of President.

Promoted by Fraser Mc Farland on behalf of John Redwood, both at 30 Rose Wokingham RG40 1XU

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