BBC BLOGS - Nick Robinson's Newslog
« Previous | Main | Next »

Discipline and the NHS

Laura Kuenssberg | 11:56 UK time, Friday, 14 August 2009

I can see from your comments that the fans and foes of the NHS among you have equally vigorously-held views, and a debate about the merits of the service now seems to be in full swing.

Andrew Lansley joined his boss in trying to hold the party leadership's line this morning, defending the party's commitment to the NHS after Daniel Hannan's distinctly off-message comments.

And of course, Labour have jumped in feet first. Lord Mandelson, the "other PM" while Gordon Brown's away, claimed that the "two faces" of the Conservative Party had been exposed. And the health secretary Andy Burnham said Mr Hannan's intervention was Mr Cameron's "worst nightmare".

In order to see this content you need to have both Javascript enabled and Flash installed. Visit BBC Webwise for full instructions. If you're reading via RSS, you'll need to visit the blog to access this content.



Now, Daniel Hannan would be regarded by the majority of Tories as on the right of the party - his views aren't typical and any attempt from Labour to portray them as such should be seen in that light. But after David Cameron's particular efforts to portray his party as sincere supporters of the NHS, the Conservatives did not want to be having this conversation now.

Pundit and punter Mike Smithson speculates about this row at Political Betting: in the quiet summer period, might it just push things a little towards Labour? We'll see.

PS: Incidentally, whatever you think of the Republican campaign criticising the NHS, it has certainly caught the imagination of thousands of Americans. Sunny at Pickled Politics has written an interesting post about its effectiveness as a campaign [some mildly strong language]: are there discipline lessons for British politicians?

Comments

  • Comment number 1.

    I don't think anyone genuinely believes that the Tories would do away with the NHS altogether - that's just a daft rumour that's being perpetuated, not helped, I don't think, by people constantly referring to Hannon as a "senior Tory" like he's in the shadow cabinet or something.

    At the same time, it's evident that the NHS needs reforming, and one thing that this debate has done at least is bring the subject to the forefront of discussion. Labour have demonstrated quite spectacularly that short of throwing money at it, they don't have any ideas, so this is an excellent opportunity for the Tories to put forth, at very least, a taste of their intentions once they enter government next year.

    If only it was this easy to get other important subjects to the forefront of the political agenda...perhaps Twitter is doing some good after all.

  • Comment number 2.

    I think if there's one thing this whole "debate" (read: slanging match) is that all the recent brouhaha over the Punch and Judy nature of our political culture is rather put into perspective by our cousins over the water. The level of invective and outright falsehoods propagated by both sides is pretty shocking. You wonder how much of it to take seriously really.

    BTW: Choosing Pickled Politics as somewhere sensible to link to is a bit odd, given that they are rabidly of the liberal left (in American terms) and therefore hardly likely to be giving out anything like sensible, balanced commentary on the whole affair.

  • Comment number 3.

    A gift for Labour.

    Conveniently hiding all those really nasty stories like unemployment.

  • Comment number 4.

    Please tell me that we are not taking an MEP's view seriously on a matter of explicitly domestic policy that has nothing to do with his role as an MEP?? Please tell me that we are not leading our news bulletins with this?? I might add that there is nothing wrong with criticising or questioning any institution, even fundamental questions as to whether it is the best way to achieve its aims - indeed we should question all such VAST spenders of tax payers' money - but it would seem that some are now deemed off limits. We are a free society and I do not notice any great reaction to criticism (some of it quite trenchant at times) of the monarch, the church, teachers etc. I thought that New Labour wanted an end to deference unless, it seems, it is for one of their political touchstones, namely the NHS. I have found the people who work in the NHS to be superb and worthy of praise but to say that the institution itself is perfect and not open to criticism is barking!

  • Comment number 5.

    Daniel Hannan does not set Conservative policy. He has even less influence over Conservative policy than Dennis Skinner has over Labour policy. [One of the critical differences between the two is that Hannan acknowledges that his views are his own and not his party's; Skinner never does that.]

    So, how closely does Labour wish to associate itself with everything (yes, everything) that Dennis Skinner has said over the last three decades?

    To suggest that Hannan's expressed views on the NHS are anything but his own is, to say the least, disingenuous. One might go further and call it dishonourable and desperate. And one might note that it is Lord Mandelson who is the one to do just that - point proven, in my opinion.

  • Comment number 6.

    Laura said, "the Conservatives did not want to be having this conversation now."

    The Conservatives MUST have this conversation, now. They either trust the free-market, across the board (the Hannan/Tebbit/Thatcher model), or they don't. Which is it to be?

    Mandy's (he's one to talk!) got that much right, about "two faces" being exposed. Cameron's got a lot of thinking to do about his true direction. If Cameron lets NHS-socialism in, then it'll be inordinately difficult to get rid of it, as with Heath & Europe.

  • Comment number 7.

    So by tweeting NuLiebour are going to fix the NHS?

    How about actually getting down to some positive action and sorting out the issues that beset our debt ridden country

  • Comment number 8.

    So what next? Are we now just one step away from religious crazies bombing abortion clinics? The UK certainly has no shortage of religious crazies in the political arena, do we?

    In the previous blog I indicated that UK politicians should not enter this debate. I have not changed my mind. The fact is that both sides of the US Health debate will twist an innocent statement out of its original context to suit their own ends. In the US media an UK politician will not have the right of rebuttal, like they could with the BBC say.

    The whole shebang is a matter for the American people and politicians. I was under the impresion that one or two things in the UK needed fixing?

  • Comment number 9.

    Dan Hannan's View "In The Plan, published last year and co-authored with Douglas Carswell, I set out at length a scheme to replace the current government monopoly in healthcare with a Singapore-style system of personal health accounts. The Singapore system produces better outcomes than ours for half the price. If we spent the same percentage of GDP on healthcare as now, but put equivalent power in the hands of our consumers, it seems not unreasonable to suppose that we would be much healthier. (Incidentally, the state pays for those who can’t afford their own accounts in Singapore, as in every developed country. It never ceases to amaze me how many British people have been convinced that free healthcare for the poor is a unique property of the NHS.)"

    So instead of NI to the Government we pay the same to a private company and recieve a better service. Sounds good to me.

  • Comment number 10.

    "7. At 12:43pm on 14 Aug 2009, StrongholdBarricades wrote:
    So by tweeting NuLiebour are going to fix the NHS?"

    In 1997 Blair famously had 24 hours to fix the nhs?

    As that was 12 years ago surely its been fixed by now!

  • Comment number 11.

    Given time the Tories will turn the NHS over to the private sector piece meal. Just as they did with BT / Power Companies / Blue Chip manufacturing Companies etc etc. Dig deep and you'll find the truth!

  • Comment number 12.

    Now here's a story which will shock you. It's true and about me and my family.

    When my son had his terrible accident (aged 15) he was taken into a top neurological unit, unconscious. In our desperation we said to the doctor in intensive care unit that he was on BUPA and would it help with his treatment? The doctor dismissed this saying our son would get first class emergency treatment on the NHS the same as anybody else and nothing would be gained by putting it through BUPA.

    OK. Well he had brain surgery, twice, and was still in deep coma but slowly making improvements, and ready to be transferred to our local general hospital - 50 miles away.

    Then the neurosuregon who performed the operations came to me and took me aside asking me if I would, in fact, put it all through on my company's BUPA scheme as it would help with the intensive care bed etc etc. I contacted my company who asked BUPA and it was agreed.

    The total BUPA paid to this hospital and surgeon was 35K - not this was years ago so it was an absolutely massive sum them. The surgeon took his whack (although presumably paid by the NHS as well)as did the aneathetist and others - I have the copies of all bills.

    When I think of it, this was a rather underhanded way of obtaining money seeing as the work had already been done under the NHS.

    I was suspicious at the time but in such distress I did not have the energy to pursue it.

  • Comment number 13.

    #3 A gift for Labour.

    Not really. Labour are so dead in the water, that the Tories can afford to have this discussion. The Tories have got more than enough spare ammunition to stop the twitching Labour corpse, at the GE.

  • Comment number 14.

    #11 Given time the Tories will turn the NHS over to the private sector piece meal. Just as they did with ...Power Companies...

    Though, blackouts in the private sector are a somewhat rarer occurrence, than the public sector variety.

  • Comment number 15.

    You ignored Daniel Hannan's dissection of Gordon Brown in the European Parliament (until it got too big to ignore), but a short interview he gave on US cable TV becomes headline news. I'm sure Lib Dem and Labour MEPs (even MPs) have said off message things but you've never given them such publicity, odd that.

    Perhaps Laura you'd like to explain what makes Daniel Hannan's comments so worthy of headline news, yet all the other off message stuff politicians say not so.

    It looks like in the run up to the election every off message statement made by a Tory MP, MEP, councillor, or activist will become a headline while the real news is pushed to one side.

  • Comment number 16.

    I am now very confused does all this howling support of the NHS from the Labour party mean they are going to take back in house all the lucrative private contracts they have given out over the past 10 years ????

  • Comment number 17.

    #11 redrobb

    Yeah, course they will, redrobb. Tried desperately to do for 18 years but failed again.

    So let's now actually have a debate about the future of health care in the UK and how it can best be funded. Or we can, like Mandelson and his sidekick Brown (and Cameron if his comments are anything to go by!), put our collective heads in the sand and think it's all going away - like magic!

    A baby boom generation, the last leg now into their 50s. This generation is going to put one hell of a financial burden on the younger generation in terms of retirement provision and, even more so, medical care!. Better diagnostics mean more illnesses to treat, better medication means these illnesses can now be treated. More expensive drugs to treat previously terminal conditions. And better care is demanded every year.

    So, Peter and his sidekick Gordon are going to fund this out of falling general taxation and, at the same time, get more nurses and doctors 'on the front line'. Really?

    We MUST have a discussion. The NHS is NOT a holy cow, not a religion. There will, at the end of the day, be a point at which the NHS can no longer continue in the way we have known for 60 years. The cash will run out.

    Anyone up for the debate?

  • Comment number 18.

    Oh the irony.

    When Hannan gave his brilliant and vastly popular speech exposing Brown for the incompetent idiot he is, Labourites everywhere were oh so quick to point out how irrelevent Hannan was. And in a way, they were of course correct, except that he captured the views of the public rather well and expressed them coherently and passinately to Brown's desperately gurning visage.

    Now that Hannan says something that they feel they can criticise, suddenly he is setting Tory policy.

    Politics in this country is becoming an absolute farce, and I for one am absolutely fed up with it. Hannan's views, that the UK's health service has performed badly for a long long time, are surely unchallengeable. It should logically follow that there is a better way to provide health care to the country (the whole country, rich and poor, I believe he cited the Singaporean model which seems to work far better (although I confess I do not know the details or how it could apply here)).

    Suddenly the whole Tory party wants to abolish the NHS and restrict health service to only those who can pay for themselves (legalise child bruatality and reintroduce crucifixion while they are at it no doubt).

    Now we are going to have to put up with a bunch of arrogant, smug, self satisfied and self righteous ministers pompously proclaiming that the Tory Party is evil becuase of one statement made by a man who has nothing whatsoever to do with domestic policy. It makes me grind my teeth just to think about what it is going to be like for the next couple of weeks. And all the while, the real news, the string of disasters effecting our once great country, will be buried in a resounding chorus of "nasty party, nasty party".

    Too much to hope that zanu will show maturity and except that one man's views do not a party's policy make?

  • Comment number 19.

    The debate we should be having is whether or not the 1947 NHS model is the most appropriate one for the 21st century. The NHS is riddled with layers of management which only exist because of meddling from Whitehall. Beveridge's original vision was not to nationalize the hospitals, Ny Bevan did that to appease Labour MP's, in following years ministers ran hospitals as if they were an extension of the civil service and this has helped to create the current mess. The NHS needs major reform, I think the vast majority of people in this country would agree, they would also agree that the U.S. model is not the way to go either. There are many other models that could be used such as the French, Australian or even the Singaporean model which Daniel Hannan favours. Lets have a proper mature debate on this issue instead of trying to brand any criticism of the NHS as treason which seems to be Labour's attitude.

  • Comment number 20.

    We are in the silly season where every gaffe is jumped on, whilst the real news on unemployment is largely ignored.

    Dan Hannan is a great self publicist - if he were a serious politician he would be in Westminster.

    Cameron has had to be reliant on the NHS because of his personal situation - he knows that the NHS [for all its flaws] is the fall back situation for everyone - even private medicine tends to offload its mistakes on the NHS.

    I don't blame labour for jumping on it, that is politics, but any reasoned person would not accuse Cameron of not supporting the NHS.

  • Comment number 21.

    17

    Anyone up for the debate?

    --------------

    If today's little lynching proves anything, it is that noone is allowed to debate anything controversial anymore.

    People will scream at the top of their lungs until blue in the face that "the NHS is great", but that does not help with the practicalities of running it. This sort of thing exposes just how illogical many people are, and just how cynical are those who lead them on and perpetuate their comfortable little worlds for them.

    It won't matter if the country does not physically have a penny to pay for doctor's, medicines and hospitals, there will still be a huge crowd frothing at the mouth and demanding that the black hole be kept open. You are quite right in your assessment, an ageing population will have more ailments to treat, the longer they stay alive the more they will cost (might sound a bit cold, but its the way it is).

    There is a simple truth people need to wake up to: This country can not afford to keep funding a national health service under the current conditions. Unless people want to start paying 60% to 70% in taxes, there is just no way it can be done.

    But the cold hard facts will make no difference to the idealists and those who rely on their votes. They will shout down any attempt at debate, as we are seeing right now.

  • Comment number 22.

    http://news.bbc.co.uk/1/hi/uk_politics/8200817.stm

    Unpatriotic?

    UNPATRIOTIC?????????????????????

    What a gibbering imbecile.

    How can it be unpatriotic to question an unsustainable institution and suggest it might need to be changed?

    What on earth is so patriotic about supporting the NHS?

  • Comment number 23.

    Laura, are you sure Hannan's views on the NHS are not typical of the rest of the Conservatives? Lets be fair last time they were in power they hardly held it in very high rigard. Waiting lists of 18 months were the norm, nursing staff underpaid and blatent underfunding! Lets not make any mistake there is still room for improvement, but Labour have changed it for the better.18 weeks is the worse case allowed and average waiting list times have fallen to an all time low. Can the Tories be trusted with our Health care, I think not! http://www.nursingtimes.net/whats-new-in-nursing/management/average-wait-nhs-treatment-falls-to-all-time-low/2007514.article

  • Comment number 24.

    What Dan Hannan said/wrote was perfectly reasonable, the problem is that it's been mis-represented by the left-wing media in the uk.

    Cameron knew that the left-wing media in the UK would misrepresent the views that Hannan gave, so Cameron jumped on it before people like the BBC/Guardian (both currently labour-funded machines) would pounce on it and twist it for their own political reasons. Cameron doesn't want to have this debate now, for the simple reason that he knows that all his logical arguments would be twisted and then used against him in a political campaign by the BBC/Guardian/Labour machine. He can only start having rational debates about these issues once he's in power.

    Give the money/choice to the people, and let them decide where to spend it; that's the only/best way that any system will work. Giving all the money to a single behemoth regardless of how well/badly they perform for their patients/customers is obviously just plain stupid, because there's absolutely no incentive for anyone belonging to that behemoth to do a good job.

    Last time I tried an NHS dentist it was a nightmare, so I went private instead; it actually ended up cheaper going private (it often does unless you're on income support), and I got a much better service.

    Give the money to the people, and let them decide where to spend it. It really is that simple.

  • Comment number 25.

    Mr Hannan criticises Gordon Brown publicly and the BBC is eventually dragged kicking and screaming into mentioning it a week later. Mr Hannan criticises the NHS publicly and within 24 hours it is the top story on the BBC news webpage. Does the treatment depend on which party was discomforted?

    Is it no longer possible in this country to hold the view that the NHS might not be the best thing since sliced bread? Perhaps a list of permissible views should be issued.

  • Comment number 26.

    RE 23

    Can I refer you to the little problem in the article you link, in the very first sentence no less.

    " The average wait for treatment on the NHS is now just 8.6 weeks – the shortest since records began, according to new government figures."

    We have at the moment a government notorious for spin, changing the rules for measurement, and in many cases flat out lying (public spending, national debt etc.).

    How is it that you think this is any different?

  • Comment number 27.

    It has always been the case that the next election must be lost by New Labour, not won by the opposition. The institutionalised advantages enjoyed by New Labour means that the Conservative Party (or anyone else for that matter) will have to work twice as hard, just to overhaul the current majority enjoyed by New Labour, let alone achieve a sufficiently large majority for itself to secure a full term in government.

    Add to that the clear self-interest of the national broadcaster perpetuating a leftist government, and hence slanting its news and current affairs coverage against the opposition parties, and it becomes clear the scale of the task facing those seeking to consign The Crashmeister's government to the scrapheap. The insistence on promoting the US debate on healthcare as some kind of proxy battle over the NHS between cuddly, caring New Labour and the evil, baby-eating Tories (in the somewhat bizarre personification of an MEP unrecognisable to, probably, 99% of the UK electorate) is simply another manifestation of this reality. Alan Duncan's pathetic intervention on the issue of MPs remuneration is but another case in point. As of course, is the way in which soaring unemployment is neatly camouflaged by the smokecreen of faux outrage being spouted by rent-a-gob ministers doing their best to keep the NHS story at the top of each bulletin.

    The fact that, given the parlous state of the public finances, there is an urgent need for an open and searching debate on how the public sector is financed and what it should be expected to provide, is clearly not a subject that a broadcaster, itself part of the public sector, will be comfortable promoting in anything resembling an impartial manner. And since it is clearly not in New Labour's interest to allow such a debate to develop, for fear that the obvious conclusion that countless billions of taxpayers' money has been wasted over the last twelve years of soaring budgets and collapsing delivery in the NHS wil be reached as a consensus view, it makes perfect sense to go for the man (or the Dan in this case) rather than attempt to engage.

    Given the less than optimistic prognosis delivered by the Governor of the Bank of England this week regarding the prospects for recovery of the economy generally, and how that will play rather contrary to New Labour propaganda, I'm afraid we can expect a great deal more of this kind of reporting, if that is what it is, from our esteemed national broadcaster, for the next ten months or so.

    Depressing, or what?

  • Comment number 28.

    #22. Yep, Labour are going to use this to close down any debate about the NHS. If you do suggest any changes you will effectively be accused of a thought crime. Hannan's views about NHS have been known for some time, why it has become an issue all of a sudden is because of the totally disgraceful suggestions of Obama's opponents that Stephen Hawking and Ted Kennedy would have been allowed to die by the NHS. Hannan's mistake is not his views on healthcare but his poor judgement in allowing himself to be feted by Fox News whackjobs like Glen Beck.

  • Comment number 29.

    Amazing how Hannan's opinions are all of a sudden of ground shattering importance, the Labour party didn't rate the last opinion he offered, indeed they did their best to pretend it was never voiced. Suddenly the NHS which under Labour has turned into a bureacratic monster with more regard for clerical job creation than patient care is the most important thing on the planet. Much more important than unemployment , the failing economy or the brave young men dying in Afghanistan for a cause they neither understand nor need to espouse. This whole affair is being blown out of all proportion at the behest of an unelected , twice disgraced, self styled stand in Prime Minister intent on furthering his own career and removing the present incumbent of Downing Street.

  • Comment number 30.

    "I would almost feel... it is unpatriotic because he is talking in foreign media and not representing, in my view, the views of the vast majority of British people and actually, I think giving an unfair impression of the National Health Service himself, a British representative on foreign media"

    What a vile simple minded statement. presenting his view as fact!
    The NHS is a bloated drain on the resources of this country. We should explore the alternatives even if we decide not to change anything. If the NHS is so good then why are the Labour Party and Tory part so scared of having a proper debate about this? If its the best/envy of the world then it will win the arguement of not changing it surely.

  • Comment number 31.

    #19 JPSLotus79

    The French system is a far better model of how healthcare would be better run but it would be an almost impossible sell in the UK, because it isn't free but is sure is fair and it would need more than one term to even begin to get moving and no party standing for election on it would stand a cats chance.
    The system we have now is as you note not what was intended in the first place. It is typical that we had the idea but left it to others to implement it properly and did the usual british thing of bodging it up and making a complete mess of it.

    As to Hannan, he can hold any view he wishes, we are a free society after all. Should he wish Dennis Skinner could have joined the Conservatives, he would undoubtedly have felt lonely but he could have taken his view and expounded it in internal party debate to his heart content. He would however not likley have been selected by the party to represent it.

    Hannan has been selected by his party to represent them. So irrespective of whether he is leader or not I can be justified in thinking he represents a view within the conservative party which depending on internal party politics may become more or less prevalent and hence policy.
    Now I understand that Hannans view is not party policy but usually if you express a view that is wildly at odds to party policy then you should not be a representative of the party, hence remove the whip.

    It is also that such silly grandstanding as Hannan has engaged in brings the over arching backlash. I just listened to Cameron restating his commitment to the NHS, ringfencing it, expanding it, improving it. This is not what i think needs doing but now we are stuck in a place where debate is going to be all about how to deliver as much healthcare as we can for free. There is not going to be a debate on whether some of what is free should remain free or be provided on the NHS at all.

    Cameron understands how such silliness is exploited by opponents and the media. So he can neutralise it very simply - state his position as he has and sack Hannon from the representative position in the party.
    It would make me personally respect his positions more and more likley to vote for him. My vote is positive, so just not being Gordon Brown is not enough, he has to work for it.

  • Comment number 32.

    I must say I really don't like the idea that Hannan might be "disciplined" for saying what he did.

    I disagree with Hannan's point of view on the NHS (for all its faults, and there are undoubtedly many, it's infinitely better than the American system IMHO), but I strongly defend his right to express it. That people are talking about disciplining him shows the worst kind of control-freakery that's inherent in party politics.

    Yes, if he were a senior member of the shadow cabinet, there might be an argument for expecting him to toe the party line. But he isn't. Allowing people to express different views is thoroughly healthy for democracy, and long may it continue.

  • Comment number 33.

    23 metalwork

    Metalwork, you should remember that the only mainstream party which has promised to maintain and improve NHS funding after the election is the Conservative party.

    Can Labour be trusted with the NHS? I think not!

  • Comment number 34.

    23. At 1:31pm on 14 Aug 2009, metalwork wrote:

    "there is still room for improvement, but Labour have changed it for the better.18 weeks is the worse case allowed"

    Yes, but the issue is, with the unbelievably large amount of extra money that labour simply threw at the NHS, if proper reform had been done at the same time would that 18 weeks now be down to 24 hours? That's where the crux of the argument lies. If you throw enough money at something then you're bound to get some improvement, but the issue is could that extra money have produced a much much better result if spent/managed/overseen properly?

    An analogy would be a school being given a million pounds by the local council to repaint their classrooms, and then that school employing the most expensive contractor available to do it and employing 100 management consultants to work out a colour scheme, instead of the headmaster deciding the colour himself and employing a local firm who'd do it for 10grand. Sure, they'd get their school painted, but it'd cost them a million quid and take years instead of costing 10grand and taking a week.

    Throwing money at things is not the solution; spending the money better is the solution.

  • Comment number 35.

    Just like Alan Duncan's outburst, there is an agenda behind it and most possible Hannan is not looking to represent us more looking to advance his own agendas. No doubt the Nu Compassionate Tory party will now stop their veiled threats to the NHS.

  • Comment number 36.

    Why is it unpatriotic to disagree?

    Andy Burnham is sailing very close to the "you're either with us or against us" kind of politics that we despise in this country.

    This utterly smacks of desperation by this thoroughly discredited Labour government to take the spotlight off the fact that the country is in a mess. Dan Hannan was irrelevant when he dissected PM Brown in the Euro Parliament and now he is the voice of the tories.... come on Labour, make up your mind.

    The death throes of a dying goverment, I'm afraid.

  • Comment number 37.

    #31 I understand your point but I don't think that Hannan's views on healthcare justify him being punished by the party. There are plenty of politicians who have said some pretty outrageous comments over the years on issues like race and homosexuality and have lost the whip or been deselected as a result. Hannan's big mistake has been to allow himself to be so closely associated with some of the wilder elements railing against Obama's helath plan, his own views on healthcare do have some merit and are worth at least considering. People should be free to articulate viewpoints on issues and to think the unthinkable.

  • Comment number 38.

    the nhs should be free from government intrusion, and be left to run itself to stop governments messing it up like recent governments have.
    with out the nhs this countries health would have gone backward towards victorian times.
    the haves would get good care and the have nots would be left to die painfully.
    opponents of the nhs should look at the history of uk health care both before and during nhs period then make comment not blindly ridicule something with out looking at the whole picture, and thr thought of going down the american road will cost lives and even more money.

  • Comment number 39.

    delminster

    Noone is advocating the American approach. And certainly not going back to Victorian times.

    But there are several, very creditable systems around the world which fall somewhre between full private and public funded free for all which work extremely effectively.

    It is these we should be considering as alternatives.

  • Comment number 40.

    Re. 26
    Lets be under no misconception here, I've had the misfortune have having four members of my close family needing the services of the NHS. In all cases the care was timely and second to non. I have experienced it first hand. Perhaps I've been lucky, I dare say some one will have a terrible experience to tell, personally I think the service is far better now. I wouldn't want to be one of the 46 million Americans without health insurance, would you?

  • Comment number 41.

    let's forget about Derek Hannan (or "Deggers" as I think they call him at the golf club ... where he's been known to cough while someone is putting out ... allegedly) since he's not that relevant to this (extremely important) debate about "our" National Health Service

    the fact is, all reasonable people (such as me, for example) would agree with BOTH of the following ...

    (a) the NHS has got considerably better under Labour, these past few years - not surprising since there was an urgent need to redress 2 decades of Tory neglect

    and:

    (b) it damn well should have done, given the oceans of cash thrown at it at a time when (we know now) we couldn't really afford it - and whether all that moolah has been well spent is ... putting it mildly ... arguable

    someone who says (a) is right and (b) isn't is probably a fully paid up member of NuLab (standing for them at the Election, I wouldn't be surprised) - whereas, if you're all (b) and no (a) you're almost certainly a clown

  • Comment number 42.

    Since sensible discussion has been discarded with Burnham's comment about NHS patriotism, does anyone else think that Andy Burnham uses eyeliner? If it's blue surely he is being unpatriotic to the Labour party?

  • Comment number 43.

    re 34.
    Ever seen where the over 70% of the NHS budget goes? Do a bit of a search and you'll see. The majority of spending goes to drug companies. If it can be run better by the Tories why did they fail the NHS for 18 years in government?

  • Comment number 44.

    I would like to make clear that the "Pickled Politics" referred to in Laura's post in not connected to me in any way.

  • Comment number 45.

    40

    No, which is why if I was living in America I would make sure I had health insurance.

    But once again, I am not proposing the American system. I am not even necessarily proposing scrapping the NHS. I believe it needs an overhaul and some serious rethinking, but as a concept it is very noble. Unfortunately, the fact that it is a noble concept does not help pay for it, and we simply can not pay for it as things stand at the moment. All the well meaning platitudes in the world will not change that.

    I pay to have my family covered by BUPA. I believe the NHS is competent to cover the big things as a general rule (anything critical and you get attention straight away, which is as it should be), but since we are all in good health we only suffer from the little things. Relatively minor illnesses, the occasional bone or muscle problem, the NHS is terrible at dealing with these things, and I would not put myself or my family through the experience of having to go through the NHS if it was not absolutely necessary.

  • Comment number 46.

    "Unpatriotic" from Andy Burnham

    "two faces..." from Mandelson.

    New levels of irony and breathtaking lack of self awareness being reached here I think.

    And whatever the merits (or lack of), at least they are democratically elected representatives, which is more than can be said of "other PM" is.

  • Comment number 47.

    I have (now) listened to Hannan's comments. Hard to make out what points he tried to get across wh9ich were relevant in the context of Obama's Health Care plans.

    As far as I can (having read several pieces about those plans) there is absolutely no intention of taking health care into national hands. There is an intent to change the way in which health care insurance is offered. That would be expensive. There seem to be some intentions of ensuring continuity of coverage wherever a citizen was in the US, with some agreed minimum standards of treatment.

    I see nothing at all to justify Hannon's blast at a "socialist" approach.
    It's like shooting a a cloud.

    Blair, Brown, Milburn and Co have injected (rather permitted the injection of) more private funds and services into the NHS than any Tory ever did!

    So it's rather silly for Burnham to talk about the "two faces of the Tories", when his own bosses have privatised significant aspects of the Nationalised service...

    It always seems sensible to consider how any service - private or public - can be made more efficient and cost-effective.
    Remember Tony B appointing Frank Field to "think the unthinkable" - but rapidly sacked him because the guy WAS actually having radical thoughts.

    Health has an inflation index all of its own. Technological capabilities don't come cheaply. Nor do new drugs, or surgical prodecures. Challenging how money could and should be raised, how it should be spent and whether the way we manage the NHS most effectively should be mandatory for every party.

    Likewise every other service provided by the State. That's not un-patriotic. Just common sense.

    Different states have different funding and delivery models for health, while sustaining general access.

    Meantime, I'm waiting to see a full exposure of how much the NHS will have to spend to pay for the PFI-financed (i.e. PRIVATE) hospital building and maintenance programme over the next 20+ years. By some accounts, between 3 - 5 TIMES the amount they would have faced if Brown had actually used public money to build them.

    Now, Mr Burnham, what about the two-faces of Labour's administration of the NHS?


  • Comment number 48.

    Is the NHS better than the US system? Probably; any system that leaves people to die if they can't pay for healthcare can't be held up as a moral system. Does the NHS under-deliver compared to the amount invested? Almost certainly. The problem is that the left are shutting down proper debate on this subject, much like they shout "racist!" when anyone dares to have a debate on immigration. They simply don't want a grown up discussion about anything.

    Not surprised Hannan has got this much coverage from the BBC about his ill advised tirade about the NHS. Shame the BBC couldn't report on his far more popular speech whilst in Strasbourg.

  • Comment number 49.

    To begin with, I have my own views on Americans and their views but I'm not here to discuss such things. They can think whatever they want because they're entitled to their opinions.

    As for our NHS, I work for the NHS and there are a few things to say.

    1. I wholeheartedly agree with the founding principles of the NHS and what it stands for.

    2. We used to have an NHS that truly meant something and provided an outstanding level of care and service that put patients and care at it's heart.

    3. Due to government interference over the years, things have changed for the worse.

    Now on to the matter at hand, we can get back to the type of service in the NHS that we used to have but it will take time, effort, investment and support from the government to put patients and service at the heart of the NHS. We already have excessive waste and bureacracy within the NHS, we have government targets and legislation that are prioritised above the skills and experience of clinicians. We have management, previously put in place due to government interference, only just beginning to get a grasp on the NHS and the service it provides. Now before you start agreeing with the americans, I would have you know that the NHS still offers excellent care and service and provides this care to the wider public and not just those who can pay for it (and I don't just mean all the excessively expensive stuff reported in the media that gets denied to patients because there are those who get treated by the NHS for simple things who would have otherwise had to pay for treatment and most likely couldn't have afforded it). I have nothing but praise and admiration for the NHS and its staff. I have nothing but contempt for the government machine that has spent far too much time destroying the core of the NHS.

    Hopefully the next governments will reconsider how to take the NHS forward and bring about reform that will take the NHS back towards its roots and not towards privatisation. The NHS has been turned in to nothing but a huge, corporate, bureaucratic, overly-centralised government machine that cares more about meeting government policy than the needs of the patients.

    If I had my way, I would cull the levels of management staff and get rid of the Strategic Health Authorities. Over the past month we have been bombarded with bureaucratic work they need that has taken valuable time and resources away from the staff here and has hindered the ability to do our work while that was going on. There are things that need changing, at times it feels like we're on a cliff edge and if government's keep pushing we will eventually fall off and prove the americans right. We're still not on a path of no return even though the NHS has fallen from its previous standards, I hope that in future, the government, the Department of Health, the various levels of management, the forntline staff and all those involved will work together to reinforce the values that the NHS stands for because they are values we share.

    In the time of New Labour most of the investment has gone towards expanding the bureaucrats as well as providing a much needed pay boost to the valuable staff that hold the NHS together. We need to get rid of the extreme and unnecessary management, waste and bureaucracy that has become the NHS and use that money to invest in the staff, equipment and drugs needed for the patients.

    To top it all off, I'm fed up with the idea of a post code lottery and how we all have to be compared at a national level when we provide services at a local basis where local demographics change from location to location which affects the provision of service that is available. Due to budget constraints and local demographics, there will always be winners and losers, and these will vary from region to region. Yes, we do need to ration due to a budget but government has invested in the wrong place which has decreased the budget available for patient care and treatment. We also need to remove this idea that the moment you choose one elemnt of private care you are no longer able to go on the NHS, that is something I totally disagree with. There will always be a tier system because those with money will always have the advantage. That will never change but discriminating against the poor is not a way forward.

    The NHS is an organisation for everyone and should always continue to be so.

  • Comment number 50.

    43. At 2:08pm on 14 Aug 2009, metalwork wrote:
    "Ever seen where the over 70% of the NHS budget goes? Do a bit of a search and you'll see. The majority of spending goes to drug companies. If it can be run better by the Tories why did they fail the NHS for 18 years in government?"

    ah, and who made those deals with the drug companies since 1997? are these the same people who made trillion pound contracts with the banks without even bothering to read the pensions rules for the failed executives? or is it the people who made multi-billion pound contracts with massive I.T. corporations for failed/flawed/pointless systems with no safeguards for the tax payer? or the same people who constantly make deals through pfi to pay firms millions of pounds every year for not doing something?

    The NHS has a virtual monopoly in the uk as far as spending goes on drug companies; the government could strike much better deals with the drug companies I'm sure.

    The government never uses its clout in this respect, and they use negligent people to negotiate the contracts. They're still throwing billions at the banks, the government now owns most of the high street banks yet the government still says they have no way to force the banks to use fair practices.

    The government basically need to employ competent people to oversee/negotiate the contracts, and then ensure the money gets spent properly, and as far as I can see neither of those things have been happening since 1997. Did it happen prior to 1997? I don't know/care, that's historic and irrelevant; the point is labour have no agenda to address these issues, and the current set of tories (probably) do.

  • Comment number 51.

    41 sagamix

    "... there was an urgent need to redress 2 decades of Tory neglect"

    43 metalwork

    "... why did they fail the NHS for 18 years in government"

    For both of you, the following is well worth reading: http://www.nhshistory.net/

    It's a bit long, but comprehensive, well written and very accessible.

    The point is, your assertion that the NHS was "failed" or "neglected" during the last Conservative government simply doesn't hold water. The health service was more effective in 1997 than in 1979. It had a higher success rate, lower waiting lists, more beds, more doctors, more nurses, better funding. It was not "neglected" at all. This is just part of some Labour-inspired myth, propaganda, in other words. It has been repeated so often that it has become "true".

    All modern governments have improved the health service. It is a political impossibility to do anything else.

    But it is impossible to have a sensible debate on the NHS without first grounding it in historical fact, and the "Tory neglect" theme is not factual. In short, you have to drop the myths, particularly this one, before the debate has any meaning.

  • Comment number 52.

    "metalwork wrote:
    Re. 26
    Lets be under no misconception here, I've had the misfortune have having four members of my close family needing the services of the NHS. In all cases the care was timely and second to non. I have experienced it first hand. Perhaps I've been lucky, I dare say some one will have a terrible experience to tell, personally I think the service is far better now. I wouldn't want to be one of the 46 million Americans without health insurance, would you?"

    I can only assume that you are using the phrase "second to none" as a figure of speech. There are far superior health services in many countries, not just in Europe but also in the rest of the world. The NHS has an advantage of many in that (most of it) is free at the point of use.

    I would not consider the NHS to be timely, my recent experience has been that it takes days to book an appointment to see a GP, then even having booked the appointment you wait over an hour to actually see them (why do they bother giving you a set time as they never seem to hit them?) only to be fobbed off after a 5 minute examination!

    And A&E is just as bad, woke up in the middle of the night in agony and still had to wait almost an hour to even be seen by triage! Ended up being admitted and discharged three times over the next two weeks with the condition. The nurse actually told me that they would like to keep me in longer for observation but unfortunately the ward was busy and to come back if the problem reoccurred - which I did involving more long waits in triage!

    I wouldn't say that my experience has been terrible but the hospitals seem more interested in hitting performance targets then actually looking after patients. I have family and friends who work in the NHS and some of the stories they tell are scary. So if the NHS is second to none I really do pity the rest of the world because the NHS is far from great.

  • Comment number 53.

    #41

    Depends on your definition of "better".

    Comparative of good.
    1. Greater in excellence or higher in quality.
    2. More useful, suitable, or desirable: found a better way to go; a suit with a better fit than that one.
    3. More highly skilled or adept: I am better at maths than English.
    4. Greater or larger: argued for the better part of an hour.
    5. More advantageous or favorable; improved: a better chance of success.
    6. Healthier or more fit than before: The patient is better today.
    adv. Comparative of well.
    1. In a more excellent way.
    2.
    a. To a greater extent or degree: better suited to the job; likes it better without sauce.
    b. To greater advantage; preferably: a deed better left undone.
    3. More: It took me better than a year to recover.

    To be a reasonable test, one ought to compare like with like, but of course, that is not possible given the difference in funding models between pre and post 1997. All that I believe that one can say, definitively, about the NHS now compared to pre-1997, is that it is significantly more expensive. But that doesn't necessarily mean it is better, unless you believe cost equals value, of course.

  • Comment number 54.

    #49 Post of the day!

    I agree entirely with what you say, politicians from both main parties have caused a huge management machine to build up in the NHS, and other public sector bodies because they have been desperate to be seen to be doing something. Their initiatives have usually just made things worse as they have needed an army of pen pushers to administer. My personal view would be to devolve responsibility for healthcare down to local aurthorities or even charitable organisations, this would get rid of the upper echelons of management and would make health provision more direct accountable to the communities they serve. I would keep the principle of taxpayer funded universal health insurance but those who could afford to should pay a contribution to the cost of their healthcare, say no more than 25% of the total cost depending on ability to pay. This sort of mixed system works well in France, Australia and Canada and could work here, if we had politicans courageous enough to implement it.

  • Comment number 55.

    "sagamix wrote:

    the fact is, all reasonable people (such as me, for example) would agree with BOTH of the following ...

    (a) the NHS has got considerably better under Labour, these past few years - not surprising since there was an urgent need to redress 2 decades of Tory neglect

    and:

    (b) it damn well should have done, given the oceans of cash thrown at it at a time when (we know now) we couldn't really afford it - and whether all that moolah has been well spent is ... putting it mildly ... arguable"

    I think both (a) and (b) are correct to different degrees. I know the left wing likes to paint the impression that the Tories cut all funding to the NHS and basically forced it to run on what nurses could find down the backs of sofas but that isn't actually true. The Tories also managed to throw money at the NHS (just not as much as Labour did) the problem is that the NHS in it's current form is so big that you could throw every penny the country earns at it and the NHS will still need more. So the Tories didn't technically neglect the NHS but the funding they did provide was inadequate.

    So while I can't agree with the actual wording I do agree with the concept.

    New Labour haven't really thrown mountains of cash at the NHS, they have increased funding over the Tories, but they still haven't provided adequate funds to the NHS e.g. There are life-saving drug treatments which are not covered on the NHS because of costs, patients are getting sick because of hospital superbugs etc. However, what Labour have done well is by changing the way that hospital stats are gathered to make it appear that things are improving more then they are. In actual fact things are improving in some areas but not in others.

    Considering the size of the NHS (I think it has the third highest workforce in the world) we really should expect much more from it then we do actually get.

  • Comment number 56.

    I'm not impressed with some of bare faced lies being peddled about the NHS by the american right - but accusing Hannan of being unpatriotic?

    thats scary language. I hope we never go down the path favoured by the Bush aministration of accusing anyone who criticised any element of government or national infrastructure of being unpatriotic.

    The fact that Hannan saw fit to go on american TV to disseminate a view of the NHS that most of his countrymen, nevermind his party, do not agree with certainly leaves a bad taste in the mouth.

    It does not , however, make him a traitor to his country as has been implied by labour.

  • Comment number 57.

    #37

    I can see you point on whether to sack him or not, were the world of politics a different place to what it is today I would agree, my own view of what should be done on the NHS is close to Hannans' but sometimes troops have to be sacrificed to greater cause. The article in pickled politics which Laura linked is broadly illustrative of why in this imperfect world, I am more inclined to the sack him view.

    The debate is now being pulled leftwards which makes it harder for Cameron to do what I think is going to be needed to address the ever increasing costs of healthcare where new treatments are always coming along and a population that is ageing against a dwindling income stream.

  • Comment number 58.

    51. jrperry

    On the other hand, It's better in 2009 than it was in 1997.

  • Comment number 59.

    Republicans are incapable of telling the truth. They misrepresent everything and use scare tactics to deal with any issue. They continually take everything out of context and will assign motives to innocent speech. It tells you something about the people they represent. The most interesting thing is that their supporters would benefit from a national health system. They provide mis-information to a group that will expend a great amount of energy to work against their own interest. Think about the Cultural Revolution in China and you can get some sense of the Republican right-wing and their agenda. Unfortunately our media outlets are in the money making business and would rather give nonsense coverage if it will fill space between commercials rather than address the issues at hand. It is a minority receiving majority coverage for the purpose of selling products. Crack whores have more integrity than Republican leadership.

  • Comment number 60.

    It's now! blindingly clear that the tories cant be trusted with our NHS.

    They opposed it's creation 60 years ago and continue to oppose it's very foundations today.

    If the Americans want to learn how to introduce a universal health care system, then by all means, let Britain show America how to do it.

    Ain't it kinda strange how fairlyopenmind has some misfiring neurons when the NHS is an issue?.

 

BBC © 2014 The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.