Forum Topic

Mr CallawayNot sure what my questions were but at your suggestion I have just read Streeting's reform plans.I think they say - “I can simultaneously want to reduce [NHS] reliance on the private sector by making sure it has the staff, the equipment, the technology it needs to treat patients on time, at the same time as recognising that there is currently some capacity in the private sector and we should seek to use it.”I quite agree with him and what I take to be his ultimate aim which is that no one need consider private health care as the service from the NHS would be unbeatable.But I don't think he is suggesting that 'more money' is all  of the answer.An organisation as large as the NHS is likely to benefit from reform in line with the current situation it faces.All big corporations do.So to avoid the poisoned chalice scenario Labour should stop just blaming a malign NHS inheritance on 'the Tories' and their supposed hatred of the service, and instead come up with some honest and sensible plans of what their aim is and what is achievable in their first period in Government.Perhaps a review of the NHS and what it faces by an unbiased, non-politicised, multi-disciplined team of management consultants and medical and health experts would produce an answer to 'what should the NHS look like today and what is the best way of funding it'. Labour could then take that as its healthcare (not NHS) policy into the 2029 election with a confidence of winning on this issue at least. 

John Hawkes ● 380d

I fear that your points are likely to fall on deaf ears because of the strong bias against the Conservatives shown by many of the contributors to the Forum. This bias is due to two main factors in my view:1) anger over Brexit, for which many hold the Conservatives and Boris Johnson in particular responsible2) the presence on the Forum of a number of individuals  described in an earlier post as urban professionals with a social conscience, who tend to see the Conservatives as aiming to enrich the haves while seeing  Labour as committed to helping the havenots.In respect of 1) above it is no use pointing out that Parliament voted by a majority of 544 to 33 to  put the decision in the hands of the British people in a Referendum. Feelings are too strong for the issue to be considered rationally.In respect of 2) it is equally useless to argue that Labour’s aim of redistributing wealth by a policy of tax and spend is likely to impoverish society as a whole, including the havenots. For individuals with a certain cast of mind the choice between Labour and the  Conservatives is not about choosing which party has the best policies. It’s about good and evil. Asking them to vote Conservative is like asking them to go over to the dark side.I recognise, of course, that there are people on the Forum who are committed to neither party. Many of them simply note that the country is in a mess, for which they naturally blame the party that has been in power for the last fourteen years, and conclude that it is time to give the other lot a go. The only thing I would say to them is that it is important to consider what the other lot are planning to do before making a decision.

Steven Rose ● 380d

The concept of inequality of wealth and income is not hard to understand. But how is it to be achieved? Wealth can only be redistributed by imposing a wealth tax, most likely in the form of a property tax or by increasing the level of inheritance tax or both. I don’t think either of these measures would be popular with the British public. A property tax, in particular, would unfairly penalise asset rich but income poor people e.g. a pensioner living in a valuable house. Equality of income can only be achieved by a general salary cap or, more plausibly, by a penal rate of income tax. This, however, would  disincentivise investment and reduce the tax take.None of this in any case is relevant to private health care. While it is true that only comparatively wealthy people can afford private health insurance (unless they are lucky enough to have a job offering such insurance as a perk), they  don’t go private because they are rich. They go private because they want to be treated as soon as possible, choosing their own doctor or having a comfortable room in hospital being secondary considerations. Everyone agrees that prompt treatment should be available to every one. But how is this to be achieved? People on the left of the political spectrum think the answer lies in ever greater investment in the NHS. Unfortunately, as Wes Streeting among others has recognised, this is simply not possible. A situation in which an ever greater proportion of the budget is consumed by health spending is not sustainable.  At some point the NHS will have to be reformed. This will probably involve a combination of affordable private insurance as well as public finance.

Steven Rose ● 382d

Hi IvonneNo I am not a politician. I am a teacher.The issue of a sick relative is no fantasy. In the TV debate the presenter Julie Etchingham asked Keir Starmer whether he would pay for private treatment for a sick relative who was unable to get treatment on the NHS and he said no. The clear implication of his remark is that he would rather let his relative suffer than commit the sin of going private. His answer was  dishonest, a lie in fact, but the leader of the Labour Party could not be seen to countenance paying for private health care.In his post this morning  Michael said to me, ‘you obviously don’t believe in levelling up as you think that those with more money should be able to perpetuate the privilege it gives them whether it’s health or education’. The implication of his remark is that people should not be allowed to enjoy the privilege of private health care or private education. How can that be achieved without a ban? Michael also said that National Insurance should be increased so that ‘we could have a better health service and people wouldn’t need private health insurance’. In other words private care would become redundant. So you see that I was not inventing things. I was simply reacting to Michael’s post.A belief that the NHS does an essential job and should be supported  is perfectly  acceptable. But this belief becomes quasi religious when any proposal to reform the NHS is seen as sacrilegious and private health care is regarded as morally wrong.

Steven Rose ● 382d

Mr Hawkes. Yes I understand about the GP arrangements. I was referring to hospital waiting lists. I think what Labour are proposing is an extention of existing arrangements where the NHS pays for patients to have operations in private medical facilities - no specific Putney connection, it would presumably be a national policy? For example, a few years ago my cousin - who worked for the NHS at the time - had her back operation at a Harley Street clinic arranged and paid for by the NHS; this was in a way to the NHS's advantage as she was back to work after a few weeks rather than being on sick leave for possibly a year or more on an NHS waiting list. (That's the reason many companies pay for employees' health insurance, they get to jump the waiting list so it reduces lost productivity.)People have different views on this: I have several friends who feel the NHS waiting lists are in part deliberate to force them to spend their savings on operations, saving the NHS money, because - although their problems haven't been life threatening - they have been debilitating and stopped them leading a normal life; others who can afford health insurance feel that, as well as getting better service than the NHS provides, they are also saving scarce public health resources even though they've already contributed to those.In a democracy it's not realistic to curtail private health or education - even if one were to try and ban it there's nothing to stop one going abroad for it; I believe it's not uncommon for rich Chinese to send their children to private schools in the UK (I'm not sure if that's still common now).

Michael Ixer ● 382d

Good afternoon Steven,Are you a politician at heart by any chance?While I agree with some things you say, I am baffled as to your idea that somebody has said that private hospitals and private schools should be banned.  Where did this come from?Who said you (or anybody else) could not use private medicine?  Who said it is either or?Well, of course, on the whole, private hospitals do not have A&E departments.  Also, if there is a serious case, they transfer patients to the NHS.  Do you remember the House of Cards and how sickened Mrs Urquhart was that her husband, the Prime Minister, was treated at an NHS hospital as opposed to a private one?Yes, I do believe in the NHS, meaning conviction in its true purpose and worth.  Nothing to do with religion..... I equally believe in honesty and fair play. None of these relate to religious beliefs.You fantasize that Keir Starmer would rather a member of his family suffered unnecessariy than pay for private treatment....  ?????????????????  That is not what he said. Perhaps it is just because you are talking about Keir Starmer?Who said they would make private provision redundant?  Are you feeling OK?As far as I am aware, there was a reorganization of the NHS a few decades ago.  This resulted in a higher number of administrative posts, some of which have a very high pay associated to them that takes a very big chunk of the funds allocated to the NHS.  In addition, there has been an enormous increase of red tape in the NHS.  Something similar to the red tape that exists at the moment for exports from and imports to the UK - mainly as a result of Brexit.All in all, for those of us who love the NHS, we are not religious freaks.  Neither would we dream of stopping anybody from having private health insurance and using it.

Ivonne Holliday ● 382d

My understanding of 'levelling up' is a commitment to ensure that all parts of the UK benefit from prosperity. It is not a commitment to ensure that people with money should not be able to spend it as they see fit, whether to pay for private medical treatment or private education for their children. Neither the Conservatives nor Labour are proposing to ban private hospitals or private schools. Indeed Keir Starmer has said that the independent sector remains an important element of educational provision in this country while Wes Streeting has promised that Labour, if elected, will use private hospitals to reduce NHS waiting lists.I think everyone understands the importance of state provision in health, education and transport. It is the word 'believe', as in 'I believe in the NHS', that I find puzzling. It introduces a quasi religious element into public policy where the state is equated with good and private enterprise with evil. I can understand that people are happy to use the NHS. I use it myself. What I don't understand is a refusal to countenance private treatment on moral grounds if the NHS is unable to provide suitable treatment. That is like someone refusing to order an Uber if  he happens to miss the last bus for fear of undermining the principle of public transport. The absurd thing is that Keir Starmer would almost certainly not be ashamed to buy a nice car given his generous salary, but (apparently) he would rather a member of his family suffered unnecessarily than pay for private treatment. This perverse ideology in my opinion is a result of the vacuum at the heart of the modern Labour Party in which a belief in socialism has been replaced by an obsession with attacking privilege, in this case represented by private hospitals, but also in the spiteful plan to tax private schools out of existence.The idea that a health service free at the point of delivery can be financed out of general taxation in such as way to make private provision redundant is utopian. Because people are living longer and treatments are becoming more expensive, the NHS is taking up an ever increasing share of the budget. This trend is unsustainable, a fact recognised by both the Conservatives and Labour, but so far neither party has had the courage to deal with the problem for fear of losing votes.

Steven Rose ● 382d

Hi Ivonne. You are quite right. Only a minority at present can afford private health insurance. But Keir Starmer certainly can afford it. He could probably afford to pay for quite a lot of treatment without insurance. But in answer to a question from the presenter he said he would never use private health care, not even if a member of his family with a serious condition was languishing on an interminable NHS waiting list. His statement was obviously untrue. No sane person would sacrifice a member of his family in such circumstances if he had the money to  relieve that person’s suffering. So why make such a disingenuous statement? The  answer is that the Labour Left, on whose support Starmer depends, regard private health care and private education as  bastions of ‘privilege’ and therefore morally wrong. In  this perverse ideology it is acceptable to book an expensive holiday or buy a nice car but not to pay for private medical treatment or send your children to a private school. Yet paradoxically Keir Starmer has said that he regards the independent school sector as  an important part of educational provision in this country, while Wes Streeting  has said that Labour will use private hospitals to reduce the NHS waiting list.  How does that make sense?I think everyone agrees that the NHS is important.  But the threat to the NHS is not from a right wing government who want to sell it to the Americans, as some on the Left believe. The threat comes from the inadequacy of the current model.  With people living longer and treatments becoming more expensive, the NHS is taking an ever increasing share of the budget. This is simply  unsustainable. The only solution, surely, is to fund health care through a combination of affordable private insurance in addition to general taxation .

Steven Rose ● 383d

I am sorry, Steven Rose, but that response is ludicrous.How many people do you know, or know of (meaning shop assistants, trades people, rubbish collectors to name a few) who can pay £500 to £1000 a month for private insurance?Today, of all days, with D-Day celebrations and considering the reasons as to why Nye Bevan created the NHS, the ludicrous talk of people affording private health insurance is inappropriate.I am a true believer in the NHS, am certain that the saying that great things created by the grand-parents, maintained by the children but destroyed by the grand children truly applies.I survived meningitis thanks to the NHS - there was no private hospital then, as there is not one today - who could have helped me.  The NHS saved me.I will fight for the NHS tooth and nail.  The preposterous idea that only the wealthy deserve medical care is - well, sickening!  Because even they cannot be helped by private medicine.Unless we pull our socks up and defend the NHS, there really is no reason to continue pretending celebrating D-Day - because at the moment, nothing seems to be working properly - let us not forget the great performance of the water companies and the sewage being spilt on rivers and seas - with the blessing of Parliament.We should all, regardless of political inclination, be  ashamed of ourselves, but above all consider very seriously what sort of country we wish to live in.From my point of view, education, health and countryside are being wilfully destroyed - shame on all of us for allowing this to happen.

Ivonne Holliday ● 383d