The National Health Service

Recently I posted a blog entitled 'A Personal Vision for Britain" (http://leavetheeuropeanunion.blogspot.co.uk/2017/08/a-personal-vision-for-britain.html) in which I wrote the following:

It seems to me that the National Health Service is unaffordable in its present form.  What is needed are ideas on total reform of the NHS (a blank sheet of paper, start again) nothing should be off the agenda. Form a group of Conservative minded people, but it must not be party political, to look at, discuss and brainstorm all suggestions. With an ageing population and the probability of rocketing geriatric medicine costs everything must be on the table. This includes Mental Health, Care in the Community and Old Persons Care Home costs.     

I then promoted the blog via Twitter and a person with the 'handle' of 'The Bald Colder' has been communicating with me on this subject. To be fair, 'Bald Colder' can only tweet in batches of 140 characters and we have had a healthy debate.  Here is a flavour of the 'Bald Colder' tweets as if I included them all it would take too much space. I am going to send a copy of this blog to 'Bald Colder' and give this person the chance to response. Their response will be published here if it is forthcoming:

Actually for the amount of money we put into the NHS, our patient outcomes trounce the American system.
The American system is horrifically inefficient because doctors over-prescribe because they are effectively on commission
Wow a Brexiteer where the penny has dropped we're in a giant ponzi scheme. With birth rate 1.9 we have to rely on immigrants
I'm more than happy to talk about healthcare in other countries but our problem is pure and simple: we don't put enough in.
What I would like to see is a tax that is specifically for the NHS and the gov't to compare results on a GDP per capita basis to our peers.

It was a quite a vibrant debate. I would like to see a national debate about what the NHS should look like now. I do not doubt its design was good for the 1940's but I am not convinced it is suitable for 2017.

I would like to see a committee set up to look at what the NHS should look like in the modern world. That committee should not include any elected politician (local or national) and be given a remit of 'here is a blank sheet of paper, what should the NHS look like?'

The chairman of that committee could be elected by a telephone poll. If you can vote for your favourite celebrity on 'Strictly Come Dancing' why not vote for your favourite candidate from a list to chair the 'NHS committee'? It would probably have to be confined to 11 members so it was not unwieldly. The person chosen to chair it, representatives of the Royal Colleges and of Patients would be nominated to sit on it.

On my blank sheet of paper:

• Take a deposit to book a doctors or outpatients appointment - a credit or debit card payment (just like a 'contactless payment'). It would be, say £5. If the person turns up to the appointment, the money would be refunded; if not the hospital or practice would keep the deposit. (This would in all likelihood reduce missed appointments)
• Make patients buy their own walking sticks, crutches or wheelchairs. A wheelchair on Amazon is £119.99. Patients would be free to donate them to the NHS after they had finished with them if they wanted to.
• Do not fund any cosmetic surgical procedures (except for body reconstruction following cancer treatments such as Mastectomy).
• Allow Local Authorities to buy groups of houses or build groups of houses in little 'villages' for respite patients, care in the community patients and to relieve bed blocking.
• Consider whether local or cottage hospitals are a possibility for simple procedures
• Is the current staffing structure fit for purpose?
• Look at the salaries being paid to senior managers

It is already the case that those over 60 disproportionately take resources from the Health Service. It seems very likely that this cost will increase radically in the next 10 years or so - we have an ageing population.

I do not know if any of the above ideas are good ones or even feasible. 

What I am advocating is a fresh look 70 years after the template was first designed to see if it should have the same look. If it needs to be reformed or re-engineered, let the "NHS Committee" report that back. Equally, if the "NHS Committee" thinks the current model is the right way for the 21st century I would accept that.

Once the "NHS Committee" reports back and I envisage them having 2 years to compile their report, it would be published and a proper public debate of at least another year would follow.  

These are just my personal thoughts. If you are going to comment please keep the comments polite. I have no power just a desire to discuss the NHS in order to change it if necessary to make it the best it can be.

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A Defence of Free Speech

I have said on this blog before that I believe in Free Speech. Further than that, in my last post I stated my position as being that anyone should be able to say anything they like about anyone and that this right should be enshrined in Law.

I was not sure how much I actually believed in Free Speech until I realised how much Free Speech is under attack. This attack is mostly coming from those who are regarded as Social Justice Warriors and the Equality and Diversity lobby but also occasionally by agents of the State such as the Police and the Crown Prosecution Service (CPS). 

I would rather that phrases like 'stupid woman' were not used and that in politics especially we could refer to people in a genderless way, for example, 'what the person said was rubbish'. It really does not matter to me that Diane Abbott is female and not white. Some of her statements during the election were just rubbish on their own terms and if they had been uttered by a robot would still be rubbish. It appears that she may have been ill when she "misspoke" (sic) so maybe some allowance should be made for Ms Abbott on that point.

This applies equally to people who are not women. Some of the statements of some senior male Conservative politicians in recent weeks have been equally nonsensical. Currently David Davis seems to be tying himself in knots. So let us all focus on WHAT is said and not WHO says them.

All that said I am dismayed by the definition of 'Hate Crime' recognised by the CPS and police, is “any criminal offence which is perceived by the victim or any other person, to be motivated by a hostility or prejudice”'

I don't have any issue with the 'perceived by the victim' part but I DO have an issue with the 'any other person' part - that could be any of about 58 million people. I think it possible that the CPS is trying to cover Social Media and Internet communication but it is still far too wide a definition.

The following article appeared in "Commentary" and was written by Sohrab Ahmadi. (https://www.commentarymagazine.com/foreign-policy/europe/englands-online-speech-crackdown/)

Censors are always looking for fresh opportunities to censor. So they relish moments of ideological ferment, antagonism, and intemperateness. At such times, people are more susceptible to moral panic and likelier to silence opposing views. We are living through such a moment now, with neo-Nazis, Communists, and various other haters and cranks on the march, both in the streets and online. That’s why open societies should be doubly vigilant against efforts to restrict free expression. 

One such effort got underway this week in England, where the Crown Prosecution Service (CPS) revised its guidelines to prosecutors regarding “hate crimes.” Director of Public Prosecutions Alison Saunders on Monday announced the new guidelines in an op-ed in the Guardian newspaper, and British civil libertarians have good reason to be alarmed. 

Writing with that unmistakable tone of hauteur common to crusading bureaucrats, Saunders didn’t disguise the fact that prosecutors in England and Wales – Scotland and Northern Ireland have their own prosecution services – will now be in the business of going after people for airing unacceptable viewpoints. “People all over the world are questioning how those in positions of power can counter the kinds of extreme views that are increasingly being aired,” she wrote, “and how societies might do more to prevent such opinions from gestating in the first place.” 

There is no easy answer to the problem, Saunders suggested. Then she went on to provide one: treating “online hate crimes as seriously as those committed face to face.” Put another way, the fellow who drunkenly throws racist barbs on Twitter may now face prosecution as vigorous as the neo-Nazi who vandalizes a synagogue or mosque with pig’s blood. The most senior prosecutor in England and Wales has expanded the definition of hate crime so far as to proscribe almost any disagreeable or uncivil statement. 

The country already has malicious-communication laws and other provisions against online harassment and abuse, and these are strictly enforced. Last month, for example, a British aristocrat was convicted of malicious communication and sentenced to 12 weeks in jail for offering £5,000 ($6,417) to any of his online followers who would run over anti-Brexit campaigner Gina Miller. In December an English blogger was convicted of racially aggravated harassment for helping direct a campaign of anti-Semitic abuse at a Jewish MP. 

The hate-crime laws are already broad. Authorities define as a hate crime “any criminal offence which is perceived by the victim or any other person, to be motivated by hostility or prejudice, based on a person’s disability or perceived disability; race or perceived race; or religion or perceived religion; or sexual orientation or perceived sexual orientation or a person who is transgender or perceived to be transgender.” (Emphasis added. Note that the definition turns entirely on the subjective perceptions of alleged victims.) 

Under rules promulgated in 2014, moreover, police are required to investigate hate-crime allegations “regardless of whether or not those making the complaint are the victim and irrespective of whether or not there is any evidence to identify the hate crime incident.” That resulted in Home Secretary Amber Rudd being investigated for hate over a speech she delivered at last year’s Tory party conference, in which she railed against foreigners “taking jobs British workers could do.” An Oxford physics professor was so offended that he lodged a criminal complaint. The police declined to investigate, but they recorded the matter as a “non-crime hate incident.” (Ironically, Rudd, who represents the nannyish wing of the Tories, endorsed the 2014 rule change.) 

Now the CPS intends to take things further by applying the subjective definition embedded in the hate-crime laws to online communications. In her op-ed, Saunders pooh-poohed free-speech concerns. “There are crucial provisions in law to ensure we do not stifle free speech, an important right in our society,” she wrote. Which ones? 

Saunders didn’t elaborate. She went on: “Hate is hate, however.” 

Well, yes, but sometimes hate speech is also protected speech. And in an age of aggressive, and often aggressively stupid, political correctness, merely controversial or disagreeable speech can end up being framed as “hate.” 

The law and CPS’s guidelines turn heavily on the concept of hostility, which is defined as “ill-will, ill-feeling, spite, prejudice, unfriendliness, antagonism, resentment, and dislike.” It is hard to see how people in England can debate, say, the hot-button issue of transgender bathrooms without running afoul of Saunders’s law against “dislike.”

It would be interesting to see the CPS definition of "Hate" and of "Extreme Views" as a start in this debate. What is a hateful statement or an extreme one come to that?

Under the "Racial and Religious Hatred Act 2006" Schedule 29J it states:

"Nothing in this part shall be read or given effect in a way which prohibits or restricts discussion, criticism or expressions of antipathy, dislike, ridicule, insult or abuse of particular religions or the beliefs or practices of their adherents, or of any other belief system or the beliefs or practices of its adherents, or proselytising or urging adherents of a different religion or belief system to cease practising their religion or belief system"
http://www.legislation.gov.uk/ukpga/2006/1/schedule/enacted

In my opinion people should be able to argue and debate freely, certainly free of a CPS intent on imposing its view of what is acceptable communication. 

What the CPS is proposing and doing could be used, despite their protestations, to constrain Freedom of Speech and we, the people and electors, must not stand for it. 

A personal Vision for Britain

This post is about the United Kingdom. It is about the kind of country I think Britain should be. I am not ashamed to say that I love my country and have discovered I love it more as I get older.

I am a Leave voter, I have campaigned and will continue to campaign to leave the European Union. I have recently begun to post lots of tweets on Twitter on this and about other issues which I feel passionate about. I read the blogs of other people and have learned from them and gained information and ideas.

Leaving the European Union is not the end, it is only the end of the beginning and so I hope that there can be a debate about what the United Kingdom should look like after we leave the European Union.

I like the blogs of Sam Hooper and he has some ideas about how those who are conservative should respond to the rise of Jeremy Corbyn, Momentum and the Left who are on the march and intend to gain power. This blog is an example of where he is coming from
https://semipartisansam.com/2017/08/21/winter-is-coming-for-conservatives-unless-we-wake-up-to-the-socialist-threat/

The problem, as far as I am concerned, is that the Conservative Party is not Conservative. It is at best a left of centre New Labour Bliarite confection. There was very little Conservative Policy in the last 'Conservative Party' manifesto.

So this post is what I would like to see in a post-Brexit United Kingdom. 

First I would like to see Freedom of Speech strengthened. It is under massive attack and not always by the left. The right of anyone to say anything about anybody should be enshrined in Law. 

That would include defamatory attacks which would be taken care of in the Libel and Slander Laws. If it is the case that a correction needs to be published (in whatever form) then that correction should be published in the same form, in the same place and in the same typeface or programme slot as the item corrected. On the front page if that is where the error was printed.

It seems to me that the National Health Service is unaffordable in its present form.  What is needed are ideas on total reform of the NHS (a blank sheet of paper, start again) nothing should be off the agenda. Form a group of Conservative minded people, but it must not be party political, to look at, discuss and brainstorm all suggestions. With an ageing population and the probability of rocketing geriatric medicine costs everything must be on the table. This includes Mental Health, Care in the Community and Old Persons Care Home costs.     

Abolish the Department for Communities and Local Government (DCLG). Return all Central taxes paid to local Government to the Taxpayer and make local authorities or regional authorities plan their own budgets, their own expenditure and make Local Government raise their own taxes. Make Local Government truly work. Chris Grayling has already suggested that the North should 'take control' of their own transport networks so why not for everything else? (http://www.bbc.co.uk/news/uk-politics-41020391)

The local authorities would recruit the people they needed such as ex DCLG Civil Servants. Such policies and expenditure would come from the budgets they set and finance they raise. Make mayors such as Andy Burnham work for their money and their pay would be decided in local referenda by the people they represent. That should increase the turnout in local elections. It would also ensure that profligacy would stop. Local people would ensure that it did. Many of these ideas are influenced by The Harrogate Agenda (THA) http://harrogateagenda.org.uk

There would also have to be a root and branch review and rethink of how Edinburgh and Cardiff were financed too but imagine a truly local tax where the budgets and the taxes were set and voted for by local people as set out in the Harrogate Agenda and where real power rested with the people. 

Reduce Parliament to Defence, Intelligence and Foreign and Commonwealth affairs only and reduce the number of MP's at Westminster to 300. Consider ensuring that some of these do not come from any political party - 'Non Party' MP's. The Houses of Parliament would be for truly National issues only.

Devolve as much power, by which I mean with the exception of Defence, Intelligence and Foreign Office matters, to Edinburgh, Cardiff and the English regions. The competence or otherwise of the leaders in these parts of the United Kingdom would soon be proved. 

Means test or target all OAP benefits such as Free bus passes. It is hard to defend wealthier old people getting free bus passes when they more than likely have their own transport and can afford to fund their own Public Transport costs. Abolish the commitment to the 'Triple Lock'. More and more company and private pension schemes are moving to increasing benefits by CPI rather than RPI - so should the State Old Age Pension.

Create a 'Graduation Tax' where, instead of loans, any graduate who agreed to get a paid job and work in the United Kingdom (and in the region in which they qualified if that was thought desirable) for 5 years and could prove that they had done so would not pay any tuition fees. One way of doing this would be to have a 'Graduates Tax Code' where the fees were deducted at source for those 5 years and then refunded in full in the 61st month and thus, as a bonus, be a Graduate Saving Scheme as well.

Any Doctor or Nurse for example who had been trained in the United Kingdom at the taxpayers' expense would repay that cost by working in the United Kingdom health sector (a reformed NHS or Private medicine) for 5 years.

The same rule would apply to other graduates; Solicitors, Social Workers and indeed anyone else who was educated at a United Kingdom University - who would repay their tuition by working in the United Kingdom for 5 years. 

Think outside the box! Imagine all new graduates working and being paid in the United Kingdom for 5 years after their qualification and repaying their debt by work.

It seems to me that the United Kingdom is going to change radically over the next five years and so let us have a debate to change it in a way so that the template we get after the UK changes is the template that we the electors want.

General Alarm

In recent days there has been some anger from United Kingdom travellers about longer delays because of tougher Schengen area border controls. The Schengen area is 26 countries of mainland Europe from Portugal to Poland and Sweden to Greece. It is a huge geographical area. As "The Guardian" reports:

The intermittent delays follow the introduction in March of new EU regulations in the wake of the Paris and Brussels terror attacks. The new rules demand both entry and exit checks on passengers from countries – including Britain – outside the 26-nation Schengen border-free zone.

Member states are not obliged to check every non-Schengen passport until October, when regulation EU 2017/458 comes into full force, but several airports are already doing so and others are carrying out spot checks on selected flights. (https://www.theguardian.com/world/2017/aug/01/passengers-facing-four-hour-security-queues-at-some-european-airports)

In this same article, it is further reported that the delays are not everywhere but that “unless Spanish border control puts in place an emergency plan to avoid queues and help passengers to get through faster, there will be a lot of devastating delays for passengers”

It seems to me that this is a dress rehearsal for worse to come. The first observation is that it is up to Spain (or Greece or France) to decide how many border staff to put on their border posts. If there are insufficient staff for those seeking entry, queues and waits will be longer.

France, the Netherlands or any of the European Union countries will not necessarily increase their staffing levels at their borders to ameliorate United Kingdom travellers and that they will be even less likely to do so once the United Kingdom leaves the European Union, especially if we leave without a deal. The Conservative Government better wake up and smell the coffee on this before they see many angry electors as the queues get longer.

If the United Kingdom leaves the European Union on 29th March 2019 without a deal then the United Kingdom becomes a third country and EU databases may well be unavailable or 'switched off' to the United Kingdom. The United Kingdom will have left the Customs Union and the European Single Market as well according to 'President' Mrs May and so the United Kingdom will have left the European Economic Area (EEA) too. 

The simplest thing is that United Kingdom passport holders (like me) will not be joining the European Union and EEA queue at European points of entry (such as Spanish airports) but will have to join the 'International Arrivals' queue. The same applies at points of entry in the United Kingdom such as Dover, Luton Airport and other Border Force entry points or these points of entry will have to create a 'United Kingdom nationals' queue.

I am also rather nervous about the Irish Border. This blog will not get into the issues around the terms of the 1998 Belfast agreement or on the state of political parties in Ireland. This is partially because I do not fully understand Irish politics. I am not interested in the Irish Border except as it is affected by Brexit. 

If the United Kingdom leaves the European Union without a deal, then the borders between the United Kingdom and the European Union have to be monitored properly. The sea is an effective barrier and border but the only land border between the United Kingdom and the European Union is in Ireland. That means border posts between the Republic of Ireland (ROI) and Northern Ireland. 

There was an excellent Twitter thread by "Shocko" on this subject, part of which reads as follows:

"There was a checkpoint UK at the top of our land, including a customs hut. Demolished in late 90s same as similar ROI one across the road". 

This customs hut is now part of a house and the ROI one is now a kickboxing gym.

"There are 300 miles of border in Northern Ireland. That's a lot of detached houses, kickbocking gyms, petrol stations, supermarkets."

In short a hard border between the two parts of Ireland as they currently exist will have to be reinstated which will be logistically (let alone politically) difficult and the work has not even started yet and there is only19 month to go! 

The European Union has said it will not negotiate a new, deep relationship with the United Kingdom until the United Kingdom has left the European Union. 

We need a transition deal. At last the mainstream media and the political class is waking up to this fact. Even "The Sun" has now said that the United Kingdom should pay something to the European Union and so it seems likely that some kind of financial offer will be made. This blog has always argued that the United Kingdom should pay into the funds the amounts that it had already committed to or our word means nothing.

The clock ticks ever louder. There is no time for a bespoke UK/EU deal. I have argued before we should go for what EUReferendum calls an 'off the shelf' deal which is EFTA/EEA. There is no more time to be lost. 

Unless there is some fancy footwork a hard Brexit look ever more likely. Mrs May has to look the 'hard Brexit' elements of her party who are influential and clearly a very large part of that party in the eye and tell them that a Hard Brexit is economically a non starter. Today. If the economy is wrecked on the altar of some 'over the rainbow' vision then the Conservative party will pay a very heavy political and electoral price.

I am alarmed. We need to start talking a sensible workable deal.

Now