Ed Miliband's speech: Fail

One of the things that you're advised when trying to get elected in Students' Unions is to not state the obvious, and to not make promises that are obvious. While those keen on you might be encouraged that you're telling them what they want to hear, others will be sceptical that you have no content, no meat behind your claims; That you are just trying to sound good without being good.

This is the trap Ed Miliband fell in to today.

See below some examples of the reverse of claims Ed made...and then see if you could see either David Cameron or Nick Clegg supporting them.

"I am determined to prove to you that the next Government will only spend what it can't afford. That we won't live within our means."

"we won't manage your money properly."

"So I’m going to tell you lies"

"I’ll tell you what I’m interested in.
Not winning back the trust of the British people.
Not winning the next general election."

"To the young people who want to get on and contribute to our country my message is simple.
I will let you be priced out of your future."

Then there was the stilted and awkward delivery, the hammy jokes, and the clear lack of any charisma, a situation that he attempted to mask by doing some strange rapper style delivery of his speech...not in terms of the words, but his body movements, and his stance. It all felt so fake, so forced.

And then the few opportunities that Ed had to actually say anything legitimate, he squandered by making a hypocrite of himself or by letting himself down with simple untruths.

First he reiterated the policy claim from his interviews at the start of conference, that he would cut the cap on tuition fees to £6k, an act that does nothing but help the richest graduates richer. Then he would go on to say...

Only David Cameron could believe that you make ordinary families work harder by making them poorer and you make the rich work harder by making them richer.

Well, sir, it would seem you believe that too.

Finally.. "New Bargain". What the hell is up with that phrase? Who came up with it? Do Labour just want to relaunch the New Deal but can't call it the same thing? New Bargain, it sounds...dirty, imbalanced. Is it to be followed by Newer Haggling?

To use a frictionless slope, you have to get on (Facebook "Frictionless Experiences")

"I gave them express permission to slap me in the face...imagine my suprise when they slapped me in the face!"

This is what the current outcry about Facebook's new push for "frictionless experiences" with third party application developers, some of the most high profile being the likes of Guardian or Independent newspapers, sounds like to me.

Somewhere along the road with this announcement it seems people have forgotten that in order to be sharing "everything you do" into your timeline (a new Facebook feature that is being rolled out) can't be achieved without you clicking a button that, in not so certain terms, "share everything I do with this site/app".

Privacy warriors, a vital set of people in the online world as companies like Facebook seek to test the boundaries of what is acceptable or even legal on a seemingly daily basis, may not realise how difficult it actually is to just use people's information from Facebook.

Those people that have left all of their details open to the world may be able to have some of their personal detail harvested by application developers, but those who employ even the most basic of privacy settings shield it all until they actively go through a process that says "let this application see my details".

And so it is with "frictionless experiences", if you're going to have that smooth ride you need to give yourself a push first.

Privacy is something you can do with as you wish, and as such it is not a privacy concern when what you're doing is being published automatically when you have approved this behaviour up front. If facebook was allowing all users data to be used by third parties for the purposes of this experiment then those with concerns would have genuine reason to have those concerns.
It is not.

And then there is concern about "noise" and lack of considered sharing. "Frictionless experiences" doesn't appear, at least for the time being, to replace the Like button. Or the share this functionality. People will still be able to post links to things they think are cool, or articles that are interesting reads, as much as they always have.

On top of this Facebook will start to log your activity on sites that are running apps that you have approved to do so and will keep that information in the background. It will get posted to that inconsequential news ticker that no-one actually reads, but it won't go in the timeline/newsfeed. It might, if it algorithmically sees a trend, push something to be shared as if you'd "liked" it...but this is a far cry from you happening to read that article about porn and it being put in to a prominent position in your friend's news feeds!

Unless you always read about porn.

I also would argue this is a positive thing. Obviously when you feel the need to hit a like button you know this is something you want to share with people, that you think they want to see. What about all the things people want to see, or that you should be sharing, but don't realise? If Facebook can get the algorithms right then you could find yourself looking at the feeds and thinking "Yeah...why *didn't* I share that?".

If you don't like the privacy implications here, then don't approve the apps. You don't have to take part, and in all honesty your experience of Facebook and the web is not going to be knowingly dampened by not approving those apps. If you are worried about the noise...well...let's watch this space. Facebook have given strong assurances over controlling the number of updates, and this should be obvious as the last thing Facebook wants to do is drive people away from using their platform. Your concerns there may well, hopefully, be unfounded too.

The Lib Dem's and *that* pledge.

It's time to accept it, the Lib Dem's have not really broken their pledge on Tuition fees. Reframing higher education funding in a way that the Tories and Labour were likely to do anyway, they have reduced the cost of tuition for the majority.

Cheaper degrees than those from 2006-2010, and more accessible than any system since tuition fees were first introduced, the cost of going to university hasn't been this low for a decade for those that need that cost to be low.

Preface: All figures below are calculated using the Money Saving Expert calculator on their standard assumptions. It assumes a retention of current student numbers at around 1.8m Full Time Equivalent (FTE) undergraduates in Higher Education (HE) in any one academic year, of which about 800,000 take out a maintenance loan of a average of £3,650, and all take the average university cost of £8,600 per year over a three year course. It assumes the average graduate salary is £20k. It assumes all values rise with inflation. It also obviously assumes the policy won't change in the next 30 years, as unlikely as that may be.

The Lib Dem plan... what's the problem?
The real problems with the system coming in to effect are as simple as the system is overly complex. The rich still have a way of getting out of contributing "their fair share", the system is not truly progressive in that those graduates who earn more money, earlier in their career, will pay back a much smaller total amount than those who earn the majority of their money later in their career or don't achieve high salaries.

It also relies on up front payment by the state for HE, with a significant lag before the majority of the funding is recouped, creating a form of deficit at a time of deficit reduction. A strange choice for a supposedly deficit reducing government!

These issues, along with the issue of the system being complicated and hard for people to understand as more progressive and *cheaper* than previous systems for funding HE, would be solved if funding was provided for purely through taxation in some form or another; graduate taxation, or general taxation.

There is also the problem that is the main reason for the Lib Dems taking a beating over this issue; the chance and perception that students will pay more than they had to when fees were capped to £3,000. In part this is true, for those who take out loans and earn above average wages. Students have long wanted education to be funded from general taxation. In this sense a graduate tax does not solve the final problem of the Lib Dem funding system, that of not shelving a burden on the students themselves for their own education.

However that is, as I say, a perception issue. It is only partly true. Educational costs have been passed more on to students themselves, but not all students...and it is certainly not the case that a tripling of fees is leading to a tripling of cost. The problem that is most often cited by angry students isn't really a problem at all.

Niggles, not problems
The reality, not accepted by the NUS who's official line is "FEES BAD (nswf link)", baulked at by those who have failed to return from their knee jerk break up from the party when the plans were announced in 2010, and ignored by Labour supporters that would rather deceive ex-Lib Dem's to keep their new found support, is that the system is fundamentally more progressive than anything Labour have brought forward in the last decade.

This system is better for poorer graduates than anything that's existed since tuition fees were first introduced to fund HE, in relative terms.

More than this, it in practice gives any student that doesn't earn over the average wage in this country a free HE education. Not just free as in the bursary scheme that Labour introduced, free as in they won't have to pay for their education, they won't have to pay for the maintenance loans they took to help pay rent and buy food during those years. For the first time graduates that earn money, but not enough money to put them in to the "better than average" bracket, will have a completely free university life.

This system, in all it's ugly convolution, is closer to "free" education than any system since Labour started us on student contributions.

There has not been a time since 2006 where so many will have a free education. Since 1998 we will not have seen as low a cost for education and living for the majority, with the benefit of repayments being more manageable than their upfront nature.

There are losers of course, but only where the losers can afford to subsidise those who lose out in their own way of not taking the premium that they were idly promised before they enrolled.

University degrees and three years rent, only £12k!
The only people interested in keeping the focus of this discussion on £9k tuition fees and £4k maintenance loans each year, and the "debt" that it accrues over three years are those that wish to make political capital out of it. They know that such a stance is now disingenuous, but they find it easier to try to confuse supporters of free education with scary sounding numbers.

In particular it's hard to make the new system sound evil when the amount that most would repay under this system is just £12k, while those paying under Labour's "cheaper" and "less debt" system would pay back all of their roughly £22k loan.

The reason for this is the values, the "debt", have been increased to such a degree that we're now looking at something much closer to a graduate tax, and a tax that has it's thresholds set fairly for earners. "Tuition fees" are dead for the majority, and it's time we should call a spade a spade.

Yes...graduate TAX
Debt this is not.

Debt does not disappear after a set of time before it is repaid, debt doesn't even disappear if you are unfortunate enough to die before you have repaid it. Debt repayment isn't based on your ability to pay.

What other system is there where you pay a set percentage of income, as long as you're over a threshold, to the state as standard? Income tax, of course...national insurance too. Both taxes, but could be described as hundreds of thousands of pounds worth of "debt" that you are continuously paying off at a set rate dependent on income.

By increasing the amounts that universities can charge, and fundamentally reforming the way that we pay back loans, a tax system has been created for all but those who choose to pay off the loan early or earn a significant sum of money. It is a clear move away from the situation of tuition fees and even loans as a principle. Instead, the focus is now on long term funding through a taxation model.

Why is this something that is worth praising rather than deriding? Progress. We need to move the language of fees away from loans and payments to that of taxation. Until we start to enter the realms where a tax, even a graduate tax, is the most effective solution, we cannot re-enter the cost of HE funding back to general taxation.

The future
We have to consider where this system will take us in the future. With 1.8mil FTE students in education at any one time there are loans that will be going out every year in excess of £15.5bn of loans delivered to institutions on behalf of students, and £9bn in maintenance loans. Each year (after 2015) a certain proportion of this will be paid back by the students. With a cut off point of 30 years we will be looking at having accrued over £475bn+£280bn (at today's money values) going out. That's £755bn.

Coming in is much harder to define, but an "average" student would likely pay back £12k over the course of their 30 year loan term. Over 30 years this would work out at £268bn paid in. This is, of course, just a "guesstimated" likely minimum. We know from the "top fliers" survey that an average salary of £25k is earned for the top 6% of graduate earners, but wage progression is also likely to be better than for average students too (in the medical profession we know this to be true). I can only guesstimate more that these people would certainly bring another £28bn, by assuming a most cost scenario for wage progression (that is RPI +6%, any higher and the amount they pay back actually decreases as they repay their loan quicker and thus interest is reduced). By doubling this I hope to conservatively get a likely average for loan repayments over 30 year of £325bn;

It's not as simple as saying this apparent large shortfall is a problem though, as 30 years worth of loans should be paid back over 60 years of repayments. In this sense the figures roughly, maybe with a slight shortfall, add up (at least £650bn brought in versus the £755bn out).

The problem is if the system continues then we will have a constant deficit of around £400bn that will have to be borrowed from somewhere to service HE funding year on year. This doesn't make sense from a government that has put their flag in the ground of deficit reduction.

In general taxation terms we could cover this quite easily. With graduates being forced to pay 9% tax on earnings over 21k it's just a case of how the yearly £15.5bn cost of HE (other sources say £12.5bn, I'm being conservative) could be shifted on to taxpayers that will, over time, largely be graduates anyway. At around 2.5-3% of the total current income tax receipts the amount of additional tax needed isn't insignificant, and it's true that this would likely be seen negatively by the public at large.

However the negative view of tax being increased is only masking the fact that as time goes on most people in this country will be paying tax rates of 29% and 49% rather than 20% and 40%. Could it go up to (for example) 22% and 44%? A tough sell right now, to change either of those rates...or to add an additional layer of tax band in between the two, but in the future? Perhaps not so tough.

It is an improvement, it is better, it is to be applauded
Anyone that is annoyed at the Lib Dem's breaking their pledge not to raise fees has some right to feel aggrieved. I am. Or at least I was. We also have a duty to see things as they really are. Rich graduates have their fees increased, in that sense the pledge has been broken, but poorer graduates have had their fees reduced, even middle income graduates will see no change to the amount they end up paying, if they're not lucky enough to still pay less than 2006 prices in real terms as well.

Are we really to cry over the Lib Dem's, in a de facto manner, keeping their pledge for the majority of students, but breaking it for those that earn significantly more than the average worker in the UK?

I'd prefer absolutely that the pledge was never made, the politics since has been complicated and the simplicity of the message was begging to come back and bite Nick Clegg and his team. However the coalition have moved us in the right direction, an it's what we do next that is important.

If we accept and applaud this situation within the confines of graduates providing repayments, but criticise the fact it is confined to graduates at all, we have never had as stronger footing for an argument to remove tuition fees since they were first introduced over a decade ago.

Next stages
The important thing now is to make it clear what the real cost of university now is. Students should not be told that they will face £60k of debt, this is irresponsible and simplistic. If poor people are getting put off from university it is because politicians are letting them get dissuaded. It's a no brainer that those that understand the value of money will be put off by a large figure being put on their back.

Tell them, however, that if they earn an average wage in this country that their debt will effectively be just £12k and they might have a different stance on whether to enter university. Tell them that they will likely have to pay just 1-1.5% of their income each year as long as they earn a middling wage and they might see the "debt" as less threatening.

Let them know that if they are unsuccessful, choose a low paid path in life, get unlucky...that the real cost of their university life, fees AND living cost loans, could decrease even further from £12k to maybe not needing to be paid back at all and their perceived threat of penalisation for not achieving, of having huge debt with nothing to pay it off with, must surely be swept away.

Let them know that there hasn't been a better, more financially managable, less risky time to try to get a university education.

The art of pledging: Ed Miliband and tuition fees

There was a law that was set in stone in the strongest possible terms in late 2010...don't make pledges that your party can't cash. Nick Clegg and the Lib Dems paid a heavy price that may end up doing long-term damage to the party by promising to do one thing (not raise tuition fees) before the election, and then being forced in to a situation where that promise was broken.

Need, tact, tempering or two-facedness aside...whatever your view on the reasons...abandoning a pledge and a promise is not something to do lightly when you are aiming to garner the trust of the electorate. So when Ed Miliband promises that he'll lower tuition fees if Labour get back in power, is he playing with fire?

The bitter partisanship of a Labour supporter

I read Darrell Goodliffe's stuff with interest, when it's in the realms of fact his views are excellent and I highly recommend them. By contrast when the issue is pure politics his views are beneath that usual standard. Take his recent "musings"

--

"Geroge Orwell would probably love a visit to the Liberal Democrat Conference. He would find enough examples of Newsspeak to convince him that rather than being a work of satirical fiction, 1984 was in fact a grimly ironic prophecy of things to come."

Maybe it's not his intention, but I think the idea of a Labour supporter citing Orwell as being prophetic through the actions of Lib Dems will do nothing but set the red rag to the proverbial bull.

"Orwell would have found Nick Clegg’s speech particularly laden with it. Clegg, as is becoming usual, spoke with his forked tongue; look at the pledge to ‘veto the abolition of the 50p tax band’ – made as if Clegg will not already know that there are, in fact, no proposals to abolish this band, in the next budget at least. Que much spinning about a ‘famous Lib Dem victory’."

Well talking of "spinning", Clegg didn't talk about the 50p tax rate in his speech. he did, in an interview where he was asked specifically where he stood should George Osborne press on with the much reported and alluded to plan to bring forward the cutting of the 50p tax rate, say he would veto such a plan if it came up.

Not so much spinning of a famous Lib Dem victory as much as spelling out the realities of consensus politics in a coalition, if you read the interview in question.

If Clegg is at all shaping up for "famous Lib Dem victories" it is on his desire to push for greater tax free allowance limits for low earners, and to shift taxation for the rich on to wealth...things that would be truly praise worthy if implemented well.

"This is the point, for all the rhetorical flourishes about the Conservatives being the “political enemies” it is still just a show being put on for recalcitrant Lib Dem members and the dwindling band of Liberal Democrat voters to convince them that they are still loyal to a Party that exists in more than theory."

How's this for theory?

Lib Dems run on policy that is, unlike other parties, actually decided by their membership.
Lib Dem manifesto's are created from these member approved policies.
Currently the Lib Dems have some 75% of their manifesto enacted, or being enacted, as government policy.

And this doesn't even scratch the surface of the nuances of tempering of conservative policy.

"Clegg’s speech and the whole conference will have been carefully calibrated in close consultation with the David Cameron and his clique within the Conservative Party as the same will be true of the Conservative conference. Cameron will make his carefully worded attacks on his allies to please his right-wing and the Daily Mail blue-rinse brigade and it will generate exactly the kind of media kerfuffle that both want."

This much is obviously true, indeed already the Daily Mail are doing what they feel they need to, the Lib Dem words of Farron and similar being portrayed as the deaths knell of the coalition when the reality will be far less interesting.

"Many Liberal Democrat’s are now so crazed in their hatred of Labour that it is unture. They are so much so that one rather shockingly accused Labour of being complicit in the killing of Baby P due to its “love of bureaucracy and red tape” on Twitter last night."

Indeed, the rantings and ravings of one individual are of course a fair representation of the entire membership's view...

"She also went onto to call all Labour members “deviants” and “vipers”. Red-eyed, demented and totally detached from the real world, you are left wondering at what Clegg has done to inspire this kind of fanatical loyalty."

The same could be said of any of the party leaders and those members of that party, who may be in the minority or not, that seem to attack other parties without actual basis in fact. It could be also questioned whether it is fanatical loyalty to one party, or an actual fanatical hatred of a party instead.

It would seem that hating the Labour party for what they did while in office is an illegitimate reason, and must be fueled instead by some kind of idolization. Hatred of the Tories for everything they did in the 80's on the other hand, is legitimate, and not at all fueled by a devotion to an ideal or an individual.

"The amazing thing is that the same Liberal Democrat’s then wonder why Labour activists heap bile on them. We are ultimately the ones who were first betrayed by a Party which pretended to share our values as long as it garnered them support."

Betrayed? The Labour party never reached the threshold of what the Lib Dems stated in advance of the election in order to become coalition partners. The fact talks were held at all shows how much the core membership and backbench MPs care about the shared ideals, and it's more than abundantly clear that it was Labour that shot themselves in the foot on this note. Betrayed isn't even close.

"This is a perfect example of why Labour cannot work with the Liberal Democrat Party as it currently exists."

Indeed, because there seems to be a core of party members, activists, and MPs, that all fail to be able to see common ground through differences within the Labour party itself. This post being a fine example of one of those viewpoints.

From my view point, speaking to Lib Dem supporters and Labour supporters before the election result...there was lots of common ground, some distrust, but little hatred. That has changed, and it's not been because of the Lib Dems suddenly turning on Labour. Quite the opposite. The fickle childishness of Labour supporters, in an essence sounding every bit like they were entitled to be handed power once again in 2010, is what has turned a lot of Lib Dem supporters' moods so hostile.

"Having said all that, there are good Liberal Democrats left. My plea to them is to leave their stinking corpse of a Party and government and if not join Labour, then at least join the opposition to the government and open up a conversation with the rest of us about the way forward."

'Leave a party that is delivering what you agreed to do, and join one that has generally failed to deliver those same wishes, and has actively gone against your core principles and hasn't yet faced up to how wrong doing that was'

Yeah, that'll work.

"Your Party is driving this country into the ground and is part of the problem. Not even your vaunted tax proposals are helping the poor, in fact, they are helping the rich,"

Really? The tax proposals still to come that could well bring more taxes proportionally from the wealthy than current taxation rules? The ones Lib Dem brought to the table that are reducing the marginal tax rate of going to work? I'd be interested in seeing where these tax proposals are indeed helping the rich.

"which is why the Conservatives are happy to implement them."

That'll be why the rich are, in the Tory press, on the back benches, and even through actual minister's words, praising current taxation on the rich and wishing it could have been like this sooner.

"Nothing is as it seems with your Party and I know you want to believe for the best of reasons but the facts are the facts."

Funny, I've not seen any facts here so far, only that "bile" that is detested so much by Mr Goodliffe.

"Leave government and join the opposition so we can overturn this government of the social elite and replace it with one that governs for the many, not the few, the country needs and deserves nothing less."

And so ends this Labour marketing pitch to do exactly what Nick Clegg warned about in his speech...

The Liberal Democrats are a family. There are those who wish to drive a wedge between us – our opponents, the vested interests in politics and the media who want to put us back in our place. They won’t succeed. Because whether you consider yourself more of a social democrat or a classical liberal, whether your hero is Gladstone or Keynes, Paddy Ashdown or Shirley Williams, we are all, to one degree or another, all of the above.

The NHS reforms: Not bad

I find myself surprised at the surprise in the actions of most Lib Dem MPs with regards to the NHS Health and Social Care Bill, passed for consideration by the House of Lords yesterday by a narrowish margin of 65 votes. Obviously this figure of 65 gives fuel to the ire because it's a number that could have been reversed by a strong Lib Dem rebellion.

It also would have spelled the end of a coalition at a time when the country least needs it, with the Tories the only party that can truly afford an election right now (if "the word on the tweet" is true), and Labour completely unprepared for taking the reigns as they rediscover what they actually bring to the table.

But I find myself more surprised at the Lib Dem supporters themselves that are aghast at the actions of their MPs doing what they agreed to do when they signed the coalition agreement in 2010; not least because this is a very "Lib Dem" bill, and, if you believe that it can be achieved, is actually better for providing a progressive and improving health service than our current legislation.

Profit driven decision making

A possible hangover from the bill before it was paused and rewritten, there was a real fear that we would be continuing down the path that the Blair administration set us down which is privatisation of public services to the lowest bidder. It's clearly a system with huge risks, doesn't deliver adequate results, and leaves devastation in it's wake as we are unable to reclaim the standard we knew before.

Thankfully the new version of the bill specifically veers away from such plans. (Section 23 14Q)

The whole point of the bill as amended is that the commissioning consortia have to improve standards in care. It's common sense really...the people that are tasked with running a good health service are legally required to ensure the service is good. They aren't, as councils and similar have been in the past, mandated to go with the lowest offer and so it is not in the interest of private bodies to put in a low ball offer, the evidence has to be there that they can do as good a job as what is currently provided, or better, and that the service is value for money on top of that.

It's decision making with the needs of the public's health put first, not how much money can be saved.

Lack of public interaction

Not all concerns are so baseless, this concern is one that is centered on a lack of real information or clarity within the bill. The bill fairly loosely talks about involving patients in their own care...the intent for this is that patients will have options presented to them of how to achieve their care, and to be part of the decision making process for the journey ahead.

It also talks of a "Health and Wellbeing" board, that operates with the overarching commissioning board that oversees and regulates the numerous, yet all that the bill talks about is these bodies giving "advice" to the various commissioning bodies.

There is also a requirement for commissioning consortia to consult those affected by any changes that they make to healthcare provisions. (Section 23 14Z).

However the trouble with all three of these things is that without further embellishment they could let lazy elements within the NHS off with doing very little to engage with the public. Indeed the wording of consultation is right along side "provide information", and if commissioning bodies are able to get away with "consultation" simply by putting leaflets on a desk in GP offices then the spirit of the legislation isn't being followed.

Inequality of care

There are concerns voiced about two tier systems of care, the charge of "cherry-picking" of profitable services by the private sector while others languish. However it is not as simple as to say that, as the GPC deputy chair Dr Richard Vautrey claims, that old and vulnerable people will be treated differently.

It would be a breach of the law if there was an active decision made by commissioning bodies to split the same service in terms of profitability, and hand some patients to a superior care provider, and retain others on lesser conditions. For example, there could never be a situation where it was actively sustained to have elderly cancer patients dealt with by one service, and young cancer patients by another, without there being a clear comparability between the two in terms of quality and effectiveness. (Section 23 14S)

There is a problem with the differences between services. Will mental health patients get a comparative level of funding and care to those treated for cancer? The truth is that the situation on that front is not equitable right now, nor is there any framework to try to ensure that it becomes more equitable. If people want better standards of mental health care right now it appears there is no route they can rely on to try and force the matter...aside from lobbying politicians.

Under the new system there is a duty for the new commissioning consortia to try to improve standards year on year, obviously it is not a requirement to always improve as sometimes that will be impossible even with the greatest of wills behind it. If this duty is not followed, then the consortium can be told to act differently, members of the consortium removed or added, and even the consortium itself dissolved in cases of severely abandoning that duty.

If we're looking for more equal patient care then we have a much more robust framework to discuss that issue with in the Lords. Before there was nothing to stop ministers actively "running down" areas of healthcare for whatever reason, now there is.

Privatisation of healthcare

An obviously big concern is that of private companies taking over our hospitals and services, at least where there is no need, with no consultation and with no patient choice. This has been, I believe unfairly, highlighted by recent reports of considerations made for a German company to run 10-20 hospitals.

Yet the reports have no bearing on the future of the NHS, as strange as that may sound. The idea of ministers contracting in private companies to deal with healthcare would actually be impossible under new reforms, where local autonomy of commissioning bodies is paramount.

It helps to be more specific about what we mean by the dangers of privatisation, as surely it cannot be argued that if the best value for money (note: I didn't say cheapest) provider happens to be a private organisation, then that organisation should seriously be considered for provision. The downside comes when that choice is made without the patient in mind, when it is done purely on cost, and when the structure of any agreements are such that we risk running down an avenue where we lose all ability to provide services as a state because expertise is lost to these private organisation...all of which have long term effects of *not* being value for money.

Simply throwing out scare stories isn't an argument of why the reforms are wrong, or dangerous. In fact part of the reforms is to extend the scope of the body "Monitor", who will take on the task of being an economic regulator for providers of health and social care in England, and in doing so will be responsible for dealing with anti-competitive behavior. (Section 57)

What's interesting though is the that language talks not only about anti-competitive behaviour, but in the sense of behaviour "which is against the interests of people who use such services". Does this mean that there is a loop hole for the co-operation of GPs with established local bodies even if such co-operation were to be "anti-competitive" as long as it can be shown that it is for the benefit the public?

This is another area that needs to better clarified; adequate provisions must be made to stop businesses following the anti-competitive behaviours that could lead to a lack of choice further down the line. This bill is essentially about competition, and about choice, so to allow any chance of the opposite occurring but for the benefit of private companies instead of the public sector must be shut out.

In the end we should accept that privatisation can, in some cases, improve our NHS; not privatisation as Tony Blair helped push through while Labour were in power, but a new way of approaching it where the contract cost isn't king.

"Free" NHS on the way out

Put simply, there are no provisions in this bill for charging for services that aren't already being charged for (Dentistry, for example). However there is the wording that leaves such an option on the table. There's not much to read in to this, it's the kind of catch all "Just in case" wording to make legislating easier in the future. (Section 1(3))

I don't see this as a threat for the now, if there were a time in the future where additional charges were intended to be made then that is an argument for that particular time, and it isn't responsible to oppose this bill on decisions that would have to be democratically taken in the future.

Lack of accountability of government

Slightly more abstract is this issue of "accountability". Accountability comes in many shapes and forms, however it seems a lot of people just don't care about accountability unless it's via an election. It's, in my opinion, a terrible stance to take when talking about having decisions made correctly, not decisions made in the most popular manner.

The Health Secretary will no longer have responsibility for providing a health service in the UK, in a sense we're turning from a National Health Service to a National Health Franchise. But this isn't necessarily a problem. When I say above that this is very "Lib Dem", the very nature of taking decision making out of the power of the central governing body of the country and devolving/distributing it to local cells is a natural Lib Dem position for most issues.

And so accountability doesn't disappear, though it does change. Gone is the rather blunt force manner of changing the direction of the NHS, i.e. electing a whole new government with all the various OTHER changes in direction that comes with, and instead comes much more local (regional at least) bodies that take over from where Primary Care Trusts left off with better regulation but also more local autonomy.

Of course the reality is also that the Health Secretary hasn't had the direct legal duty to provide services since 2002 anyway, when Labour decided that those PCTs should be the ones that carry the duty. Sure, the Health Secretary could call back his legal duty, but in practical terms the authority and accountability of decision making with the NHS isn't really going to change.

The change the bill provides on this is only a problem if you believe that you need to elect everything in order to make them accountable. I, on the other hand, don't believe that we get better decision making through elected officials, nor do I think areas like policing or health benefit from the public having ultimate control over strategic direction. Quite frankly very few of us are crime, safety and health experts, and it's not our place to interact with those areas in such a direct manner.

Freedom of information

A concern across all areas of outsourcing and privatisation is that of lack of transparency within the organisations contracted to do the work. Freedom of information is a tool that is supposed to ensure that the public can see what is going on behind the scenes of public bodies, but some are concerned that not enough is being done to ensure private bodies would also be accountable to relevant freedom of information requests.

A lot of new approaches to how competition is approached are taken in this bill, it would also be the perfect time to quash this concern and start a new trend of telling companies that wish to get involved in public sector work that they have to accept public sector responsibilities too.

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The ultimate question that should always be asked of reforms is "are they necessary?" and "How does it benefit us?"

It seems to me that the bill isn't quite selling itself as "necessary", but it does have interesting ideas on how to help make the health service more relevant to patients, to embed a culture in strategic direction that drives improvement and progress. These are ideas that, if they do work, could seriously benefit us and our healthcare; and given the practicalities of the duties are very similar to what we already have with regards to Primary Care Trusts and Foundation Hospitals there's a certain element of not taking a huge leap to get there.

I am not going to say I think that these changes will definitely work in improving our health service, I have deep reservations any time that the issue of privatisation and competition come up in areas that need such consistent and improving service. However I also can't take many of the criticisms leveled at the bill seriously, some seemingly out of date accusations of a bill that was clearly much worse before Lib Dem interventions on rewriting it to what it is today, as some of these criticisms simply do not stack up against the reality of what is being proposed.

The Tories were always going to reform the NHS, and the Lib Dems have come in and saved the country from a continuation of Blairite privatisation methodologies that have lead to tensions and problems where such a model has been applied. They've developed a robust framework for checks and balances, and as long as some more elements are improved through the passage through the House of Lords, there is a strong argument to be made that these reforms will help make the health service in this country more relevant and more progressive for patients.

Quite frankly, the reforms aren't bad, they have great potential...and I'm happy to "blame" the Lib Dems for that fact.

Edit:

Been made aware of this motion for Lib Dem conference that goes quite a way to dealing with most of the concerns that are legitimate above, and is worth a read.

If I were a rich man...

If I earned £150k I'd be possibly just outside the top 1% of earners in the UK. If the 50% tax rate was abolished...I would receive no different income than I was on before it was abolished.

If I earned £300k I'd likely be within the top 0.2% of earners in the UK. If the 50% tax rate was abolished I would be able to take home an extra £15k. This equates to around £175k instead of the higher £190k, a loss of about 8% of disposable income.

If I earned £500k, I'd be nearer to the top of the 0.1% of earners in the UK. If the 50% tax rate was abolished I would take home an extra £35k.

If I earned £1m, aside from being one of the highest paid people in the world, the 50% tax rate being abolished would let me take home an extra £85k.

I might be a bit of a freak here, economically speaking...but I can't quite get my head around why, even on something as "paltry" as £300k, the idea of *only* having over £150k of disposable income (after pensions, perhaps) instead of £165k is "punishment". Sure, if I had those earnings I might be able to keep more money if I lived somewhere else...but in the UK I would still have enough money alone that would sustain 8 whole *average* families, even if without the 50% tax I might be able to sustain 9 whole families a year instead.

Maybe those that are in the top 1% of earners in the UK don't think in such selfless terms. However even if this were the case, and they all felt so punished, how does removing the 50% tax rate help our growth situation?

I can't help but think that if our growth is truly down to this small, extremely small, section of society that we have much deeper problems than our income tax system. If growth is down to these few hundred thousand individuals then they hold far too much power, and the fall of the 50% tax rate may be inevitable. There is also the threat that even with the removal of the 50% tax rate that we could be undercut even more by an emerging market, and that we could be forced to reduce our own revenues even further to compete.

This is not a healthy position to stand from, and with widening income gaps between the rich and the poor a position that gets more perverse each year. The idea that our entire economy rests on the shoulders of such a dwindling proportion of people should scare the pants off of us.