He might believe he doesn’t care, but he does by implying himself, for they know not what they do…

I can guarantee you that Linehan would care after a couple of years of Tory government.

Why is it that we must wait until then to see fickle faces turn?

This de-politicisation of the political reduces us all to atomised individuals. That’s great if you’re someone like Sunny, but there are millions out there who are not, whose lives and happiness depend on political outcomes. The liberal left has to understand this.

Parties get a bad press. Many think they are dying. But the reality is that they continue to monopolise political power and will continue to do so as long as any social force has a material interest in allowing them and creating them.

These being the rules of the game, there needs to be a way for those who support the NHS to win.

Childishly putting fingers in ears and throwing tantrums on your own is just a tiny, tiny part of the solution. You can start #welovetheNHS, great and well done, but how will that help if Dan Hannan is inside No 10?

This is not a game of ‘who can be less tainted’.

If you don’t like parties, but you want to actually affect the world around you, my advice is to join one that can win nationally, or in your area, the one that is closest to you. Only with the dissenters involved can the problems with the parties be solved.

The “top story” headline says it all…

Labour created it…not THIS Labour though, this Labour has spent more time dismantling it than improving it.

Not true. Far be it from me to defend New Labour’s reliance on market based ‘reform’, but there has been some social democratic meat in there too. We have had over 130 new hospital builds since 1997. You only have to look at the waiting lists now vs then to see that even under the most capital-fearing of Labour government there has still been a massive improvement.

Now we have to move on to the next stage, which for me means more power for both staff and patients, and a lower emphasis on national targeting, along with a re-emphasis towards the polyclinic model, and longer opening hours.

We also need to to cut spending on management consultancy and badly negotiated PFI deals.

NuLab are like Jeykell & Hyde when it comes to the NHS.

To be fair to them we must acknowledge a substantial increase in funding, while NHS clinical staff are just about the best paid in Europe.

Waits have decreased (overall) and improvement in outcomes have been achieved for some of the most common diseases (diabetes, cancer, cardio-vascular disease, etc).

If we compare ourselves to America (bearing in mind Hannan’s recent love-in with the neocon media) I would say the NHS provides a better deal due to its relatively low cost (cheaper than France, Germany, Switzerland and certainly far cheaper than the USA) and better outcomes on key measures such as infant mortality, life expectancy, universality, etc.

BUT (and its a big but) NuLab have ushered in an unprecedented degree of marketisation/commercialism while front clinical staff have effectively been side-lined due to a reliance on managerialism (managers are in effect the conduit for a never ending stream of centrally issued diktats from the DoH).

The Stafford debacle has been directly attributed to this system while the official report makes for grim reading (Trust obsession with cost cutting [figure of £10mil cited], drive to attain coveted ‘Foundation’ status, management unresponsive to clinical concerns while failing to properly interpret their own mortality data, etc).
http://witchdoctorlearning.files.wordpress.com/2009/03/investigation_into_mid_staffordshire_nhs_foundation_trust1.pdf

I’m not sure I go quite as far as Lee Griffin [4] but there are plenty who do.

Why the hell shouldn’t Labour be jumping on this particular bandwagon? We only created it in the first place and have commited ourselves to improving it

Ah, those improvements that are back-door privatisation, like ISTCs, FTs, ‘World Class’ Commissioners being ‘advised’ by the private sector’s stormtroopers (McKinseys) to buy private etc? Oh and PFIs, LIFTs etc?
Are there some reliable data on how much capital investment has been planned, centrally funded and delivered by Labour over the last 12 years? NOT counting PFIs as investment, but as albatrosses, and not couting Connecting for health as anything other than a horrendously over-expensive farrago?
Billions have been spent, but what percentage on services?
Have no illusions that New Labour are any more opposed to privatisng the NHS than the bastard Tories:
Former health secretary Alan Milburn became a director of Covidien, a healthcare product provider, and adviser to Bridgepoint Central, a venture capital firm involved with financing private health firms. Patricia Hewitt, another former health secretary, became “special consultant” to Alliance Boots and adviser to Cinven, a private hospital and healthcare group. Sally Morgan, a Tony Blair aide, was subsequently a director of Southern Cross, the UK’s largest care home operator, and an adviser to Lloyds Pharmacy. Is it any surprise that the arguments for greater private-sector involvement in the NHS get a better hearing in Westminster and Whitehall than most voters would wish?

Who was it said that when you jump on a bandwagon it’s already gone past? Or something like that?

It’s worth reading a recent OP-ED piece in the FT which argues that the main issue for Americans with their healthcare system is cost control:

“Why does it cost the US about $7,000 per person annually for our incomplete national healthcare system, while other major economic competitors provide universal coverage for about half that? The answer is quite simple: the federal government pays whatever the cost will be.”
http://www.ft.com/cms/s/0/4049dac4-8d05-11de-a540-00144feabdc0.html?nclick_check=1

The incentive systems in American healthcare and the need for protection against law suits there generate unnecessary tests and procedures which add to the incomes of clinicians and costs.

From a British perspective, these regular comparisons between the NHS and healthcare in America are a huge irrelevance. On independent assessments, other west European countries get better healthcare than we do in Britain and that should matter to us. The regular annual review of European healthcare by a think-tank in Sweden continues to rate the NHS as fairly mediocre in performance:
http://www.healthpowerhouse.com/files/canadaIndex03.pdf

Try: What Obama can lean from European healthcare, by Steven Hill
http://www.huffingtonpost.com/steven-hill/what-obama-can-learn-from_b_173154.html

The French Health Care System
http://www.medicalnewstoday.com/articles/9994.php

It has to be admitted that in 1997, Labour inherited a situation where we had fewer physicians per capita than other west European countries in mainland Europe – how come? See the bar chart here:
http://www.economist.com/world/britain/displaystory.cfm?story_id=E1_PQTNND

This de-politicisation of the political reduces us all to atomised individuals. That’s great if you’re someone like Sunny, but there are millions out there who are not, whose lives and happiness depend on political outcomes. The liberal left has to understand this.

Tom – in this case I understand it and I’m not denying it. I probably veer more towards Andreas’ point than the view that Labour has nothing to crow about at all re: the NHS.

Citizen Andreas, quoted in the article:

Why the hell shouldn’t Labour be jumping on this particular bandwagon? We only created it in the first place and have commited ourselves to improving it. There are plenty of reasons to winge, but it would be nice if for once, people could take a look at the NHS and give Labour a little credit where it’s due.

I, for one, am very happy to give credit where credit is due. The Labour party, and the overwhelming national movement behind it, created most of what is ethical and compassionate about British government. Most certainly, the Labour party deserve that credit.

The reason I am unwilling to allow current ministers or cabinet members any adulation over the issue is that New Labour are not the party of labour and never have been. They’re an experiment in the politics of the business-owning middle- and upper-classes with a gloss of populist language. All spin, no trousers.

Their ideology is not that of the Labour movement. Their policies have not been those of the Labour movement. Their efforts to paper over the cracks in their commitment to the poor have led only to the right hating them for being too soft, the left hating them for being too rich and all the actual people feeling like they got yanked around for 12 years and then told it was all their fault.

New Labour are bully-state meddlers, not welfare-state creators. They have for some eight or nine years systematically undermined the legacy of their party ancestors, implementing neo-Thatcherite economic policies such as (to quote Mr. Cable) “privatising profit, nationalising debt”, and using paramilitary forces to violently crush peaceful, left-wing dissent.

And yes, I’m angry about it. Under John Major, when I immigrated permanently, the welfare state was more accessible than it is today, for me personally at any rate. Unemployment was higher then, too; but it will soon top 3 million again, and then we’re right back where we started except that then we knew the government didn’t care. And we also knew the next one would.

To make a hollow laughing.

The current administration do not deserve any credit for the NHS. It seems some people finally noticed.

“Most certainly, the Labour party deserve that credit.”

C’mon. This may come as a terrible shock but credit for first implementing a national insurance scheme for personal healthcare costs in Europe goes not to Britain for creating the NHS in 1948 but to Count Otto von Bismarck, first Chancellor of the German Emprire.

“The Health Insurance bill . . was passed in 1883. The program was considered the least important from Bismarck’s point of view, and the least politically troublesome. The program was established to provide health care for the largest segment of the German workers. The health service was established on a local basis, with the cost divided between employers and the employed. The employers contributed 1/3rd, while the workers contributed 2/3rds . The minimum payments for medical treatment and Sick Pay for up to 13 weeks were legally fixed.”
http://en.wikipedia.org/wiki/Otto_von_Bismarck

Whatever else, Count Bismarck had no socialist inclinations whatever. Quite the opposite, in fact. For a comparison between a Bismarckian national insurance scheme for healthcare and Beveridge’s scheme for the NHS in Britain, try:

Bismarck or Beveridge: a beauty contest between dinosaurs by Jouke van der Zee and Madelon W Kroneman
http://www.biomedcentral.com/content/pdf/1472-6963-7-94.pdf

The distinctive characteristic of the NHS is that it combines a system of universal social insurance for healthcare costs with a verging-on state monopoly to supply centrally managed healthcare services. Other west European countries have avoided that combination and have focused instead on social insurance schemes without state monopolies providing healthcare services. On the evidence of independent assessments, that latter structure without state monopolies has yielded better healthcare performance.

The various charts in this academic paper: EUROCARE-3 summary – cancer survival in Europe at the end of the 20th century, yield little comfort on behalf of the relative performance of the NHS:
http://annonc.oxfordjournals.org/cgi/reprint/14/suppl_5/v128

Cancer survival in the UK is still below the European average, despite recent improvements, a report says.
http://news.bbc.co.uk/1/hi/health/6955545.stm

The government’s national cancer plan, backed by a massive injection of cash for cancer services in England, has failed to boost survival rates substantially, a major study shows today.
http://www.guardian.co.uk/society/2009/mar/20/cancer-survival-rates-no-impact

Bob B [13] comparative cancer stats are not straight forward – take a look at this;
http://scienceblog.cancerresearchuk.org/2009/08/17/we-need-to-be-careful-when-comparing-us-and-uk-cancer-care/

#14: Of course, the stats on cancer survival rates are not mine. I’m just quoting news reports of a study published in Lancet Oncology (the BBC news report) and of another (in the Guardian) by a team led by Professor Michel Coleman at the London School of Hygiene and Tropical Medicine.

Naturally, I tend to defer to those academic authorities cited.

The fact is that there is a growing number of independent assessments which rate NHS healthcare as somewhat mediocre in comparisons with other west European countries. Going back a few years:

“Defenders of Britain’s system point out that the UK spends less per head on healthcare but has a higher life expectancy than the US. The World Health Organisation ranks Britain’s healthcare as 18th in the world, while the US is in 37th place.”
http://www.guardian.co.uk/world/2009/aug/11/nhs-united-states-republican-health

But since then:

“The NHS has seen a year-on-year fall in productivity despite the billions of pounds of investment in the service, latest figures show. The data from the Office for National Statistics showed a fall of 2% a year from 2001 to 2005 across the UK.”
http://news.bbc.co.uk/1/hi/health/7610103.stm

On the compounding evidence, I don’t think we can deny that by European standards, the relative performance of NHS is fairly mediocre even if it is decidely superior to the sad deal that Americans collectively get from their healthcare system at exorbitant cost.

Bob B can you name a specific condition with a significant differential in outcome (comparing the NHS to the rest of Europe)?
Don’t forget cancers account for at least 200 different diseases – for example, the hospital I work at does some great work in the sphere of haematological malignancies.

I am willing to accept that the the French or Germans might have a year or two longer despite disseminated metastatic cancer – but that sort of longevity comes at a high price both financially and emotionally.

Once we take into account historic spending patterns bearing mind the French, Germans and Swiss for example have been spending more on health than the NHS for DECADES is there really such a significant difference in outcome?

#16: “Bob B can you name a specific condition with a significant differential in outcome (comparing the NHS to the rest of Europe)?”

I’m wholly dependent on the news reports of published studies by the BBC and the Guardian cited in #13.

As a retired private citizen, I don’t have general access to journals, papers, studies, reports and manuals with (often steep) subscription barriers but have to rely on media news reports and what I can gain from reading books.

Consider the frequent claim (or belief) that the NHS provides us with cheaper pharmaceutical drugs. But from outside academia or governmental and corporate access to sources with subscription barriers, it’s verging on the difficult to impossible to find accessible international comparisons of (pharmaceutical) drug prices. If anyone here knows better, please post signposts.

One (obvious) problem in making such comparisons is the choice of appropriate weights (or baskets) to use in deriving price indices. The following comparisons, published in 2004, result from country price comparisons for the basket of drugs as purchased in Australia, are quoted in the new edition of the Paul Krugman/Robin Wells textbook: Economics (WH Freeman, 2009) p.361 to make the point about how costly healthcare in America is.

How much more expensive are drugs compared to prices in Australia?

US 250%
Canada 68%
UK 57%
Sweden 52%
France 15%
Spain 1%
New Zealand -5%

Data source cited: Wagner + McCarthy: “International Differences in Drug Prices” in Annual Review of Public Health 25(2004) pp.475-495. This source is available online but access is subject to a subsription barrier.

By this report, pharmaceutical drugs in Britain are not “cheap” as compared with the other European countries quoted even if they are much less expensive compared with America.