Opinion: What Andy Burnham didn’t tell you about NHS privatisation

nhs sign lrgAndy Burnham’s recent set-piece speech on the NHS, the latest instalment of Labour’s “summer offensive”, opened with a neat bit of scene-setting. By briefly championing a group of Darlington mothers who are presently marching 300 miles in protest at the use of private providers in the NHS, he conjured a mood of protest while subtly co-opting their campaign. Thereafter he sought only to reduce the 2015 general election to a “binary choice” between “a part-privatised, two-tier health market under David Cameron” and “a public, integrated national health and care service under Labour.”

In terms of how he defined that choice, though, Burnham could hardly have done worse than to frame his argument with an example from Cambridgeshire, singling out for particular criticism its attempt to integrate care services for older people. On one level, it is easy to understand why he did so. Cambridgeshire’s clinical commissioning group is one of the biggest in the country, meaning that the contract was able to provide the headline figure, £800m over 5 years, such a speech requires.

Politically expedient though this may have been, it is a serious mistake. As the former Secretary of State for Health, Andy Burnham ought to know that highlighting goings-on in Cambridgeshire would immediately invite comparison with Labour’s own record in the Fens. This can only be unhelpful, because, from 2004-10, Cambridgeshire was in effect a national testing ground for Labour’s experiments to involve the private sector in the NHS.

So, as the mothers of Darlington lace-up their walking boots and embark on their march, retracing the footsteps of the Jarrow Crusade, I humbly invite them to take a minor detour from the marchers’ original route so that I can show them around a county whose health economy, although home to some of the best specialist provision and research in the UK, is among the most financially challenged in the country.

Our first port of call would undoubtedly be Hinchingbrooke, the Huntingdon district hospital that is controversially run as an “operating franchise” by Circle Healthcare. The previous Labour Government initiated this £1bn project, a fact which still has the capacity to generate intense cognitive dissonance, even outright denial, among the party faithful. Thus, LabourList’s “definitive” online spreadsheet cites Hinchingbrooke as the second biggest contract “offered to Private Profiteers on David Cameron’s watch” (and the biggest to have been awarded).

Scratch the surface, though, and it quickly becomes clear that the “offering” took place under the Brown Government in July 2009, when the Treasury and the Department of Health approved the outline business case and procurement plan, which meant that private organisations would be invited to bid to run the hospital. Andy Burnham was Secretary of State for Health at the time.

Labour are formally correct to point out that the procurement did not report until November 2010, when the preferred provider was presented to the new government, but it is silly to suggest that Hinchingbrooke is therefore a Coalition initiative. Even if one overlooks the fact that the procurement took place under the Labour legislation that made such tenders possible, every last public-sector bidder had either been eliminated from the procurement by February 2010 or had dropped out, leading the BBC to conclude at the time that the hospital was “poised to be privately run”.

This puts our man Burnham in rather a contradictory position, calling on Cambridgeshire’s commissioners to stop an £800m procurement because a private provider could potentially win a 5-year contract, “which would tie the hands of the next parliament”, when he, while in office, agreed to an even bigger £1bn tender to franchise the management of an NHS hospital, not for five years but for 10. As outgoing Labour MP Frank Dobson says: “that’s the embarrassment in the chamber: because they shout back ‘You started it.'”

Fascinating though it is, the history of Labour’s franchising of Hinchingbrooke should not detain the marchers for long. Much deeper damage to Cambridgeshire’s health economy was wrought by Private Finance Initiatives, two in particular. A £22 million PFI-funded treatment centre, built at Hinchingbrooke in 2004, was based on numerous miscalculations and subsequently contributed to the hospital racking up a £39m deficit that provided the impetus for the franchise arrangement.

Just down the road from Huntingdon, PFI-funded Peterborough City Hospital has been an even bigger disaster. Whilst the hospital itself is a gleaming edifice, significant over-specification and interest repayments that are up-rated using the Retail Price Index measure of inflation quickly led to it amassing a £45.8 million deficit, making it the most loss-making Trust in the NHS. Monitor, the NHS regulator, had warned both the Treasury and the Department of Health that the Trust might be bankrupted by this loan, but these warnings were not heeded. So it is hardly surprising that local health professionals bridle at Mr Burnham’s hectoring remarks about “financial sustainability”.

Unfortunately, the problem is not merely financial. In addition to the vast sums the NHS now spends servicing these extortionate loans, the projects themselves have ossified Cambridgeshire’s existing overprovision of acute care for the foreseeable future. This makes it even more difficult to shift spending out of hospitals and into the community, where care can be preventative, as the hospitals have 30-year loans to pay off. Timescales like these dwarf those of the Older People’s Programme, and make the shadow Health minister’s objections to a five-year contract look absurd.

In such an environment it makes obvious sense to integrate the range of older people’s services in a single contract, as Cambridgeshire is now doing. Aligning financial incentives with clinical outcomes for the system as a whole will end the perverse contractual incentives that currently pull older people into the most cost-intensive care environments, and address the “ever increasing hospitalisation of older people” Burnham criticises in his speech. In this respect the Older People’s Programme is arguably a good example of the “whole person care” that he advocates, even down to the “single point of contact” in his speech.

I am anything but a cheerleader for the current Government’s health reforms. The new commissioning environment has weaknesses, well-exemplified by Serco’s community services contract in Suffolk. However, I would argue that the greatest threat comes not primarily from private sector organisations like Virgin – rank outsiders when competing with world-class NHS providers like Cambridgeshire’s – but from incompetent commissioners who do not properly test the realism of tenders and simply award contracts to the lowest bidder. This does not make it impossible to commission good services in the new system, however, and to suggest otherwise is to mislead the public.

Moreover, as even The Guardian recently acknowledged, it would be a dereliction of political debate if serious politicians were to pretend that the structural challenges facing the NHS are reducible to the private sector question. The fundamental challenge that we face is how to continue to provide top-quality universal healthcare to an ageing population at a time when we can no longer rely on economic growth, and it is clear that deep integration of services is the only way to do so.

In the event of a Lib-Lab Coalition I hope that both parties will make common cause to achieve this integration. Another top-down internal reorganisation will certainly not achieve it; nor can the necessary changes be centrally micro-managed, given the inherently fragmented model that we inherit, which goes back to Labour’s acceptance of the Tories’ purchaser/provider split, and the rise of foundation trusts. Solutions will have to be engineered at a local level by commissioners and providers.

If Labour propose simply to go back to the previous system – and even this is unclear – they urgently need to explain how they will prevent provider organisations from running rings around commissioners as they did previously. This is why care services for older people in Cambridgeshire are so fragmented, and why other attempts to integrate them have failed miserably: because in the previous system each of the provider trusts was necessarily focused on its own interests and commissioners did not have enough weight to effect integration. None of which makes for a neat stump speech, but it must be addressed before May 2015.

In the meantime, as the Darlington mums march south to the beat of Andy Burnham’s drum, he might be forgiven for hoping, privately, that Virgin actually wins the £800m contract. Otherwise, if the public sector wins it, the candidates fighting for Labour in Cambridgeshire will find themselves campaigning in a county with two disastrous NHS PFI contracts and the first £1bn privately-run NHS hospital in Britain – which would be ideal, were they not all Labour projects.

* The author is known to the LDV team but is anonymous for professional reasons.

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  • Mack(not a Lib Dem) 17th Aug '14 - 10:32am

    Involving the private sector in the NHS in a strictly limited way as Labour did is very different to privatising the whole of the NHS as the Coalition has done. Your Coalition Agreement promised to democratise Primary Care Trusts, not to abolish them ! This was as great a betrayal as your party’s betrayal on tuition fees and for which you will not be forgiven by the electorate. That’s why your polling results are so dismal.

  • Thoughtful article which lays bare the hypocrisy of so much Labour says about the NHS.

    If there is a Lab-Lib coalition, we should leave health policy entirely to Labour and their dogmatic statist ideology – give them enough rope to hang themselves.

    @Mack The Coalition has not privatised the whole of the NHS, and New Labour did more to bring the private sector into the health service than any government in history. A lot more. Suggest you go back to the Guardian comments board where facts aren’t important if Lib Dem-bashing is what you want to do.

  • @Mack(not a Lib Dem)
    “Involving the private sector in the NHS in a strictly limited way as Labour did is very different to privatising the whole of the NHS as the Coalition has done.”

    “Privatising the whole of the NHS” you say? In reality, even now private sector providers carry out only around 6% of NHS work. So you are saying 6% amounts to “privatising the whole of the NHS”?

    Please try looking at the facts first before making emotive statements.

  • @RC, @Mack – Yes, and 4% of that 6% private involvement (i.e. most of it) happened under Labour, so there is literally no mathematical or logical way in which it can be claimed that “The Coalition privatised the NHS” in which it isn’t even more true that “Labour privatised the NHS”.

  • John Broggio 17th Aug '14 - 1:50pm

    Keynes: “When the facts change, I change my mind. What do you do, sir?”

    ATL, Andy Burnham seems to be accused of not following that noted Liberals advice. Ho hum.

  • Tony Dawson 17th Aug '14 - 1:57pm

    Andy Burnham is allowed to get away with a lot by Britain’s media, partly as a result of his fluttering Thunderbird eyelashes and partly because of his good work over Hillsborough. He should never be allowed to get away with pretending to want to stop the faster and faster orbiting of NHS privatisation when he himself provide much of the rocket fuel, including Guaranteed Fixed Value contracts where the private provider was paid regardless of how much treatment they actually provided. Frank Dobson is always good for a sniping attack on Burnham, Blair, Brown & co for their privatisation of he NHS. A more neutral analysis is here:


  • Little Jackie Paper 17th Aug '14 - 2:24pm

    It is worth making an addition here. It is important to remember that when it comes to the NHS there is a ringfence in place on spending. Now, yes – there are, ‘efficiency savings,’ being made. And the NHS is having to pay things like increased costs where applicable so there are arguments to be had about the quality of that ringfence. But even so, compared to most other budgets across government the NHS has been on the better end of the deal over the past few years. Whether PFI and the like can be sustained from budgets that are not ringfenced is the real question here.

    The NHS’ day of reckoning as a sacred cow may yet come, that’s when the real problems hit.

  • Jenny Barnes 17th Aug '14 - 3:38pm

    It strikes me that a lot of these PFI contracts were entered into somewhat unethically, in order to provide off-balance sheet borrowing, on the one hand, and with invidious terms and conditions on the other. Perhaps the concept of “odious debt” could be applied to these long term contracts for private firms to batten on the taxpayer.

  • Mack (Not a Lib Dem) 17th Aug '14 - 4:02pm

    Of course the whole of the NHS has been privatised by the Tories and the Liberal Democrats. The Health and Social Care Act enforces competitive tendering and when this Act is harmonised under the Transatlantic Trade and Investment Partnership this will put the NHS at the mercy of global national bidders, including the huge American health care companies, all intent on making billions out of ill and dying Britons. “Harmonised” standards favour private companies over public sector providers and The Transatlantic Trade and Investment Partnerships will make your total privatisation almost certainly irrevocable.. How can you deny that your actions in supporting the Tory government have resulted in the complete privatisation of our NHS? Read the article in the New Statesman
    On- Line: “How the EU is making NHS Privatisation Permanent”. You might find out what it is that you’ve actually done to the peoples’ NHS. None of you on here seem to realize. http://www.newstatesman.com/politics/2013/12/how-eu-making-nhs-privatisation-permanent

    Or perhaps you prefer to console yourselves with your irrelevant and specious figures and your usual knee jerk assertions, whatever the context, that it was all Labour’s fault?

  • @Simon Shaw

    Labour did not privatise dentistry.

    Here’s an article in the BMJ about privatisation of dentistry : http://www.bmj.com/content/312/7036/922

    Note the date it was published – 13 April 1996. ieThatchers reign.

    GPS have always been private companies so I suggest you’re being deliberately disingenuous.

    Some private services such as opticians have been great for the NHS – nobody wants to go back to the days of the heavy old style glasses but it’s wrong to say that every privatise service within the NHS has been down to Labour.

    I’m really fed up with all this Tories & LibDem good, Labour bad rubbish – if you want to stick with the Cons then join forces with them in your manifesto & let your constituents decide.

  • Tony Dawson 17th Aug '14 - 4:49pm

    @Mack (Not a Lib Dem):
    ” perhaps you prefer to console yourselves with your irrelevant and specious figures and your usual knee jerk assertions, whatever the context, that it was all Labour’s fault?”

    Some of us think it is not ALL Labour’s fault – simply stating that Andy Burnham is being totally dishonest and falsely-amnesic about his own role does not make it ALL his fault. HLabour’s accidental(sic)giving of a massive pay rise to doctors and deliberately diverting significant NHS resources to top managers’ pay didn’t exactly help, either. But you would appear to have a serious bout of Pot-Kettle disease, since you are suggesting it is ALL the Coalition’s fault. Now, why would you be doing that?

  • @Mack: LOL. Seriously – LOL.

  • Mark Inskip 17th Aug '14 - 5:20pm

    So @Mack (Not a Lib Dem) realises he’s been found out with his original line of argument and now takes a different line. Again is is of course also nonsense, see http://trade.ec.europa.eu/doclib/press/index.cfm?id=1115

    The question @Mack (Not a Lib Dem) should answer is why he was praising Burnham’s NHS privatisation initiatives when the last Labour government was in power.

  • stuart moran 17th Aug '14 - 5:34pm

    Mark Inskip

    and I think you will find that bthese steps for privitzation of the NHS were why a lot of Labour voters, amongst other things, stopped voting for them.

    The Coalition has continued and deepened the privitization with the support of the LD, so now all three are tarred

    The LD took a lot of those disaffected Labour voters fed up with the rightward drift under Blair and Brown. Now they find you supporting even more right wing policies as part of the Coalition…..

    If you want to stand any chance of retaining these voters (and to me there is very little chance of it) you have to quickly come up with some credible policies that we think you actually believe in….are the LD in favour of continuing the Lansley reforms or, as Burnham has said he will do, abolish them because they are wrong?

    I echo the comment of Martin B, if all we see is LD members coming on here to parrot Coalition policies that, because of the split in MP numbers, are significantly more Tory than LD then why bother voting for them.

    The are a whole number of policies such as NHS, student funding in all its guises, austerity, environment where I am completely at a loss to understand what the party policy is. I assume that a manifesto will set out significantly (if not drastically) different policies from the Coalition – which is 80% Tory – but then see all the members defending all those Coalition policies. Is my assumption false, and seeing the manifesto is coming from Laws then who knows.

    I then also see Danny Alexander and other ministers announcing LD prospective policies in interviews but I was led to believe policy was decided by the membership. So by what authority are things being announced.? I also though that Cable was still economic affairs spokesman despite not having the portfolio in the Government – is Alexander now your ‘Shadow’ of Osborne. If so, then God help you!

    I am very, very confused…….

  • Mack (Not a Lib Dem) 17th Aug '14 - 5:58pm

    Mark Inskip
    “The question @Mack (Not a Lib Dem) should answer is why he was praising Burnham’s NHS privatisation initiatives when the last Labour government was in power.”

    But I never did!

    Your response suggests that you haven’t read or understood the New Statesman article or the import of my previous posts. The link you give offers no guarantees that the recently privatised NHS, particularly under the Tories and the Liberal Democrats, will be protected from the consequences of the Transatlantic Trade and Investment Partnership.

  • Stephen Campbell 17th Aug '14 - 6:54pm

    @Stuart Moran: “and I think you will find that bthese steps for privitzation of the NHS were why a lot of Labour voters, amongst other things, stopped voting for them.”

    Exactly. I started voting Liberal Democrat in 2001 when it became clear that Labour were going to continue to be just as Thatchetite as Thatcher herself. There were probably millions of people like me who wanted a left-of-centre alternative to Labour who were not as authoritarian and beholden to fundamentalist market dogma. And whether or not that was truly what the Liberal Democrats stood for, it was certainly the impression I got from the days of Charles Kennedy (oh how I miss him).

    Seems the Liberal Democrat excuse for further privatisation is: “Labour did it first. Blame them!” Here’s a tip, Lib Dems: just because some other party did something your voters don’t like does not absolve your actions in any way when you do the same. In fact, it acts as further evidence that all three main parties are not much different from each other.

    As an aside, the moment the NHS “reforms” were passed into law was the moment your party lost my vote, quite possibly forever.

  • Technical Ephemera 17th Aug '14 - 7:12pm

    This sort of academic whataboutery is a prime example of why the Lib Dems are probably stuffed in 2015. It might play well on LDV, but if you attempt that line on the general public they will rip you to pieces.

    Mack pretty much has it surrounded, the privatisation and laying of waste to much of the NHS that your party happily promoted is real, it is happening on the ground and some of the most vulnerable in society are dying or having their quality of life worsened as a result.

    The people I know who work in the NHS have their heads in their hands because of the damage your policy has done. They are starting to lose the ability to work round the Lansley-Clegg train wreck as their services are fragmented and their jobs handed to second rate private companies.

    While student fees is a serious wound to the body of the Lib Dems, the NHS debacle is a huge sucking chest wound that will drag you down unless you take action. Articles like this make it fairly clear that the party has not recognised the problem and therefore has no chance of treating it.

  • Stephen Donnelly 17th Aug '14 - 7:14pm

    Good article, form someone with direct experience.

    Killian reminds us of the point made in a Guardian editorial that ‘it would be a dereliction of political debate if serious politicians were to pretend that the structural challenges facing the NHS are reducible to the private sector question.

    As Liberals we are uniquely (because we do not represent a vested interest) able to look at the best solution regardless of the ownership of the body providing it.

    The commissioning system set up under the Lansley reforms, may reduce costs, and will provide opportunities for finance, but it will not provide the healthcare services that people want.

  • Mack (Not a Lib Dem) 17th Aug '14 - 8:21pm

    @Stephen Donnelly
    “As Liberals we are uniquely (because we do not represent a vested interest) able to look at the best solution regardless of the ownership of the body providing it”.

    Really? It seems to me that the Liberal Democrats’ vested interest is in achieving and grabbing power as a minority party and they will do anything that their more powerful political hosts demand of them in order to hang on to it: even when that includes betraying their tuition fees pledge, acceding to the total privatisation of the NHS and reneging on the Coalition Agreement.

  • Mark Inskip 17th Aug '14 - 9:04pm

    @Mack (Not a Lib Dem) you wrote “The link you give offers no guarantees that the recently privatised NHS, particularly under the Tories and the Liberal Democrats, will be protected from the consequences of the Transatlantic Trade and Investment Partnership.”

    It deals with the point directly, but if you’re not convinced the try this one; http://trade.ec.europa.eu/doclib/docs/2014/july/tradoc_152665.pdf

    As for your views on Burnham as health secretary, which Labour privatisation initiatives did you object to?

  • Mack (Not a Lib Dem) 17th Aug '14 - 10:40pm

    None of the assurances you adduce are worth a hill of beans because the Transatlantic Trade and Investment Partnership enables huge global enterprises the right to sue governments that try to protect their citizens through democratic and legal process. I suggest you read this. http://www.theguardian.com/commentisfree/2013/nov/04/us-trade-deal-full-frontal-assault-on-democracy.

    I am opposed to all privatisation initiatives because I support extensive public ownership. That’s because I’m a Socialist.

  • @Stephen Donnelly

    “As Liberals we are uniquely (because we do not represent a vested interest) able to look at the best solution regardless of the ownership of the body providing it. ”

    So, the £1m of donations from Alpha Healthcare had nothing to do with waving the legislation through parliament?


  • @Mack (Not a Lib Dem) you have posted a couple of opinion pieces from 2013. I have posted links to a couple of factual responses from July 2014 to concerns raised about the TIPP with regard to the NHS and public services. Those responses are from people directly involved in the negotiations from the EU side.

    In addition the ISDS (Investor State Dispute Settlement) which will be used with the TIPP has been revised compared to the one in earlier trade agreements. The earlier revision of the ISDS applies to agreements already negotiated by previous governments.

  • A Social Liberal 18th Aug '14 - 12:40am

    Hospitals built during the Labour era were not good value for money but you have to put the reasons for using PFI into context.
    *The Thatcher era had left the NHS starved of funds and with a health infrastructure which was not fit for purpose.
    *Labour had promised to match Tory funding for a fixed period, but the shortage of hospitals and of hospitals which were fit for purpose needed sorting out immediately.

    Given these two facts, there was little Labour could do. I would be interested in how some of Labours gainsayers would have squared the above circle.

  • Mack (Not a Lib Dem) 18th Aug '14 - 9:49am

    But none of that matters because the Health and Social Care Act has made competitive tendering mandatory and the EU has accepted that subsidiarity is paramount in such areas. In other words, the Coalition Government, operating under the conditions of a privatised NHS and the Transatlantic Trade and Investment Partnership’s harmonisation practices will always favour private as opposed to public providers. And when a Labour Government tries to protect the people against the global healthcare predators through parliament or the courts they will be forced by the healthcare companies to pay billion s in compensation. That’s why, Oliver Letwin was reported by Mumsnet as saying that the NHS would not exist within five years of an election victory. http://www.mumsnet.com/Talk/in_the_news/a1812594-Oliver-Letwin-NHS-will-not-exist-under-Tories

    Well, the Tories did not get their election victory but that didn’t matter because the Liberal Democrats were on hand to help the Tories achieve their complete privatisation of the NHS . Technical Ephemera (see above) has described the consequences of your Health and Social care Act. As an example of what’s to come under NHS privatization I give as an example the case of the NHS Blood Plasma Service which has been sold to a private equity company. http://www.independent.co.uk/news/uk/politics/is-there-no-limit-to-what-this-government-will-privatise-uk-plasma-supplier-sold-to-us-private-equity-firm-bain-capital-8718029.html
    Or perhaps visitors to LDV might care to read WideShut’s description of how NHS privatisation has been assisted by the establishment of Foundation trusts.

    But it’s understandable that the Liberal Democrats don’t want to acknowledge that the NHS has been privatised under their watch. That would see their lamentable poll ratings (currently between 8 and 10 per cent and behind UKIP’s) plunge even further.

  • Mack (Not a Lib Dem) 18th Aug '14 - 12:40pm

    @Simon Shaw

    Yes, many people are completely unaware of the extent to which the NHS has been privatised by the |Coalition. They only discover the consequences of the Health and Social Care Act when they have to seek treatment.

    My GPs’ surgery has never been politicised and it has never promoted a political campaign. The other day I was in there and saw a poster prominently displayed in the waiting room urging patients of the practice to join a campaign to protect GP services by signing a petition. In my experience this is unprecedented. I, of course, signed the petition. This is just one example of the consequences of your appalling Health and Social Care Bill. The Liberal Democrats on here seem to be in complete denial about what they have done to the peoples’ NHS.

  • Mack (Not a Lib Dem) 18th Aug '14 - 2:35pm

    @Simon Shaw

    Now what was it I was saying about being in denial?

  • ErnstRemarx 18th Aug '14 - 4:38pm

    @Simon Shaw

    “Still doesn’t tell me what you think the petition was about”

    I think you’re rather missing the point. The petition was there (a first, apparently) and they were asking for signatures, and I’m willing to bet that more and more people are seeing the deterioration in NHS services and waiting times and asking the sort of uncomfortable questions that will not be good for the current government parties. Such as – why is is taking so long to get an appointment? Why do they keep on cancelling my operation? What good came from the massive and expensive reorganisation of the NHS?

    People aren’t stupid. They’re going to start putting two and two together and whilst some people might want an Americanised health care system, there are many, many more who know the state of national health care in America and understand the implications for the UK should the NHS become fragmented or a ‘sink’ service for the difficult and non-lucrative treatments that private providers will be highly unwilling to take on.

    People realise that the Lib Dems are a vital part of the government – providing, as they do, the working majority – that enabled the Tories to put their (unannounced in their manifesto) NHS plans through into law. That won’t be forgotten – as noted above by at least one ex-Lib Dem voter – or, I would suggest, quickly forgiven.

    One final point: it’s not unreasonable to point to Labour failings when in office regarding the NHS, but context is, or should be, important and PFI deals (for example) were an attempt to rebuild services whilst cutting down immediate costs and in all likelihood avoiding endless media hostility towards ‘spendthrift Labour’. That’s part of my point; my main point is that now – less than a year to May 2015 – it would probably be a very sensible policy indeed to reach out to the Labour party, given current poll ratings, since you’re only likely to sniff power again as part of a coalition with Labour. Of course, if there’s a Labour majority as polls suggest, then it’s quite possible that past and recent anti Labour sniping by the Lib Dems will not be viewed with anything other than grim pleasure by the Labour leadership, Burnham included.

    You may want to choose your opponents more carefully.

  • @Simon Shaw

    “particularly with Labour. No we don’t!”

    Do you think that is a bit presumptuous on your part Simon? You are an individual person with individual idea’s and opinions. I am sure you do not speak on behalf of the entire Liberal Democrat Party, so maybe you should detract the comment “No we don’t”

    To throw my 2 pennies worth in on the actual subject matter.

    As someone who is heavily reliant ant on various NHS services, I experience first hand the decline and level of care provided which has got progressively worse over the last 24 months.

    Unless you have first hand experience and an ongoing need for these services then most people are unlikely to understand just how much things are changing. That’s my personal opinion, for what it’s worth 😉

  • Mack (Not a Lib Dem) 18th Aug '14 - 9:06pm

    @ Simon Shaw.

    I hate to see a Lib Dem languishing in ignorance over the consequences of his party’s policy, so here’s a link which explains it all for you. “BMA Launches Campaign to Highlight Rising Pressure on GPs” http://www.pulsetoday.co.uk/news/finance-and-practice-life-news/bma-launches-campaign-to-highlight-rising-pressure-on-gps/20006678.article#.U_JVvhEg_IU

    I appreciate that this is going to provide you with some hefty dissonance problems as we all know that the Lib Dems and the Tories love GPs when they are wearing their small business hats but when they are wearing their BMA hats they like to characterise them as trade unionists and therefore people with vested interests. Even so, I think you’ll agree that GPs recruiting patients in a political campaign is unprecedented. Don’t bother coming back to tell me that this campaign has nothing to do with your privatisation of the NHS: it was the Health and Social Care Act that put GPs under intense pressure by making them responsible for commissioning in addition to curing the sick. And then of course, there are all the funding cuts they’ve had to bear. All labour’s fault, of course.

  • @Simon Shaw

    Well I can not deny your right to express your opinion on such a limited assessment 😉

    However, if that where the majority collective view of the party no wonder it is doing so badly in the polls. Not a very good advertisement to swing voters either.

  • Mack – I’m a professional researcher (and a very left Lib Dem). Your conclusions on TTIP are wrong, but that’s ok because there’s a sh*tload of misinformation kicking around the internet on this subject.

    In any case, I am of the personal opinion that any privatisation of the NHS is wrong, no matter who implements it, and so I imagine we agree. I trust from your statements you won’t be voting Lib Dem, but nor should you be voting Labour (PFI contracts anyone?).

    I would add that it is my view that you make huge mistakes in your notes by lumping the Lib Dems and the Tories together on this (and frankly anything). No, we aren’t yellow Tories, no we aren’t yellow Labour either. There’s a new generation of Lib Dems coming up the ranks btw, and we are all very angry with the Orange Bookers.

    Anyway, Collective Miniserial Responsibility means that for every Gay Marriage or Free School Meals our Ministers implement, we have to swallow a Health and Social Care Act or Badger Cull. It is utterly wrong to lump Lib Dem activists in with this – I think the difference between you and I is not where we fall on the spectrum, or really even our ideology, it’s pragmatism. I stick with the Lib Dems because, in spite of some stuff I truly disagree with, they have stopped the very worst of the Tories (trust me, it’s my job to know exactly what hasn’t gone through) and I will never go to Labour because they really are just the Conservatives in red rosettes.

    You’ll get the same cuts with Labour, but because we’ll probably be down quite a number in 2015 the Lib Dems won’t be there to stop them introducing something like 90 days detention without trial the same way we stopped the Tories from removing benefits from under-25s. Sad but true.

    Rant over.

  • @Simon Shaw

    I recollect many times you have said on these forums that you do not wish to see the Liberal Democrats form a coalition with either Labour or Conservatives. And you have been very consistent in saying that you would prefer to see a Labour Majority in 2015 ( which miffs me to be honest).

    I think it is fair to say though that the likelihood of Liberal Democrats forming a majority government within the next 50 years is next t o zero.
    Given that the Liberal Democrats are supposed to believe in “plural” politics. And going by your comments earlier in regards to a coalition with Labour and where you said
    “Firstly, don’t forget that my key statement is about whether the Lib Dems want to be part of a coalition government in 2015 at all, rather than whether it is with Labour or the Conservatives.
    All I can say is that I have asked a small number of other Lib Dem activists (probably no more than half a dozen) what they think, and they all happen to think the same way. I’m not suggesting that proves anything scientifically, but until someone produces some better evidence of the Party’s collective view, I’ll stick with it, thank you.”

    If that is truly the consensus of the Liberal Democrat party as a whole. How then is that encouraging swing voters to vote for the Liberal Democrats?

    I am a swing voter who lives in a constituency that is a traditional Labour seat, which went to the Liberal Democrats at the last General Election by just over 300 votes. I put my hands up now though and confirm that the likelihood of me voting Liberal Democrats at the next election is near on zilch unless a miracle happens over the next couple of months, it is almost a certainty that my vote will go back to Labour.

    However i do not understand the logic and how you would expect the party to reach out to swing voters, especially to those in Tory/Libdem marginal seats if the party as a whole had the same thought process as you when it comes to future coalitions, especially with Labour.

  • Peter Watson 18th Aug '14 - 10:47pm

    @Tom “There’s a new generation of Lib Dems coming up the ranks btw, and we are all very angry with the Orange Bookers.”
    Comments like this – and almost any post by Matthew Huntbach – give me hope that the Lib Dems will be a party to which I can return. Unfortunately, I don’t see evidence that this is a significant feature of the party at the moment, and the impression has long been given by senior Lib Dem figures that only Labour is the enemy and every Coalition compromise is a Lib Dem dream fulfilled. I am left waiting to see what a post-2015 / post-Clegg Lib Dem party looks like.

  • Peter Watson 18th Aug '14 - 11:45pm

    @Simon Shaw “If [coalition with the Conservatives] there is a real danger the Lib Dems would be seen as a permanent adjunct to the Conservative Party.”
    I agree with this but worry that sitting alongside the Conservatives in opposition to a Labour government would have the same effect.

  • Peter Watson 19th Aug '14 - 1:23am

    @Simon Shaw “You may worry that, but the worry would be completely misplaced. After all that’s what we have done for most of the last century – at least until 4 years ago”
    I think we’re in very different territory now. Until 4 years ago, the Lib Dem stance was “a plague on both your houses”. In the 2010 campaign we criticised what Labour had done and what the Conservatives planned to do. Clegg (and his predecessors as Leader) would stand up in the Commons to berate both sides of the House and offer a Lib Dem alternative. I can’t see the 2015 campaign being anything like as even-handed, and a spell in Opposition to Labour would inevitably mean siding with the Tories to defend the record of 5 years of Coalition and to criticise the actions of Labour.
    My gut-feeling is that a Lib-Lab coalition, one in which the junior partner gives the impression that it has settled for hard-fought compromises rather than casually reversed its position on key areas, could be a good outcome for the Lib Dems in the longer term, showing the party’s independence and ability to be truly a party of government.

  • @ Peter Watson

    “My gut-feeling is that a Lib-Lab coalition, one in which the junior partner gives the impression that it has settled for hard-fought compromises rather than casually reversed its position on key areas, could be a good outcome for the Lib Dems in the longer term, showing the party’s independence and ability to be truly a party of government.”

    Here, now that is a statement that I strongly agree with.

    Me being a more natural inclined Labour voter, I voted Liberal Democrats last time as there was a lot of things that Labour where doing which I strongly disagreed with, and I wanted the Liberal Democrats to provide a strong Liberal perspective towards government and taper some of Labours Authoritarian policies that I disliked. And I thought plural politics should be given a chance to show it can work in “National Government”

  • Mack (Not a Lib Dem) 19th Aug '14 - 9:30am

    @Simon Shaw
    ErnstRemarx is absolutely right: you are completely missing the point. BMA members are so under pressure they have resorted to enlisting the support of their patients in a political campaign against your Liberal Democrat/ Tory government to protect GP services. That’s what your Liberal Democrat/Tory government has achieved. It is unprecedented and never happened under Andy Burnham. By the way, have you never heard of the MPIG cuts that your ministry of health have imposed? That’s what GPs and health professionals are marching and demonstrating about. I’d send you some links illustrating this but from your previous remarks it is patently clear you don’t read them.

  • Jayne Mansfield 19th Aug '14 - 6:47pm

    I support the National health Action Party. Those contributing to this discussion wwould do well to rad an article by one of the Co-chairs, Dr Clive Peedall, a consultant oncologist in South Tees. ” Outsourcing of cancer care – the biggest and most reckless NHS privatisation yet?’ It may provide food for thought.

    Dr Peedall will be running part of the way on the Darlington mothers’ march.

  • Tony Dawson 19th Aug '14 - 9:30pm

    @Mack (Not a Lib Dem)

    ” when a Labour Government tries to protect the people against the global healthcare predators………… ”

    ……….the day after hell freezes over? No Labour government would be any more likely to do this than they would be reversing Welfare reforms… or cuts in local government finance…. or increasing the armed services budget……. (contd p94)

  • Mack (Not a Lib Dem) 19th Aug '14 - 11:15pm

    ‘Tony dawson
    I’d remind you that Labour is committed to repealing the vindictive bedroom tax and the Act that privatised the NHS. And that’s just for starters.

    When it comes to a clear choice between Labour and the party that helped the Tories introduce the bedroom tax, privatise the NHS, massively hike up tuition fees, reward millionaires with thousands of pounds in tax relief, sell off the Royal Mail at knock down prices to the City, deprive hundreds of thousands of their rightful benefits and make nearly a million of them dependent on food banks . . . (Cont p94) I don’t think it will be the Liberal Democrats that the people will be trusting to protect them from predators.

  • “When it comes to a clear choice between Labour and the party that helped the Tories introduce the bedroom tax, privatise the NHS, massively hike up tuition fees, reward millionaires with thousands of pounds in tax relief, sell off the Royal Mail at knock down prices to the City, deprive hundreds of thousands of their rightful benefits and make nearly a million of them dependent on food banks . . . (Cont p94) I don’t think it will be the Liberal Democrats that the people will be trusting to protect them from predators.”

    Spot on. The Liberal Democrat party slagging off another party as ‘untrustworthy’? Who says satire is dead.

  • Peter Watson 20th Aug '14 - 8:00am

    @ErnstRemarx ” The Liberal Democrat party slagging off another party as ‘untrustworthy’?”
    But the other parties are untrustworthy. A problem for Lib Dems though is that they are no longer seen as being any different. This is made so much worse by Clegg who made himself the face of “no more broken promises” and a “new kind of politics”.

  • @Simon Shaw

    You are being a little disingenuous I feel.

    As far as I understood the “bedroom tax ” for private tenants, this was introduced for new tenants. It did not effect those immediately as the coalition did with social housing tenants . And besides those renting in the “private sector” had a far better chance of obtaining alternative housing. The same could not be said for those in the social housing due to the lack of smaller 1 and 2 bedroom properties.

    As far as the “Increased” privatization of the NHS. It was the coalition government that allowed NHS trusts to up the amount of private patients care to 49%

    But the point should surely not be what Labour did ,nah nah nah nah. If a previous Government recognizes that a policy that they may have once introduced is proven to be damaging, then surely that is right that the party would reflect on this and vow to repeal it when they get back into office.
    Surely that is the party putting the Countries interest ahead of the parties interest.
    A lesson that Liberal Democrats will do well to learn themselves, instead of this well Labour did this, Labour did that, it’s all Labours fault.
    Nick Clegg promised only a few weeks ago that the party would learn from it mistakes and start listening to the electorate. I see no evidence of that happening thus far.

  • Mack (not a Lib Dem) 20th Aug '14 - 10:49am

    @simon Shaw
    Matt is absolutely right: Labour’ s tax on spare rooms for those on benefits in the private sector was not retrospective and only affected new tenancies. This was quite different to the Lib Dem’s vindictive bedroom tax which forced people on benefits out of the homes they had lived in for years. and in many cases decades. That’s why Labour will repeal it. There has always been a certain number of individuals operating within the NHS on private terms i.e. Consultants,dentists, opticians, chiropodists etc. and Labour, quite wrongly in my view , under Blair introduced a small amount of private involvement. But it was this Lib Dem /Tory Coalition that used this as a justification to seize the opportunity to completely privatise the NHS under the Health and Social Care Act. It is this appalling Act that Labour have promised to repeal.

  • Peter Watson 20th Aug '14 - 12:44pm

    @Simon Shaw “You weren’t being “a little disingenuous” there, were you?”
    Perhaps you are being a little disingenuous yourself. I believe that matt meant “retrospective” rather than “immediate”, a point made explicitly by Mack (not a Lib Dem), and a very important factor that you have not addressed when comparing the public sector bedroom tax with Labour’s original policy (did Lib Dems support that one at the time?).
    But as I understand it though, Lib Dem policy is no longer to support this Coalition policy and we’re now free to call it a bedroom tax on this site 😉

  • @Simon Shaw
    “Incorrect. Not only does Labour’s Bedroom Tax apply to all private sector tenants”

    Strange, as the first three random sources I’ve just checked all back Matt and Mack’s claims and refute yours. Can you give a source to back up your assertion?

  • Peter Watson 20th Aug '14 - 1:29pm

    Perhaps “retrospective” is not the correct term, but in this debate it is understood to mean that the Coalition’s bedroom tax penalises people who have lived in their homes for a long time whilst Labour’s policy only affected people making new claims.
    If I have used “retrospectively” incorrectly, then perhaps you could (more politely than in your last post, I hope) suggest a more technically correct word. You might also want to come up with a better word than “all” which I believe you might have used misleadingly when you wrote, ” Labour’s Bedroom Tax apply to all private sector tenants”. I know you are a stickler for detail so you may well have meant that the rules apply to everybody, but in the context of the debate the implication of your message was that established residents had their housing benefits capped even if they did not move which does not seem to be the case.

  • @Peter Watson

    Thank you, that is exactly what I meant 😉

    I acknowledge that my vocabulary and grammar is appalling at times and I struggle to make myself understood.

    It is comforting to know though that there are some people who are willing to see past my weaknesses and take the time to understand and put into context what I was trying to say and meaning.

    There will always be a Simon Shaw among us though ready to pounce and attempt to pull apart someone’s argument based on a Speech technicality, rather than addressing the real context of the debate.

    I do look forward to his response to you, Stuart and Mack as I know I was right when I said Labour did NOT introduce the “bedroom tax” on existing “private tenants” and the policy was only subjected to NEW benefit claimants in the private sector. Unlike the policy that was introduced by the coalition government which had an immediate effect on ALL “existing tenants”

    I am rather concerned that Simon Shaw has got his information from an “expert” from Sefton Council. I rather hope He/She is not a Liberal Democrat and giving out misinformation.

  • Mack (Not a Lib Dem) 20th Aug '14 - 2:59pm

    @ Matt and Stuart

    I am attaching a link to an excellent summation of the contrasts between Labour’s Housing Allowance ,2008 (What Simon Shaw call Labour’s Bedroom Tax) and the Coalition’s actual Bedroom Tax introduced in 2013. http://notpaying.tumblr.com/post/55537295011/how-the-bedroom-tax-differs-from-the-local-housing

    This document is a compare and contrast exercise conducted by a full time carer and not a nameless official.

    It completely debunks Simon Shaw’s assertions that Labour introduced a “Bedroom Tax” and from it you will see that there is no comparison between Labour’s measure and the Lib Dems’ Bedroom Tax . For a start, Labour’s measure was designed to stop unscrupulous Landlords abusing Housing Benefit by putting rents unreasonably high. You are quite right that Labour’s Housing Allowance only affected some new tenants in the private sector and no existing tenants in the private sector at all. Unlike the poor tenants in the public rented sector on benefits (many disabled) who were unjustly taxed out of homes they had lived in for years by the Liberal Democrats and the Tories with their pernicious and retrospective Bedroom tax. By the way, you will be pleased to see that the document uses, quite correctly, the term : “retrospective”. Retrospective is a synonym for “retroactive” which means to act backwards or to ” take effect from a previous date”.

  • Mack (Not a Lib Dem) 20th Aug '14 - 3:21pm

    @ Simon Shaw

    “Could you explain what part of either Labour’s or the Coalition Government’s Bedroom Taxes are backdated”

    Again you’ve missed the point. Labour’s Local Housing Allowance 2008 was not retrospective, i.e. retroactive, or, as you put it, “backdated” . It only applied to certain new tenants in the private sector who moved in after the Act came into force. . The Lib Dems’ Bedroom tax was retrospective because it applied to people on benefits who were living in public sector rented accommodation before the Bedroom tax came into force. Some of them for decades. Is that back dated enough for you? Clear now?

    “Consultants shouldn’t be on that list. They do not operate within the NHS on private terms.”

    I chose my words carefully. Bevan arranged for consultants to operate within the NHS and do private work. Indeed, I know of people who, years ago, have been seen privately by consultants and then operated on in NHS hospitals.

    “That’s actually an awful lot of private involvement under Labour.”

    There would never have been an NHS if Bevan had refused to accept some measure of private involvement.

    “You are talking in slogans again. Please stop it.”

    Whenever I speak the truth you accuse me of talking in slogans.

  • @Simon Shaw
    “My source is the expert at Sefton Council”

    I was hoping for something more like a hyperlink.

    Though if you have a name and email address for this “expert”, I’ll be happy to ask him/her myself.

  • Kilian Bourke 3rd Nov '14 - 4:55pm

    I thought it might interest you to know that the party changed its policy on NHS commissioning at conference in Glagow in October. You can read more here: https://www.libdemvoice.org/opinion-a-radical-liberal-and-localist-alternative-to-nhs-commissioning-42906.html#utm_source=tweet&utm_medium=twitter&utm_campaign=twitter

  • I live 15 miles from Darlington, it’s my opinion that labour did start the private element of the NHS my local Hospital wishes a relocation and it seems that it would be PFI for now it’s postponed and I hope for one scraped PFI was one of the worst ideas ever carried out in the NHS.

    The problem the NHS has now is the range of procedures it is called on too Cary out gastric bands, repair cosmetic breast implant bought under the private sector and that is only a top of the mountain.

    I am a supporter that NHS should be free at point of delivery for official residents of the UK (not illegal immigrants ) even if this meant an increase of funding

    Using a term for Andy Burnham pot calling the kettle labour started this stupid privatisation add the billions wasted on a computer system is the NHS safe under Labour I have the view well intentioned but financially inept

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