The Liberal Democrat Spring Conference and the NHS Bill have become synonymous.

I spoke against the bill, saying the concessions that we claim to have acheived are, at best, platitudinous.

Mark Pack’s round up of the debate can be found here and the Guardian Live Blog here.

The newspapers have been quick to denounce the Liberal Democrats and imply that they are clearly fracturing with the creation of the “Liberal Left” that will be launched at the Spring Conference 2012. Alongside the occasionally maverick group Social Liberal Forum, such factionalism is both embraced and abhorred by members of this political party.

The Liberal Democrats have not had an easy two years; it takes a great deal of guts to pursue a pluralist agenda in what is essentially a two-party system which bases all of its ideals on empirical content only. The Conservative, and major partner, within the coalition, have being keen to follow the political science predictions of the coalition, viewing it almost surely is a thorn in their side as they move towards a majority government.

However, with the global economic crisis, with significant divide in wealth and a growing, and ageing, population, empiricism has little value. Rather than the obvious predictions of the Coalition in 2010; that the economy would pick up, the Conservatives would be able to sell the nationalised banks on a vast profit and take control of the government quickly and easily with the help of the Murdoch press, the Conservatives have had to develop some humility. Not only have they been forced to sell one bank at a loss, and the other one is not looking too good, but they are not seeing any growth and being forced into quantitative easing which they had vehemently criticised in opposition, but they are also now looking at further hung parliament in three years time. So much for empiricism.

The unhappiness within the party is demonstrated by tantrum-like behaviour from the far right and the Eurosceptics. However, a similar level of unhappiness is demonstrated within the Liberal Democrats, by creations on formal and informal bases, of factions.

There is nothing wrong with factionalism in principle. Indeed, the Liberal Democrats could learn a lot from not only their coalition partners but also from Labour asboth parties encompass a range of factions that create identities depending on their true beliefs as opposed to the whole. The Conservative party has their 1922 committee and associated followers, the Thatcherite liberals, the Eurosceptics, and the more Traditionalists. The Labour Party had their own little groups, such as the Fabians, Compass and also the relevant Brownites and Blairites groupings alongside the Socialist Campaigners and Bennites. As the Liberal Democrat party has grown, both in elected and in non-elected members, their number of associated bodies must also grow. It is unnatural for everyone to the left of the fence to support complete nuclear disarmament for example.

The development of the Social Liberal Forum, a thorn in the side of the Orange Bookers as the centre left-rightists of the party are referred to and who form the majority of the Cabinet members, has caused enough so-called trouble. They have heavily contested the NHS Bill, heavily contested the Welfare Bill and helped to disrupt an entire conference by bringing Hugh Grant along.

Now we have the Liberal Left. This particular murmeration of Liberal Democrats works on the premise that they are anti-coalition, therefore, in principle, they are anti-pluralism. Or, alternatively they are only anti-coalition with the Conservatives. Unlike the Social Liberal Forum, which seeks to open debate around policy developments, the Liberal Left is seeking to back the party into a corner.

Not only is there a risk of the factionalism descending into bickering amongst the party; alongside snide blog posts by more “economic facing Lib Dems” for example, there is a real risk that the party is effectively being divided and ruled by their own inability to focus on what is important to them. And when factionalism becomes bickering, as indeed such affiliated formations are in danger of becoming, the party is going to lose any merits it can gain from all of the extremely positive things they have done in the coalition.

On an official basis the largest problem about the “Liberal Left” is an organisation is it will upset the whips and the coalition agreement. People may be unhappy with what the Coalition is doing in principle, but they don’t make such striking statements on websites or conduct launches within their own federal boundaries. Indeed, this could constitute breaching the party’s own constitution of bringing the party into disrepute. This level of upset among the grassroots could then become upset amongst the ministers and subsequently across government. It is unlikely to get that far, but it should be noted that on the first event that the Liberal Left hosting, there is not one minister or MP attending as a speaker. Unlike the Social Liberal Forum which has elicited support from across the ministerial cabinet, the Liberal Left seems to be being left alone to fight amongst themselves.

With a prolific Mid-Term Review due within the party and within the coalition, perhaps the liberal left will be able to provide grassroots support for such a striking anti-coalition stance. However, the majority of the Liberal Democrats would benefit from turning the other cheek to tantrums that we generally only expect from the Conservative Euro Sceptics.

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This post originally appeared on Postdesk blog

A lot of feminist bloggers and journalists have commented on the growing marketing campaigns around women proposing on the leap year, 29 February 2012. One of my favourites was by Rosamund Urwin of the Evening Standard.

She proclaims;

“If we’re on the back foot in relationships, we won’t help things progress by continuing to stick to sexist rules”

The sexist rule she is talking about, it is, of course, the liberty that is placed upon a woman to propose to her beloved on this one day every four years. Lucky us!

However, declarations across the world not to propose marriage are as symptomatic of an elephant in the room as the French banning the use of the terms Miss and Mrs.

Columnists have come out on both sides of the fence over whether or not they are a Miss, a Ms or a Mrs. As I understand, some women wear the label “Mrs” as some form of badge of honour. Our society is a far cry from the Roman tradition of bearing a double-barrelled surname as a rite of passage, but for many women the evidence that they can and have “caught a man” is a rather diminutive behaviour encouraged by women’s magazines.

However, I’m sure that some are genuinely proud of their own marriage and any symbol of that is celebrated as thus. the ring, the label, the taking of the man’s surname are all demonstrative forms of nesting at a couple set up home together.

ultimately, it should be no one’s business weather you are married or not. Such an archaic practice is detrimental to gender equality causes worldwide, whether you are in France or whether you were in Malaysia.

However, rather than challenge a hegemonic, normative and religious institution of marriage has become, we find society not mentioning it, and instead celebrating small steps like not proposing on the 29th or not declaring our marital status when we introduce ourselves.

Such behaviour is akin to putting a plaster on a severed artery, and the sooner we tackle the institutionalisation of marriage and subsequent gender inequality head-on, the better.

in·cred·u·lous
adj.
1. Skeptical; disbelieving: incredulous of stories about flying saucers.
2. Expressive of disbelief: an incredulous stare.

The Evening Standard mentioned a small story on Lambeth Council’s apparent vehement and politicised approach to budgets.

It seems prudent to mention the Local Government and Housing Act 1989 which clearly identifies the necessity of political restriction on Local Authority path. If you have ever worked for a local authority, you’ll know the paranoia that exists around any political leanings.

However, it seems that in Lambeth, the communications teams and the finance teams are excluded from this act. So much so, that they can deliver their targets in a fully promoted politicised opinion on what the National Government does and doesn’t do.

Certainly, there is great concern for subjective political bias presented in such a vociferous way.

What is the purpose of such political restriction? Ultimately, it is democracy. We acknowledge that the frequency of elections is higher than the frequency of business plans, and, as such, it is beneficial for staff not to be flung from left to right (pun intended) as they deliver objectives.

The risk of adhering to politicised intentions in this manner is that nothing would ever get done. Should Lambeth Council stick attentively to their message, come 2015 they may seem rather foolhardy if Labour is elected back in and continues to make cuts.

Such a bias message can also help to make the local environment more unstable. What is essentially a petulant and immature way of tackling cuts (unlike, say, reducing stationery overspend and outlay on consultants?), the public are hardly going to invest their faith in elected further councillors, in trusting the information the council provides or maintain local pride and value.

Fear-mongering about the NHS is commonplace now, although it is largely lacking in content.

“Don’t Let the Tories Privatise the NHS”

screamed the headlines. The message that the proposed reforms that has all but eclipsing very valid argument towards reform.

There is a principle that the NHS is steeped in bureaucracy. Very few people will disagree. Many of us have sat in a GP surgeries watching them fill out another form or take another box of a computer system in order to meet their requirements. This bureaucracy was created by the Labour Administration in order to justify the vast expense of the NHS and to ensure that they were meeting targets. And yes, while waiting times reduced, and more people are able to access dentists, as a result paperwork quadrupled.

Then there is the assumption that there are too many managers. There are. Whether they are front-line staff (matrons are now entitled “ward managers”-which most tabloid newspapers seems to interpret as not having nursing training at all) or administration based box-tickers, there is a top-heavy management structure within the NHS that is not justifiable.

Yet despite the many things are crying out for reform, there are serious and valid arguments presented against the NHS bill. However such arguments are seemingly too complex for our soundbite nation to process.

Privatisation

The NHS is not for sale

Firstly, the “privatisation” argument. Private hospitals already deliver NHS care due to Labour administration expanding services in order to meet waiting time delays. However, the reality is far more daunting under Lansley’s proposals. The existing proposals would actively promote competition between the NHS and private care. This is one of the key issues the Liberal Democrats have objected to. There is nothing wrong with private hospitals providing alternative care where it’s more easily accessible (for examples plans, assessments and even surgery). However, to compete will quite simply cripple the NHS. Private health care have additional incomes to allow them to beat NHS hospitals hands-down. All they are lacking in is locations. The moment competition is created, the state provisions will automatically become a second-caste system. This is not “privatisation” directly, but the creation of a system like we see in America, where only the destitute attend public health centres.

Another argument can be made under this heading is that of transparency. During 13 years of Labour administration, a number of public services began to be commissioned, therefore contract and tendering became a normal part of councils, education and the NHS. However, having private companies that run public services are protected by “commercial sensitivity”.

While a lot of people may be anti-Freedom of Information requests, such requests allow us to hold our public services, and the politicians that decide them, to account. The moment a private hospital starts to deliver public services, they are excluded from this transparency. This is a curse of privatisation across the public sector.

Take the example of ATOS health care, currently contacted to deliver investigations into people’s disability conditions, of which 7/10 rejections are found to be valid applications on appeal. It’s taken solid months of campaigning to bring this organisation to account, as they are not liable to normal freedom of information requests. This is bad enough in the welfare state, but imagine how bad it can get under the hospital state. We could end up with people not being treated for hours, no beds available, waiting lists expanding far beyond the current timelines, and all of its protected under a veil of private organisation.

Choice

If choice is so good for markets, why are energy prices so high?

Then there’s all this “choice” malarkey. I don’t look for choice in my NHS care, I look for universal accessibility. As many people are aware I have a disability that requires a great deal of medical time. I often have the opportunity to travel 45 miles in order to be seen quicker. However, this is a balancing act between needing to be seen quickly and needing to take significant amount of time off work in order to be seen so quickly. Ultimately, we want quick and close to be relational.

Mark Steel provides a stunning riposte to a senior member of the NHS commenting that having the most hospitals per head in the region was inefficient. And yes, often, outpatient units can be outsourced to more modern buildings, where experts in specific areas can congregate and see more people at once. However, if you’re having a baby, or a heart attack, or indeed anything that requires swift medical attention, you want as close as possible.

So so-called efficiency, while it may make business sense, does not make medical sense. Certainly not to the patient.

If you’re not convinced, quite a good story is a friend of mine who sat in the deckchair that promptly collapsed. Her finger got caught within the deckchair and the pressure chopped off the top of her index finger, just above the bone. The obvious thing to do was to wrap it in ice and get to the nearest hospital. However, due to closures at nearby hospitals, she was forced to travel 45 minutes in the ambulance. As a result, while they sewed the top of the finger back on, it was already dead and later dropped off of its own accord. The consequence of this is my friend doesn’t have the top of her finger. This is a significant impact in her life issues as she is a vet. Conducting examinations, even typing, this failure to provide swift service has a significant impact on her life.

GP Consortia

Thousands of staff will move from primary care trusts to GP commissioning consortia – and areas including Cumbria are already reporting problems

David Cameron makes the argument that a GP knows patient care best. This is an interesting, but unsurprisingly, paternalistic persuader from our current prime minister. GPs represent a paternalistic figure in society whom we look to for advice and guidance, therefore in whom we normally trust. However, what David Cameron doesn’t say is that the “GP consortia” is not a consortium of all of the GPs in the applicable area. Rather, it is a collective of GPs who have effectively tendered for the project and will pull all other GPs into line with their management system. Rather than it being my kind doctor knowing what’s best for me personally, as indeed Cameron’s smooth lines imply, it’s a collective of faceless GPs who have employed a management company or other limited company organisation to manage the administration and have reasonably little interest in the benefits for their patients other than to save as much money as possible.

And of course, when one talks about a GP knowing best, one must first believe in that statement. If you never had any idiopathic condition, you will know that GPs are generally reluctant to make referrals, know very little about condition in depth and will always refer you to a consultant. Yes people with long-term conditions are only around 18% of the population, but they still account for a significant amount of service use from the NHS. I’d much rather a consultant looked at what care was necessary for me then a General Practitioner. Of course, I don’t do GPs down as much as Prof Illich does, but I don’t necessarily hold them in such reverence.

Funding

Hospital sites in London could close if a crisis-hit NHS trust is allowed to go bust, it emerged today.

Another significant argument against the NHS proposals is that the funding of the so-called GP consortia. under the proposals, and largely in the reorganisation in the run up to 2014, NHS trusts have to reduce all debts to zero. they cannot have a financial deficit when they hand over to GP Consortia. In the event the GP consortia go into financial deficit, then the consortia will be closed down.

Let’s put it in another way. We’ve all seen the article about NHS cutting so-called ‘cosmetic’ surgery due to costs, this includes IVF, gastric bands and breast implants. However, in a lot of cases, as with this particular south London site, such cost-cutting may not save the trust. therefore, there will be no trust for the GP consortia to takeover, and so there will be no obligation for the GP consortia to deliver NHS healthcare.

When the GP consortia does take over a Healthcare trust, in the event that they experienced some form of miasma, whether an outbreak of cholera or a particularly violent car accident, the trust may well expend all of its budget in a very brief period of time. What are the options then? Well, they could charge?

This is another very strong indication of an indirect route to privatisation.

One term that I have loathed for the duration of the coalition has been the “free at the point of entry”. This has been used about so many things now that it’s become trite. University it is “free at the point of entry”. The NHS could well be “free at the point of entry”, but that does not prevent retrospective payment through insurances or invoicing.

Right to Healthcare

The NHS provides a comprehensive service, available to all

The key issue that barely gets a mention, let alone a headline in the arguments against reform is that the proposal removes the duty upon the Secretary of State to provide health care. This is the fundamental founding principle of the NHS. There is a right to healthcare in the UK.

It’s not rocket science. To remove such a duty on the Secretary of State would remove that entitlement to the National Health Service. And this is completely unacceptable.

Ad Infinitum

A host of technical changes to the legislation will get politically lost in the simple, top-level picture that most members of the public do not trust the Tories on the NHS and most health professional bodies do not trust Andrew Lansley.

The arguments extend. Rather like a strategic chess game, we must accept the proposals under Lansley’s bill are influential positioning of key pieces to direct significant change to a health system. Not only will the bill present many opportunities for indirect privatisation, but it continues to undermine what the healthcare services. For most British people, the National Health Service is universal, openly accessible health provision. All of these elements will be removed by the NHS bill.

Those who are pro the health Bill have sought to undermine campaigners against proposals as being emotional and hysterical, and therefore to be ignored. However, there is logic in the outbursts just as there is logic in the headlines. Instead of the emotive and therefore dismissible as nonsensical campaigners outside Downing Street who launched a bitter role at Lansley, we should be presenting coherent arguments in reshaping the legislation.

The Lib Dems have not been quiet about their position on the NHS bill. While the coalition agreement makes assertions, the bill produced is outside of our ideologies.

I cannot put it any better than the Social Liberal Forum does here;

“You will have seen that the long-running debate over Andrew Lansley’s Health and Social Care Bill has again come to a head.

The Social Liberal Forum has had grave concerns about this Bill from the beginning. Our motion suggesting major changes to it was overwhelmingly supported at the Spring 2011 Conference in Sheffield, leading to some improvements to the Bill.

While Liberal Democrat peers have managed to secure some further concessions, we remain concerned that the Bill is a mess, full of dangers – and unnecessary anyway to deliver Social Liberal outcomes, such as better responsiveness to local needs.

We therefore, with regret, no longer have any confidence that the Bill can be redeemed. We are now calling on the Liberal Democrat leadership to withdraw support for the Bill, while preserving those liberal elements that do not require legislation. Our full statement is here.

Here, here.

Sign the petition

Coeliac disease can be a very debilitating condition where the person cannot consume wheat gluten, items which can be found in the majority of Western food substances. As a result, the NHS in the UK has provided free prescriptions for those suffering from coeliac disease to get their food.

However, in the age of austerity, and the entire reform of the National Health care system, Oxford Primary Care trust are looking to ban prescriptions for people suffering from coeliac disease.

There has been what may seem to be a completely justified outcry. The disease affects approximately 1 in 100 people, and such a decision by the PCT will have a detrimental effect on this percentage of people in Oxford.

However, the petition to Parliament is not going to resolve the miscellaneous problems that this issue raises.

First and foremost, it should be considered the coeliac’s not the only people to suffer from dietary specifics have a detrimental effect on their life. People who suffer from lactose, milk allergies, gluten intolerance (separate coeliac disease), wheat intolerance and sugar intolerances, are all affected. Then there are people that suffer from IBS, Crohn’s disease, ulcerative colitis and other life changing bowel conditions who are forced to change their entire diets.

However, it is only people that suffer from coeliac disease who are effectively given their shopping for £10.40 A month.

(£10 a month refers to the NHS Prepayment Prescription card which is a godsend to people with long-term conditions were required to get regular prescriptions. Where a normal prescription costs £7.40, the Prepayment card allows you to make a payment of £10.40 a month and therefore covers all descriptions that you need for yourself for 12 months. For want of better terminology, it simply isn’t fair that one particular bowel diseases entitled to a shopping for £10.40, and all other types of bowel disease are not.)

Given that “we are all in this together”, and coeliac disease is not automatically preclude someone from working, one must wonder why they are allowed such financial considerations when all of the people are not. I don’t like peas, does this mean I’m automatically allowed to get my food on prescription?

Joking aside, there is an inconsistency in application that must be addressed.

Rather than putting a petition to the government to challenge one small area’s Primary Care Trust decision to address the issue directly, we should be actively campaigning to reduce the costs of specialist dietary food and bringing them in line with “normal” purchases.

If you look at the growing range of free-from foods, you will notice that they are generally priced at 120% minimum of so-called normal foods, not freely available and there is extreme difficulty in buying in bulk. This is largely due to manufacturers’ inability to apply economies of scale due to lower numbers of accessing specialist dietary foods. In the event that we campaign for local stores to hold more ranges of dietary foods, other than Mrs Crimble’s Macaroons (which most people don’t realise is a dietary specific biscuit anyway!), Manufacturers would be able to increase their production methods assupply increase therefore reducing the cost of their food, bringing it more in line with so-called “normal” purchases.

All the time we allow people suffering from Coeliac Disease to get items on prescription, we are allowing companies to include charging ludicrous prices as the Government is effectively paying them.

If governments can look at having an minimum alcohol price cap, why can they not look having a maximum price limit on dietary specific foods?

All the sympathy I had for the Occupy movement dissipated the moment they started to occupy buildings. Not only are the current wave of protesters behaving in a sanctimonious manner, they also lack an appreciation of the difference between crime against the person in crime against property and an understanding of value in the consumer-based society they so keen to protest against.

Rather like Laurie Penny assessing during the student protest riots that criminal damage is a victimless crime, I get vexed by people that do not understand that property, like possessions, belong to people. It’s one thing to occupy public land to demand recognition of the significant public problem, the extent of social divide, it is a completely different thing to occupy privately owned building space whether or not that building space is owned by a rich corporation.

The ipaper says today covers a brief story of “protest-bashing incitement” as has become the trend in left-wing media. Seen since the beginning of the demonstrations against the coalition, such lazy journalism is as predictable and mundane as the right wing media is the vilification and vindication of parents over varying levels of punishment.

However, in this particular article, protesters complained about the untoward behaviour of a bailiff. It seems that it is perfectly acceptable for Occupy protesters to squat in a commercial building owned by banking Corporation is a former demonstration, thereby harming the corporation, harming the employees and harming the owners and maintainers of the building. However, in contrast, it is not acceptable for anyone protesting to receive any harm.

The continual inability to identify between acceptable and unacceptable behaviour in the eyes of the protest is not only produced my sympathy for the protest. More and more people are coming out against it, from all range of political spheres, to complain about sanctimonious left wing protesters who feel justified in causing harm to other people.

Another of the key problems with the rapidly politicised youth, from UK Uncut to Occupy is that they seem to have everything yet know the value of nothing. Just as they are keen to protest about things not being fair, they are equally likely to protest against treatment of a similar kind towards themselves.

The article in the ipaper presents an argument made by one of the protest as he was photographing those nefarious bailiffs when one punched him. That’s harm against a person. That’s illegal. It completely legitimate to follow up charges against a bailiff. However, choosing instead of this to moan about damage to your £600 camera lens is something of an irony.

In effect there is a contradiction between you harming other people’s property being acceptable, but completely unacceptable with its damage to your own.

And that’s without examining, alongside the “we are all in this together” message, who runs around with £600 worth of camera equipment on a daily basis. Certainly the people living on £50 jobseekers allowance a week after being made redundant by the financial crash couldn’t imagine owning £600 worth of camera lens. But as we know, the protesters are particularly anti- buying things from Starbucks and other ubiquitous commodity-based activities, so why should owning a vast amount of camera equipment matter?

Perhaps, alongside Gove’s odd proposals on the education system, we ought to be teaching this so-called radicalised and anti-consumerist youth the value of what they have on their person, the value of property, the value of society and value of humility.

My posting of 2012 has been poor, so it’s easier to announce I’m on sabbatical (ran out of spoons/gave up smoking/am moving house) than try and catch up at the moment.

However, I’ll post the occasional comment.

Today’s yelling at the radio;
• If you ask someone if we should give a family £26,000 in benefits, they tend to say no. If you ask them whether a family of six can live on £400 a week including rent, bills and food, they tend to think again. Ref

…to be continued…

The ipaper leads today with the archaic and outdated Tories allegedly planning a rebellion against a bill on gay marriage.

Rather like their behaviour over the EU referendum, the Conservative party are demonstrating that they can show a soft-left-side at a push (hug a hoodie) but they won’t allow that sort of behaviour to become entrenched.

With increasing rebellions from coalition parties over diametrically opposed bills (Welfare reform, NHS, EU et al), one must wonder at what point the rumblings cause a massive earthquake.

When one considers Ministers are whipped on the basis that the coalition agreement supercedes all party manifestos and opinions, such rebellions eventually begin to unstable the whips and the government.

It really should be remembered that the Lib Dems, we who have a tendency towards the radical and progressive, have insisted on the not-so-radical levelling of the playing field of marriage. To not allow such an equal right is the equivilant of Victorias hiding all social issues with silk curtains. And by denying that right, the Conservatives are showing a complete lack of public awareness and that really, they haven’t changed much since the times of the Victorians either.