Category: Politics

Politics in the UK, with a Liberal Democrat (LibDem) slant

Jan 12 2012

Freedom!

Scottish independence is in the air again; the Scottish National Party (SNP) won an overall majority in the Scottish Parliamentary elections in May 2011, independence for Scotland is the SNP’s signature policy and they have been pushed to state their intentions by the UK parliament (source). Independence is a natural successor to devolution which was achieved by Scotland in 1999 (source). Devolution transferred some powers from the UK parliament to the newly formed Scottish Parliament.

There is at least one anomaly in the current system: the “West Lothian Question”, originally put by Tam Dalyell, member of parliament for West Lothian in 1977:

For how long will English constituencies and English Honourable members tolerate … at least 119 Honourable Members from Scotland, Wales and Northern Ireland exercising an important, and probably often decisive, effect on English politics while they themselves have no say in the same matters in Scotland, Wales and Northern Ireland?

The label was coined by Enoch Powell.

This is not a hypothetical question: in January 2004 the then Labour government won the vote on university top-up fees by dint of the votes of Scottish Labour MPs whose constituents were unaffected by the changes since university fees are a devolved matter (source).

The West Lothian Question has not been addressed in part because for the instigators of devolution in modern times it is troublesome since it presents the possibility of a government that has a majority in the UK as a whole but not in England and Wales. The logical solution is equivalent devolution for the English regions or indeed all of England; the English regions have never shown much interest in this idea – England has not been given the choice.

From a Conservative point of view, Scottish independence now would have very welcome electoral benefits; at the last General Election, in 2010, Scotland returned 41 Labour MPs, 11 Liberal Democrat, 6 SNP, and 1 Tory MP (source). It did this on vote shares of 42%, 18.9%, 19.9% and 16.7%. The proportional result is 25 Labour, 12 Lib Dem, 12 SNP and 10 Tory. The oft-repeated quip that there are more pandas in Scotland than Tory MPs is another quirk of the first past the post system. Despite this there is unanimity amongst the national Westminster parties against Scottish independence, presumably they are all reluctant to give up territory, and the glory that Andy Murray brings.

Personally, Scottish independence would make no difference to me; experience with the European Union has shown how freely people can move for work and leisure within the Union, the likelihood is that ties between England and Scotland would be stronger than those with other EU countries. It seems such opinions are not uncommon, YouGov carried out polling after the May 2011 elections which showed 41% of respondents in England and Wales in favour of independence with only 29% of Scots in favour (source). Which begs the question: “Why aren’t our elected representatives representing our views?”

Alex Salmond finds himself in an interesting position, given current opinion poll ratings he would lose an independence poll, and if he won – where would he be? Unrequited desires for independence are the best sort.

Scotland should be entirely viable as an independent country, it has a population of around 5 million, the UK currently has a population of around 60 million. Looking at the populations of other European nations: an independent Scotland is comparable in size to Denmark, Finland and Norway and a little larger than Ireland.(source). Scotland appears to have a fairly diverse economy, financially it would seem that financial flows between Scotland and the rest of the UK are close to balance (source).

I believe in localism: that power should be devolved to the lowest practicable level. Scotland clearly is viable as a country, so my logic is that is how it should be treated.

Jan 07 2012

“French-maid Breast Implants”

I’ve been struggling a bit with the story of PiP and the breast implants, because every time radio presenters say “French-made breast implants”, I hear “French-maid breast implants”.

The BBC has a useful Q&A on the subject here. Essentially the problem is that PiP manufactured breast implants using industrial rather than medical grade silicone, subsequently there have been reports, initially in France, that the rupture rate of these implants is significantly higher than expected. There is no evidence that the implants lead to an increased risk of cancer, given the prevalence of breast cancer it isn’t surprising that some patients with the implants have gone on to develop cancer. The striking thing is that the implants were banned for use in 2010 because they were found to be using industrial grade silicone gel, surely it was at this point that they should have been recalled (i.e. the decision made to remove those already implanted)?

The situation in the food industry is quite different: if a company discovered that one of its suppliers had provided non-food grade ingredients then the product that the company made would be withdrawn from sale pretty much immediately. There would be no waiting around to see if the ingredient was actually hazardous, it would be withdrawn on the grounds that it was out of specification. I’m pretty sure similar applies in the car industry, and the aviation industry. I know this because Mrs S used to work in the food industry; food scares on the morning news always led to an exciting day at work as every retailer sought confirmation that the company she worked for did not use any of the products involved in the scare. Food companies trading legally would have this traceability information.

Healthcare does offer a slightly different scenario, in the sense that carrying out an operation to remove breast implants does carry a risk which means there is a downside to removal, but this is the only relevant consideration: all other things being equal the implants should be removed, by the original installer where possible.

Some people seem to feel that women having breast implants have brought this on themselves, that they shouldn’t be helped on the NHS. Clearly the first port of call for removal is the installer but there are cases in which the installer no longer exists; the NHS is a universal service – if someone has a qualifying medical problem then regardless of how they came by it (excessive eating, drinking, drug taking, climbing, skiing) they are treated free of charge. The same should apply to people who have medical problems arising from surgery outside the NHS – the liability is with the original supplier but sometimes they no longer exist, the patient should not be punished for this.

The Medical and Healthcare Products Regulatory Agency (MHRA) is responsible for regulation in the UK. There is a page on their website about the subject of the PiP breast implants here. Other medical devices, such as replacement joints, appear to be handled differently: alongside the MHRA there is the National Joint Registry, which attempts to register all joint implants, here on the National Joint Registry there is a list of alerts for joints. The MHRA has issued a series of alerts, dating back to March 2010, regarding PiP breast implants (you can see them here), the emphasis has been on establishing the potential toxicity of the filler material. This, presumably, can be done using lab-based testing. The problem seems to be that the rupture rate is relatively unknown, this report in the Telegraph says:

A UK Breast Implant Registry was established in 1993 on the recommendation of the Department of Health to track implant patients’ health, but it closed in 2006 as too few women wished to take part in the scheme.

The final report of the UK Breast Implant Registry is here, and the MHRA confirms that the scheme closed because too few patients would consent to remain in long term follow-up here. This would seem to be the significant factor in this case: there is some follow-up for medical devices but it is voluntary and in the case of breast implants the uptake rate for follow-up was not considered high enough to warrant continuing the process.

It still leaves the question as to why the removal of breast implants made from out of specification materials is not assumed, except for considerations of the safety of the removal operation.

Dec 27 2011

‘Planned 49% limit’ for NHS private patients in England

Mention of the NHS seems to result in a serious outbreak of irrationality amongst the commentariat, this week it’s because the new Health and Social Care Bill with contain a cap of 49% on the fraction of income an NHS hospital can earn from private patients (BBC news here). Clearly this represents end-times, privatisation of the NHS etc etc…

Currently most hospitals are limited to a cap of 2% income from private patients, although a quick search shows that the Royal Marsden already gets 26% (source), Christies 6% (source), Papworth 4.5% (source). These are not hospitals renowned for poor service to NHS patients.

The key point here is that 49% is a cap, not a target. Since only 8% of the UK population has private health insurance, amounting to 14% of health expenditure (source) it’s very difficult to see how NHS hospitals as a whole will reach anything like 49% of income from private patients. The current situation must be that private patients are largely (lets say 90%) serviced by entirely private hospitals – NHS hospitals will only pick up that trade if they offer something better. The area they will offer something better is in specialist care – which isn’t viable for a private system serving less than 10% of the population. The limit case is that NHS hospitals would get 14% of income from private patients and the private hospital sector would disappear, clearly this isn’t going to happen.

Private patients in the NHS wouldn’t be displacing publicly-funded patients from beds, if that were all they were doing then what would be the point for the patient? To get private patients an NHS hospital would need to build (or convert) private “wards”, this is what hospitals like the Royal Marsden do already. To do this they’d need a fair expectation that they could attract the custom otherwise they’d simply end up poorer.

I’ve had private medical care – I liked it a lot, I wish everyone could have it. The benefits I received were in getting rapid treatment for a non-emergency condition, having my own room for the run-up and post-operation and having consultations in a slightly more pleasant environment. As a family (unborn included) we continue to use the NHS for most of our medical care. As someone with private health insurance, I get to pay twice for some of my health care – I pay for NHS treatment which I don’t use, then I pay again for private treatment. I don’t resent this, I do resent the idea that my private care must be entirely separate from any public provision that is available – in that case why can’t I withdraw my contribution to the public system?

The figures on health expenditure in the private sector give some idea of the potential funding gap for the NHS – what we’d need to pay for a gold-plated NHS where, for example, there were no waiting lists and we all had private rooms (if that was medically appropriate). Currently the NHS gets £106billion per year, equivalent to 25p basic rate tax. Private health insurance appears to cost about 1.75 times as much per head therefore a crude estimate is a gold-plated NHS would cost  £185bn or 46p basic rate tax. This would put us at a level of spending that is equivalent to Switzerland and only exceeded by the US (source). It’s possible that you could do it for rather less but not if every attempt to change anything in the NHS is met by a hysterical and apocalyptic knee-jerk response. The important thing is patient care, not the institution that provides it. Providing a healthcare system isn’t simply a choice between the NHS or US-style system, you can see the range of systems here.

And before we get hoity-toity about people paying directly for health care – all the NHS does is launder the process of paying for health care. We pay tax to the government, the government funds the NHS – it isn’t some vast charity run on goodwill. Consultants and doctors in the NHS are really paid quite well, and in my experience individual consultants are working for both public and private sectors at the same time. It is rather offensive to the wide range of people in the private sector service industries to imply that the service they provide is somehow inferior because they are paid by the customer, not by the government.

Update

More on this at NHS Vault (here), definitely worth reading.

Dec 10 2011

The Eurozone

There has been much excitement over David Cameron’s use of the veto at the recent European negotiations over rescuing the Eurozone. For people that don’t like Cameron for political reasons these are obviously the worst of times, for a large fraction of his Tory backbenchers these are the best of times.

The problem the Eurozone has is that when the system was set up some members lied through their teeth to meet the convergence criteria which allowed them entry and none of them where prepared to comply with the constraints on their fiscal policy (tax and spending) after the Eurozone had formed. Now, when times are difficult, these shortcomings have become very obvious. The solution towards which the rest of Europe are heading is to treat the Eurozone as a proper national economy with a European Central Bank which takes on the mantle of a national central bank and a degree of fiscal discipline not yet common across the member states. This would weaken the powers of the constituent nation states.

Sarkozy’s comments are quite clearly self-serving, he wishes to portray the UK veto as a result of of Cameron trying to protect the City because that is the French see the cause of the problem as the Anglo-Saxon economic model, not the Greek economic model. Angela Merkel’s position is a little more subtle: she would probably really welcome a UK that stood alongside Germany at the heart of Europe but she has her own problems with the German constitution which limit her flexibility in fully throwing her weight behind the Euro.

I have long been a pro-European and given the choice I would have taken the UK into the Euro at the very beginning, but that didn’t happen because John Major negotiated an opt-out and then Tony Blair and Gordon Brown (more the later than the former) kept us out of the Euro. These days I have my doubts, I can see a Euro zone with a core membership of nations I would trust to run a whelk store running quite nicely to the benefit of all concerned but that’s not the situation we are in now.

This attitude is reflected in the following passage in the Liberal Democrat 2010 manifesto:

The European Union has evolved significantly since the last public vote on membership over thirty years ago. Liberal Democrats therefore remain committed to an in/out referendum the next time a British government signs up for fundamental change in the relationship between the UK and the EU.

We believe that it is in Britain’s long-term interest to be part of the euro. But Britain should only join when the economic conditions are right, and in the present economic situation, they are not. Britain should join the euro only if that decision were supported by the people of Britain in a referendum.

The Guardian has leapt to it’s tired, old Nazi collaborator meme (here) in its description of Nick Clegg. To be fair there have been a lot of tired, old Nazi memes (appeasement being the favoured route of the right and some Lib Dems). It’s somewhat ironic that effectively the demand is that Nick Clegg must exercise a veto over David Cameron to not exercise a veto. For the enemies of the Liberal Democrats they will never be able to do any right in coalition: these enemies will laud the original policies of the Liberal Democrats (which often they did not vote for) and demand every one is implemented, and that the Coalition must fall if these demands are not met.

David Cameron has put himself into a tricky position in part through his own actions – withdrawing from political groupings in the EU, and reforming with only the most fringe characters, and in part through the party he inherits: John Major said he could here the sound of “flapping white coats” as one of them approached. Cameron did make the only decision he could: any treaty agreed would face parliament where it would lose because the Labour Party would side with a large Eurosceptic wing of the Tory party and even if it passed that hurdle it would fall at a referendum.

The Labour Party find themselves in an interesting position though, they cannot say they would support the current treaty proposal. Resorting only to the famous route directions: “If I was going there I wouldn’t start from here” but actually the relationship with Europe has changed little in the 18 months since the general election.

For other nations in Europe, to use the old breakfast analogy: the chicken has an interest, the pig is committed. All the other non-Eurozone countries are on some sort of track to join the Euro – we, uniquely, are not. This has been the case since before the election and it remains the core of our issue. Cameron’s posturing to satisfy his eurosceptic wing is not helpful, and a better statesman would perhaps have achieved some consensus outside the core Eurozone countries but fundamentally this is window dressing and the other members of the EU are already on a different track, they have been for years.

Dec 09 2011

Strike!

Today I am on strike.

The details of why I’m on strike are not particularly important but since I am sure you will be curious: I am on strike because the company I work for is closing the final salary pensions scheme to which I belong and moving me to a career average scheme – I anticipate losing 13% of my pension. You can see us in the news (here on the BBC, here in Motley Fool which I think gives the best detail and here in Professional Pensions – plenty of other reporting elsewhere).

I prefer to think of myself as a research scientist but my company describes me as a “manager”, and in fact one of my roles is “line manager” so I am a little unusual for a union member: I have dealt with the union from the “other side” – I appreciate the local union representatives and the contribution they make to the smooth running of the business.

For me union membership is a question of equality: equality of representation. Should I ever be in dispute with my employer I will be faced by the pointy end of an organisation containing roughly 150,000 employees. Under these circumstances I will need some support and in the UK this support comes from membership of a trade union.

I am a member of Unite, to be honest, I remain a member largely by ignoring their national pronouncements; as a Liberal Democrat I’m fairly sure they will have organised marches outside my party’s conference where they used the word “scum” to describe my colleagues.

Which raises for me the question of whether unions must be political and politically left-wing. Historically the unions founded the Labour party, and the stance of the major unions is now firmly to the left of the majority of the Labour party and therefore most likely to the left of most of the UK workforce. Companies  make a fair crack at good relations with governments of any stripe. Unions, on the other hand, seem determined that the only governments they will deal with are Labour governments and that a Tory government (or a coalition containing Tories) is its sworn enemy. Surely this is not a good thing for a unionised workforce.

I grew up in rural Dorset near to the unlikely birthplace of the union movement in Tolpuddle. Somewhat entertainingly it seems Adam Smith (18th century economist and freemarket idol) was not unsympathetic to the union movement:

It is not, however, difficult to foresee which of the two parties must, upon all ordinary occasions, have the advantage in the dispute, and force the other into a compliance with their terms. The masters, being fewer in number, can combine much more easily; and the law, besides, authorizes, or at least does not prohibit their combinations, while it prohibits those of the workmen. We have no acts of parliament against combining to lower the price of work; but many against combining to raise it. In all such disputes the masters can hold out much longer. A landlord, a farmer, a master manufacturer, a merchant, though they did not employ a single workman, could generally live a year or two upon the stocks which they have already acquired. Many workmen could not subsist a week, few could subsist a month, and scarce any a year without employment. In the long run the workman may be as necessary to his master as his master is to him; but the necessity is not so immediate.

The Wealth of Nations, 1776

There is a bit more on the history of the trade union movement in the UK here.

I have form in striking, I was a lecturer at UMIST during the merging with the University of Manchester. Although we were never in dispute over the merger, during the process there was a pay dispute. At one point an e-mail came from management asking me to tell them whether or not I was on strike, rapidly followed by an e-mail from the union rep saying “Don’t tell ‘em, Pike”!

The worrying thing is the number of my colleagues who have said how “brave” I am for striking this time round.