Left wing? Right wing? Or plain Common Sense?

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Tim Montgomery @TimMontgomerie of ConHome Tweets: “On NHS, taxing the wealthy, gay rights most voters are on the so-called Left”.

I think that’s open to debate.  Today’s Sunday papers carry stories “1165 NHS patients starve to death”, and “80 women sue (NHS) after botched surgery”.  I don’t think anyone today thinks that the NHS is “the envy of the world”, and I believe (despite being a eurosceptic) that we could learn from some of the health-financing models of European countries.  I think the public generally would share the view that “something needs to be done”, though there would be (and indeed is) a lively debate over what to do.

But I’m grateful to Tim for his reference to “the so-called Left”.  So many people — including lazy media folk who should know better — characterise UKIP policies as “right-wing”, and insist that UKIP votes come largely from disaffected Tories.

It’s true that much UKIP support does indeed come from disaffected Tories — we’re expecting several East Midlands Conservative Councillors to cross the floor to UKIP before the May elections.  But we’re also getting huge support from former Labour voters, former Lib-Dem voters (yes, Lib-Dem!) and (as Nigel Farage loves to point out) from many disaffected non-voters who simply haven’t seen any party worth their vote for years, but now see UKIP saying what they instinctively believe.

I saw this last attitude night in the Stephen Nolan show on BBC Radio Five Live, when I debated with left-wing journalist @vincegraff.  I pointed out that I’d campaigned in the recent Rotherham by-election, which is solid Labour territory.  Yet UKIP got what was then a record share of vote — around 23% — though even that was soon eclipsed at Eastleigh.  And Eastleigh is a Lib-Dem stronghold.  The idea that UKIP is no more than “the Conservative Party in exile” is plain nonsense, and belied by our results around the country.  The fact is that immigration — which Vince Graff insisted was “a right-wing issue” — had been the Number One worry on the Labour doorsteps of Rotherham.

We had a similar discussion on Foreign Aid.  Both Stephen Nolan and Vince Graff tried to use the line “But don’t you agree that if we cut foreign aid, children in poor countries will die as a consequence?  Is a life in Botswana less valuable than welfare benefits in the UK?”.  To which the answer is “Today’s papers report 1,165 people dying of starvation in NHS hospitals.  The first duty of the British government is to British citizens.  If you want to support dying children in poor countries, that’s an excellent thing, and you can give privately to charity, but it’s a personal choice, not what our government should be doing with tax-payers’ money.  If Cameron wants to play Lady Bountiful, let him use his own money, not ours.  And in any case, trade (if the protectionist EU would get out of the way) is a far more cost-effective way to take poor people out of poverty”.

I’ve always argued that UKIP is neither right, nor left — just common sense.  And the ultimate irony of the outmoded “left-right” model?  We regard Labour as Left, Tories as Right (sort of), and the Lib-Dems as terminally bewildered.  Yet in essence, they’re all social democratic parties.  They all want EU membership, and wind farms, and foreign aid, and political correctness.  The choice between them is no choice at all.  That’s why UKIP is doing so well.  Just common sense.

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18 Responses to Left wing? Right wing? Or plain Common Sense?

  1. edmh says:

    Why the health service works for Patients in France

    It is of great sadness to me that political dogma manages to blank out any consideration that methods and experience from elsewhere could ever be applicable in the UK.
    This is particularly so in the NHS, where the dogma that the government has to be directly responsible from taxation for the supply of health care have been inbuilt for so long. This combined with “free at the point of use” is particularly damaging.
    What is even more amazing is the fact that so little in the NHS is actually free at the point of use, prescription charges, dental costs (if available on the NHS at all) and the endemic rationing, which itself translates into huge costs for the individual patient.

    So why are things so different here in France. These are a few simple conclusions:

    A The system is run on an insurance basis based on income supported and mandated by the state but with no direct participation by the state: the insurers are even competitive amongst themselves. The system has state protection for the low paid, the chronically ill, pensioners, children, etc. Top up insurance can be purchased out-with the system to cover the balance not paid for within the system.
    The insurance organisation reports on all transactions and produces an annual account for each of its clients showing the premiums paid and the amounts disbursed on behalf of the insured so it is abundantly clear the actual costs of health services.

    B “Free at the point of use” in the UK is a fallacy and only encourages people to use UK medical services unnecessarily and to regard the access to such services as being as of right. The public perception of that “right” may even be one of the causes of violence towards hospital staff in the UK A+E departments.

    C Here the modest fee €22 payable to the GP, most of which is normally reimbursed later, is a disincentive to time wasters and malingerers, even in this country of hypochondriacs. It is amazing how effective the cash flow consequences of having to pay the doctor his €22 fee, even though it can be claimed back later, is in making sure that patients really need to be there. Of course anyone with a noted chronic condition or socially disadvantaged will be reimbursed 100% and if he has a Carte Vitale the GP is credited automatically without money changing hands. The GP’s or consultants charged fees are his income and he like other health professionals are in overt competition with each other.

    D Here the €22 / visit is the GP’s income (not a capitation fee) so he will welcome patients and be attentive as he should, (in a competitive manner with his colleagues).

    E The Pharmacist will provide over the counter advice and drugs for almost any common aliment. He will also provide prescription drugs (un-reimbursed) if needed at his discretion. Thus the load on the GP is much reduced.

    F The local pharmacist also doubles as the hospital pharmacy for any outpatient day patient procedures such as and it is the patient’s responsibility to get the drugs prescribed before and take them to his appointment.

    G All the providers in the system, the GPs, consultants, diagnostic labs, district nurses, etc. are independent organizations or self-employed private contractors within the system. They normally work at proscribed fee scales.

    H The contractors in the system choose their mode of working from the point of view of their own businesses and lifestyle choices, within those fee scales. This results in the outcomes most of which would be remarkable in the UK except in the costly private sector:
    • The GP (General Practitioner) has no secretary and no appointment system. Turn up when you need and wait perhaps 15 minutes on a busy day.
    • GPs are not paid by a capitation fee based on patient numbers but only on their actual patient appointments, (a piece-work basis just like UK dentists remuneration). And only recently a system of affiliating patients to GP’s has been introduced, before that it was totally open to the choice of the patient on any particular occasion
    • The patient also has the choice of which consultant to see but the GP will always recommend the one he considers suitable. It is not necessary to get a referral via a GP to be able to see a consultant, just phone up and make an appointment.
    • The GP will also be happy to make home visits: the reimbursed charge is rather more.
    • The dentist has no dental nurse and runs the practice single-handed. A significant proportion of his fees are reimbursed to the patient.
    • The busy cardiology practice with three consultants has just one administrative assistant.
    • The district nurse will turn up at on the doorstep to take a blood sample at 7.00 am in the morning for a fee of €6.35 (reimbursed).
    • The consultant dermatologist answers his own phone and makes his own appointments without any need for administrative help.
    • As well as doing major surgery, the consultant orthopaedic surgeon does his own minor splint work on the spot.
    • Etc. etc.

    Thus the administrative load created by centralised control and rationing of consultants and hospital appointments does not exist.

    I As separate private contractors, all health professionals work as if “their time was their money”. This difference was emphasized on a Gerry Robertson programme when an NHS consultant clearly stated, that this was the difference was between his work in the NHS and his outside private practice. Most UK hospital consultants are already private contractors as well as being well-paid part-time government employees. The difference in France is that their Health service fees are regulated by the government and controlled by the insurers.

    J There is a real emphasis on preventative medicine and prompt treatment is considered to be economically worthwhile. Thus certainly in my experience waiting lists just do not exist.

    K Admittedly there is an abundance of medically qualified people in the system and indeed there is a degree of competition between them. According to OECD figures, there are almost twice as many medically qualified professionals per head of population as in the UK health service.

    L The medics run the hospitals and other facilities not the government or the administrators. They see the benefit of having an absolute minimum of administrative overheads. Those that exist are mainly involved with the ensuing that the Insurance organisations are charged correctly. This also means that there are no artificial limits placed on maximizing the use of expensive capital equipment and the hospital installations. Their seems to be no multitier administrative structure of trusts and quangos to control the system. That costly administrative load is eliminated.

    M Also, crucially, as the government is not supplying the service, the state does not own the product of the service nor most importantly the patients’ medical records:
    • Patients have bought the service either directly at the proscribed rates or via their insurance and they are therefore the owners of the results.
    • Responsibility for the ownership of such records is reasonably unloaded on to the patient.
    • This eliminates another whole swathe of administrative costs. And as there is no government duty of care with regard to patient records, there is no need / apparent obligation / or demand to create an expensive nationwide database of everyone’s medical records.
    • I believe that it is only in very few chronic cases that longstanding records are essential for treatment.
    • Any minimal useful information (such as the fact that I am diabetic, allergies, blood type, etc.) is retained on the chip of my Carte Vitale. The Carte Vitale is a type of credit card with a chip, that is used to organise the data required for my insurer to pay the sums necessary to the whichever part of the health system I have used. The card can be updated automatically with any changed circumstances at a terminal at any pharmacy. This seems to be a truly efficient use of Information Technology as applied to the health service.
    • Along with a pragmatic hands-on approach to consultant referral and appointment making, the need for a failing £20 billion government organised Health IT project collating everyone’s medical records is eliminated at a stroke.
    And here a much simpler IT system works and it has been working for decades. Nobody in the UK seemed to have bothered to cross the channel to ask how it worked.

    I certainly I believe that health outcomes for a similar percentage expenditure of GDP (Gross Domestic Product) are much better here than in the UK. The NHS is certainly not the only way of organizing a health service and the clear evidence is just across the channel.

    The care about hospital infections is particularly impressive. This is because the staff all know that it would be quite possible for patient to chose to go elsewhere and therefore having an outbreak of MRSA, C Difficile, etc. would disastrous for the business of the hospital and thus their livelihoods.

    The additional complexity of GPs (as opposed to care trusts) controlling and being limited by their budgets in what they can provide as drugs, treatments or referrals does not exist. The spending on care seems to be much more laisser faire. The professionals are trusted, so those other tiers of administration are non-existent.

    So the system is not over administered and it does not seem mind that it patients are old. The aging like me are treated with a lot of respect and are sincerely cared for. Going to hospital here holds no fears, I am very glad even as someone with a UK medical background that I do not have to face the prospect.

    So in effect everyone in France gets a Private Quality service provided at costs similar to the Nationalised service in the UK.

    The Nation’s Health not the National Health Service should be the priority of government.

    As someone who worked in the NHS albeit some long time ago, frankly I think that Sir David Nicholson should be in court for about 10,000 cases of manslaughter and all those administrators below him should be enjoined for their participation, disciplined and sacked.
    The NHS would run a lot better with less than half of the current administration.

    • Jane Davies says:

      Certainly the NHS is past it sell by date. An overhaul is long overdue and the French system sounds superior to me. I spent 20 years working in the NHS, in the rehab of seniors, I am appalled by the “care pathway” that seems to be the norm now and I agree that David Nicholson (sorry I cannot bring myself call him “Sir”) should be charged with manslaughter. I have retired to Canada and hold dual citizenship and the healthcare here is based on the UK NHS even to the extent of going down the P3 route which as we Brits know does not work. But at least the system here makes sure that only those entitled get the free treatment (like the UK not everything is free). Before every hospital treatment one is asked to produce the health card that permanent residents and Canadian citizens must have in order to qualify for free care. This should also be mandatory in the UK, no card, no free treatment. That alone would save millions of pounds and prevent the health tourists and anybody else from claiming free care when they are not entitled to it. Having spent all my life working in the UK, paying NI and taxes I find that as I have not lived in the UK for over five years I’m no longer entitled to free health care if I fall ill on a visit home, yet those who arrive in the UK having never paid a penny into the UK coffers get free treatment!

    • Strongly agree with this, EDMH. I am opposed to government from Brussels, but I have no problem at all with learning from our European neighbours when they do things better than us.

  2. Charles Wardrop says:

    Absolutely so, but your Party gets labelled, in the Scottish press at least, as if it were a right wing fellow traveller of the BNP or the like.
    As far as I know, that is libel and/or ignorance and quite unjustified con propaganda originating in leftist commentators and other dreary chip-on-the-shoulder types.

  3. Patryk says:

    Roger – having read your blog since December it is clear to me that you are a sensible, pro-market politician. This is why I wonder what you are doing among the UKIP lunatics. Before you stop reading, please have a look at my list and answer sensibly and truthfully – it will be much appreciated. UKIP are against gay marriage but want to give gay couples same tax cuts as to hetero couples. Ukip want to cut council tax but ‘encourage’ councils to build more social housing. Ukip want generally to cut taxes and yet they want to increase spending on defense, border control, reintroduce student grants and increase the provision of free school meals (P Nuttall). Do you not have a suspicion that these policies simply don’t hold together?

    • Sorry, Patryk, but I have yet to meet the lunatics. We are against gay marriage but OK with Civil Partnerships. I’m not keen on Civil Partnerships personally, but I can accept them as a fair compromise between conflicting views. There are other financing models for social housing than paying from the council tax. When we leave the EU we will save up to 10% of GDP in regulatory and other costs. That leaves room for lower taxes and some judicious spending adjustments.

  4. Rich Tee says:

    I used to be happy with the NHS, and I had a couple of routine operations when I was young. No major complaints, although I remember being concerned about a few things I experienced back then in the 1990s.

    Then my dad died a horrible death from an infection he caught in an NHS hospital.

    Now I have private medical insurance. Only the basic level that covers operations. I pay it out of my own money from my modest salary. This is just because I dread what would happen to me now if I go into an NHS hospital for an operation.

    • I live in something of a mixed economy/pragmatic household. I had reason to go private through my partner’s company insurance. One of the test I had was an echo cardiogram. I was late. The consultant came and explained that the person before was having a heart attack. I went to phone my partner at the front of the ‘hospital’. There were two administrators there waiting for an ambulance to take the heart attack victim to hospital. You can choose how to look after yourself/your family but you undermine the NHS when you go private.

      The X-ray machine at the ‘hospital’ would not move around the ceiling freely and its operator swore at it. An MRI operator cut my cast off using office scissors. I say ‘operator’ because I don’t believe they had a nurse’s training. The MRI operator did not know how to treat someone with a broken wrist.

      The consultant who operated on my wrist was good but his day job was at the NHS. He worked from 6 until about 10 that night. I wonder how he performed the next day. Maybe he had time off. Maybe he wasn’t available for emergencies.

      • Typing with one hand…

        The test was late because of the occasion of the heart attack.

      • Rich Tee says:

        “you undermine the NHS when you go private”

        I also take some of the burden off the NHS because the cost of any operation I have will be paid by my insurer.

        As I said, I dread going into an NHS hospital now. I pay to stay out of it. I am not going to suffer to comply with your ideological purity.

  5. mikestallard says:

    The comments on this blog are getting really good!
    ” If you want to support dying children in poor countries, that’s an excellent thing, and you can give privately to charity”
    Here’s another idea. I worked in our Church last night. We have got teaching English completely right because, as a Christian organisation, we have to accept people as individuals who are all equally important. We also have to love them – even smelly old……….who has spent the night out because he was thrown out of the hostel for fighting.
    We are instructed to support the Missions overseas because it is our duty to be good Samaritans.
    Obvious? Not to the government, actually. We have been – here – hamstrung with Health and Safety, Bureaucracy and Sensible Rules and Regulations. The trickle of money which dribbles out intermittently has to come with important qualifications and targets and detailed micro management. At the end, there is no space for people. And that is why what we are expected to provide is bent in the wrong direction.

    If only the government would get out of the way! If only it would close down all those bossy departments and let the Churches get on with what we do best: looking after everyone whatever condition they are in!
    When Mr Cameron talks of the Big Society, he really means the struggling churches. But he dare not say so for being laughed at. We Churches are more or less alone in the front line, you know.

    • Hugh Davis says:

      The Churches should refuse all help (i.e. interference) from the government.
      The formerly great charities such as Cafod, Save The Chidren, Oxfam etc have been seriously compromised by Government and EU takeover. Many are now effectively run by political appointees (mostly appointed by Gordon Brown) on enormous salaries and all have some sort of political agenda (eg lecturing Africans on climate change and keeping them in poverty by not letting them build gas or coal fired power stations)

  6. Ask “left wingers” to define left wing and you will get incoherent and incompatible answers. An SNP MSP told me that anybody who didn’t want hundreds of thousands of 3rd world immigrants in Scotland or who thinks free markets work was “right wing”. A Green told me that the definition is that “anybody who doesn’t like paying taxes” is right wing. In which case who, sane, can be on the left?

    The acceptance of the Greens, the most reactionary movement in British politics since Bloody Mary, as “left wing” shows the intellectual bankruptcy of the movement.

    The one thing all the “left” agrees on is that free enterprise must be attacked. Since the evidence that free enterprise societies outperform controlled ones and outperform in fairly close proportion to how free they are all that is required is to say this convincingly to the British people, and not to be censored. Only UKIP is willing to say it. If convinced that free enterprise is the best way to achieve growth the British people will overwhelmingly vote for any party that offers it.

    This reinforces the evidence that the state owned BBC is a wholly corrupt totalitarian propaganda organisation which deliberately censors any individual or partty that speaks this truth.

  7. raymond jones says:

    I hate to say this, but unless life is made miserable for more Britons, and more get kicked out of work we will still move slow but faster than before eastliegh .there are those who will not rock the boat,they need more pushing.Comonsence is what is on the back burner.

  8. David says:

    Nice one Roger, nothing I dissagree with here, or in any of your other posts.

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