Danny Alexander lays out Liberal Democrat economic plan

Today the day after George Osborne delivered the final budget of this coalition Government Danny Alexander the Liberal Democrat Chief Secretary of the Treasury laid out our plans for tax and spending.

Lib Dem plans include borrowing £70bn less than Labour and cutting £50bn less than the Conservatives, keeping Britain on the path to prosperity, showing that we still believe in a stronger economy AND and fairer society; the Conservatives recently dropped the latter in a campaign poster and in their budget plans.

Danny announced using the same figures that were available to Osborne that there is still roughly roughly £30bn of fiscal consolidation by 2017/18 to complete the job of economic recovery. To go about funding this the Liberal Democrats will ensure that those with the broadest shoulders to bear the largest share.

To fund this the Liberal Democrats will raise £6bn through shutting remaining tax loopholes, £6bn will come from tax rises, with high value properties and the banking sector paying more. The additional money will come from £12bn of departmental savings and £3.5bn from welfare savings.

Public expenditure can then start to increase once this threshold is met and ensuring that the NHS has the £8bn a year it needs to secure its future.

 The measures to tackle tax invasion include:

•  Introducing a new strict liability criminal offence for off shore evaders so that pleading ignorance can no longer be used in an attempt to avoid criminal prosecution. 
• Introducing a new offence of corporate failure to prevent tax evasion or the facilitation of tax evasion. This would stop organisations from being able to get away with facilitating or abetting others to evade tax. 
• Increasing financial penalties for offshore evaders – including, for the first time, linking the penalty to underlying assets. A billionaire evading £5m of tax won’t just be liable for that £5m. 
• Introducing new civil penalties so that those who help evaders will have to pay fines that match the size of the tax dodge they facilitate. So if you help someone evade £1m of tax, you risk a penalty of £1m or even more yourself. 
• Extending the scope for HMRC to name and shame both evaders and those who enable evasion.

Five Lib Dem MPs call for rethink of #NHS Bill

add "declines to support the bill in its current form" and calls for an urgent summit of the royal colleges, professional bodies, patients' organisations and the government to plan health reforms based on the coalition agreement. 

It appears that five Liberal Democrat MPs Andrew George, John Pugh, Greg Mulholland, Adrian Sanders and David Ward have listened to Spring Conference. Not necessarily how votes went down over the weekend but the body of the speeches from the debate on Sunday. They have tabled to above amendment on the Health and Social Care Bill opposition day debate. 


They are not leaving it up solely to the Lib Dem Lords to come to their conclusion, the discretion given by conference removing those lines on Sunday, but having heard conference and the views from the professional bodies are looking for the best way forward. The way in which those in the health profession who know what is required at point of delivery can help shape what is required rather than leaving it up to politicians whimsy.

Has the amendment from the Sheffield Conference in March 2011 been delivered?

Here is something for my fellow Lib Dem Conference Reps to consider before voting on the Emergency Motion debate tomorrow.

Dr Charles West and Dr Evan Harris, who proposed the amendment, report back.

Conference therefore calls on Liberal Democrats in Parliament to amend the Health Bill to provide for:


I) More democratically accountable commissioning.


The Government says:
“Commissioning will now be more democratically accountable. Clinical Commissioning Groups will have to involve Councils’ Health and Wellbeing Boards in commissioning decisions.”
[Source: Government leaflet at Gateshead Conference]

The true position:

• The Bill has had no significant amendments in this area [see Schedule 1, clauses 189-193]
• The Coalition Agreement called for elected members on commissioning bodies. The Bill never permitted this [see Coalition Programme page 24-25]
• The Bill provided that the Health and wellbeing Boards need not have naymore than one or a minority of councillors on them. That has not changed. [Clause 193]
• The only duty on commissioning groups is to consult the HWB on a commissioning plan. If the HWB disagrees it has no power to stop the CCG and there is no statutory right of appeal. [Clause 25, section 14Z12]
• Overview Scrutiny Committees have lost the automatic right to call in a health decision to the Secretary of State so the new NHS would be less democratic than before. [Clause 189]

II) A much greater degree of co-terminosity between local authorities and commissioning areas


The  Government says:
"There is now a clear presumption in favour of co-terminosity . We expect the vast majority of commissioning groups to sit within social care authority boundaries. But where this is not the case, Health and Wellbeing Boards will be able to object to any boundaries that cross social care boundaries."

[Source: Government leaflet at Gateshead Conference, dropping the word “much” from the motion”]

The true position

• There has been no amendment to the Bill and there is no mention in the Bill of co-terminosity [Clause 24]
• There is no statutory right of Health and Wellbing Boards (who could have only one councillor on them) to object to CCG boundaries let alone to veto them. The decision on boundaries is made by the Commissioning Board 9a quango) with no statutory duty to even have regard to HWB's views [Clause 24, ssection 14A & B]
• There is no role for Council's Overview and Scrutiny Committee [Clause 24, section 14A & B]

III) No decision about the spending of NHS funds to be made in private and without proper consultation, as can take place by the proposed GP consortia.

- Delivered

IV) The complete ruling out of any competition based on price to prevent loss-leading corporate providers under-cutting NHS tariffs, and to ensure that healthcare providers 'compete' on quality of care.

- Impossible to deliver. Tariffs cannot reflect the full complexity of services, and EU and UK
competition law will not permit the NHS to ignore price.

V) New private providers to be allowed only where there is no risk of 'cherry-picking' which would destabilise or undermine the existing NHS service relied upon for emergencies and complex cases, and where the needs of equity, research and training are met.

The Government says:

"The tariff will accurately reflect the clinical complexity of the service to stop any new providers from undercutting NHS services. New requirements on transparency for providers will ensure that they are only allowed to refuse patients on clinical grounds*, so they won’t be able to cherry-pick the profitable easy cases"
[Source: Government leaflet at Gateshead Conference]

The true position

• The Sheffield Conference called for a duty on commissioners and Monitor to avoid destabilising existing essential services from the outsourcing of profitable services, such as elective orthopaedics, making a trauma service unviable. Amendments doing this tabled by Andrew George MP were not accepted by the Government
• Refusing patients on "clinical grounds" and getting the same price for the easier clinical cases that are taken is actually the definition of how to "cherry-pick the profitable easy cases" that the motion rejected.

VI) NHS commissioning being retained as a public function in full compliance with the Human Rights Act and Freedom of Information laws, using the skills and experience of existing NHS staff rather than the sub-contracting of commissioning to private companies.


The Government says:
"Commissioning groups will be public bodies, not private organisations, and will be subject to these pieces of legislation. Commissioning decisions will have to be taken in-house by commissioning groups, not outsourced to private companies so it cannot be privatized."
[Source: Government leaflet at Gateshead Conference]

The true position

• There have been no amendments preventing the wholesale privatisation of commissioning work referred to in the Sheffield motion. The original Bill already provided that the final decision be made by the CCG, but the Government's plan is to allow and encourage the outsourcing of commissioning work to private companies, called "commissioning support" companies.
• Designing care pathways and evaluation the quality of rival bids, should not be done by private companies with vester interests which are not subject to FoI or the HRA.
• The spending of £60 Billion of NHS money should remain a public function

VII) The continued separation of the commissioning and provision of services to prevent conflicts of
interests.

The Government says:
"Commissioning Groups will now be required to establish robust procedures to tackle conflicts of interest"
[Source: Government leaflet at Gateshead Conference]

The true position:

• All the Bill now does is to require CCGs to have a register of interests. But there is no sanction against such conflicts unlike in Council. The register doesn't apply to the companies doing "commissioning support".

VIII) An NHS, responsive to patients’ needs, based on co-operation rather than competition, and
which promotes quality and equity not the market.


The Government says:
"Monitor will have a primary duty to promote patient interests rather than to promote competition and can promote co-operation between providers when it is in the interests of patients."
[Source: Government leaflet at Gateshead Conference]

The true position – it's been made worse.

• After the Sheffield motion the Government increase the promotion of the market by commissioners by increasing the duty on commissioning groups and the NHS Commissioning Board to promote patient choice more than to tackle access and health inequalities [Clause 25, section 14S versus amended 14U]
• Monitor's duties are only to prevent anti-competitive behaviour [Clause 61(3)] where it deems this works against the patient interest. An amendment to ensure Monitor had a duty to prevent anti-collaborative behaviour in these circumstances was rejected by the Government. [Amendment 165 Baroness Finlay]
• The part of the Bill [Clause 73] which gives Monitor its enforcement powers omits to do so in respect of integration and co-operation.

Diagnosis: In summary, of the 8 broad (or in some cases narrow) requirements that this conference
passed, at most 3 have been delivered and 5 have clearly not. That is why even the non-political
Royal Colleges, who have read the Bill, are calling for the Bill to be dropped.

Back to me


We are being told that everything that Conference asked for last year has been settled. As you can see above it clearly has not. We do believe in devolving power out to the Trusts but with that we still expect accountability which is clearly missing from what has been done. The Bill still is full of holes and no matter what the Bill with Shirley Williams' name attached says will not save the NHS. Only a rejection of that motion tomorrow stands a chance of doing so.

I'm not Andy Burnham's poddle Nick! #LDConf

I hated to hear our leader say during his Q&A

"We need to say tomorrow we're on Shirley Williams' side & not on Andy Burnham's."

For a start I also hated the fact that one of the two motions on the NHS yesterday bore the subtitle The Shirley William's Motion. I thought as Liberal Democrats that were not in the business of political personality cults, but rather into testing each option on the facts.

The fact that even with Our Shirl on the motion it only won by 29 votes after transfers should tell Nick that it isn't just about Andy Burnham. 280 Liberal Democrats voting reps at conference are not and were not persuaded by the screams of Andy Burnham.

Many of us have been following with forensic scrutiny the coming and goings of every step along the passage of this bill. Even last Spring just after its publication we were ready to tell you and our MPs what to change. Yes Shirley was one of those, but so were all many of medical professionals within our own party. Many of them are still telling us that this Bill needs more time, shouldn't be rushed so that you and David Cameron can conveniently put it into the Queen's Speech. However, it is possible that those that voted a second preference on this weren't aware of the depths of issues and saw the words save, NHS and Shirley Williams all together without a great deal of thought, I've spoken to one voting rep since who did just that.

We're not against reform, we know it is needed. But we're saying you need to stop and think again. If that means dropping the current Bill and rethinking then that is what is needed. We know what was agreed in the Coalition Agreement and this is still going far beyond that.

The Liberal Democrats I know is not about personality. Indeed on occasions as you know Nick, bringing a big name to bear on a vote when conference is in a volatile mood can be the end of what is wanted. So don't tempt us to turn our backs on following Shirley, we might just do that.

So the Lib Dems are not debating Dropping the NHS Bill, but...

Save the NHS - The Shirley Williams Motion 309
Withdrawal of the Health and Social Care Bill 280 after transfers

So the result of the ballot on the emergency motion came as a disappointment to me. The outrage that flowed on Twitter afterwards less so following on from the number of tweets urging conference to drop the bill in the last 24 hours. That was something that as I had access to a left of centre blog with more Labour readers I chose to write about elsewhere.

However, there are a few things to note about that outrage.

Firstly there have been 1,000 amendments to the Health and Social Care Bill. The majority of these have come from Liberal Democrats and not from Labour. So don't believe the lie that Labour did all they could to change this bill.

Last year the Liberal Democrats did pass a motion that had 13 sizeable changes on them to make the Health and Social Care Bill fairer. Of these 6 are now included in the Bill, as demanded by Lib Dem conference last May. So see the Lib Dem activists have been working on getting these changes for over a year, not just the last 24 and not just the fours hours from 9am to 1pm that the Emergency Motion Ballot was open. Indeed Liberal Democrats have been writing to their MPs of ALL parties and yes that does include the Northern Irish parties about making the right changes to this Bill, not just hounding Lib Dem activists for the last 24 hours.

The vote itself was within 30 votes. Yes it was on transfers, but you don't hear any Lib Dems lamenting that the decision is made under AV, only those who were urging us from outside to vote to drop the bill. Some are lamenting the failure of democracy, but Lib Dem party democracy has yet to run its course. Sure the establishment motion with the witty moniker Shirley Williams* has got through but there will still be a vote on that motion, democracy within my party had not ended yet, there will be a debate, there will be a vote. And with less that 30 votes in it when it comes to the emergency motion nobody can tell how it will go once the arguments are laid out (I speak from experience there).

What you may have are people who not knowing the issues fully transferred their second preferences to the issue that bore the name of Shirley, but if the Drop the Bill speaker(s), and there will be at least one, called in the dabate put a strong enough case, there may be swing votes in the hall that reverse the decision of today (again Lib Dem Conference can be a volatile place in this mood).

There have been a number of personal attacks to me on my own Twitter feed. Obviously from people who have no idea of my stance on this matter, even with my current Twibbon. Some saying that MY Voters will never vote for me again. Thankfully I know from the messages (by Twitter or email) that my voters have sent to me over tuition fees, over taxation, over the NHS over the past 21 months that actually my voters, know exactly where I stand on such issues, and more, are would quite happily vote for me again. They also know that I have moved away from Scotland so I may have to find a way to get back.

As for the Lib Dems we will survive. We will continue to fight on. We have brought changes to what a majority Conservative Government would have wanted to do with the NHS, in time people will see that, because their manifesto will take them further along the line, doing the things that Lib Dems in Government have prevented them from doing.

Update BBC New briefly went across the Q&A session with Nick Clegg who said:

"We need to say tomorrow we're on Shirley Williams' side & not on Andy Burnham's."

Seeing as I thought we were an evidence based not a personality based party I find the assumption that the 280 Conference reps who voted to drop the bill are being knocked aside with such a line from the leader. If he hasn't listened to the people, and isn't listening to his own reps so far, we'll have to make him listen in the morning.

* Having seen this tactic used by the SNP in 2007 I'm seriously considering a Constitutional Amendment that no motion entering the emergency ballot can pull on the name recognition of any party member over the substance of the arguments.

Endorsement of the Day

This morning I had a debate with John Prescott on Twitter regarding NHS Direct. I reckon we both fought our respective corners and fought them hard. Figurative punches were being thrown much to my relief. Me pointing out the lack of money to do everything and the rational for looking at what was essential and therefore needed to keep being funded was what was important.

The fact that nurses currently on the NHS Direct lines will be returned to front line duties and actually treating people. At one point John seemed to suggest that NHS Direct nurses in their current number were essential as "It's about the quality of service - the reassurance and knowledge that saves lives." But NHS Direct isn't where lives are saved that is through the diagnosis and treatment by Doctors and Nurse Practitioners in our surgeries and hospital.

Anyway we got to a point where the entrenchment was shifting, John said, "In case you hadn't noticed, YOU'RE the Government now. Enjoy!"

To which I replied "Sadly John I didn't get elected. But yeah I know that. At least this Government has realised there is a fiscal hole unlike you"

That led to this:

While I'd obviously welcome such a ringing endorsement for my debating skills from an ex-Deputy Prime Minister from a former Government. I'm sure I can could on the endorsement of the current Deputy Prime Minister in the current Government and leader of my party Nick Clegg.

Zero Tolerate as I Say Not as I Do

"Anyone contemplating fraud against the NHS should be aware that they will be caught, and if they are caught, they will have to face the consequences of their fraudulent actions.

"Let me be clear today about what is a zero-tolerance approach to fraud and to fraudsters. Fraud perpetrated against the NHS is, in my view, a fraud perpetrated against each and every one of us and that is why it is so important to combat it. So it does make sense for all of us, in our own ways and in our own roles, to act as counter-fraud champions."

So spoke the SNP's Scottish Health Secretary to more than 100 delegates at a conference aimed at combating NHS fraud. Of course that role is one that is filled by the MSP for Glasgow Govan, the other being Deputy First Minister, for all three hats belong to Nicola Sturgeon.

This was 4 months after she first became away of the case of her constituent Abdul Rauf, but before she wrote that letter. In the letter she asked that even if the consequences of his fraudulent actions against the Department of Work and Pensions merited a custodial sentence that alternatives should be considered.

It adds another question to the list that she will have to answer after the current Scottish Parliament recess. Why is zero tolerance OK against fraud in the NHS but not against the DWP? Is it not also a fraud perpetrated against each and every one of us? Should we not also act as "counter-fraud champions"?

Bathgate Man with Two Left Feet

No it is not my audition for So You Think You Can Dance, and how dare you for thinking it would be.

Local Bathgate man 76 year-old Patrick Morrison (pictured) went into Astley Ainslie Hospital, Edinburgh after losing his right foot. When he returned home upon removing the protective sock covering it his wife Alexia aged 75 burst out laughing as he had been fitted with a left foot on his right.

She called the hospital who cut off the lower part of the replacement limb and replaced the foot with a right footed version.

However, false limb expert Malcolm Griffiths has been sacked by NHS Lothian, pending a hearing of the Health Professions Councilhe may be considered unfit to practise and either suspended or struck off.

NHS NOT Safe in Dave's Hands

Well not if this comment from Dr Helen Evans on Nurse's for Reform Website is anything to go by:

I had been invited by him to discuss NFR’s ideas on the future of health policy and presented a range of ideas. Amongst others, these included the end of national collective pay bargaining for nurses and doctors, the view that the state should not own or have any of its agents manage hospitals, a world of widespread health advertising (to overcome problems of patient ignorance through trusted brands) and a dramatic liberalisation of hospital planning laws. On this latter point, central government should have no say in when and where any hospital is opened or closed.

If he becomes Prime Minister I have no doubt NFR will meet with him and his policy team again.

So who are Nurses for Reform? Their website says:

"In Britain, NFR believes that the government should re-cast the NHS as simply a funder of last resort alongside an insurance and self-funder based market. It believes that the state should set free – through a range of full blown for and not-for-profit privatisations – all NHS hospitals and healthcare provision."

These are the people that Dave has been meeting with and by the comment above appears to want to meet with them again along with hus policy team if he becomes Prime Minister.

Should we believe that the aims of Nurses for Reform are in line with Dave's caring conservatism. His support of the NHS 'brick and mortar'. Well he has announced plans to offer free personal care to the elderly, but only if they stump up £8,000 upon retirement. It sounds like that is just the first step.

We can't go on like this. Dave shouldn't be allowed to set hands on the NHS.

Hat tip to Tom Harris.

U is for Uncosted

A continuing series of spelling out Conservative plans Part 4.

I've just taken a quick look through the Conservative Party's manifesto chapter on health (you can access it here). Now on a cursory glance although expense and savings are mentioned many times there is no actual figures for much of this. Indeed apart from a line of in the introduction that says:

"By the time you've finished reading this sentence we'll have racked up £33,000 more in [national] debt"

There are only three figures of actual costs either current or future of what is involved.

First up we have we have that poor mental health costs the economy £77 billion each year. Before they go on to say that rules preventing welfare-to-work providers and employers purchasing services from Mental Health Trusts.

There is of course the one-off payment upon retirement of £8,000 for their 'free personal care for the elderly' as I blogged earlier during their conference this is but a poor imitation of what the Lib Dems have been proposing for a number of years now, and delivered in Scotland.

The only other monetary amount to be mentioned is a £10 million a year commitment beyond 2011 to support hospices in their vital work with children.

In the past the Tories have often thrust the argument out at the Liberal Democrat manifesto pledges that they were uncosted and meant nothing. That of course is no longer the case Lib Dem manifestos are fully audited and costed. For all their talk of expense and savings the Tories have not indicated one costing of what will be saved or what will be committed in what is Chapter one of their manifesto.

Lib Dem MP Norman Lamb had this to say about the announcement this morning.

"All today’s announcement confirms is that the Tories can’t be trusted with the NHS and have every intention of playing fantasy politics all the way up to the election.

"The NHS is facing enormous shortfalls in funding over the next few years yet the Tories continue to promise extra health spending without any details of where the money will come from.

"The time has come for David Cameron to be honest with the British public. If the Tories want to pledge extra spending on health in some areas then they must admit that without extra funds it will lead to cuts in frontline services elsewhere. And if they plan to remove all central targets how do they intend to prevent a return to the waiting lists of old?

"The sad truth is that David Cameron knows his health policies don’t add up. How else do you explain the sudden U-turn today on their flagship single room’s policy?"

Alistair Darling meanwhile has pointed out:

"The Tories have made over £45bn of promises, but can barely explain how they can pay for a quarter of this. This leaves them with a credibility gap of £34bn.

"These are not long forgotten promises from another time. All have been confirmed in the last two years. Most have been repeated in the last few months.

"You can't fight an election on a nod and a wink; sometimes claiming you are committed to these promises, and when challenged claiming you are not."

Maybe he has a point.

P is for 'Progressive'?

Speaking as in Woodstock today David Cameron has launched the Tories election campaign. He said:

"The next general election is no more than 153 days away and I don't think it can come soon enough.

"Let's make this the year for change - the year when the positive defeats the negative.

"We can't go on in these difficult times with a weak Prime Minister and a divided government."

He also said that he would from today and every day until the General Election he would spell out what that means. That is a good idea I'll be waiting each day to see just what Dave D.A.V.E. Dave spells out and reporting back.

Well to be fair he did give us three of those letters today, n, h and s. He said the following:

We are progressive Conservatives.

"Our goal is to create a fairer, safer, greener country where opportunity is more equal.

"It's because we are progressives that we will protect the NHS.

"In its bricks and mortars, care and compassion, it is the embodiment of fairness in our society.

"We recognise its special place in our society so we will not cut the NHS, we will improve it for everyone."

So he is using the P word too progressive. But there are no cuts for the NHS, but hang on, bricks and mortar come top of his list ahead of care and compassion. Isn't Dave meant to be the caring, compassionate Conservative. The main concern that many of us have is that as part of his plans for the NHS certain aspects of it will be sold off. Putting brick and mortar ahead of care and compassion may not speak of the total fairness to society that Dave aludes to later.

Other P's that were used today include public sector pay. He announced he would freeze it for a year. All of it. Even those on the lowest grades. This in the name of fairness?

Those on the lowest grades suffer because the consumer price index is where the bulk of their spending is not the retail price index. The former is still increasing while the former may show deflation. To freeze pay for the lowest paid public servants as the Conservatives want to do is being positive to defeat the negative, indeed it will add to more negative for those people. There will be little 'aspiration' from the lowest paid public servants to be 'supported'.

The Lib Dems on the other hand have promised to freeze pay at the upper ends of the pay scales only and help out those at the lower end by lifted the Tax Allowance to £10,000.

However, Chapter one of the manifesto is promised on Monday, so obviously Sunday is a day of rest in this statement (precised by Woodstock above):

"We are starting our campaign to win the general election today and we will be spelling out exactly what that will mean every day from now until polling day."

See Also: Kasch Wilder isn't impressed saying it lacks radical change we need. Tory Blogger Byrne Tofferings even said in his predictions yesterday "Cameron to back-track on certain planks of Tory policy. I would expect Cameron to be very middle-of-the-road in his first term. I do not expect any major changes."

Is This a Progressive Party?

The Conservatives seem to think that a few key placed, if misused, words can help the branding of their party. They have been using the words 'clean' and 'honest' in the Norwich North by election then they were far from transparent but successful. So they are repeating the mantra in Glasgow North East.

They are also attempting to use the word 'progressive' to describe their past, present and future. Though interestingly seeing as the Lib Dems don't do well in polling to come equal top of the parties with the Tories in one poll on progressiveness slightly above out voting intention level, with them well down is a telling sign.

Heck there is even a piece in today's Torygraph by Antony Sheldon who has an upcoming book called Trust which tries to highlight Cameron's progressive theme. He opens by saying that Robert Peel, Benjamin Disraeli, the Marquis of Salisbury, Stanley Baldwin, Winston Churchill and Margaret Thatcher are rare in Conservative history in being prime ministers who changed their party and the direction of the country. But what was the direction of their country at the times that they were trying to change.

Disreali was up against Gladstone and his reform agenda. Baldwin may well have introduced votes for women but called his first election to gain a mandate for a protectionist pact, failing to gain a majority. Of course Churchill was a great war leader but post war was voted out for not having the vision to help the people recover, and then in opposition opposed the establishment of the NHS, something that still causes division in Tory ranks just last week. As for Thatcher she was hardly the great social reformer, her reign from milk snatcher, to unfair taxation, supporting the apartheid regime, section 28, suppression of rights to protest.

One telling quote is this:

"Thatcher had been radical on economic reform and [David Cameron] was going to be equally modernising on social reform."

See the above, think and also watch the below. Is being as radical as Thatcher was on economic reform necessarily going to be a good thing for social reform? I for one dread to think what social inequality that can bring after the economic inequality of Thatcher's 'steal from the poor give to the rich' Dooh Nobir* strategy.



*For anyone not catching that it is Robin Hood in reverse.

Well Tory Bear Some Reasons Why #WelovetheNHS

Last night Tory Bear posted two tweets the first:

The NHS is not free. You end up paying far more than you ever take out. Free
healthcare can be achieved without 500,000 bureaucrats. ARGH

Followed by this:

In America you get far more than you ever pay for. Here you get taxed to shit
and then die on a trolly.

Now there is some truth in the first point are 500,000 bureaucrats really needed in the NHS, but he ignores that tdue to the legal mitication nature of America that there Health Care Provision employs a larger army of lawyers to protect their practitioners than we do here.

The thing is that in the US as he points out you do have to pay for it. As at the moment under a recession where you health insurance contributions may have been paid for by an employer finding yourself out of work can lead to a sudden reduction or end in that provision. The tax we pay in the UK goes towards an all incompassioning welfare system, which Mr Cole after just qualifying from University has yet to actually need to experience the full benefit off.

I'd hate for him should he ever live in an American style system of healthcare to be out of work or even between jobs when he needs emergency life saving surgery. While he is lying on the gourney they check his insurance cover and then debate what provision they can make for him when they find out he has none.

The 65,000 Person Question

The launch of the National Pandemic Flu Service coincides with the announcement that the NHS is preparing for the worse case scenario of 65,000 deaths this year through swine flu. The advise is based on 30% of the population falling ill. Children under 14 are being hit hardest and the NHS was told to plan for a worst-case scenario of up to half of all children being infected during a first pandemic wave.

The figure of 30% for the model is based on the pandemics of 1957-58 and 1968-70, the scenario is also ranging the number of fatalities from 19,000 to 65,000 based on the 33,000 in that first pandemic and a few thousand less at the time end of the 60s. The NHS is being prepared for 12% of the workforce being off work sick, but emphasis this is not a prediction just a figure based on the worse case scenario. They are expecting the occurrence of cases to drop off over the summer but to peak again in October after children have returned again to school.

While Tower Hamlets has the highest proportion of visits at 769, per 100,000 0f population and London boroughs of Hackney, Islington and Lewisham not far behind the rich and famous are also not immune to it. Harry Potter star Rupert Grint, ex-Prime Minister's wife Cherie Booth, England footballer Micah Richards are just the tip of the iceberg of high profile cases.

To put things into perspective in some years there can be as many as 20,000 extra deaths a year related to influenza. Those with underlying health conditions, the young and the old are most at risk and are the categories being targeted for the government immunisation programme.