The Thin End

Last year the Prime Minister, David Cameron, pledged to deliver a 7 day a week GP service by 2020. It was one of those pledges typical of Prime Ministers when they avoid the real problem - funding. In his announcement Mr Cameron said: "Our plans for a truly 7-day NHS will transform services for millions of patients. It will offer hardworking taxpayers and families the security of the care they need at a time that is convenient to them. I want to pay tribute to the fantastic work of GPs and indeed all NHS staff across the country." Frankly, it was an ill-thought through, headline grabbing statement. The problem for patients in accessing a GP are not solved by opening all hours including Sundays. The problem is lack of funding and GPs under pressure to deliver in an overstretched system. There is little evidence that opening on Sundays would help alleviate the problems GPs face, or that it would improve patient care. Now a report on pilot opening on Sundays shows that

The trick continues. Mr Cameron's inability to give assurances that nobody would be worse off from any changes in working tax credits left him floundering and blustering in the House of Commons. But slowly the defence has been mounted outside parliament and it is the usual trick, tainting those who receive benefits as 'work-shy' and 'on the take'. The first line of argument was that it is necessary to cut welfare in order to cut the deficit, but why should hard working people on low pay be made to pay for the deficit?  That fairness question is difficult to answer. They do try of course. 'The £30 billion cost of tax credits', they say is 'too big'.  But welfare is big because wages of the poorest workers are too low.  The bill is big because millions have been forced into low payed insecure jobs. But that £30 bn isn't the real cost.  The real cost would subtract the costs of unemployment if these people were not in work.   Tax credits keep

When governments run out of ideas or wish to avoid major funding decisions they introduce measures that sound good but in practice do little to address the real problems.  The Secretary of State for Health has announced the introduction of 'Osted-style' ratings for GP practices in England. The announcement received a no-nonsense response from the BMA. Dr Chaand Nagpaul, BMA GP committee chair, said: “We do not believe that simplistic Ofsted style ratings will lead to any improvement in patient care or give an accurate picture of services in local areas. The Secretary of State needs to also listen to the report from the Health Foundation, which he himself commissioned, which advised strongly against composite indicators which mask the details of quality of care, and which he is proposing now to introduce.” An ageing population with complex health conditions has increased the burden on front-line services at a time when social care services have been cut.  Cuts in so

Taking the Tory narrative on the economy you would be forgiven for thinking that current problems with the economy are due to 'out of control' spending on welfare.  It is a false narrative. It is a dangerous narrative because it means we are not learning from history. The Tories set up this narrative of welfare spending so that they can do what they are ideologically good at doing - cutting social investment.  But it is more sinister.  It is a political trick that shifts the burden of the financial crisis to the poorest and enables the government to 'keep taxes low'. It aims at 'middle England'.   But it is a false narrative. If you want to see graphically what went wrong you can do no better than consider household debt.  The massive and rapid increase in household debt as percentage of incomes fuelled an unsustainable boom.   Household debt-to-income shot up over the course of a decade to 170% of household income before the financial crash.  In

It is relatively easy to create an economy that works for the rich but it is difficult to create one that works for the poor.  But it isn't rocket science. The huge public investments in health, education and housing in the three decades following world war two demonstrated it can be done, lifting people out of poor housing and providing them with opportunities in education and work inconceivable before the war. The Tories and the Tory government, as did the Tory-LibDem coalition have instead targeted the deficit. They have not learned from history.  Despite Britain being bankrupted by the war, and inspire of massive national debt, both Labour and Tory governments invested in social infrastructure and welfare - more so did Labour.  As the economy grew, the national debt fell precipitously. A healthy workforce became a more productive one; a skilled workforce become a more adapted one. Yet, now, cutting down the deficit has become an objective for a 'strong' economy

Opposition and criticism of the governments proposed cuts to working tax credits is coming now from across the political spectrum. It has been widely reported in the newspapers that he right-wing think tank, the Adam Smith Institute has criticised the governments proposed cuts in tax credits.  In a press release the ASI said: "Working tax credits are the best form of welfare we have, and cutting them would be a huge mistake. The government has long claimed to want to make work pay for everyone, but cutting tax credits would disincentivise work and hurt those at the bottom of society. "Contrary to the government’s claims, the National Living Wage will do little to help those affected by these cuts and, according to the Office for Budget Responsibility, it risks adding insult to injury by pricing tens of thousands of workers out of the labour market altogether. There is little evidence that tax credits ‘subsidise’ employers, except to the extent that they make more peop

The biggest beneficiaries of public spending over time has been the middle class not the poor. Yet it is spending on the poorest that is cut through  Tory austerity.   The middle class has been largely protected. Votes count.  The Tories have targeted the poorest. First they created the myth that the poor are work-shy. They used the language of 'welfare dependency', as if welfare was a drug on which the poor were hooked and a dose of cold-turkey was in order.  The work and pensions secretary, Iain Duncan Smith said that cuts would be 'good for them'.  It was as if the single mother with a disabled child living on £14,500 a year had brought this on herself - if only she could be weaned off welfare, the narrative goes, she would then be able to miraculously 'stand on her own feet'.  Not only was this narrative a distortion, but the greatest beneficiaries of public funding support are not the poor but the middle classes.  But we don't call the middle class fe

With the storm raging over the cuts in tax credits it appears some Conservative MPs are getting a little nervous of this being Cameron's Poll Tax debacle.  It probably isn't but it has some similar trade marks: the government doggedly carrying on regardless of the consequences.  Their argument is that the tax credit system is cumbersome and expensive and 'out of control'.  This simply means that the cost is big.  Yes, it is, but it is the result of promoting a low pay economy. The tax credits help lift people out of poverty but they are also a massive subsidy to business. The reason the cost is getting 'out of control' is because millions have been forced into low paying and insecure jobs. The real reform needed is to move to 'living wage' economy. The real idiocy of the government's approach is that they are putting the cart before the horse.  First you should introduce a living wage and ensure that it is implemented and only then should they st

This week  the Tories were on the back foot over impending cuts in working tax credits. It demonstrated the effectiveness of Jeremy Corbyn's approach to PMQs. His use of a question from a real person demonstrating the impact of the cuts produced a response that hoisted the Prime Minister on his own petard. The leader of the opposition planted a ticking bomb which put the government on the back foot through the week. The Labour leader repeated his PMQs tactic of asking questions submitted by the public, saying he had received 2,000 emails about tax credits. One was from a single mother who he said would be £1,800 worse off under the government's changes to tax credits. Sure enough, the bomb exploded with an emotional intervention from a member of the BBC Question Time audience again illustrating the real impact, in this case on someone who had voted Conservative and feels betrayed. Cameron had promised in the general election that there would be no changes to working ta

The news that the NHS is seriously in deficit is not surprise. One major reason is the failure of the social care system leading to added burden on the NHS. Cuts to local authority budgets have had a huge impact on the care system, and we are now witnessing the devastating effects. Meanwhile care costs are hitting families struggling to provide care for their loved ones. AgeUK has warned that the care system in England is in crisis. In 2011 the Dilnot Commission called for a cap of £23,000 on the costs to be born by an individual. This would have meant that when the care costs had reached that threshold then state funding would kick in. Next year the Government will set a cap of £72,000 - three times that recommended by Dilnot. This will leave individuals in considerable difficulty. Local authority funding is varied across the country, leaving a post code lottery for public funding of social care and hundreds of thousands are missing out on support for care costs. The root caus

Some years ago now Prime Minister David Cameron assured voters that the NHS was 'safe' in Tory hands.  It was in 2006 in his speech bringing to end the Tory Party conference that year.  And here is the irony.  Not only did he say it would be safe in his hands but he also said this: "When your family relies on the NHS all of the time - day after day, night after night - you know how precious it is. "So, for me, it is not just a question of saying the NHS is safe in my hands - of course it will be. My family is so often in the hands of the NHS, so I want them to be safe there." And then he promised this: "no more pointless and disruptive reorganisations". Instead, change would be "driven by the wishes and needs of NHS professionals and patients". Fast forward to 2015 and his governments have imposed a pointless and disruptive reorganisation of the NHS and starved it of funding.  They have brought the NHS to crisis and with junior doct

So, the cat is out of the bag and it was Mr Jeremy Hunt the Health Secretary who let it out at a fringe meeting of the Tory Party conference today.  Cuts in benefits to the working poor are not to help draw down the deficit but to 'teach the poor a cultural' lesson. They must work harder. The cat of course has never really been in the bag.  Austerity has had little to do with economics but a lot to do with political ideology and a cultural attitude to the poorest.  It began on day one of the previous Tory/LibDem coalition with the narrative of good 'workers' and bad 'scroungers' with the implication that those receiving benefits are the 'undeserving' poor; work-shy scroungers. This has been the narrative now given greater emphasis with the Tories freed from any Liberal Democrat constraint.  They are now rampant.  The nasty party is back.  It is the sequel to Thatcher. So what is it that Mr Hunt has said.  What he said is that cuts in working tax cred