Wednesday 1 May 2013

The dangers of ring-fencing

As government cuts continue to incur the wrath of ordinary people the length and breadth of the country, there are still three sectors which remain immune from them. Specifically, education, health and foreign aid are exempt from these cuts. To be absolutely clear, the NHS will avoid cuts whereas Social care remains under the control of local government. This little detail has huge ramifications for anyone currently within the social care system. This includes a lot of elderly care in the community which is stretched to breaking point as things stand. Going back to the NHS though, two prominent experts this morning warned of the dangers of ring fencing its budget because it has the potential to create a culture of complacency within the hospital hierarchy. That is to say, the hospital comes to expect that level of income so that it is less likely to seek cost savings and more likely to concentrate on the actual spending of the money. A good point made. The point they missed though is that they failed to see the NHS as a big pipe-line. It is this approach which will ultimately bear fruit as wee explore ways to reduce the extent of its impact on our national finances.

There is very little we can do about an elderly lady in her mid 80s who has suffered a debilitating stroke. We obviously have to provide care for her and aim to give her the best quality of life from that point onwards. At the other end of the scale though, there is a considerable amount we can do. A young person arriving at A and E on a Friday night who is obviously drunk is an avoidable drain on resources. There are of course many other examples but the point remains that they are being fire-fighted as things stand.

Taking alcohol as a case in point, much fury was vented earlier this year when a minimum price was suggested for a single unit of alcohol. The truth is that minimum pricing allied to a comprehensive alcohol education programme is riddled with common sense. As things stand, I can go home tonight and share a reasonable bottle of wine with my wife for less than five pounds. A minimum price of 50p per unit would not affect me either in terms of the amount I drink or in terms of the price I pay. A typical bottle of wine has 9 units of alcohol so a 50p minimum price would make that £4.50 per bottle. It would affect the problem drinker who arrives at A and E on a Friday night. Such a minimum price would have to apply to everyone in the retail sector including supermarkets. This would be a shot in the arm for community pubs and would give our high streets a more level playing field.

Whether it is justified to ring fence NHS spending is debatable but I would argue that such a ring fence needs to be far more conditional than at present. Fire fighting is all well and good but doesn't ever really address the actual cause. If that same young person was made to go back to A and E a week later to witness (in their sobriety) the problems caused by alcohol excess, it would at the very least give them some food for thought. Things seldom look so good when we are sober. Such a scheme was piloted a few years ago but has since vanished without trace and I don't understand why. It makes a lot of sense to me.

The deputy leader of the Labour party (New or Old? I'm not sure) today admitted that under a Labour government, spending would have to go up. While her party leader has tried desperately to avoid answering this question in recent weeks, she has been rather more forthcoming with the truth. Granted, it is hardly a surprising admission but does make the choice facing the voter next time around a little more clear. If you aren't too bothered about controlling national debt, Labour is the party for you. If you are anti everything and listen to Elgar's Pomp and Circumstance at night, you need to vote UKIP. If your priority is to cut the national debt and reduce borrowing, you have to choose which of the coalition members is most genuine. It might be that you care about the environment. In such a minority, your choice is a lot more straightforward.  On a serious note, I listened to the UKIP leader on the radio this week and felt very uncomfortable. Mr. Farrage is sailing very close to facism. His pronouncements have overtones of the worst aspects of the far right. His opposition to further immigration was perfectly clear and very worrying. The news that a UKIP candidate has been seen giving a nazi salute on social media has been treated with outrage by candidate in question. His outrage is founded not on the salute which he made but on the fact that his social media account had been allegedly hacked. I should have thought that transparency was a basic requirement for someone intent on taking public office. I for one, will be very sad if UKIP do well in the council elections because at a time when several bomb plots have just been thwarted, the last message anyone needs at the moment is one of rejection and isolation. Rather than try to further alienate parts of our population, we would do well to engage with them. History shows that building bridges tends to work better than destroying them.

The by-election in South Shields reminds me of a bit of advice I once received when living in Barnsley. Like Barnsley, South Shields is just about as near to a guarantee of a Labour win in the country. My advice was that if there was a general election tomorrow fielding a man with a blue rosette, a man with a yellow rosette and a ****ing donkey, they'd vote for the ****ing donkey. And, do you know, it was true!

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