Phil Taylor

Tonight I am off to see the Borough Commander and his boss as a member of the Ealing Riots Scrutiny Review Panel. I am keen to hear at first hand the details of the police response to the Ealing riots and to have the opportunity to ask on your behalf the questions we want answered.

At the end of September I was in Richmond, Virignia visiting my American in-laws. I was taken to a shooting range by my father-in-law to shoot his Smith & Wesson 45 and 9 millimetre automatics. These are kept loaded in a gun safe in his bedroom. My father-in-law, like many Americans, cherishes his Second Amendment right to keep a gun for his self-defence. The Second Amendment to the United States Constitution says:

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

The whole American gun thing is alien to us in Britain today and it comes at huge cost. The rate of gun deaths in the US is 30 times that in the UK, see here.

It is worth noting though that those that advocate the Second Amendment in the US cite the 1689 English Bill of Rights and the historical right of an Englishman to be able to have arms to defend himself as the historical source of their right. The Bill of Rights says:

That the Subjects which are Protestants may have Arms for their Defence suitable to their Conditions and as allowed by Law.

In the UK we have a different history to the US and we have been content over the last 300 years or so since the Bill of Rights to allow the state to ever tighten its monopoly on the use of force. The riots in August have not caused us to question our choice and neither do I think it should. But, if the police are to hold a domestic monopoly on the use of force they must use it, and use it effectively, to keep us safe. I don’t keep a gun at home like my father-in-law. I don’t want to. But, I don’t want riots in my town that leave me and mine undefended. August must not be repeated.

During yesterday’s Lords debate on the NHS Elaine Murphy, Baroness Muphy, a crossbench peer talked emminently good sense:

Seldom have so many health policy folk fought so many pre-Bill skirmishes over what in the end has proved to be rather modest changes intended to preserve and improve the NHS based on the principles of the NHS constitution, and rarely have I received so much misinformed lobbying about a Bill. I hear that the Bill heralds the end of the NHS as we know it; I read that armies of evil capitalists from the United States and the Middle East are geared up to zoom into the UK like the hordes of Genghis Khan to hoover up our favourite hospitals and services. It is twaddle. In fact, this Bill contains no privatisation at all, it does not transfer any assets to the independent sector and, if we build on the contribution of the independent sector of 1 to 2 per cent per annum, we shall be doing quite well. We have been building on the expansion of existing policies that have been in place and developing slowly over the past 20 years and introducing a new level playing field for providers from all sectors.

As another noble Lord said, this is a vast improvement on favouring the independent sector treatment centres. I quite understand why that had to be done in the early days, but this puts everybody on a favourable, equal footing. It will sharpen NHS commissioners to get the quality of care improved and, crucially, will improve productivity, which has fallen quite catastrophically as investment has risen in the past decade. This Bill improves the contribution of clinicians to the planning and management of services and shifts a hospital system chained to central diktat towards a regulated emancipation to manage their own affairs. In my view, the most important aspect of this Bill is the introduction of the independent regulatory framework for providers, with the tools to promote a sharpening of competition and co-operation that will promote the kind of integrated care across primary community and specialist services that we all want.

Those of us who were at the meeting last night heard Sir David Nicholson repeat what the NHS Confederation has constantly stressed: that any delay will be profoundly depressing to the service, which now wants a clear steer and direction of travel. We have had two years of delay already. Almost all the features of this Bill are familiar to us: clinical commissioning; foundation trusts; a regulatory system; competition and collaboration between qualified providers; and patient choice. They have all gone before, so the new Bill builds on what has been learnt, especially by ensuring that competition is based on quality not price. There seems to be a widespread misunderstanding that we are basing these new proposals around price. That is absolutely not the case, and I would not support this Bill if it did.

Some people talk nostalgically about the demise of PCTs and SHAs, but the demise is in an orderly fashion, and as a former chair of a strategic health authority, I can only say “Hurrah”. In fact, clinical commissioning groups are what primary care trusts were supposed to be in the first place. For those who can recall primary care groups, those were also what clinical commissioning groups were meant to be. The difference is that we have a national framework to support and empower them that will not be diverted into the provider system.

Murphy is one of those rare creatures an experienced doctor and administrator. Maybe we should listen to her and not the wreckers who are playing politics and do not have a viable alternative.

I am not impressed with the 60 or so “medics” who have signed a letter in today’s Independent titled: “No one voted for the NHS to be privatised”. They are a motley crew of Labour activists, ridiculous luvvies and retired busy bodies. The real doctors who have signed the letter risk their reputations on such a nakedly political attack.

Just take the title for starters. No-one is privatising the NHS. Do the signatories of this letter suggest that we nationalise factories, power stations, mines and steelworks so that their scalpels can be produced entirely in the public sector? The health sector in the UK is now 10% of GDP. One tenth of ALL economic activity. There is always going to be a mix of providers and we really need to get the most efficient mix and not be doctrinaire about who provides what.

The “doctors” claiming that no-one voted for healthcare reform clearly did not read the Coalition party manifestos. The Tories said:

Give patients more choice

We understand the pressures the NHS faces, so we will increase health spending in real terms every year. But on its own this will not be enough to deliver the rising standards of care that people expect. We need to allow patients to choose the best care available, giving healthcare providers the incentives they need to drive up quality.

So we will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers. We will make patients’ choices meaningful by:

• putting patients in charge of making decisions about their care, including control of their health records;
• spreading the use of the NHS tariff, so funding follows patients’ choices; and,
• making sure good performance is rewarded by implementing a payment by results system, improving quality.

We will strengthen the power of GPs as patients’ expert guides through the health system by:

• giving them the power to hold patients’ budgets and commission care on their behalf;
• linking their pay to the quality of their results; and,
• putting them in charge of commissioning local health services.

GP commissioning is there in black and white.

The LibDems approach was slightly different but implied equally radical change and the idea of any willing provider which was also in Labour’s own plans.

• Empowering local communities to improve health services through elected Local Health Boards, which will take over the role of Primary Care Trust boards in commissioning care for local people, working in co-operation with local councils. Over time, Local Health Boards should be able to take on greater responsibility for revenue and resources to allow local people to fund local services which need extra money.
• Giving Local Health Boards the freedom to commission services for local people from a range of different types of provider, including for example staff co-operatives, on the basis of a level playing field in any competitive tendering – ending any current bias in favour of private providers.

The language of privatisation which these ill-advised medics are indulging in is Socialist clap trap, language that even the Labour party did not use when it was in power. Furthermore, the idea that people didn’t vote for change in the NHS is unsustainable.

Some of the signatories are:

Carl Barat – musician with no medical experience

Russell Brand – potty-mouthed comedian with no medical experience

Dr Chris Burns-Cox – Labour supporting retired doctor

Julie Christie – lefty actress with no experience of medicine

Dr Amy Ford – Manchester law academic with no experience of medicine

Sadie Frost – actress and stuff and Hampstead Labour luvvie with no medical experience

Dr Katy Gardener – academic, social anthorpologist, member of Socialist Health Association with no medical experience

Ken Loach – left wing film maker with no medical experience

Caroline Lucas MP – Green party MP with no medical experience

David Morrissey – Labour supporting actor with no medical experience

Tony Robinson – Labour Luvvie actor/comedian/presenter with no medical experience, Labour party member and one-time NEC member

Dr Alex Scott-Samuel – academic who is active in Keeping Our NHS Public campaign group with no medical experience

Will Self – left wing writer with no medical experience

Dr Nigel Speight – retired doctor

Dr Norman Traub – Southend NHS Activist, retired doctor and serial letter/petition signer

Professor Cathy Warwick, General Secretary, Royal College of Midwives – union leader

Dr Tony Waterston – stood as Green party candidate in local elections Newcastle 2010

Dame Vivienne Westwood – self-promoter and dressmaker with no medical experience

Dr Patrick Zentler-Munro – retired letter/petition signer

Dr Pam Zinkin – retired doctor who spends her time signing petitions, including Islington Labour ones, she turned up to her first ever BMA meeting to vote against the NHS bill carrying Nye Bevan’s book ‘In Place of Fear’

Two GPs from the same Liverpool practice signed. I am sure they are OK GPs but they are only two NHS workers at the end of the day, highly paid £150K workers, but just foot soldiers!