All that we really need here is local control of charges via our councillors - if they are to create up-front charges for services they should be empowered to fire civil service wooden tops and increase efficiency whichever way they choose; if they fail they get fired at a local election.
Simple.
I had a rough crack at some Swindon numbers here
http://thepurplescorpion.blogspo...vo-
swindon.html
I say 'rough' because the local speed cameras partnership seem oddly coy about their recent figures.
What about the assertions that there are:
"ever higher expectations of public services" (KPMG)
and
""The demand for public services – and for improvements in the quality of those services – is growing inexorably... As citizens and users of public services, we are no longer willing to accept and be grateful for a basic level of service" (Charles Clarke)
All I want is a basic level of public services provided at the lowest possible cost. I suspect that most people would say the same. In fact, we get ever-rising costs and ever poorer service.
The idea that they need more and more money is spurious.
The Today's programme's website have the piece on their listen again page.
All I want is a basic level of public services provided at the lowest possible cost. I suspect that most people would say the same. In fact, we get ever-rising costs and ever poorer service.
++++++++++
In terms of health care, the first two sentences are wrong. People want the highest possible standard of care from the NHS including brand new, unproven, cripplingly expensive cancer drugs. They want surgery to remove tattoes; to flatten their bellies; to remove their threat veins; their demands are insatiable and unrealistic.
I agree with the third sentence. The Labour government has wasted billions on unusable IT projects; on target driven medicine that does not deliver care; on process rather than on results.
There needs to be a front end charge with an appropriate abatement of taxation (not, as Wat said on the radio, both) so that people would begin to understand the real cost of healthcare
John
"There needs to be a front end charge with an appropriate abatement of taxation (not, as Wat said on the radio, both) so that people would begin to understand the real cost of healthcare"
For once I agree with Dr "public sector fat cat" Crippen, but not in the context of the NHS as we know it today. The continental social insurance system would be far better with taxpayer subsidies for essential services, not the luxuries such as cosmetic surgery.
Free at the point of use, leads to abuse". Even truer today than ever in the past.
The government as the purchaser and provider of a service, is a concept that has passed its sell by date. It is a concept of socialism that continually fails, whenever and wherever it is introduced.
There are few services that really need to be supplied by the government sector. Defence against our enemies; of our borders; our sovereign assets; our culture; our fair share of the planet.
Apply the concept of local taxes for local spending whenever practicable, even for welfare. When the people can clearly see the cost of doing something locally or even the cost of not doing something, they tend to take a lot more interest.
Translation:
We're going to charge you more for less.
Apparently, according to Crippen, I'm wrong to say that "in terms of healthcare" I want a basic level of public services at the lowest possible cost or to suppose that most people would say the same. Excuse me for being wrong about what I want.
In fact, I don't want any "healthcare" from the NHS - I'd rather it weren't provided by the public sector (let leave the issue of funding aside for one moment, I'm talking about provision). I especially don't want treatment to flatten bellies, remove tatoos or whatever and although some individuals might demand this, I suspect that most of us would say "your problem - pay for these things yourself". Insofar as we do have a public healthcare system, I'd rather it limited itself to simple healthcare programmes such as vaccination and other simple and cheap measures that bring 80% of the benefit of healthcare at 20% of the cost.
I agree 100% with David and Acorn about funding and provision.
Crippen neatly omits to mention that most of the extra spending on the NHS has gone on increased salaries.
Clarke also said, in passing in order to illustrate the alleged iniquities that would be rectified by his proposals, that it would stop the general taxpayer funding motorists. I just simply cannot believe the utter drivel these idiots come out with.
Oh gawd HJ, you can't get off your hobby horse even when I nearly agree with you.
What you, as a vaguely reasonable person, may want from the NHS is one thing. Sadly, public demand is entirely different.
John
Swindon hasn't made the decision - its simply considering it. Given the opaque and sneaky local camera partnership (although I'm hearing that they have cleaned up their act of late), I'm not surprised.
Independent Tues 15/7 p5: "The council is to make a decision on funding the camera network within the next two months."
Crippen,
Come off it. You know perfectly well that most of the extra money spent on the NHS has gone on increased salaries and pensions. Why did you not mention this when you mentioned other wastes of money? Were these hikes in salaries needed? No - there has never been a shortage of people wanting to work in the medical sector, only a restriction on the numbers allowed to train and qualify.
I disagree with you profoundly about the "real costs of healthcare". The most effective healthcare is principally of the straightforward variety and could be very cheaply provided. Some medical care (as opposed to healthcare) is expensive, but the benefit of this to health is, on the whole pretty modest and certainly delivers much less benefit than could changes in lifestyle, exercise and diet. However, assuming people do want this sort of medical care, it could be provided at better quality and lower cost were the provision of it much more free-market based, by which I mean not just independent providers but also de-restricting the supply of staff and training and the organisations representing the producer interest, such as the BMA and Royal Colleges. You may try to label me some sort of lunatic, but I am in the company of the likes of Adam Smith, Milton Friedman on this.
Even the Independent Newspaper is coming round to my way of thinking (I noticed you avoided commenting on this before):
http://news.bbc.co.uk/1/hi/sport...port/
439867.stm
Having listened again, again (twice again in fact) to Clarke and The Bloke on Today, I now know what's wrong with that segment: Mr Naughty didn't let The Bloke in at the end on the topic of this govt having run out of big ideas. But the elephants in the room on paying for public services were two (making that small soundproof booth very crowded): the huge costs (to LAs) of supporting the elderly (including my incredibly ancient Mum - even she can't believe how old she is), and the wrong uses that the public sector makes of so much of our money.
Of course it was Tories who created the free higher education provision in the 1950s and 60s, without which many of us doing well at school would never have got to university, and also they created the environment in which there were so many technology jobs for us to go on to. Who ruined that the first time round? Who is ruining it this time round?
I am rather late to this party, but the mention of student loans has set me off. Our kids now all long settled in their graduate jobs. Parents well used to the repeat...repeat...repeat phone calls about payment of their student loans. They started again today. That kid has a socially very important job for a children's charity -- with typically low pay. How much extra will he have to pay for the loan than his high-earning pay-it-off-quick siblings?
OK, he is actually male, but in general it is a gender issue. Because of the gender pay gap, women tend to take longer to pay off their loans, so they are paying more for their loans than the better-paid men. Very fair.
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