A group of individuals in Northern Irish politics obstructs change In a matter of months, the Republic of Ireland will hold a referendum on repealing the eighth amendment of the constitution and paving the way for legal abortion for the first time in the country. With both the Taoiseach, Leo Varadkar, and the leader of the opposition, Micheál Martin, declaring that they will campaign for repeal, and with the electorate broadly supportive of the move, change looks likely. Following only three years on from the country’s historic same sex marriage referendum, Ireland appears to be moving from one of the more socially conservative countries in […]
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There are pressing reasons for understanding a bit about how our tax system works and very specifically what National Insurance is. NI is used as successive governments’ tax increase of choice because of a widespread and mistaken belief that it is a direct payment to the NHS. The Liberal Democrats had it in their 2017 manifesto, Gordon Brown put 1p on NI to ‘pay for’ the NHS, Frank Field (Labour) gave evidence on NI to the Lords Committee on the long-term sustainability of the NHS and his website says he is working on this issue with Oliver Letwin(Conservative) and he wants to restore a ‘something […]
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‘Where to find the money to pay for the NHS’ is a recurrent theme of successive governments. As if changes to our public services are simply a matter of practicality under adverse financial conditions rather than political choice.   Jeremy Hunt appears to have added his voice to the calls for tax increases, which apparently is now ‘general consensus’ in parliament and being ‘backed’ by the public. This blog looks at how those arguments are presented from different sources. Politicians and think tanks – yes, and campaigners too – limit the debate about funding to who will have to  pay the tax burden and which tax needs to be increased.  For some the answer […]
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Speaking the truth to power is always a risky business.  No more so than when considering how millions of pounds of public money should be shovelled into developments and contracts. Local government overview & scrutiny has been with us since the Local Government Act 2000 and the advent of the cabinet system and executive mayors. In the case of executive mayors –  a single politician making the decisions to spend millions of pounds of public money albeit with the advice of officers and an appointed cabinet – it is easy to see how local councillors could feel disempowered if they […]
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It is a pleasure to be speaking with you about something that I know all of us in the room are passionate about changing in this country – health inequality. It comes as no surprise that the Office for National Statistics found earlier this month that the least deprived men at birth in 2014 to 2016 could expect to live almost a decade longer than the most deprived. This decade has seen a slowdown in improvements in life expectancy, an appalling consequence of this Government’s failure to improve the chances of the worst-off, as years of underfunding in health and social […]
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Poverty is an ongoing problem facing all societies, and there are many different ways of exploring the issue. On the one hand, there is concern with inequality, including the drivers behind the unequal allocation of advantage versus disadvantage. On the other hand, there is concern with measurement and definition. In the latter case, poverty defined in relative terms implies that no society will be without it. The measurement of poverty raises important issues regarding how it should be conceptualised. With an increasing awareness that reliance on income alone as a measurement of poverty has many limitations, the issue of measurement […]
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There is an unwritten – but golden – rule in political speech-making (as in story telling): pledges should come in neat numbered clusters, often in threes or fives, any fewer and it seems you have nothing to say, too many more and no one will remember them. So, the Health and Social Care Secretary Jeremy Hunt was taking a chance when on 20 March he made his first speech on social care to the British Association of Social Workers, setting out seven key principles to guide the forthcoming social care Green Paper. But the risk is not only that the commitments will […]
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Over the past decade there have been growing calls for reform of social care funding. Following numerous Commissions, Inquiries, and election promises, yet another Green Paper is promised for summer 2018. There are strong arguments in favour of a social insurance approach, and much to be learned from Germany’s experience about building a financially and politically sustainable funding model. Mandatory long-term care insurance (LTCI) was introduced in Germany in 1994. Launched at a time of welfare state retrenchment, it was configured to deliver financial sustainability. After a decade of stable funding that built institutional and popular legitimacy, there have been […]
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In recent years we have made great strides in the UK, not only tackling the stigma around mental illness but have also seen the issue of mental health rise to the top of the political agenda. In June 2012, Charles Walker MP and I both spoke in parliament about our personal experiences of mental illness, something which at the time was seen as groundbreaking. I am pleased that people from all walks of life have spoken about their experiences since then, adding to the debate to ensure that mental illness is no longer seen as the taboo it once was. […]
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NHS Providers has accused critics of trusts creating wholly owned subsidiary companies as being “inaccurate and misleading” in their arguments. The body, which represents NHS trusts, believes these companies help attract key staff, deliver VAT savings and increase oversight of previously low priority back office services. It has published a briefing note today saying trust leaders “are clear that wholly owned subsidiaries are a key tool” to deliver current strategic requirements. Nonsense.  The reasons why dozens of Trusts moved to set up wholly owned subsidiary companies over the last 18 months is clear enough.  The change brings the immediate cash […]
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By  Ian Kirkpatrick, Andrew Sturdy and Gianluca Veronesi Few topics have provoked as much debate and controversy in many western societies as the growth in public spending on management consultants. In the UK’s public healthcare sector, the National Health Service (NHS), this spending more than doubled from £313 million in 2010 to £640 million in 2014. Understandably, it is under constant scrutiny and there are considerable pressures to cut the use of management consultants, but spending remains high. Management consultants provide advice on strategy, organisation, financial planning and assist with the implementation of new information technology. Frequently, they promise significant improvements in efficiency. According […]
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The interim Parliamentary Review, published in July 2017, observed the the Welsh NHS and social care has been subject to many well-considered reviews since devolution. They all shared the common fate of not to achieving transformational change as they never successfully made the transition from the page to the front line. In an attempt to address this it recommended that Welsh health and care services should concentrate on a limited number of significant innovations, evaluate the outcomes and implement the most successful ones with a sense of urgency. Despite this the Final Report (January 2018) itself produces ten “high level”recommendation […]
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