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David Cameron certainly seems to have got more than anyone (probably including himself) expected out of the EU budget summit.  But before we all go overboard with the congratulations, we might register three churlish reservations.  First, the UK contribution to the budget will actually increase, even if the reduced overall budget negotiated in Brussels is approved.  Indeed, if the Commission makes full use of the concession that it secured from the heads of government under which it can vire spending between one year and another, enabling it to spend more in the first year or years of the budget period so long as it spends less thereafter, the UK contribution might well go up quite steeply in the first year or two.  The Europhobes who dominate the Conservative party in parliament and the country won’t like that, and UKIP will hate it.  Secondly, there are already warning signs that the European parliament may refuse to approve the budget.  Thirdly, the reduction in the overall budget negotiated by Mr Cameron and his austerity-loving allies in northern Europe has been obtained at least in part by axeing EU infrastructure projects that are urgently needed to provide a stimulus to the stagnant economies of many EU countries.  Keynes, thou shouldst be living at this hour.

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It’s difficult to be optimistic about the chances of lasting improvements in the standards of patient care in numerous failing NHS hospitals in the wake of the sickening revelations about conditions in the Mid-Staffs Hospital Trust.  There simply aren’t enough Florence Nightingale-type nurses and health-care assistants in the whole UK, even when extensively supplemented from the Philippines, the Caribbean and west Africa, with the fervent dedication and inspired motivation to provide the number of committed nurses needed by the enormous NHS.  The only way to eradicate the negligence, indolence, arrogance and indifference to patients that characterise a huge number of NHS ward nursing staffs is to subject them to regular unscheduled and challenging visits by hospital doctors, including especially consultants, and by hospital managers from the chief executive down.  Sadly, in my limited experience anyway, these exalted beings are very rarely to be seen on the wards except on the consultant’s ritual weekly rounds, escorted by a flock of terrified junior doctors and other hangers-on, when the courage of Achilles would be required by a patient daring to venture to complain about conditions on the ward and the deficiencies of the nursing.  Revenge following the departure of the great man (or woman) and his or her retinue would be instant and terrible.  The same applies to any hospital employee venturing to complain of shocking defects on the wards, either to his or her superiors in the Trust or by whistle-blowing to the media.  Unfortunately the managers are mostly too busy filling in interminable forms for the Department of Health, or devising cunning wheezes to disguise their failure to hit the innumerable targets imposed on them, to spend time in the wards, observing and talking to patients and nurses;  and the consultants are similarly too busy earning enormous fees from their spare-time private practices to spend a couple of hours each day on the wards checking on the welfare of the patients for whom they are supposed to be responsible.  Of course there must be many laudable exceptions – surely there must be? – but there is too much anecdotal evidence of disastrous mistreatment of helpless patients in NHS hospitals to allow either satisfaction or optimism about the scope for real reform.  Give men and women unaccountable power over others, and sooner rather than later it will be abused, as happens every day in our prisons, boarding schools and the armed forces, as well as hospitals.  Having said all that, the NHS remains a precious national asset, and the latest revelations of what most of us knew already must not be exploited as an excuse for the programme of NHS privatisation by stealth on which the coalition government is clearly bent (in both senses).

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At a time when the poorest and most vulnerable in our society are being reduced to homelessness and penury by the benefit cuts imposed by a government obsessed by the case for austerity and ideologically incapable of ensuring an equitable distribution of any genuinely necessary sacrifice, big business and high finance in Britain and elsewhere in the recession-ridden western world have more cash than they know what to do with.   While the incomes of ordinary working people are being steadily eroded by inflation and cuts, those of the highest paid and the possessors of the greatest wealth are apparently casting around for investment opportunities promising the highest returns on capital, regardless of their longer-term consequences for society.  Needless to say, such returns are rarely available on investment in socially useful projects that might re-inflate demand in the economy and restore some measure of prosperity to those who have been most badly damaged by the recession.  Instead, unbelievably, the investment bankers are back at their old tricks, devising complex derivatives and selling packaged debts to each other.  According to a front page report in today’s Financial Times, “Sales of securitisations such as asset-backed securities and collateralised loan obligations are now at a post-crisis high, as investors seek out higher-yielding securities. Many bankers are experimenting with new assets which can be bundled and sold to investors, as well as new deal structures.”  Once again investors are buying packages of debts whose complexity makes the calculation of overall risk impossible, with the strong likelihood that yet more bubbles will be blown and blown until they burst, taking banks and investors down with them. We are back to leveraged (i.e. debt-financed) buy-outs, this week of Virgin Media and Dell Computers, the latter aiming to go private and thus insulated from the prying of regulators.  It’s as if 2007-08 had never happened – for some.  In the words of the song, when will they ever learn?

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As usual, comments on this post are very welcome, be they approving, condemnatory or corrective.  But please don’t send comments by email:  write them in the comments box at the foot of this post.  And this time, please don’t expect a response to your comment, however provocative it might be.  Ephems will be at sea, literally as well as metaphorically, for the next few weeks, paying for internet access by the minute at exploitative rates.  Your comments will be read from time to time, the ship’s satellite connection permitting, but answer will come there none.  Emails and messages from this website may be read occasionally, but they will almost all go unanswered.  This blog will have other, less important, things to do.  Au revoir!

Brian

2 comments on Notes on February 2013

  • john miles says:

    My wife died last week of brain cancer in the North London Hospice (a charity, only partly funded by the taxpayer.)
    No words of mine can do justice to the care she received from everyone involved. both in the hospice and in the four hospitals she was in over a period of more than a year, and  nothing you say about the NHS seems to have any relevance to our own experience.
    Perhaps we were just lucky, though I find that very hard to believe.
    In my never very humble opinion the main thing wrong with the NHS is they try to run it on a shoestring.
    I think I’m right to say that we spend a smaller portion of our GDP on healthcare than most other comparable countries, and many of us seem to want to spend even less.

    Brian writes: John, all of us who always enjoy your contributions to this website will be very sorry to read your sad news. It must be some small compensation for you in your loss that both you and your wife had such a good experience at the hands of NHS staff. Obviously nursing and other standards vary enormously from one hospital to another and from one area of the country to another. I can only say that my own experience of NHS nursing, and that of quite a number of my and my wife’s friends (although not all) has been very negative indeed. I don’t think that this problem would be solved by more money alone, although it would help.

  • john miles says:

    More money would certainly help.
    I’ve often seen our NHS compared unfavourably with the French system.
    Yet I’ve read that that the NHS costs us an average of £1510 per head per year while the French pay £2034.
    And I shudder to think what the Americans pay.

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