Attn Sinkov

[1959_60]

I have just sent you a private message!

Sometimes it works, sometimes it doesn't.

[The Bedlington Terrier]

Please share? I'm bored sh-itless!

[sinkov]

Nothing in my Inbox mon ami. Did you send it with a little 's' as in 'sinkov', ?

[1959_60]

Sorry, I failed miserably.

BT - is the personal message facility actually working?

[sinkov]

I've sent you one 59, to see if it works.

[sinkov]

Got them mon ami, I'll have a look and get back to you later. Something needs to be done, that's a given, but coalition must be a long way off, how can you trust anyone who thinks overturning referendum results on a whim is all part of a day's work ???

[1959_60]

Well, on a personal level, we have left and that's that.

Interesting times in America...A leading Republican suggested that Blue States such as New York should go bankrupt instead of receiving aid from the Government.
There seems to be much more inter state infighting in the US than in the EU at the moment.

Time for New York etc to have a referendum on leaving the Union?

https://thehill.com/homenews/senate/...nkruptcy-route

[sinkov]

There's the basis for a discussion there 59, and one certainly needs to take place. Not sure a hypothecated tax is the way forward, health spending would then be based on tax revenue available, which could mean shortfalls, whereas it should surely be based on the Health Care system's needs. That's how NI started out I think, but health spending outstripped NI many years ago so ring-fencing that for health spending again wouldn't solve the problem, but I suppose it could be the basis of a way forward. Best of luck with it, the real debate about health funding, why no other country chooses to replicate our model and what can we learn about the way the rest of the world approaches funding, will never take place, so you might as well push your model, it's the only debate there'll be.

Slightly off topic, and not really wishing to go there again, but I was amused by this "The continuing failure to relieve pressures on our hospitals", pressures caused by an increase in population of 4 million people over the last ten years. 400,000 extra patients a year, every year for the last ten years, that's an awful lot of pressure to be placed on any health service, however funded, but it's like the elephant in the room, we can't discuss how that happened for fear of being labelled a racist, bigoted, Little Englander. Never mind, too late now, best of luck with your project 59, you'll need it, the words 'long grass' and 'can kicked down road' keep coming to mind.

[1959_60]

There's the basis for a discussion there 59, and one certainly needs to take place. Not sure a hypothecated tax is the way forward, health spending would then be based on tax revenue available, which could mean shortfalls, whereas it should surely be based on the Health Care system's needs. That's how NI started out I think, but health spending outstripped NI many years ago so ring-fencing that for health spending again wouldn't solve the problem, but I suppose it could be the basis of a way forward. Best of luck with it, the real debate about health funding, why no other country chooses to replicate our model and what can we learn about the way the rest of the world approaches funding, will never take place, so you might as well push your model, it's the only debate there'll be.

Slightly off topic, and not really wishing to go there again, but I was amused by this "The continuing failure to relieve pressures on our hospitals", pressures caused by an increase in population of 4 million people over the last ten years. 400,000 extra patients a year, every year for the last ten years, that's an awful lot of pressure to be placed on any health service, however funded, but it's like the elephant in the room, we can't discuss how that happened for fear of being labelled a racist, bigoted, Little Englander. Never mind, too late now, best of luck with your project 59, you'll need it, the words 'long grass' and 'can kicked down road' keep coming to mind.

Good Morning Mon Ami, and thank you for reading it.

The full sentence that you highlighted was "C. The continuing failure to relieve pressures on our hospitals by making adequate provision for those no longer needing hospital care but unable to return home."
This relates to bed blocking by people who have had treatment but are unable to go home because the ongoing care is not there. We suggest that NHS/Social Care be merged, funded adequately and in such cases there would be a smooth transition from treatment to care and the hospital bed would be available for the next patient. At the moment, a patient having undergone medical treatment and needs ongoing social care has to be referred to the care agencies who are a totally different animal with little connection to the NHS. This is time consuming, complicated and inefficient. In a joined up service these matters would be dealt with automatically.
Your point about an increase in population is a totally separate issue. As far as the NHS/Social Care are concerned they just have to deal with individuals as they need treatment or care. Without doubt, the rising population will continue to put increasing strain on the services and this must be reflected in the budgets of the services moving forwards.

As for funding the service, well the current situation is simply not working. The NHS and particularly Social Care, have not been funded adequately for many years, as can be seen by waiting lists and people having to fund their own care (including selling their houses in some cases).

If Beveridge were to look at the situation today I am certain he would produce a model that merged NHS and Social Care services under the same umbrella. And that is what we suggest.

As long as a political party sets the budget then the NHS/Social Care will not know how much they are going to get and, as we have seen, the funding may not be appropriate. At election times the various parties make these decisions with getting elected their main priority - not what the services actually need.

We suggest that a new ring fenced tax be introduced and the annual budget be set by a panel of independent "experts" who are not forced with deciding between funding for the NHS/Social Care and another public service such as Defence.
Germany uses a similar system and, while it may need a few tweaks to be used in the UK, it provides excellent levels of health/social care and is very popular with the tax payers.

If the public were offered an excellent Health/Social Care system that they could rely on then I am certain that most would agree - even though it would mean paying a bit more money towards it. They generally have more intelligence than they are given credit for and realise that you don't get owt for nowt.

Of course, this would need cross party support. The Lib Dems have been pressing for cross party working on this matter for yonks, but the Tories and Labour have never agreed to it. With the result that we have poor outcomes for both services. .

[sinkov]

There are pressures caused by 'bedblocking' 59, and I appreciate this approach is meant to go some way to resolving that. There are other pressures on NHS services though, the one I always pointed out, the massive annual increase in population caused by free movement from the EU. Elephant in the room though, never discussed, best of luck with it anyway. And I'm not getting at you LibDema here, neither Tories or Labour will address it either.