No 'top-down reorganisation' of the NHS at No. 10

"Boy, Oh boy!" Arturo said, "you know something, mi old pal - we're living with Humpty-Dumpty. Remember what he said, do you?

“When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’

And that's just what 'Boy David' Cameron has been doing with words on the NHS!"

So - I looked up to find out just what Cameron had said about the NHS - when he hoped to catch people's votes.

Mr Cameron called the NHS one of the 20th Century's greatest achievements.

"Tony Blair explained his priorities in three words: education, education, education," he told Tory activists in Bournemouth.

"I can do it in three letters: NHS."

These sentiments were quoted by the BBC in 2006 - before Cameron attained power. In the same speech, the BBC reported

He promised "no more pointless and disruptive reorganisations". Instead, change would be "driven by the wishes and needs of NHS professionals and patients".

This was part of a speech in which:

The Tory leader also hit out at those accusing him of peddling spin rather than substance.

In an attempt to refute these accusations:

He said: "I want to deal with this issue about substance. Substance is not about a 10-point plan, it is about deeper things than that. It is about knowing what you believe, it is about sticking to your guns.

"It is about taking time to think things through, not trotting out the easy answers that people want to hear.

"It is about character, and judgement, and consistency. It is about policy, yes. But it is about developing policy for the long-term."

http://news.bbc.co.uk/1/hi/uk_politics/5403798.stm

So - the NHS is 'one of this country's greatest achievements', is it? It WAS! But - 'Baby, look at it now!'

So - 'substance' is about 'knowing what you believe, it is about sticking to your guns' Well - let's look at the evidence.

Some guns!! Cameron with the help of the LibDems have done a demolition job on the NHS - couldn't do that with just a Colt 45, could he?

What else did this man of substance do about the NHS? He embarked on a radical plan of re-organisation almost as soon as he became Prime Minister. The reorganisation was under the guidance of Hatchet-man Lansley. The King's Fund had this to say:

The Health and Social Care Bill represented the biggest shake-up of the NHS since its inception...

http://www.kingsfund.org.uk/topics/nhs-reform/health-and-social-care-bill

Protests were rife - this was not what Cameron had pledged. Not at all. So - ever the PR man, he set to work to keep the masses happy. He didn't quite ask them to 'eat cake' - but almost! He told them he would have further consultations and would listen! I bet, he did!

After that, Emily Fox in 2011 wrote in The Express

David Cameron admitted ministers had “learnt a lot” in recent weeks and insisted that many people had changed their minds about the proposals.

In a speech to NHS staff in London, the Prime Minister admitted there were areas of the reforms that needed to change.

He said: "Hospital doctors and nurses - not just GPs - would now be involved in commissioning, clinical senates would bring together healthcare professionals to oversee the integration of care over wide areas and the health regulator Monitor would have a duty to promote integration."

Acknowledging widespread concerns about the Health and Social Care Bill, Mr Cameron promised there would be no “selling off” of the NHS, that waiting times would be kept under control and that competition would only be used as a means to improving services.

The Prime Minister said there had been an “important debate” over the past two months which had led to “a whole range of people” changing their views.

http://www.express.co.uk/news/uk/251349/Cameron-NHS-is-safe-in-our-hands

Nothing daunted and with the LibDems' sycophantic help, the Health and Social Care Act was passed. Last year, Cameron was still uttering his mealy-mouthed words. ITV reported:

David Cameron said the NHS was "completely safe" in the Government's hands after 11 failing hospitals were placed under "special measures" management.

Speaking after Sir Bruce Keogh's damning review of hospitals, the Prime Minister said: "I think everyone can have confidence in the NHS and everyone can have confidence that their local hospital either is a good hospital or is being turned around and being made into a good hospital.

The man obviously thinks he is in 'Alice in Wonderland'! ITV went on to report Cameron's musings:

"There is much to celebrate in our NHS and I love our NHS, and I never want to do it any harm, but we don't serve our NHS by covering up problems and difficulties and clearly there are some hospitals with too-high mortality rates."

http://www.itv.com/news/update/2013-07-16/cameron-nhs-completely-safe-in-coalition-hands/

Sadly, we are not in the fantasy world of 'Wonderland'; we are in the here and now. So, let's see what the present situation really is.

According to the headline written by Mark Gould in The Guardian:

GPs braced for shutdown after 'toxic mix' of loss of funds and high demand: At one of 98 GP surgeries in England under threat of closure there is despair that NHS reforms could kill off good care

The article continues.

"Give it a year and I think we will have to close," says Naomi Beer, a frustrated and angry GP who works in a surgery (Jubilee Road) which has been providing care to a largely poor and deprived area since the start of the NHS in 1948. In February, NHS England admitted that 98 surgeries could be under threat of closure as a result of what doctors' leaders have described as a "toxic mix" of a flawed funding system and seemingly uncheckable demand for medical care. ...

But, due to changes in the labyrinthine system of funding general practice, Jubilee Street faces the loss of many hundreds of thousands of pounds, which Beer and the equally angry practice manager, Virginia Patania, say will soon make it financially unsustainable.

"We are now eating into practice savings to continue providing a quality service. But we are planning for a 'red button day' when we will have to dissolve the practice," says Patania, who gives a detailed breakdown of their financial crisis. "I have been raising our concerns with NHS England since Christmas and I get no satisfactory answer. I want to know sooner rather than later because I'd rather dissolve at six months than wait 12 and face even higher losses."

The article continued:

The practice hits all the government's quality targets, has a 94% patient satisfaction rate, and has introduced internet-based consultations, appointments, repeat prescriptions, and while-you-wait phlebotomy. And it is the only surgery in Tower Hamlets that has received the Royal College of General Practitioners (RCGP) Quality Practice Award – for excellence in training and for the quality of its care.

Mark Gould gives details of the consequences of this catastrophic situation for the NHS. It is not just this practice, as he makes clear:

Dr Richard Vautrey, the deputy chair of the British Medical Association's GP committee, fears the Jubilee Street situation could be repeated in several hundred practices, not just the 98 identified by NHS England as at severe risk. "This is the tip of the iceberg," he says. "Practices are struggling with workload and funding and many GPs, although they love general practice, are seriously considering retiring early. The knock-on effect of losing high-quality general practice and cutting its funding will be more pressure on hospitals. We need concrete action from NHS England and that requires more financial resources."

http://www.theguardian.com/society/2014/apr/16/gps-surgeries-shutdown-loss-funds-high-demand-nhs

Of course, this is only one small bit of the story! We don't know the full picture of what's happening in our hospitals - apart from the fact that many are closing! Also - there's the little matter of privatisation! But - we can only whisper about that! Otherwise Cameron might have apoplexy - then where would he go to be treated!

So, after all the Cameron rhetoric, this is the state of the NHS in 2014. Just read what he pledged in a speech at the Royal College of Pathologists on 2 November 2009:

"With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS."

http://www.newstatesman.com/politics/2013/11/pre-election-pledges-tories-are-trying-wipe-internet

The present parlous state of the NHS throughout the country is really bad timing for our 'Safe in Our Hands' Coalition of Tories and LibDems - the European Election is looming and there's to be a General Election next year! Let's hope that like elephants, the voting people of the UK have long memories!

Arturo said, after a little while, "Of course, mi old pal, you have to recall the whole of the Humpty-Dumpty quotation to get the full picture. Let's see, if I remember it correctly, it is:

"When I use a word," Humpty Dumpty said, in a rather scornful tone, "it means just what I choose it to mean -- neither more nor less."

"The question is," said Alice, "whether you can make words mean so many different things."

"The question is," said Humpty Dumpty, "which is to be master -- that's all."

http://iheartquotes.com/tags/lewis_carrol

"That, of course is the problem here in Downing Street," Arturo hissed, "Humpty-Dumpty rules OK. He's certainly the 'master' of verbiage in these corridors!"

Arturo and I felt more than a little queasy after all this malarkey - so it's just a little dim sum for us tonight!

Bye

How do you solve a problem like Maria? at No. 10

I was padding along the corridor when Arturo ambushed me. He waved a sheet of song lyrics in front of my nose.

"It's from the 'Sound of Music'" he said. "The lyrics are perfect for our shenanigans here and in Parliament - you know - What to do about Maria Miller! Maybe, we need some nuns to solve the PM's problem with her!!"

To my dismay, I was then treated to Arturo's discordant caterwauling ...

Many a thing you know you'd like to tell her

Many a thing she ought to understand

But how do you make her stay and listen to all you say

He continued ...

When I'm with her I'm confused, out of focus and bemused

And I never know exactly where I am

Unpredictable as weather, she's as flighty as a feather

Finally, I made out the words ...

She'd out pester any pest, drive a hornet from its nest

She could throw a whirling dervish out of whirl...

http://www.allthelyrics.com/lyrics/rodgers_and_hammerstein/how_do_you_solve_a_problem_like_maria-lyrics-213832.html

"Oh! Do shut up!" I heard myself saying. Arturo just grinned.

He stopped 'singing' and fixing me with a beady eye, he said: "Our Maria Miller, Member of Parliament for Basingstoke, Secretary of State for Culture, Media and Sport and Minister for Women and Equalities, is not a happy bunny at the moment. Or hadn't you noticed?"

Of course, I had noticed - how could I NOT have noticed! It's Maria here, Maria there - Maria everywhere but not where she should be! For those of you who haven't been following the sorry story - let me fill you in.

The Observer reported that:

... the commissioner for parliamentary standards, Kathryn Hudson, recommended that Miller repay £45,000 in expenses for a house she shared with her parents and had wrongly claimed was her "second home". The rules say second homes must be used exclusively for parliamentary purposes that would not include using them to accommodate parents. The cross-party House of Commons standards committee, which adjudicated on the report, overruled the watchdog and decided she only needed to hand back £5,800 in overclaimed mortgage interest. Miller was ordered to apologise to the Commons for failing to co-operate fully with the inquiries, which she did in a statement whose brevity shocked MPs.

http://www.theguardian.com/politics/2014/apr/05/maria-miller-support-ebbs-away

The article was written by the paper's political editor Toby Helm. He gave a thorough account of the plight in which Maria Miller now finds herself. He wrote:

The former chairman of the committee on standards in public life, Sir Alistair Graham, said he was shocked at Miller's behaviour. "The degree of lack of co-operation and the attempt to divert the commissioner from addressing the issues concerned both seem fairly exceptional.

"I think particularly for a senior cabinet minister, who you expect to show a leadership role in co-operating with whatever expenses system is around, it is pretty shocking.

"I think the public will be very shocked that the committee did overturn one of the key recommendations about how much should be repaid back, when there is a real possibility that the minister made a capital gain with the help of public funds."

Tut! Tut! I thought that this Coalition Government claimed to make their future expenses claims whiter than white! In 2009, Andrew Sparrow, writing in The Guardian commented on 'Boy David' Cameron's statements about MP's' expenses:

Cameron also said he had told members of his shadow cabinet to publish more information about what they are claiming.

From 12 May, they have been publishing their expenses claims online.

But, from today, they also will have to publish "significant correspondence" relating to their expenses and their receipts on the internet.

"This is a large but necessary task," Cameron said. "All MPs must explain their past errors and account for them.

"But I am determined that, from this point on, myself and my shadow cabinet will do all we can to be as transparent as possible. Only then can trust between the public and their politicians begin to be rebuilt."

http://www.theguardian.com/politics/2009/jun/19/gordon-brown-david-cameron-expenses-transparency

Well - blow me down! So - transparency was the order of the day back in 2009 - what about in 2014? Just read what Maria Miller was quoted as saying in the Telegraph by Peter Dominiczak, Claire Newell, Holly Watt and Christopher Hope

When asked to explain details about her mortgage, Mrs Miller wrote an email which said: “I am not sure I am able to assist further. The matter was over six years ago and I’m reluctant to speculate without attempting to locate any documents on the subject if I still have any”.

http://www.telegraph.co.uk/news/newstopics/mps-expenses/conservative-mps-expenses/10743455/Maria-Miller-expenses-report-MPs-conspired-to-save-Culture-Secretary.html

Some transparency! Some cheek! However, all may not be lost for our little Maria. She may have found her very own Georg Ludwig von Trapp. Who might this be, do I hear you ask? Well none other than that delightful Clown of the House of Commons who enjoys his own beer and bingo - yes - you've guessed it:

Apple Schnapps Shaps

who was quoted in The Mail

Conservative Party chairman Grant Shapps said it was time to ‘draw a line’ under the controversy.

http://www.dailymail.co.uk/news/article-2597821/British-public-want-David-Cameron-axe-shamed-Maria-Miller-Culture-Secretary-expenses-dodge.html

As I pondered all this malarkey, I heard Arturo caterwauling - for the umpteenth time:

She'd out pester any pest, drive a hornet from its nest

She could throw a whirling dervish out of whirl...

A right old can of worms, if you ask me. And Arturo says we ain't seen the end of it yet! It's hungry work all this listening to caterwauling - I'm off to the Italian pizza parlour round the corner. Maybe - if Arturo sings loud enough, the opera loving chef will give us some scampi just to get rid of us!! Some hope!.

Gentlemen prefer Bonds @ No. 10

"What's with this 'gentleman's agreement' that they were talking about during PMQs?" Arturo asked.

"Whatever it was - it doesn't sound as though they kept to it." I replied.

"Go and dig up some dirt on it, mi old pal." Arturo said. And that's what I am about to do!

UK Reuters reported:

Prime Minister David Cameron came under pressure in parliament on Wednesday over his government's sale of Royal Mail with the Labour party accusing him of selling the firm off too cheaply to a handful of rich London investors.

The government's handling of the sale of a 60 percent stake in the 500-year-old state postal operator last October at 330 pence a share has come under renewed scrutiny after the country's spending watchdog concluded the government had set the price too low.

Labour has seized upon the flotation, and the quick profits made by big banks and City investors, to reinforce one of its central arguments ahead of next year's general election - that Cameron's government is out of touch with ordinary voters.

"He sold at 330p and this morning the price was 563 pence," Ed Miliband, Labour's leader, told parliament. "It is basic maths. Not so much the Wolf of Wall Street more the dunce of Downing Street," he quipped, referring to the street where Cameron has his office.

"A third of the shares were sold to just 16 city investors and there was a gentleman's agreement that those city investors wouldn't sell the shares," Miliband said.

I say! I say! I say! Miliband certainly came up with a good one-liner: Not so much the Wolf of Wall Street more the dunce of Downing Street. Arturo will like that turn of phrase. I researched a bit further into the Reuter's article.

"What happened? Within weeks half of those shares had been sold and they had made a killing worth hundreds of millions of pounds. In other words 'mates rates' for his friends in the City. This is a sale nobody wanted and nobody voted for - a national asset sold at a knockdown price to make a fortune for the few."

http://uk.reuters.com/article/2014/04/02/uk-britain-royalmail-cameron-idUKBREA310WB20140402

Some agreement! Some gentlemen! I decided to look up the definition of the phrase 'gentleman's agreement'. Here is what I found:

gentleman's agreement

An arrangement or understanding which is based upon the trust of both or all parties, rather than being legally binding:

http://www.oxforddictionaries.com/definition/english/gentleman%27s-agreement

So this 'agreement' that they 'wouldn't sell the shares' was based on trust. Dodgy thing that! Who can you trust these days? Particularly anyone involved in finance! I ask you - gentlemen! So - who were these 'gentlemen'? Maybe the Business Secretary, Give-him-a-big-hand, 'InVinceable' Cable himself would know the answer. After all he was organising the 'deal'.

Simon Jenkins in The Guardian wrote:

There was only one loser in this Royal Mail privatisation: the taxpayer: The Treasury was badly advised on the sale, relying on firms accused of unethical practices and corporate greed

Jenkins gave details about the negotiations.

A chief executive was hired, and by May last year the business engineered a 60% surge in profit. It was clearly being gold-plated. So why was it sold as tin? Cable chose Lazards, Goldman Sachs and five other banks to advise on the sale. As anyone who has witnessed these events will attest, they are carnivals of cash.

Privatisation fees alone totalled £12.7m, according to the National Audit Office report. Since the banks advising on price are also placing shares with clients, Chinese walls are put in place to separate "sellers from buyers" within offices. But is this really possible in the City of London, where Chinese walls are most likely made of rice paper? Don't commissions and fees have money dripping from meeting rooms and wine bars, as bankers and lawyers sniff out the nearest and deepest trough?

Yet more neat phrases: 'carnivals of cash' and 'in the City of London, where Chinese walls are most likely made of rice paper'. It certainly doesn't sound a place to find 'gentlemen!

Jenkins continued:

Within weeks of the sale, Goldman Sachs's own analysts were predicting a price of 610p, almost twice what the "advisers" had been advising. The government had been shockingly ill-advised. As the price went up past 600p, Cable kept dismissing it as "irrational exuberance, froth, speculation". He indicated everyone should wait until the price came down. It is now 562p. Worse, he had allocated bundles of shares to 16 City institutions on a "gentleman's agreement" that they would hold them as "a core of high-quality investors who would be there in good times and bad". Within weeks, over half this stake had been sold, and to precisely "the hedge funds and other speculators" that Cable had pledged to keep out. Just four of the 16 are still big shareholders.

Cable was massively naive. On Tuesday he protested that he was merely showing caution against "risk of failure". I can hear the City laughing. As the head of the NAO, Amyas Morse, points out, had Cable been prudent when warned of an undervalued sale, he would have held back 49% of shares for the Treasury, as opposed to just 30%. Indeed, he might have held out for postponement and upped the price. As it is, he valued Royal Mail at £3.3bn – it should have been nearer £5.5bn.

So - InVinceable Cable ain't quite as invincible as we all hoped!! What more did Jenkins have to say?

Cable was spending millions on advice from firms such as Goldmans and Barclays that have been widely accused of unethical practices and corporate greed. This was not cautious but reckless. As the NAO's Morse said on Tuesday: "The price was borne by the taxpayer."

http://www.theguardian.com/commentisfree/2014/apr/01/royal-mail-privatisation-taxpayer-loser

A dog's breakfast you might say! I'm sure that's what Arturo would say! And we all know how he feels about dogs and 'gentlemen'! Certainly, we'll be keeping our eyes open for more gold-plated Porsches and empty bottles of Veuve Clicquot Ponsardin floating around the place. Meanwhile our dear old Postie is stuck with his shares! He and his mates can't sell them for years - unlike the 'gentlemen'.

"C'est la vie!" Arturo said, when I showed him the various news items, I'd found. "So - it's 'Gentlemen prefer Bonds', is it, mi old pal? Never trust 'gentlemen' like this lot! After all..." Arturo paused for effect. "After all - what is politics but institutionalised lying?"

So it would seem! Never trust a gentleman! We're going to nip into the kitchen of the Athenaeum tonight - just to see what's cooking!

Bye