Sarumano

Ward Sisters / Charge nurses should have authority to deal with these guys, as well as the authority to protest against the caterers shoddy/cold food to the hospital manager (Who MUST sort the complaint).

Otherwise we get the same as my sister who lost serious weight in hospital through lack of appetite after an abdominal op. WE tempted her to eat again by smuggling in family meals.

On the subject of treatments not essential to health and vitality, I agree, but... for example
Getting your boobs done on the NHS should not be possible, though there is a case to be made for disfigurement after mastectomy; the problem with such cases is where do you draw lines? Can the woman with AAA breasts have implants for her sanity's sake? What of the woman with one D one AA?

And No I do not have a breast fixation :roll:

Intbel

__________________
We are all free to choose - every step of the way - no exceptions.

Lawrie Boxall

I thought UKIP wanted to get people elected - yes?
But if that is not a priority a policy of scrapping the NHS is another great way of achieving it - better even than having no policy at all.

Labour's original plans for Foundation Hospitals were a nod in the direction outlined by Paul but designed not to frighten the public and the NHS staff too much with the prospect of major and rapid reform. The plans failed because Labour party dogma would not allow it.

This the challenge for any party - how to introduce the ideas and concept of change along the lines outlined by Paul in such a way that the voters retain confidence that the service will continue to meet their needs and the NHS staff unions will be outflanked.

UKIP should promise to continue to meet the Labour party's existing spending plans while an independent study is commissioned to examine the alternatives - a continuation of the massive growth in public spending advocated by Labour or a change to locally managed and independent trusts and all degrees in between the two extremes. UKIP in government would then put the alternative recommendations in front of the voters allowing a national debate to ensue and a referendum to decide. There would have to be comitment to a transition period to allow any major changes to be phased in probably over several years.

I cannot see any other way of overcoming the vested interests.

Paul Birch

Er... I presume you mean that a policy of scrapping the NHS would be the way not to get elected? I'd tend to agree - at least that it would probably be a vote loser for established parties. In the case of UKIP, I'm not so sure. It would certainly be risky - but we can't avoid risk entirely if we want our policies to be sufficiently distinctive to get people to change their voting habits. I think the idea probably could be sold to them. Though we'd have to be very careful how we explained it. Obviously we wouldn't call it "scrapping the NHS" but something like "a badly needed major reform of the health service".

True.

I understand what you're getting at; unfortunately I don't think it would work. Allegedly independent studies (they can't really be independent) are a common way of giving the appearance of being open to change, while avoiding having to do anything about it. If one genuinely wants change, delay is fatal; it just gives the vested interests time to regroup and mount a defence.

I don't like to admit it, but the most effective way to introduce economically beneficial radical changes that are likely initially to be electorally unpopular is probably to say little or nothing about them until you're in government (or even lie about what you intend!) then immediately bring them in. The faster the better. This will make your government very unpopular for several years, but that doesn't matter; by the time of the next election, five years on, the electorate will have forgotten its early annoyance, and the positive benefits of the policy will have become apparent. This is roughly how Thatcherism was implemented; Thatcher's mistake was that she wasn't radical enough. But you mustn't delay, or the next election will come too soon for your policies to have proved themselves.

Lawrie Boxall

I understand your arguments Paul - the well known template for the first 100 days and all that - but you could not take that approach with the NHS, certainly not at this moment in time, without splitting the country down the middle. Fine if that's what you want. But why pick a fight if there is another way. My ideas are based on involving the voters more fully in the decision making process - it's an entirely new form of government.

Intbel

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We are all free to choose - every step of the way - no exceptions.

Paul Birch

I don't entirely disagree with the referendum approach, but I'm afraid I don't see why you would expect the public to make a sound decision in a referendum if they cannot be persuaded of the same in an election campaign. The opposite seems more likely, because in a "national debate ... and ... referendum" the vested interests can afford to mount a concentrated defence with a barrage of propaganda. They will almost certainly be able to manipulate and distort the findings of any "independent" commission charged with producing recommendations. They will certainly do all they can to scare the public and portray any radical changes as dangerous and unnecessary.

Intbel

__________________
We are all free to choose - every step of the way - no exceptions.

Lawrie Boxall

The idea is quite simple - to give them what they want not what you or I think they should have. A national debate where all the vested interests are allowed to have their say is exactly what is needed. Politicians are ultimately just another vested interest pushing their own dogma and they must be prepared to justify their positions and have their ideas thoroughly examined. That does not happen in a general election. My proposal would be the end of politics as we have known it - and that can only be a good thing. This way people learn and a process begins where they become responsible for the way they are governed. It puts the power back in the people's hands wher it belongs.

The NHS would make an interesting test case. I would like to see and hear how the trade unions would justify strike action and the staff complain about being demoralised if people chose the route of a radical restructuring along the lines you propose. And I would like to hear the Tory pips squeak if they chose the alternative - say 5p on income tax.

The fly in the ointment would be a vote for the status quo which would put us back where we started with the politicians in charge.

Paul Birch

My point was that people do not simply choose "what they want" in a referendum (or an election). They choose according to the way they've been manipulated. The original referendum on the Common Market is a case in point. I see no reason to believe they will be any more rational or knowledgeable in this sort of referenda than in elections. They'll just get hit with even more confuscatory and downright dishonest propaganda, with the truth a feeble voice that gets ignored, especially when it has inconvenient or unpleasant things to say. That's how politics - and human nature - works.

I also challenge the view that "the people" should be given "what they want". If the majority want things that violate the rights and liberties of individuals, they shouldn't get them. That's the big flaw with all democracy; it comes down to two people ganging up on a third. Power does not belong in "the people's hands". It doesn't really belong in anyone's hands. What we need to ensure is not that power gets INTO phpbb_the "right" hands, but that it is used only to enforce justice and maintain liberty. That's an ideal, and sometimes we may get closer through referenda than by leaving all the decisions to politicians, but there's nothing magical about them, no intrinsic superiority either moral or practical.

I bet they would, all the same. But my argument was that it wouldn't come to that; in such a referendum the NHS vested interests would almost certainly be able to win; not through honest debate but through massive scare-mongering, personal abuse, control of the media and endlessly repeated lies.

Quite so.