British Politics: Coalitions, Cuts and AV

[MikeH]

I've voted Lib Dem and Labour historically...

Er. I think he's doing a better job than he's being credit for. I think the Tories would have ass-raped us even harder without the Lib Dems involved.

[MikeH]

But I'm really disappointed about a few key things. Tuition fees, the balance of cuts falling so heavily on the poorest.

[MikeH]

The backdoor privatisation of the NHS.

[Hauldren Collider]

Yeah, kind of true. Basically like Vice President.

That depends on the vice president though. Dick Cheney was powerful because Bush gave him that much authority. Joe Biden does more than you think because he acts as a laison to the Senate. But if the President didn't particularly care for his VP then the VP would be almost totally powerless. So what I'm wondering is how much power Cameron actually allows Clegg to have.

[MikeH]

How much influence he really has is the subject of a lot of debate internally in the UK!

[Krill]

How much influence he really has is the subject of a lot of debate internally in the UK!

Pretty much true, and we won't ever know exactly what the Tories would have done without the Lib Dems holding them back. I agree with Mike that we would likely have had it even worse if a coalition hadn't existed. As Clegg said, they didn't win the election.

[C0ckney]

I've voted Lib Dem and Labour historically...

Er. I think he's doing a better job than he's being credit for. I think the Tories would have ass-raped us even harder without the Lib Dems involved.

ah, i must of confused you with mobius (sorry mobius ).

i like the idea of more local control of the NHS and reducing the number of non-medical staff, but i'm not very familiar with the details of the government's plan.

[Cort Haus]

People seem to think that hospitals can run without an infrastructure. It's a nice sound-bite to talk about reducing non-medical staff but in the same way as an army needs a lot of people supporting the front-line troops, so does a hospital.

Hospitals have CEO's whose job it is to minimise costs. They don't employ non-medical staff for the fun of it. This is not to say that there isn't dead wood in the NHS, as there is, but if they wanted to get rid of waste they might consider ways of being able to get rid of crap people more easily.

I can give a direct example of gratuitous axe-waving. In a hospital near me a 'new broom' has come in at the head of an IT section who thought he could re-structure and cut jobs. He didn't know what he was doing, made some good people redundant and pissed off a lot of others, who are now all leaving, and many clinical staff who are dependant on good support, and appreciate it, are now worried about how its all going downhill.

[MikeH]

Yeah. I want doctors to provide medical care, not be managers and do administration.

And allowing hospitals to do as much private work as they want (and consequently as little NHS work) is inevitably going to lead to a two tier health system and mean poorer people get worse care.

We all know how everyone getting good care benefits us all, rich or poor.

[OneFootInTheGrave]

I do not know enough about the NHS changes proposed, so I need to read more, but from my experience the "philosophy" of care should be changing in UK and not the system itself.

UK comparing to central Europe is very reactive, ie they ignore you as long as they can and once you have a problem "big enough" they take you in but that takes an order of magnitude more effort to sort out than teh preventive care which is regularly ignored.

What is happening however is more "market oriented" or an attempt to create such a service with focus on rewarding rationing of the service + localization of it... rationing is a terrible idea, but as I said I do not know enough about this bit, to be able to comment... I just hope this is more of a media soundbite than the reality on the ground... while localization is I think a fact, and a bad idea, it will not make service better overall, but just be another segmentation in the society between rich and poor areas, leaving the majority with even worse service than they currently have.

In any case I need to learn more about it to be able to really comment...

[MikeH]

Sounds like you already understand it pretty well.

People like local services, localisation is always popular as a concept for the NHS, being able to get any treatment down the road from where you live. But from efficiency and effective care perspective it's rubbish. You are better off having a few national centres of excellence, where people with specialist conditions can go and get really excellent care from teams that deal with their condition all the time, and who can afford all the latest equipment etc. than you are having every hospital being generalist and average at everything.

Some things, like maternity, A&E, you really do need to have everywhere.

Other rarer specialisms, people can potentially travel for, but they don't want to.

[OzzyKP]

I don't understand the opposition to the Alternative Vote. In my opinion it is the best possible option. Better than both first past the post AND proportional voting. You guys should consider yourselves lucky you get to vote on such an option. Don't for a moment that voting for AV will make whatever your favored voting system harder to happen. It'll just make it more likely that nothing will ever change.

So as long as folks are making numbered lists:

1. It'll reduce tactical voting - There are plenty of voters who would love to vote Green or LibDem or whoever but feel they are "throwing their vote away" so make a tactical decision to pick the "least bad' option of the two major parties. These people aren't being fairly represented.
2. It keeps the connection between MP and their district. They aren't picked out of a hat by party leadership based on a national vote total, they actually represent their community, which is how representative democracy is supposed to work.
3. Right now plenty of MPs get elected with less than 50% of the vote (most of them perhaps). That doesn't represent their communities. AV ensures that even if their MP isn't everyone's first choice, he was 2nd or 3rd choice on enough people's ballots to enjoy majority support. This makes them far better representative of their voters.
4. It helps minor parties, but in a more natural way than PR.
5. PR would probably hurt regional parties like SNP, Plaid Cymru, etc.
6. While not AV, equalizing the districts sounds like a good thing too.

I don't see what's not to like about this. You guys should definitely vote for this.

[JackRudd]

3 & 4 seem rather meaningless to me. as in, how can voting for a candidate ever damage their chances under any system

OK, here we go, two similar but slightly different AV elections:

a) 33 Livingstone > Paddick > Johnson
16 Paddick > Livingstone > Johnson
16 Paddick > Johnson > Livingstone
35 Johnson > Paddick > Livingstone

b) 31 Livingstone > Paddick > Johnson
16 Paddick > Livingstone > Johnson
16 Paddick > Johnson > Livingstone
35 Johnson > Paddick > Livingstone
2 Johnson > Livingstone > Paddick

The difference here is that two voters have moved Johnson up from last to first on their ballots, keeping all the other candidates in the same order. Who wins election (a), and who wins election (b)?

[C0ckney]

it seems to me that when the NHS budget has increased by more than 3x since 1997, it's tough to believe that there aren't some economies to be made. i remember reading that the number of non-medical has increased at a much faster rate than the number of medical staff, by like 4x or something. i'll try to find the figures. obviously, you have to take care what you cut.

mike, i don't think that more local control necessarily means that you do everything everywhere. also i suppose it's a balance between having a top class facility and not making people travel an unreasonable distance to use it.

[MikeH]

Yes, sorry if that wasn't clear.

I totally agree that there's a balance. The news and political coverage hasn't necessarily made the strong arguments for national centres of excellence though.

The NHS service has also dramatically increased since 1997. Modern treatments, equipment and drugs are much more expensive than older treatments. There might be administrative savings to be made, but:

1. The Tories promised to ring fence the NHS budget so theoretically they aren't cutting it. ( Yeah, right any one who believed they wouldn't cut the NHS was an idiot)
2. Making medical staff into administrators doesn't seem like the best solution to having too many administrators. Means doctors spending less time with patients, and I guess a lot of them aren't great administrators.