Re-shuffle cafuffel

[MooseBreath]

Plus whenever we invest in rail the price of tickets goes up.

What is the major cost of running an airline? Is it the cost of using airports and runways? I doubt it. Probably more like the cost of fuel and of producing and maintaining the fleet. Can't see how having more runways is going to have much of an impact on prices and the idea of the skies being literally full if planes is ridiculous.

Still, if the cost of building another runway is cheaper tickets then I am all for it.

[Captain...]

Sorry but this isn't one of your better posts.

Air travel is greener than rail per mile travelled and this isn't really so much about passenger travel anyway.

You're going to have to back up that last claim with a source, as I don't believe it.

Plus whenever we invest in rail the price of tickets goes up.

What is the major cost of running an airline? Is it the cost of using airports and runways? I doubt it. Probably more like the cost of fuel and of producing and maintaining the fleet. Can't see how having more runways is going to have much of an impact on prices and the idea of the skies being literally full if planes is ridiculous.

Still, if the cost of building another runway is cheaper tickets then I am all for it.

That is because the railways are run by idiots, the government pays, or at least heavily subsidises any infrastructure improvements.

I don't think I used the word literally, but I lived in West London for a while, and I lived about 5 minutes walk from the tube stop, in that time I counted at least 20 planes heading to and from Heathrow, it is ridiculous, fortunately I wasn't close enough to really hear them, but those that are must find it unbearable. The point is there are already a fvck load of planes in the sky.

Now if Heathrow were to build a new run-way, then it would need to get it up capacity ASAP, to justify the cost of building it, I don't know the exact ins and outs, but if they currently have 2 runways operating at capacity, and this is the world's busiest airport, then they would need to increase the number of flights by 50%, that is a huge amount, to do that they would need to cut the cost of airlines to operate these flights.

Now they have put on all these flights, the airlines need to fill them, so the easiest way to fill them is to slash the prices, as they have reduced costs they can do that. Now we have more people flying than before, not because they need to, but because they can.

We will also have people taking these flights and not using the other UK airports because they are cheaper, so it would negatively impact them, they would need to cut prices to keep competitive, or airlines will start cancelling flights from Stansted, Gatwick etc.

[MooseBreath]

Fair points. I would still build it. If you're waiting for an opportunity to progress with no drawbacks you'll be standing still forever.

[Nick]

Kerfuffle.

I wondered how long it would take.......

[DJ Barry Hammond]

Depends what you define by "want" and "need", we "need" it in the sense that we are in danger of losing out on vast amounts of trade to other european countries that have got their transport networks in order quicker than us. Its not really about cheap air travel for passengers as a low budget airline can set up out of any old airfield, its about freight. The so called environmental arguements are poor as under that logic we would ban all further development of the country which obviously is not going to happen.

Nobody has had the balls to take the political gamble of going ahead with a scheme so far and the price will be paid in the future.

If the argument was about Freight air traffic, I'm surprised a new runway at Heathrow would be so sought after? It's positioning and transport links are not that great so surely a custom built air freight centre with a specialised customs and excise centre on site and good air and road links would be more desirable?

Having stayed in a hotel near to Heathrow for the Olympics (thanks Thomas Cook, real close to the action!) I have to say its a god depressing place!

[DJ Barry Hammond]

The only thing that will get Cameron a second term is a substantial improvement in our economic position, which doesn't seem to be coming. Jeremy Hunt being promoted to health is an odd one, but certainly not a killer of election chances. I'd be amazed if most people could name even the previous five secretaries of state for health.

Good point, I can't think of the last five (Landsley obviously, Burnham was health minister when labour were in office wasn't he and I believe John Reid held the position once?)

However, the reason I think the appointment is an election killer for the Torries is that they've already betrayed a pre-election policy of not reforming the NHS from top down by looking to reform the NHS bottom up. That move has been sufficiently bungled, so to appoint someone to the head role who's already a bit of a tainted reputation amongst the news reading classes just gives the opposition too much shit to throw at the Torries on the topic of the NHS and of course some of that shit will stick.

Clearly the public do take notice of politicians if they don't like them, judging by the booing of Osbourne and May (who looked ****ing terrible in the last picture I saw her, she clearly needs to sleep and eat more) so I suspect more people that you think will be watching his early moves with interest. And let's face it, that picture of him doing jazz hands isn't a great start!

Kerfuffle.

I still prefer my way of spelling it, even if it is wrong!

[Guest Col city fan]

Good point, I can't think of the last five (Landsley obviously, Burnham was health minister when labour were in office wasn't he and I believe John Reid held the position once?)

However, the reason I think the appointment is an election killer for the Torries is that they've already betrayed a pre-election policy of not reforming the NHS from top down by looking to reform the NHS bottom up. That move has been sufficiently bungled, so to appoint someone to the head role who's already a bit of a tainted reputation amongst the news reading classes just gives the opposition too much shit to throw at the Torries on the topic of the NHS and of course some of that shit will stick.

Clearly the public do take notice of politicians if they don't like them, judging by the booing of Osbourne and May (who looked ****ing terrible in the last picture I saw her, she clearly needs to sleep and eat more) so I suspect more people that you think will be watching his early moves with interest. And let's face it, that picture of him doing jazz hands isn't a great start!

I still prefer my way of spelling it, even if it is wrong!

Do you think that people booed Osbourne because they don't like HIM... Do people generally know much about George Osbourne, the politician? What he stands for, what his economic policy is etc etc..

I think people booed 'The Tory Party'... Basically because of cuts in spending. And the debate over the third runway, to name but two salient issues. Then again, I don't profess to know enough about current politics to say this with any authority.

I also find it rather bizarre that an award was given to an athlete by the Chancellor of the Exchequer?

[ADK]

You're going to have to back up that last claim with a source, as I don't believe it.

Turn out i was wrong, train travel is very fuel efficient - i was probably thinking air travel compared to automobiles.

Either way air traffic isn't as bad as road traffic and planes are improving their efficiency so an integrated air + high speed rail network is clearly the way of the future.

I don't personally mind where they build the extra capacity so long as it gets done and not eternally postponed. My vote would be a new hub in the Birmingham locality served by HS2.

[Captain...]

Do you think that people booed Osbourne because they don't like HIM... Do people generally know much about George Osbourne, the politician? What he stands for, what his economic policy is etc etc..

I think people booed 'The Tory Party'... Basically because of cuts in spending. And the debate over the third runway, to name but two salient issues. Then again, I don't profess to know enough about current politics to say this with any authority.

I also find it rather bizarre that an award was given to an athlete by the Chancellor of the Exchequer?

Well they didn't boo Cameron, and he is head of the Tories, so I think it was directed at Osbourne because he is a cvnt and has taken the economy backwards.

[LJS]

Good point, I can't think of the last five (Landsley obviously, Burnham was health minister when labour were in office wasn't he and I believe John Reid held the position once?)

However, the reason I think the appointment is an election killer for the Torries is that they've already betrayed a pre-election policy of not reforming the NHS from top down by looking to reform the NHS bottom up. That move has been sufficiently bungled, so to appoint someone to the head role who's already a bit of a tainted reputation amongst the news reading classes just gives the opposition too much shit to throw at the Torries on the topic of the NHS and of course some of that shit will stick.

Clearly the public do take notice of politicians if they don't like them, judging by the booing of Osbourne and May (who looked ****ing terrible in the last picture I saw her, she clearly needs to sleep and eat more) so I suspect more people that you think will be watching his early moves with interest. And let's face it, that picture of him doing jazz hands isn't a great start!

I still prefer my way of spelling it, even if it is wrong!

I'm not sure people are bothered about the reforms not being in the Conservative Party election manifesto. Who reads them? We increasingly vote based on who looks or sounds the best, sadly. Although they did promise not to enact top-down NHS reform, Lansley had been telling people for years what he wanted to do.The Health and Social Care Act sn't a million miles away from his original vision, even if it does include some tinkering around the edges by the Lib Dems. That Cameron kept him on as shadow health secretary for so long would suggest that he approved of Lansley's ideas on some level.

When you look closely at the reforms they aren't all that revolutionary. I interpret them as a continuation of the direction in which health policy has been travelling since the late 1980s. The broad themes; giving GPs more financial control, increased provider competition, more patient input etc, have been around for years. Some of the opposition has come about because it's easy to bash the tories because, well they're the tories, and some of it because things are shitty economically and everything is seen through the prism of "cuts!" and "privatisation!". But most of it has come about because Lansley was terrible at communicating his vision. He could have made life easier for himself by framing the reforms as the latest stage in a slow evolution of health policy, but he refused to credit (depending how you see it) Labour for anything and was keen that the whole thing had his name written all over it. This arrogance made it seem as though he was ripping the whole thing up and starting from scratch, which was always going to be unpopular.

I'm opposed to many things that this government are up to (although I do not believe that Labour would be doing much differently) but as somebody who works in the health service and has to read widely on health policy as part of my job, I think most of what the reforms are attempting to do will result in better services for patients, which goes beyond party politics. Unfortunately the NHS is a very emotive political football, and the Conservative Party are historically seen as the party wanting to privatise it (even though Blair's Labour did more than any other government, historically, in that regard), which disadvantages them when they are in a position to make changes and rather clouds the issues at hand.

[Guest Col city fan]

Well they didn't boo Cameron, and he is head of the Tories, so I think it was directed at Osbourne because he is a cvnt and has taken the economy backwards.

I thought Cameron was booed too?

Maybe I'm wrong?

I can't think in my living memory of any Chancellor who was popular to be honest.

Maybe Gordon Brown? Perhaps because he spent money the country didn't have? And continued to do so?

I'm sounding like Ben Elton now... Oooh a bit political...

[DJ Barry Hammond]

Do you think that people booed Osbourne because they don't like HIM... Do people generally know much about George Osbourne, the politician? What he stands for, what his economic policy is etc etc..

I think people booed 'The Tory Party'... Basically because of cuts in spending. And the debate over the third runway, to name but two salient issues. Then again, I don't profess to know enough about current politics to say this with any authority.

I also find it rather bizarre that an award was given to an athlete by the Chancellor of the Exchequer?

Cameron was presenting medals at the same time as Osborne wasn't he, yet I don't believe he was boooed was he? Someone who wants to cut everything is hardly going to be popular, but he certainly isn't going to be popular if what he's trying to achieve with these cuts ain't happening either?

[Guest Col city fan]

Cameron was presenting medals at the same time as Osborne wasn't he, yet I don't believe he was boooed was he? Someone who wants to cut everything is hardly going to be popular, but he certainly isn't going to be popular if what he's trying to achieve with these cuts ain't happening either?

I think that's my point DJ... You could have had David Beckham standing there and AS CHANCELLOR I think he would have been booed currently. A Chancellor making cuts is never going to be popular is he.

But as I said, I don't really know enough about politics to say this with much authority.

[LJS]

I thought Cameron was booed too?

Maybe I'm wrong?

I can't think in my living memory of any Chancellor who was popular to be honest.

Maybe Gordon Brown? Perhaps because he spent money the country didn't have? And continued to do so?

I'm sounding like Ben Elton now... Oooh a bit political...

Actually, as Chancellor Brown wasn't too profligate. He didn't spend much more as a percentage of GDP than he received in tax as a percentage of GDP. Indeed under Blair's premiership the two figures were as closely aligned as at any time since Callaghan was PM, although there was still a small discrepancy in the wrong direction. It was when Brown got the top job that he went mad (or perhaps, more to the point, was allowed to). His spending was just above 44% of GPD, whilst tax income was about 37.5% as an average over the course of his time at the helm. I've no issue with high public spending personally, but he didn't have the balls to raise the taxes to pay for it. You can't have high spending and (relatively) low tax income, which is something we are learning now.

[Guest Col city fan]

Actually, as Chancellor Brown wasn't too profligate. He didn't spend much more as a percentage of GDP than he received in tax as a percentage of GDP. Indeed under Blair's premiership the two figures were as closely aligned as at any time since Callaghan was PM, although there was still a small discrepancy in the wrong direction. It was when Brown got the top job that he went mad (or perhaps, more to the point, was allowed to). His spending was just above 44% of GPD, whilst tax income was about 37.5% as an average over the course of his time at the helm. I've no issue with high public spending personally, but he didn't have the balls to raise the taxes to pay for it. You can't have high spending and (relatively) low tax income, which is something we are learning now.

I bow to your greater knowledge on this LJS..

[DJ Barry Hammond]

I'm not sure people are bothered about the reforms not being in the Conservative Party election manifesto. Who reads them? We increasingly vote based on who looks or sounds the best, sadly. Although they did promise not to enact top-down NHS reform, Lansley had been telling people for years what he wanted to do.The Health and Social Care Act sn't a million miles away from his original vision, even if it does include some tinkering around the edges by the Lib Dems. That Cameron kept him on as shadow health secretary for so long would suggest that he approved of Lansley's ideas on some level.

When you look closely at the reforms they aren't all that revolutionary. I interpret them as a continuation of the direction in which health policy has been travelling since the late 1980s. The broad themes; giving GPs more financial control, increased provider competition, more patient input etc, have been around for years. Some of the opposition has come about because it's easy to bash the tories because, well they're the tories, and some of it because things are shitty economically and everything is seen through the prism of "cuts!" and "privatisation!". But most of it has come about because Lansley was terrible at communicating his vision. He could have made life easier for himself by framing the reforms as the latest stage in a slow evolution of health policy, but he refused to credit (depending how you see it) Labour for anything and was keen that the whole thing had his name written all over it. This arrogance made it seem as though he was ripping the whole thing up and starting from scratch, which was always going to be unpopular.

I'm opposed to many things that this government are up to (although I do not believe that Labour would be doing much differently) but as somebody who works in the health service and has to read widely on health policy as part of my job, I think most of what the reforms are attempting to do will result in better services for patients, which goes beyond party politics. Unfortunately the NHS is a very emotive political football, and the Conservative Party are historically seen as the party wanting to privatise it (even though Blair's Labour did more than any other government, historically, in that regard), which disadvantages them when they are in a position to make changes and rather clouds the issues at hand.

Maybe people don't read manifesto's, but it's a topic that will be brought up by labour come the next election (a lot no doubt) and it will be on the place so it just provides another stick for them to throw at the Torries.

If you take a very simplistic view, you could say the poor / lower class will vote labour if they can be bothered, the rich / upper class majority would be pro Tory and then you have the floating middle that are swayed by the press and arguements at the time. The Cons current policies are resulting in more people slipping into that lower tier and with quite a lot of policies hitting the middle this is surely going to push more of that key sector towards labour. Cameron could have at least tried playing the women card with the reshuffle as this is a very lucrative vote winning sector, yet he hasn't even played a strong hand here.

I know there are plenty of holes to pick with the above theory, but I reckon there's some logic here. Then turning to the NHS, I don't really know what the answer is really, it's a huge emotive issue with many problems and solutions, none of them perfect. But clearly you want to see the best man for the job in charge, a good truthful communicator with a dynamic vision. Jeremy Hunt is hardly a good communicator and it's not his vision.

I do wonder though why the state can't run it's operations in the style of a business to make them more sucessful. The railways is a classic example where if the private sector are able to come in and make vasts profit out of them, why couldn't the state just higher an independent MD to run them for the goverment and do the same - thus boosting spending in other areas?

Could the NHS work on a similar vein, with hospitals receiving set tariffs from the goverment for patient treatment, based on the price charged by the private sector, with bonuse included for hitting waiting time targets?

[LJS]

Could the NHS work on a similar vein, with hospitals receiving set tariffs from the goverment for patient treatment, based on the price charged by the private sector, with bonuse included for hitting waiting time targets?

That's exactly how it does work. The NHS is given a budget by central government, which is divided into regions and then sub-regions using a convoluted formula based on local health needs. Each time you are treated, say in hospital, the local commissioning organisation pays the provider for the treatment using a set tariff. There are bonuses attached to tariff, by the name of CQUINs.

You are entitled to choose where you are treated, and who by, but in my experience GPs are pretty poor at informing patients of this. You are perfectly within your rights, for instance, to choose to be treated for whatever your health problem is by a private provider, who will receive the same tariff as a state hospital for delivering your treatment.

[Guest Col city fan]

Maybe people don't read manifesto's, but it's a topic that will be brought up by labour come the next election (a lot no doubt) and it will be on the place so it just provides another stick for them to throw at the Torries.

If you take a very simplistic view, you could say the poor / lower class will vote labour if they can be bothered, the rich / upper class majority would be pro Tory and then you have the floating middle that are swayed by the press and arguements at the time. The Cons current policies are resulting in more people slipping into that lower tier and with quite a lot of policies hitting the middle this is surely going to push more of that key sector towards labour. Cameron could have at least tried playing the women card with the reshuffle as this is a very lucrative vote winning sector, yet he hasn't even played a strong hand here.

I know there are plenty of holes to pick with the above theory, but I reckon there's some logic here. Then turning to the NHS, I don't really know what the answer is really, it's a huge emotive issue with many problems and solutions, none of them perfect. But clearly you want to see the best man for the job in charge, a good truthful communicator with a dynamic vision. Jeremy Hunt is hardly a good communicator and it's not his vision.

I do wonder though why the state can't run it's operations in the style of a business to make them more sucessful. The railways is a classic example where if the private sector are able to come in and make vasts profit out of them, why couldn't the state just higher an independent MD to run them for the goverment and do the same - thus boosting spending in other areas?

Could the NHS work on a similar vein, with hospitals receiving set tariffs from the goverment for patient treatment, based on the price charged by the private sector, with bonuse included for hitting waiting time targets?

Isn't the evidence that the bulk of the population actually know sweet FA about politics? Many many people wouldn't even know what a manifesto is, let alone know what was in one.

Many people always used to vote in the same way as their parents. I don't know whether this is still the case?

I always used to laugh at my Grandma.. When I asked her why she voted for Tony Blair in 1997 I think? Her answer: 'because she liked his smile'...

Enough said..

[Guest Col city fan]

That's exactly how it does work. The NHS is given a budget by central government, which is divided into regions and then sub-regions using a convoluted formula based on local health needs. Each time you are treated, say in hospital, the local commissioning organisation pays the provider for the treatment using a set tariff. There are bonuses attached to tariff, by the name of CQUINs.

You are entitled to choose where you are treated, and who by, but in my experience GPs are pretty poor at informing patients of this. You are perfectly within your rights, for instance, to choose to be treated for whatever your health problem is by a private provider, who will receive the same tariff as a state hospital for delivering your treatment.

Has this ever really worked?

Do the bulk of people visiting their GP's actually make a choice regarding where they want to have their treatment? I think it's usually a case simply of people go to the hospital that can provide the treatment the quickest?

If that be BUPA or the Nuffield then so be it...

How many people know they can change their consultant if they want to? Or change their 'named nurse' if they choose to?

These things were introduced in the Patients Charter (1990) I think.. But how many people either know about them or actually are really bothered anyway?

[Guest MattP]

Isn't the evidence that the bulk of the population actually know sweet FA about politics? Many many people wouldn't even know what a manifesto is, let alone know what was in one.

Many people always used to vote in the same way as their parents. I don't know whether this is still the case?

I always used to laugh at my Grandma.. When I asked her why she voted for Tony Blair in 1997 I think? Her answer: 'because she liked his smile'...

Enough said..

I've known people vote for the Liberals as they liked the logo.

That's the problem with democracy, two idiots can outvote a genius.

[LJS]

Has this ever really worked?

Do the bulk of people visiting their GP's actually make a choice regarding where they want to have their treatment? I think it's usually a case simply of people go to the hospital that can provide the treatment the quickest?

If that be BUPA or the Nuffield then so be it...

How many people know they can change their consultant if they want to? Or change their 'named nurse' if they choose to?

These things were introduced in the Patients Charter (1990) I think.. But how many people either know about them or actually are really bothered anyway?

I didn't know until I started working for the NHS. I have never once been informed of this by a GP, whose job it should be, as the 'gate keeper' to hospital services, to tell me. A GP (several have told me this) will send patients to the most geographically convenient hospital, which in fairness to the GP isn't a decision without merit. Personally, I believe that patient choice is a bit of a myth. In theory my grandma, should she fall ill tomorrow, can choose to go to the best hospital in the UK for her particular treatment, whether that's in Newcastle or in Cornwall. But in reality, she isn't going to do that because her husband can't visit her in those places. Is a frightened elderly patient going to choose to spend a significant amount of time away from friends and family, even if it means receiving the best treatment there is? Of course not.

That isn't to say that patient choice shouldn't exist, of course. I think it's a good thing, even if the choice isn't exercised all that regularly.

[Guest Col city fan]

I didn't know until I started working for the NHS. I have never once been informed of this by a GP, whose job it should be, as the 'gate keeper' to hospital services, to tell me. A GP (several have told me this) will send patients to the most geographically convenient hospital, which in fairness to the GP isn't a decision without merit. Personally, I believe that patient choice is a bit of a myth. In theory my grandma, should she fall ill tomorrow, can choose to go to the best hospital in the UK for her particular treatment, whether that's in Newcastle or in Cornwall. But in reality, she isn't going to do that because her husband can't visit her in those places. Is a frightened elderly patient going to choose to spend a significant amount of time away from friends and family, even if it means receiving the best treatment there is? Of course not.

That isn't to say that patient choice shouldn't exist of course. I think it's a good thing, even if the choice isn't exercised all that regularly.

There is simply no point in having choice unless it is informed. It's yet another example of a service saying it is offering something, without then monitoring whether people are aware of such choice and are enabled to exercise it.

And who is going to penalise GP's for not informing people that such choices can be made?

The Health Commission, the CQC?

Maybe.. I don't really know.

[LJS]

There is simply no point in having choice unless it is informed. It's yet another example of a service saying it is offering something, without then monitoring whether people are aware of such choice and are enabled to exercise it.

And who is going to penalise GP's for not informing people that such choices can be made?

The Health Commission, the CQC?

Maybe.. I don't really know.

The difficulty with GPs is that they aren't NHS employees. They contract their services to the NHS but they are private enterprises. So long as they uphold NHS clinical standards there isn't very much the NHS (or its regulators) can do. I suppose removing their right to work for the NHS would be an option, but we don't have enough GPs as it is and they make more than enough money through the private ventures not to have to worry about that anyway.

I do agree with you that patients should be informed of the choices available to them. Secondary care providers are getting quite good at it, and it does make a difference. But there does also have to be a certain amount of personal responsibility. People should be making themselves aware of what they're entitled to. It is beginning to happen, particularly among the younger age groups who are more at ease with the internet and keener to understand what they're entitled to.

That's all part of a big cultural change as regards healthcare. It used to be that doctors were seen as gods, unquestionable by patients. Healthcare was something doctors did to people rather than with them. That is no longer the case to anything like the same extent, largely because those who had that attitude are dying out.

[davieG]

I don't really want choice I want my local services to match the best, if there was more emphasis on quality of service rather than choice we wouldn't need to choose.

Who really wants to go travelling to see consultants and have treatment if they are ill, I can't imagine anyone wanting that as a first choice they'll want quality local services. It's the same with schools.

We then complain there's too much traffic and pollution so in the scheme of things it is not economical or environmentally good to have all these people on journeys, we'd be better off putting "that spend" ( I know it's an abstract cost as far as the Gov. is concerned but you get my point) into the NHS pot.

[Reynard Bleu]

I always used to laugh at my Grandma.. When I asked her why she voted for Tony Blair in 1997 I think? Her answer: 'because she liked his smile'...

Enough said..

Knowing what we know now about him pehaps this was reasonable rationale.