Who do you want to form the next Government?

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  • il_principe
    il_principe Posts: 9,155
    DonDaddyD wrote:

    I'm not for a minute suggesting that investing in school sport will avert the obesity crisis or help to mend broken bones. I'm merely using the disparity between £150 million and £8 billion to demonstrate lunacy of NHS spending. Successive Govs have done little to tackle the issue of personal health/behaviour - smoking, drinking, diet etc, and yet continue to throw money at the NHS. It's an unsustainable model especially when combined with an ageing population.

    The two, school sports and NHS funding are not directly comparable. It doesn't demonstrate the disparity because the size, scale and distribution of NHS funding is far beyond the size of the schools in this country.

    Example: A school has anywhere between 300 - 1500 pupils. Some NHS Trust provide services to more than 1500 a day. A single NHS Foundation Trust has a turnover of about £300million - and the one I'm thinking of provides community services to East London and parts of Essex. The Acute Trust's is where the real money is spent and its not all staff that this money goes on. There are services, building costs, medicines, medical technology, computers etc. Multiply that by the number of NHS services (Primary Care, Secondary Care, Community Services, Mental Health Services, Rehab Services, Local public health, specialised services, offender healthcare, armed forces, immunisation, research - add the regulatory bodies, training and development) and multiply that again to include the entire country - because the NHS provides services to all those of all ages and not just school kids (a infinitely smaller demoraphic). This is why I struggle with the comparison. You cannot compare school funding to NHS funding.

    I'm not comparing them as I think I've made clear. I'm simply pointing out how low spending on things like School Sport is. I could have used investment in cycling as another example. We need a Gov to committ to spending billions on tackling the cause not treating the symptoms.
    DonDaddyD wrote:
    I also have to disagree with the notion that the Government and health services are not doing enough done to change peoples health related behaviour. The cycling revolution shows no sign of stopping. More people are taking up sport, running etc in their pass time. More gyms around than ever. Pubs are closing up and down the place. Less smokers.

    Cigarettes: forced to carry smoking kills and smoking damaged lungs, hidden in Supermarkets, banning TV adverts, ban on smoking in indoor public places, high taxation, quit smoking teams.

    Drinking and diet: Loads of healthy eating information, more rigid rules around kids TV adverts, school dinners have changed, quality of food in hospitals has increased. Mental health services and attitudes have changed dramatically.

    People are more aware of things like cancer. Far more healthier babies being born - less deformities, less fetal-alcohol syndrome. Less kids with filings and dental problems.

    When you talk to a 50 - 60 year old about health awareness when they were 30 (and what the Country was like - stressed pregnant women encouraged to smoke - hamlet cigar adverts on TV etc) compared to us, who are in our 30s, and what we know it say then it is completely inaccurate to say "Successive Govs have done little to tackle the issue of personal health/behaviour - smoking, drinking, diet etc"
    People think (perhaps subconsciously) f*ck it, I'll do what I want because the NHS will pick up the pieces.
    9 years in the industry, I've met a range of people with small injuries to long term conditions. I've never met anyone who has used that rationale.

    I said 'perhaps subconsciously'... :roll:

    Cycling - the per head investment in the UK is risibly low. I see no cycling revolution, certainly not outside of London.

    Smoking - Still around 19% of the pop smoke. Incidentally in Australia where they've had blank fag packets since 2013 there is no evidence to show this has had any effect.

    Diet - Obesity levels are rising, we're among the worst in Europe.

    Drinking - Pubs aren't closing because people drink less. It's just that they tend to drink at home more having bought cheap booze in the Supermarket. The WHO found that The average global intake was 6.2 litres for adults over the age of 15. In Britain, the average intake was twice as high, at 11.6 litres per adult.

    Dentistry - The 2013 Children's Dental Health Survey for England, Wales and Northern Ireland also found that 46% of 15-year-olds had decay in their teeth. I just spent a week cycling in Spain. A fellow guest was a dentist, he said that oral health among children in the UK was a national disgrace.

    Health awareness changes since the 40's etc are more down to scientific progress than government intervention.
  • tgotb
    tgotb Posts: 4,714
    If the numbers on the Electoral Calculus site are reflective of what actually happens, the only vaguely possible outcomes are Con/SNP or Lab/SNP. Unless one of the two major parties sees a massive upswing, the Lib Dems are never going to be big enough to fill the gap.
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  • jedster
    jedster Posts: 1,717
    elbowloh wrote:
    My overriding concern is over the NHS. You might not like, but I think its something we should be proud of. Yes it does need reform and improvement, but it really is an incredible institution.

    I'm convinced that the Tories are determined to privatise it and they are doing so for ideological reasons.

    They blatantly lied to us over the "no top down reorganisation of the NHS" debacle and Lansley's Health "reforms" were so bad that even the conservatives admit they were disastrous.

    So for me, anything but Tory (or UKIP because they're clearly utter barstewards and bonking barstewards at that).

    I am proud of the NHS but the thing I am proud of is that we have a system of healthcare that is available to all and is (overwhelmingly*) free at the point of demand.

    (*better not mention prescription charges, dentistry, eyecare....)

    I'm not proud of it because the hospitals are overwhelmingly owned by the State or that the operations are overwhelmingly managed by the State** or that the majority of health workers are employed by the State**. On those issues I'm in favour of whatever works best and most efficiently so if a private company can do, say, cataract operations cheaper and better than an NHS hospital I'm totally open to my taxes being spent on that. If not then I am happy for the State to manage it. The last Labour Government (which I voted for) shared this point of view so we did get some more private sector involvement. Current Labour leadership seem to believe there is magic amount of private sector that is OK but cross x% and it is suddenly "PRIVITISATION" boo!!! hiss!!! I think that is utter ballcocks and simply about sucking up to the Unions (Burnham has ambitions to replace Milliband and has taken the obvious lesson about needing the Unions for the leadership campaign).

    (** of course we already have had privatised pharmacies, drug R&D and manufacturing, medical equipment manufacturing, GP practices, etc - the idea that we don't have lots of private sector involvement in health is a nonsense)

    I take your point on top down reorganisation - it was foolish for Cameron to agree to this given his promise. But my concern is that the reorganisation wasn't the right one. No one who has been a customer of NHS hospitals can seriously think that they are so slick that they wouldn't benefit from reorganisation. Again I think Labour are being very misleading. The integration of Health and Social Care (as Labour and I think the other main parties now advocate) is obviously the right thing to do but to pretend that it will not be a major reorganisation (boo!!! hisss!!!) is clearly nonsense.
  • il_principe
    il_principe Posts: 9,155
    The Dutch model appears to work well and, crucially be fair. Yes hospitals and insurance firms are private, but they are not for profit. IME (and I deal with the Public Sector a fair amount with work and have done so across a number of industries), they have a very poor grasp of what efficient means. I've come up against some terrible attitudes re expenditure as well 'it's not our money so who cares'.
  • elbowloh
    elbowloh Posts: 7,078
    jedster wrote:
    elbowloh wrote:
    My overriding concern is over the NHS. You might not like, but I think its something we should be proud of. Yes it does need reform and improvement, but it really is an incredible institution.

    I'm convinced that the Tories are determined to privatise it and they are doing so for ideological reasons.

    They blatantly lied to us over the "no top down reorganisation of the NHS" debacle and Lansley's Health "reforms" were so bad that even the conservatives admit they were disastrous.

    So for me, anything but Tory (or UKIP because they're clearly utter barstewards and bonking barstewards at that).

    I am proud of the NHS but the thing I am proud of is that we have a system of healthcare that is available to all and is (overwhelmingly*) free at the point of demand.

    (*better not mention prescription charges, dentistry, eyecare....)

    I'm not proud of it because the hospitals are overwhelmingly owned by the State or that the operations are overwhelmingly managed by the State** or that the majority of health workers are employed by the State**. On those issues I'm in favour of whatever works best and most efficiently so if a private company can do, say, cataract operations cheaper and better than an NHS hospital I'm totally open to my taxes being spent on that. If not then I am happy for the State to manage it. The last Labour Government (which I voted for) shared this point of view so we did get some more private sector involvement. Current Labour leadership seem to believe there is magic amount of private sector that is OK but cross x% and it is suddenly "PRIVITISATION" boo!!! hiss!!! I think that is utter ballcocks and simply about sucking up to the Unions (Burnham has ambitions to replace Milliband and has taken the obvious lesson about needing the Unions for the leadership campaign).

    (** of course we already have had privatised pharmacies, drug R&D and manufacturing, medical equipment manufacturing, GP practices, etc - the idea that we don't have lots of private sector involvement in health is a nonsense)

    I take your point on top down reorganisation - it was foolish for Cameron to agree to this given his promise. But my concern is that the reorganisation wasn't the right one. No one who has been a customer of NHS hospitals can seriously think that they are so slick that they wouldn't benefit from reorganisation. Again I think Labour are being very misleading. The integration of Health and Social Care (as Labour and I think the other main parties now advocate) is obviously the right thing to do but to pretend that it will not be a major reorganisation (boo!!! hisss!!!) is clearly nonsense.
    The private health care companies can sometimes do things cheaper than the NHS, but they are reliant upon the NHS paying for the training of all of their staff, prior to employing them.
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  • rick_chasey
    rick_chasey Posts: 75,660
    they have a very poor grasp of what efficient means. I've come up against some terrible attitudes re expenditure as well 'it's not our money so who cares'.

    Not familiar with the Dutch example, but I know in the US there is the same attitude, only 'it's the insurers money', and the US is plenty more inefficient than the UK (if you look at quality of care versus proportion of GDP spent on healthcare).

    SO it's not just a state/private thing. It's more nuanced than that.
  • il_principe
    il_principe Posts: 9,155
    they have a very poor grasp of what efficient means. I've come up against some terrible attitudes re expenditure as well 'it's not our money so who cares'.

    Not familiar with the Dutch example, but I know in the US there is the same attitude, only 'it's the insurers money', and the US is plenty more inefficient than the UK (if you look at quality of care versus proportion of GDP spent on healthcare).

    SO it's not just a state/private thing. It's more nuanced than that.

    I'm well aware that it is more nuanced. However (and as I said, IME) businesses, even not for profit ones tend to be far more efficient than PS. Some of the organisations I deal with (one of which is a big London one with a transport mandate, naming no names :) ) manage projects so badly it makes me want to weep.
  • jedster
    jedster Posts: 1,717
    "The private health care companies can sometimes do things cheaper than the NHS, but they are reliant upon the NHS paying for the training of all of their staff, prior to employing them."

    Firstly, that isn't true - there are lots of doctors and nurses working in the UK who trained abroad for a start.

    Secondly, so what if it was? If a doctor can do more operations and so treat more NHS patients working for a private company than for a state run hospital why would we want to stop that? We would be getting more value for his NHS training by leveraging it through a more efficient system.

    Of course one answer you hear is that we should just apply the same (private sector) process in the state hospital. But it rather misses the point. It is the fact of competing to offer a more efficient service motivated by profit that drives the innovation that develops the new process.
  • DonDaddyD
    DonDaddyD Posts: 12,689
    What is telling is that of the private companies providing NHS services or running NHS Hospitals, they aren't doing any better.

    Also, private company gets an £10mil NHS contract. Spends £7mil running the service and £3mil profit. Or they're Not For Profit, but their CEO and Exec team are taking a home a wedge comparable to a National private company who employs 3000 - 4000 people and has £300 - £400mil through the books.

    I don't think private companies are the answer. I've yet to see a private company running public service that has truly done a incredible job. Energy companies - our fuel bills are ridiculously high and so are the profits, I don't think the service is that much better (rolling brownouts in the 70s - but technology had moved on). National Rail - ticket prices are ridiculously high and the service/trains aren't great. Dentist and GPs are privately owned - how hard is it to get referred to a NHS dental specialist through a Dentist, who will happily charge you for the same dental work that could be free (happened to me, I was quoted £600 - £800 but then learned I could go to a NHS dental surgery and get the reconstructive dental work on the NHS).

    I could go on, but Private Companies running public services isn't always the answer. Sometimes it is, but not always.
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  • jedster
    jedster Posts: 1,717
    "Energy companies - our fuel bills are ridiculously high and so are the profits"

    I know a lot of people think that (egged on a bit by Milliband) but everyone professional who has studied this (including myself) has concluded that bills are high because providing energy (particularly the clean kind) is really expensive and profits are not high given the amount of capital invested. The CMA is currently reviewing the UK energy market and is only part way through but the interim findings are totally consistent with this. The CMA are really impressive - the great and the good of academic economists and highly independent. I met one of the senior panel members and as he pointed out "look we are a pretty grey and aging bunch, towards the end of our careers, and quite prominent in our chosen fields - all we really have to play for is our reputations and we are not going to be leant on by anyone to come out with anything but what we believe to be right." I believe him.

    The CMA interim reports are on their website if you want to dig in to this but please don't say "our fuel bills are ridiculously high and so are the profits" until you have made some effort to understand what is really going on.
  • rick_chasey
    rick_chasey Posts: 75,660
    jedster wrote:
    "Energy companies - our fuel bills are ridiculously high and so are the profits"

    I know a lot of people think that (egged on a bit by Milliband) but everyone professional who has studied this (including myself) has concluded that bills are high because providing energy (particularly the clean kind) is really expensive and profits are not high given the amount of capital invested. The CMA is currently reviewing the UK energy market and is only part way through but the interim findings are totally consistent with this. The CMA are really impressive - the great and the good of academic economists and highly independent. I met one of the senior panel members and as he pointed out "look we are a pretty grey and aging bunch, towards the end of our careers, and quite prominent in our chosen fields - all we really have to play for is our reputations and we are not going to be leant on by anyone to come out with anything but what we believe to be right." I believe him.

    The CMA interim reports are on their website if you want to dig in to this but please don't say "our fuel bills are ridiculously high and so are the profits" until you have made some effort to understand what is really going on.

    Saw a chart a while back where they plotted the prices of each big 6 together, and, surprise surprise, they all moved in lockstep, save a handful of months.

    Annoyingly, can't find it.

    This: http://blogs.ft.com/off-message/2013/10 ... gy-market/
    sums it up fairly well.
  • jedster
    jedster Posts: 1,717
    "Saw a chart a while back where they plotted the prices of each big 6 together, and, surprise surprise, they all moved in lockstep, save a handful of months."

    Er... of course they do. And I would of thought it was crushingly obvious why that happens. Their major input costs are wholesale gas and coal prices. And a move in those impacts all of the companies (with some modest time variations based on hedging policy). So while you can get some variation in the exact rises that result the companies are bound to be moving the prices roughly in sync - it's not evidence of any kind of rip off.
  • elbowloh
    elbowloh Posts: 7,078
    and yet when there is a whole-sale gas price increase/decrease, they all seem to increase/decrease their own prices by different amounts.

    They also increase prices immediately after a wholesale price increase, but can't lower their prices immediately when there is a decrease as they've supposedly already bought a certain amount of gas at the higher price. Surely this argument would also apply when there is an increase in wholesale prices?
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  • rick_chasey
    rick_chasey Posts: 75,660
    jedster wrote:
    "Saw a chart a while back where they plotted the prices of each big 6 together, and, surprise surprise, they all moved in lockstep, save a handful of months."

    Er... of course they do. And I would have thought it was crushingly obvious why that happens. Their major input costs are wholesale gas and coal prices. And a move in those impacts all of the companies (with some modest time variations based on hedging policy). So while you can get some variation in the exact rises that result the companies are bound to be moving the prices roughly in sync - it's not evidence of any kind of rip off.

    Not really.

    I sit next to a chap who's entire job is speaking with physical gas traders. Guys at EDF Trading, GDF Suez, Eon Energy trading, Centrica downstream etc. Last year he spent about 6 months tearing his hair out because all gas trading desks were being shut down or shrunk as a result of a huge drop in gas price volatility.

    All fair enough.

    Only in that period I got a call from British gas to 'explain' the price rise they had just put in, and the women started off by referring to 'high volatility in gas prices....'. :| That's a flat out lie.

    They make their pricing deliberately opaque and confusing, and they tacitly collude on prices.

    I regularly get sent bills from EDF and they don't explain random additional charges until I call them up. Then, I would say 20% of the time, I get those refunded because I called up and asked.

    The CC or whatever they're called now rightly needs to have a look at it. I'm not for price caps, but they are certainly not providing transparent pricing or real competition.
  • jedster
    jedster Posts: 1,717
    elbowloh,

    to be honest most of what you observe is "confirmation bias" - interpreting data points in a way that fits our prejudices:

    "and yet when there is a whole-sale gas price increase/decrease, they all seem to increase/decrease their own prices by different amounts."
    Well the starting points in terms of selling prices, hedges in place etc are somewhat different. Plus perhaps company x has been losing market share for the prior quarters and wants to address that, they then cut a bit deeper than others. My point is, we shouldn't be surprised that the broad direction of moves is relatively in sync with some minor variations between the companies.

    "They also increase prices immediately after a wholesale price increase, but can't lower their prices immediately when there is a decrease as they've supposedly already bought a certain amount of gas at the higher price. Surely this argument would also apply when there is an increase in wholesale prices?"
    The argument does apply to increases - and they don't always increase prices immediately. Indeed you get a bit of a "chicken" game going on when no one wants to go first because they will get the bad press (and some customers will switch). Once someone has made a move it is obviously easier for the others to follow. From what I see it TENDS to be the company with the weakest hedge position or who has taken market share recently that makes the first move.

    Generally the stuff you see on the front page of the papers or being touted by politicians who want to bash the utilities is VERY selective about time periods - they pick two points to maximise the price spread over the wholesale price and don't mention the prior period when retail prices had been lagging and margins were squeezed. I (with some other investors) met with the Labour energy team after Milliband's conference speech when he announced the price cap. They showed us their analysis supporting the idea that consumers were being fleeced and it was embarrassing. We all just picked the obvious holes in it. One bloke pointed out that if he delivered analysis like that he would be sacked. To be fair they did look a bit sheepish. It's all a political game - politician's know that people resent utility bills, they feel like a tax*. It is so much easier to tell voters that it is all because of the evil companies than to deliver the hard truth that prices will have to keep going up as we replace our knackered 70s power stations and 60s grid, particularly if we care (as I think we should) about CO2...

    * and yet is there anything more important to our way of life than the fact that when we flick a switch we are confident that the lights will come on?
  • rick_chasey
    rick_chasey Posts: 75,660
    Sounds like you want to protect your own investment mate.

    Which is fine.

    It's not about evil companies. It's about companies protecting their own interests, which isn't the same. That's a legitimate position to have, even if it is counter productive for wider society.

    They have an oligopolistic position in the market, which needs to be better regulated than it currently is, particularly from a competition & price transparancy perspective.
  • jedster
    jedster Posts: 1,717
    Sounds like you want to protect your own investment mate.

    Actually no - I've been avoiding UK energy utilities as investments because the political rhetoric is so toxic and ill-informed. I'll start getting interested again once the Government has actually done something stupid (as opposed to talking about it) and people start to worry about the lights going out.

    They have an oligopolistic position in the market, which needs to be better regulated than it currently is, particularly from a competition & price transparancy perspective.

    Yes, you are asserting this but like I say, I've been searching for a serious piece of work that shows that the companies are exploiting us to any material degree and I haven't found one. If you find one please to point it out to me.
  • tailwindhome
    tailwindhome Posts: 19,458
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  • rick_chasey
    rick_chasey Posts: 75,660
    Think last night Lib Dems were evens to be in government - higher than any other party.
  • tgotb
    tgotb Posts: 4,714
    Think last night Lib Dems were evens to be in government - higher than any other party.
    I don't understand that; none of the forecasts I've seen suggest they'll win enough seats to be "useful" to a larger party looking for a majority.

    Based on current forecasts, the only way for Con/Lab to secure a majority is with SNP (or each other). Once they've done that, they don't need the Lib Dems.
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  • MrSweary
    MrSweary Posts: 1,699
    The worst bit about this election is that unless a miracle happens we're going to have to put up with at least a month (and probably very many months) more of carping, baseless speculation, alarmism and general b*llsh*t until they sort it all out.

    FFS.
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  • rick_chasey
    rick_chasey Posts: 75,660
    TGOTB wrote:
    Think last night Lib Dems were evens to be in government - higher than any other party.
    I don't understand that; none of the forecasts I've seen suggest they'll win enough seats to be "useful" to a larger party looking for a majority.

    Based on current forecasts, the only way for Con/Lab to secure a majority is with SNP (or each other). Once they've done that, they don't need the Lib Dems.

    Lib Dems will get in bed with anyone.

    Edit* apart from UKIP / other far righters.
  • il_principe
    il_principe Posts: 9,155
    TGOTB wrote:
    Think last night Lib Dems were evens to be in government - higher than any other party.
    I don't understand that; none of the forecasts I've seen suggest they'll win enough seats to be "useful" to a larger party looking for a majority.

    Based on current forecasts, the only way for Con/Lab to secure a majority is with SNP (or each other). Once they've done that, they don't need the Lib Dems.

    Lib Dems will get in bed with anyone.

    Edit* apart from UKIP / other far righters.

    Annihilated
  • First.Aspect
    First.Aspect Posts: 17,379
    Vote SNP to keep the Tories out. :roll:
  • rick_chasey
    rick_chasey Posts: 75,660

    Annihilated

    Yeah. Gutted.
  • The Rookie
    The Rookie Posts: 27,812
    Democracy is a burger when your on the wrong side!
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  • rick_chasey
    rick_chasey Posts: 75,660
    Credit Suisse research note:

    "given absence of a coalition it now seems reasonable to expect material fiscal tightening from next year which will likely to provide a considerable headwind against growth"

    Blergh.

    Let's hope they're wrong.
  • rjsterry
    rjsterry Posts: 29,811

    Annihilated

    Yeah. Gutted.

    Went to bed hoping that the exit poll was wrong; woke up to find that it was even worse than that.

    The Lib Dems clung on in my constituency, which is some consolation. Now feeling a little isolated. :(
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  • orraloon
    orraloon Posts: 13,269
    Vote SNP to keep the Tories out. :roll:

    Eh, do the maths.

    Even if all 56 SNP seats had gone to Labour they would still have been 288:331 down against the Cons.

    Don't blame the Scots for a Blue govt.
  • letap73
    letap73 Posts: 1,608
    orraloon wrote:
    Vote SNP to keep the Tories out. :roll:

    Eh, do the maths.

    Even if all 56 SNP seats had gone to Labour they would still have been 288:331 down against the Cons.

    Don't blame the Scots for a Blue govt.

    How many English voters were frightened by the prospect of a potential labour SNP coalition?