Enough is enough.

Call me naïve if you like, but I still believe that most politicians go into the business because they want to make the world a better place. They may lose their way, become seduced by the sense of their own importance, carried away by the thrill of the chase or corrupted by the influence of big money and lobbyists, but mostly they start off with good intentions. that certainly is why I went into politics. As a GP I was in a position to help individuals, but so often I realised that it was the system that needed changing. I could not prescribe a house for the homeless or a job for the jobless, but as a politician I might, I just might be able to do these things.

My early experience of life as a politician was encouraging. In our District Council we Liberal Democrats ran the administration with the support of some independents. We pushed up our recycling rates to one of the highest in the country. We delivered more new affordable homes for our size than any other authority. We attracted inward investment in the arts and developed our sports and leisure services.  IMG_3416Things locally started to go downhill when we moved to Unitary Authority and the Conservatives took over, but by then I had moved on to the national political scene.

Nationally too, the position was optimistic. Party Conferences were a heady blend of idealism and optimism. Liberal Democrats had real influence and if leaders occasionally risked getting ‘too big for their boots’ there were plenty of stalwart members ready to remind them of the pledge enshrined in the Party constitution “to build and safeguard a fair, free and open society… in which no-one shall be enslaved by poverty, ignorance or conformity.”

Then came May 2010: a hung parliament. Like the vast majority of members of the Party I supported the decision to go into coalition. We knew that it would damage the Party, but having sung the praises of coalition government for decades it would be bizarre not to accept the challenge when it was offered. By September 2010 we could see that it was going wrong. The hastily written coalition agreement was already being overtaken by policies that the Conservatives wanted to introduce. The Liberal Democrat Conference warned Nick Clegg that he needed to stand up more for Lib Dem values, that he did not need to agree to everything that his friend Dave wanted. At a private meeting of Local Party Chairs I tackled Nick on that subject. He argued that the most important thing was to give the public a united view. He had to hold the coalition together for the full five years. We disagreed.

The mistakes were many, but for those who know me it will be no surprise that the Health and Social Care Act of 2012 was for me the most catastrophic mistake. I worked closely for months with another doctor who was also chair of his Local Liberal Democrat Party. Graham Winyard had a public health background and had been Deputy Chief Medical Officer and Medical Director to the NHS. Between us we had experience of most parts of the NHS and we had contacts throughout the Service. We were in a position to give the Party Leadership authoritative advice. At no point did Nick Clegg agree to see us. He telephoned us once and spent an hour and a half detailing all the concessions he had wrung out of the Prime Minister after the so-called ‘Listening Pause’. Those apparent concessions started to unravel when the Department published the official response five days later, and within a couple of months it was clear that they did not amount to a can of beans. Graham Winyard resigned from the Party in frustration and disgust. I decided to fight on. I fought on through Liberal Democrat Conferences. Time and again the inner caucus of the Party would block my attempts to allow the Party members to debate the changes being imposed on the Health Service. If I did manage to get to through to the membership, I found great support from the members.

I fought on when the regulatory framework for the Health Act was published. I served on a policy working group that was preparing future policy options for Liberal Democrats with regard to delivering public services. Seven of us in that working group produced policy proposals that included the removal of the wasteful and destructive use of markets in the NHS. Those proposals were never debated. It seemed that Nick Clegg was actually in favour of breaking up the NHS and with the help of junior ministers Paul Burstow and Norman Lamb and with Shirley Williams in the House of Lords he was able to deliver the NHS on a plate to the Tories. Nick Clegg and Shirley Williams Nick Clegg and Shirley Williams voting in the Health debate at Conference

May 2015 saw the Liberal Democrats reap the reward for cozying up to the Tories. The Party was almost wiped out. But every challenge brings an opportunity. Tim Farron had long waxed eloquent on the need to return to the values of Beveridge. If the NHS was conceived by Beveridge and delivered by Bevan there might be hope that Liberal Democrats would rediscover that value of a single nationalised health service. Alas, Tim Farron has made no response to our policy proposals.

And now; and now the final blow. Tim Farron has lead his tiny bunch of MPs through the lobby to support Cameron in his madcap bombing escapade in Syria. Tim Farron Tim Farron in the debate on Syria

I shall not repeat all the arguments against escalating the war in Syria. Many others have put clearly the tactical, strategic, political and diplomatic arguments against escalating the violence there. I must, however, point out that war is a public health disaster. The purpose of bombing is to kill and injure, but over and above that, the damage to the infrastructure of a country leads to homelessness, poverty, starvation and disease. Mass migrations of terrified peoples then exacerbate and spread the suffering. No doctor can look on unmoved while their government or their political party deliberately causes so much illness, suffering and death, and I shall not do so. Enough is enough. I shall resign from the Liberal Democrat Party.

 

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Paris: Life goes on.

Private

Place de La République: personal witness.

Three days on and Paris is very much ‘open for business’. Place de La République was packed. There were concentric circles round the statue: first flowers then small groups, couples and individuals whom I took to be family, friends and well-wishers. Next were the messages, chalked on the paving or spelt out in candles. Outside that were those of us who claimed no greater connection to this tragedy than the fact we see ourselves as part of  humanity and wanting, wishing and hoping to see a better world.

In the final, outermost circle were the media: cameras on tripods, floodlights and long fluffy microphones all tied by cables to vans with satellite dishes on their rooves.

Press and the media

Paris: the World bears witness

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All was sombre and respectful, but Paris is not afraid. Paris lives on. Good luck Paris.

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Daylight reveals the flowers and cards in the rain.

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Saxophone Sundae

We  had the pleasure last weekend of taking our saxophone quartet to a Christmas Fayre in Bridgnorth. Over six hundred people visited the event which was focussed on recycling, and we certainly saw some imaginative examples: bags made of folded newspaper and jewellery made of enamelled dominoes. Perhaps the prize should have gone to the large snowman who welcomed us; he was (mostly) made of old plastic drinking cups.

Our Saxophone Quartet in action

Saxophone Sundae

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We can show those French a thing or two

We got off the ferry at Dover with a crowd of Belgians, French and Germans. The lorries were from further East, Poland, Czech republic or Latvia, but the cars and motorcycles were mostly from Western Europe. We had driven two thousand miles in France and had occasionally suffered from congestion; in total we had been delayed by perhaps twenty minutes. We set off on what should have been a four hour drive. By the time we had been driving for an hour, the predicted journey time had increased to five and a half hours.

We decided to stop at one of the UK’s motorway service areas. French travellers should note that service areas are not as frequent in the UK as they are in France, and in order to ensure that drivers get back into their cars and join the traffic jam on the motorway as quickly as possible you will be fined £60 if you stay for more than two hours. It is perhaps better not to order a three course meal and then hope to enjoy a leisurely cup of coffee afterwards.

Motorway Services

Quality dining at a British Motorway Services

This particular service area consisted of a tin warehouse with no less than five fast food outlets. There was no-one serving what one could describe as a meal. You could have sandwiches, burgers or bits of chicken in batter. There were no fresh salads or Boeuf Bourguignon and no drinking-water fountains. I opted for a jacket potato as the healthiest option I could find and had it served in a cardboard tray. I didn’t have to eat it with my fingers, I was supplied with a plastic knife and fork which broke.

Before long I was back on the crowded motorway. By now it was apparent that the M6 was closed and there were traffic jams on the M1, M25 and M40. Our journey took six and a half hours. Still, that was better than a previous visit when there were four motorways closed and the journey took seven hours.

We Brits certainly know how to live. No wonder these all these foreigners are trying to get into the UK.

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Lib Dems to be offered radical new Health Policy

I shall go to Glasgow this weekend with a group of others to promote our new policy on the NHS.

After a year of deliberations, a policy working group set up by Liberal Democrats failed to reach agreement. Two policy documents were produced. One favours the status quo, continuing to outsource public services and subject the NHS to all the rigours of market competition with the complexity and costs that that entails. This is the policy that fragments healthcare and offers parts of the service to private providers in what amounts to a one-way route to privatisation. The other promotes a view of a public service NHS: a service for all regardless of where they live or what their medical need.Hosp_corridor

One document will be promoted with the full vigour of the central party machine, the other will be promoted by a group of individual party members and experts.

We have seen the Conservatives protesting their love of the NHS, while starving it of cash and at the same time breaking it up and offering it up for sale. We have seen Labour protesting at Lansley’s disastrous Health and Social Care Act (HASCA), but leaving open the door to privatisation by continuing the cumbersome, dangerous and damaging market in healthcare. Andy Burnham says that he will repeal the HASCA but he is not committed to removing the market. Labour under Blair and Brown did more privatising of the NHS than did Margaret Thatcher. Simply repealing the HASCA leaves more questions unanswered than answered. What happens to all the Clinical commissioning Groups or to NHS England, which Labour themselves have described as the biggest quango in the land.

Our proposed policy draws on the evidence of experts and the experience of international healthcare systems. We have consulted with doctors from all fields, and our view is that the NHS does not need a market: not the internal market, not the external market. The NHS does not need to sell itself. We believe that a directly provided, publicly funded NHS is the best way to deliver a joined-up service that is efficient, effective and equitable.

We look forward to welcoming Professor Allyson Pollock, a renowned expert in public health research and policy to our meeting in Glasgow. Allyson spoke out for years against the iniquitous and wasteful Private Finance Initiative and the damage that it was doing to the NHS. For years the establishment tried to ‘rubbish’ her. Now politicians of all parties accept that she was right. We look forward to hearing what she has to say.

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Will Lib Dems take the high road or the low road to Scotland?

Liberal Democrats meet this weekend at Glasgow for the Autumn Conference. It is only a few days since the eyes of the world were looking to Scotland with one big question in their minds. Anyone who cares about politics will now look at the Liberal Democrats with another question in mind.

Has the Liberal Democrat Party disappeared? The Liberal Democrats were known as a radical campaigning party, a party of its grass roots, a liberal party, a democratic party. Has it become another version of New Labour: another unnecessary and unwanted pale imitation of the Tories? Or will the radical thinking re-emerge. Will Liberal Democrats once again show themselves to be a party that listens, a party that thinks and a party that campaigns for what is right?

Members attending the Lib Dem conference at Glasgow this week will be offered two views on Public Services: the liberal one, and the neo-liberal one.

Some of us have spent much of the last year going to weekly meetings of a working group developing Party policy on Public Services.

Unfortunately both the process and the outcome were very frustrating to me and several other members of the working group.

The resulting policy document is pretty lack-lustre and seems to accept as party policy the Tory agenda on the marketisation of public services. This has never been Lib Dem policy in the past, and in our view what is needed now is a more radical Liberal Democrat Party, not an anodyne ‘don’t lets rock the boat’ party

Seven members of the working group have produced an alternative report which we believe contains some exciting policies. We submitted it to the Federal Policy Committee who have attempted to suppress it. We shall therefore be promoting it at a fringe meeting at Glasgow on Saturday.

“Serving the Public: an alternative report on Public Services” is available to download.

Our Fringe meeting:

“Is there an alternative to the market in delivering excellent public services?”

is 12.00 – 13.00 on Saturday 4 October
and takes place in,
Staffa.
Crowne Plaza, Congress Road,
Glasgow G3 8QT

Charles West

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The hush hush health policy

So what are these proposals that no-one dare let Liberal Democrats see at Conference?

There is an increasing body of reputable opinion and evidence that market competition is an expensive irrelevance in healthcare. It is interesting to note that every government since Margaret Thatcher has pursued the same policy: that of exposing the NHS to more and more market competition. The assumption has been that the only way to raise standards and reduce prices in the NHS is the market. Recently a string of professors have spoken out. Calum Paton and Alan Maynard on the costs of running a market, Clare Bambra on widening inequalities and Chris Ham on the way competition is a barrier to the provision of integrated care. Judith Jolly, until recently the co-chair of the Liberal Democrat Parliamentary Health Committee said that the action taken by the Competition Commission over the proposed merger of Bournemouth and Poole Hospital Trusts was scandalous “We need to sort out the competition thing.” Chris Ham says that we need legislation to unscramble at least some of the Lansley Bill. David Nicholson, chief executive of the NHS, has said that competition is a barrier to delivering quality.

Several witnesses to the Public Services Policy Working Group have pointed out the advantages of funding healthcare by means of a capitation budget, but acknowledged that this was very difficult when operating in a market of many providers.

My proposals are simple but radical. The full document with supporting evidence is available.

  • Set up Local Health Boards covering populations of around 1 million.
  • Abolish the market (internal and external) in healthcare.
  • Give Local Health Boards a budget based on capitation and direct management of hospitals, community services and GP contracts in their area.
  • Pool nationally the PFI debts of hospitals, to facilitate the re-negotiation of those debts.
  • Give patients the choice, through their GP to be referred to any NHS hospital in the country.

These proposals would render redundant a large number of national quangos and return at least some measure of local democratic control over the delivery of health services. The costs of running a market are already large and are set to rise very greatly. These proposals would therefore save large sums of money, and a very considerable amount of clinician and management time. There are more details in the full document and there is more work to be done.  We need to bring together the fragmented Public Health roles and work on integrating health and social care but these proposals would, I believe, go a long way to alleviating many of the cost pressures on the NHS and removing the key barriers to integration and improving quality.

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