"Open " Consultation: Setting the mandate to NHS England for 2016 to 2017

Although you wouldn't know it, the UK's Department of Health has been running a consultation on NHS England.  It has kept this quiet in the hope that no one would reply, and it could just do what it wanted.  

You can read its consultation document pretty quickly, but it probably won't do much good: it's written in the finest officialese that manages to sound impressive, but say very little.  You can respond online, and here's what I've sent them:

Do you agree with our aims for the mandate to NHS England?

Although the mandate is largely fine, it suffers from an excess of generalities. What it lacks is any concrete statement of about how things should be done. I think it is vital that the NHS should be committed to providing a world-class health service using public resources, not private ones. The reasons are simple.

First, the US health system shows us that private healthcare is incredibly expensive, incredibly inefficient, and fails to deliver good healthcare. Moving in that direction would be foolish at best, and downright negligent at worst, since people will die as a direct consequence of doing so.

Moreover, privatising healthcare is foolish for economic reasons: private providers by definition must make a profit, and so by definition are more expensive than publicly-provided resources. Invoking "competition" as a reason why private health provision is better makes no sense, since that competition leads to cost-cutting, which again leads to patients suffering, as recent experiences have shown here in the UK.

Finally, privatisation makes no sense because there is no ownership of skills and knowledge. This would make the NHS a hollow, precarious structure.

Is there anything else we should be considering in producing the mandate to NHE England?

Yes: it should specify as a matter of principle that services will provided publicly, not through private provision. The use of private contractors by public bodies is fine, but the control of every key aspect must remain in public, not private hands, otherwise the profit principle takes over, and people will suffer.

What views do you have on our overarching objective of improving outcomes and reducing health inequalities, including by using new measures of comparative quality for local CCG populations to complement the national outcomes fin the NHS Outcomes Framework?

Fine words again, but without adequate resources, essentially worthless. Unless the NHS is funded adequately, as a matter of priority, it will be impossible to achieve those fine objectives. This will lead to the NHS being dubbed a "failure", which a cynic might suspect is the intention so that privatisation can be offered as the "solution." It is not.

What views do you have on our priorities for the health and care system?

The key priority should be providing world-class healthcare to everyone in the UK free of charge. That is the sign of a civilised country, and failing to do so is to fail that test too. Of course, that requires more resources, in which case it becomes a matter of priorities. But far more lives will be lost as a result of underfunding the NHS than will be lost through terrorism, however much the government likes to exaggerate the threat of the latter. Indeed, the greatest threat to this country is not ISIS/Daesh but things like the end of antibiotics, which could see all major surgery becoming impossible in just a few years. The government should be spending its billions on researching new ways of killing bacteria, not beefing up its surveillance apparatus.

What views do you have on how we set objectives for NHS England to reflect their contribution to achieving our priorities?

Despite all the claims of openness, this consultation has been conducted in near-secrecy. If the government really cared about what the public thinks on this matter (and I do realise that it does not), it would have made far greater efforts to publicise the existence of this consultation. Given the government is now trying to emasculate FOI requests, this is hardly a surprise, but I find the emphasis on openness here a little galling, to say the least.

Do you have any other comments?

I think I have probably said enough...

Urgent: Net Neutrality in EU under Threat; Please Write to your MEPs Now

The long saga of net neutrality in the EU is approaching its end, and things aren't looking good.  The compromise text contains some huge loopholes, which I've written about elsewhere. The key vote is on Tuesday, so there's still time for EU citizens to write to their MEPs. 

You can find contact details for all MEPs on the SaveTheInternet.eu site; those in the UK can also use WriteToThem.com.  Here's what I've just sent - please feel free to use its idea, but don't just copy and paste: MEPs will rightly disregard it.

The Internet has risen more rapidly and had more influence on society than any preceding technology. At the heart of its success lies an obscure technical feature: net neutrality. Simply put, it means that all traffic is treated equally. That level playing field has allowed innovation to flourish, and startups to create new industries in a way never seen before.

As you know, on Tuesday the European Parliament votes on new rules that supposedly enshrine net neutrality in Europe. In fact, those proposals contain such serious shortcomings that they are likely to have the opposite effect, and will undermine net neutrality.

I would therefore like to urge you to vote in favour of amendments that would return the text to a form nearer the earlier one approved by the European Parliament, which was far superior. In particular I would like to ask you to support the amendments specified here:

https://www.laquadrature.net/files/20151019-Amendments_TSM.pdf

In a surprising turn of events, the US has passed strong net neutrality laws (https://www.whitehouse.gov/net-neutrality). If the EU does not follow suit, it will threaten digital innovation in Europe, and hamstring its entrepreneurs, thus ensuring that the digital gulf between the EU and US widens, rather than narrows. For this and other reasons, it is vital that the amendments indicated above are included in the final text.

Thank you for your help.

Urgent TTIP Vote: Please Write (Again) to Your MEPs before Wednesday

There is (another) very important plenary vote in the European Parliament on TTIP this Wednesday, when the European Parliament will vote on a resolution concerning TTIP. The first time around, the vote was pulled for tactical reasons by the pro-ISDS camp, rightly afraid that the European Parliament would reject the inclusion of this anti-democratic idea in TTIP. Now they have cobbled together a "compromise" on ISDS which simply calls it something else, without solving the fundamental problem, which is that it gives corporations unique rights to sue entire nations, with us, the public, footing the bill.  Here's the proposed amendment:

to ensure that foreign investors are treated in a non-discriminatory fashion while benefitting from no greater rights than domestic investors, and to replace the ISDS-system with a new system for resolving disputes between investors and states which is subject to democratic principles and scrutiny where potential cases are treated in a transparent manner by publicly appointed, independent professional judges in public hearings and which includes an appellate mechanism, where consistency of judicial decisions is ensured, the jurisdiction of courts of the EU and of the Member States is respected and where private interests cannot undermine public policy objectives;

The good news is that MEPs are often responsive to their constituents contacting them, especially if large numbers do so on a particular theme. So I would like to urge you to write to your MEPs, using WriteToThem, or directly, to ask them to reject ISDS in all its forms.

If you want to find out more about TTIP in general, I have written a 6000-word explanation; you can also browse through the 51 columns I have written on the topic over the last two years. Finally, there is a documentary about TTIP, which provides a superb introduction to the issues – I'm in it, but please don't let that put you off.

I've included below the letter that I have sent to my MEPs: please feel free to draw on its arguments, but I urge you to put them in your words: MEPs hate and will dismiss letters that are carbon copies of others. Individually-written communications, by contrast, are very powerful.

I hope you will excuse me writing to you again on the topic of TTIP ahead of Wednesday's plenary vote. I would like to urge you to vote against the proposed "compromise amendment" on the topic of ISDS, which supposedly addresses the problems of this system. It does nothing of the sort: it still provides corporations with unique rights against entire nations; it creates a similarly unfair system where companies can win huge awards, to be paid by the public, but the best the public can achieve is not to lose. This is the very definition of a tilted playing-field.

The avowed intent of this "compromise", and of ISDS itself, is to ensure that foreign investors are treated fairly. That is only right, but ISDS and the compromise are exactly the wrong way to go about this. If either is in place, there is no pressure to address the real problem, which is that local laws may not treat foreign investors in the same way as domestic ones. Far better to change laws to make them truly fair, than to introduce another unfair system that undermines the rule of law by creating special structures outside it.

I would therefore ask you to reject ISDS completely, as well as any attempts to introduce it in other ways, for example through the "compromise amendment".