The previous post argues that to stop the rot in the quality of our government and lives and achieve the modest competence worthy of a rich developed nation we need to ditch our arrogant delusions of exceptionalism and subject our institutions to root and branch examination and fundamental reform.
Should there be any doubt as to the reality of our exit from the list of leading nations some figures cited by an Edinburgh GP, Gavin Francis, in a “Long Read” in last Thursday’s Guardian (24th August) provide the dismal evidence.
In 1950 the UK was in the top six countries for life expectancy worldwide.
By 2015 the UK had slipped to 21st.
By 2019 it had fallen to 29th.
Francis then cites an international study of NHS finance which shows that we are paying a lot less towards health than other comparable countries (Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland and the US)) and suggests that to argue that we cannot match the healthcare spends of such countries means that “the UK is now "too poor to have a 21st century European standard of healthcare."
Or, I would add, too mean, or too deluded by the economic legacy of what we have come to call Thatcherism
To halt our decline we must recognise the flawed nature of that doctrine, which can be summed up as:
Low taxation
Deregulation
Privatisation
Restrictions on collective action by trade unions
These were supposed to release the energies of our entrepreneurs and the resulting prosperity would trickle down to the benefit of everyone.
None of the assumptions are verifiable.
Taxation levels are much higher in many of the countries now much more productive than we are.
Regulations are necessary to protect us from fraudsters, opportunists and charlatans
The private sector is not automatically more efficient, however that is defined, than the public sector.
Restrictions on TU activities have not led to harmony in the workplace. Quite the reverse. Significant Employee Representation on boards and where appropriate, profit sharing, are more likely to do the trick. .
Yet the Tories still think the solution is tax cuts.
As well as a root and branch reform of our systems of government (see previous post), we also need to ditch this failed economic dogma which has now dominated our thinking for nearly half a century, and be prepared to pay for the quality of life and society of which we are capable.
I thought you were all in favour of declinism? After all you keep writing about how we should embrace our decline from being world leaders and not try to reverse it.
ReplyDelete\no, I simply think that we ought to be content to "punch at our weight" rather than above it. Realism.
DeleteI simply think that we ought to be content to "punch at our weight" rather than above it.
DeleteYou have a very declinist view of what ‘our weight’ is though, don’t you?
Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland and the US
ReplyDeleteHm. All of those countries except one have two things in common:
1. Their health services have better outcomes than ours.
2. Their health services run on a mixed public sector / private sector model.
So the lesson is that we should ditch the NHS and instead use a mixed public / private model like Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden and Switzerland, right?
I'm sure that those interested in making money out of illness will hammer this one for all it's worth. It would inevitably lead to a two-tier system. I want to see us fund the universal system properly our of fair taxation.
DeleteI'm sure that those interested in making money out of illness will hammer this one for all it's worth.
DeleteWhat is wrong with ‘making money out of illness’? Don’t all doctors and dentists do that (and usually very well thank you)? Would you describe supermarkets as ‘making money out of hunger’?
I want to see us fund the universal system properly our of fair taxation.
Despite the fact that that demonstrably leads to worse outcomes than are found in countries which use a mixed system like Australia, France, Germany, Switzerland, etc, etc?
Do you not think that a health system should be judged on how well it keeps people alive?
I mean, are you really saying you’d prefer an equal system where outcomes were worse, to an unequal ones where outcomes were better?
DeleteSay system A produced equal outcomes: everyone’s life expectancy is 77. Under system B, however, the life expectancy for the poor is 80 but for the rich it’s 95.
It seems obvious to me that system B is strictly better than system A, because under system B everyone is better off than they would have been under system A. Some are a little better off, and some a lot better off, but everyone is better off.
You however seem to be saying that the inequality in system B is not a price worth paying for everyone being better off, and you’d rather everyone was equal, even if that means everyone is worse off.
To which I can only say: seriously?
Yes, but what if the resources to keep the rich alive until 95 were diverted from the poor whose life expectancy then dropped to 70?
DeleteYes, but what if the resources to keep the rich alive until 95 were diverted from the poor whose life expectancy then dropped to 70?
DeleteAh, so you agree there’s nothing wrong in principle with a two-tier system?
And in practice, mixed systems like Australia’s and Germany’s and Switzerland get better results for everyone. So what you’re worried about in fact doesn’t happen: everybody is better off under a mixed system.
Regulations are necessary to protect us from fraudsters, opportunists and charlatans
ReplyDeleteAnd also necessary to stop people from advertising perfectly legal products https://www.bbc.co.uk/news/business-66582141
And necessary to protect us from seeing pictures of cake https://www.theguardian.com/media/2023/jul/05/london-theatre-shows-cake-poster-falls-foul-of-junk-food-ad-rules
Imagine the chaos if people could just see images of cakes on walls, or advertise their wares willy-nilly!
Good thing we have regulations to stop that sort of thing, eh?
Not a problem for me.
DeleteThe Health sector..Public private is ,in the long, run more likely.The problem is we have not got a DETAILED public discussion of the pros and cons of the future NHS. There is NO WAY the US private health companies should be given a free hand to asset strip and make excess profit from being involved..The NEW NHS will have to be regulated. to prevent sharks.creaming of the money.
ReplyDeleteSpecific regulations ARE needed .They w;ll have to be planned in DETAIL for each position
The country needs change but not from one old decrepid party to another that just wants to maintain the status quo.A root and branch change is needed BUT NOT OVERNIGHT (slowly).The trick is to get the public to accept change for it does not come easily.
ReplyDeleteAgreed. I see a role here for some Citizens' Assemblies
ReplyDeleteI see a role here for some Citizens' Assemblies
DeleteWe already have an assembly of citizen representatives voted for by their peers, it’s called the House of Commons. Why would we need another?
A (or a series of) Citizens' Assemblies would be selected by a random or stratified method to be properly representative of the people (which the Commons are not, especially if elected by FPTP.) They would focus on the single issue and hear all the evidence and different points of view. Obviously Parliament would have the final decision, but the Assemblies would give the politicians an idea of what the people really thought after they had studied the issue in detail.
DeleteThey would focus on the single issue and hear all the evidence and different points of view.
DeleteSo basically all the power would be handed to whoever decides what the participants are allowed to hear and who is allowed to address them and what arguments they are allowed to make.
To say nothing of the self-selected nature of the participants.
the Assemblies would give the politicians an idea of what the people really thought
They wouldn’t give the politicians an idea of what I really think, though, would they?
It's not just what you as an individual want but what the majority would really like to see and and be prepared to pay for.
ReplyDeleteSee Martin Kettle’s article in today’s Guardian (31st August):
Not for the first time, modern Ireland seems to offer a way forward from which Britain can learn. Ireland has for some years developed a system of deliberative democracy. In this system, a demographically and politically representative sample of up to a hundred voters, sometimes dubbed a citizens’ assembly, commits to examine the issues and listen to submissions, before attempting to write a policy agenda that all, or most, can endorse.
QED
It's not just what you as an individual want but what the majority would really like to see and and be prepared to pay for.
DeleteIt is indeed. But we’re definitely not going to find that out by taking a self-selected group and then brainwashing them with a heavily biased selection of information and arguments designed to get them to come to whatever conclusions the organisers of the assembly have pre-determined they want them to reach.
QED
A baseless assertion — a wrong assertion — doesn’t demonstrate anything.
Not at all. Read the article, or at least the extract. The participants are not "self-selected" but "demographically and politically representative," and they are not "brainwashed" but provided with a comprehensive range of available research, arguments and opinions.
DeleteThe participants are not "self-selected" but "demographically and politically representative,"
ReplyDeleteParticipation wasn’t compulsory, and indeed some of those selected refused to participate and were replaced. So it is accurate to say the ones who did participate were self-selected (because they chose to participate).
As for ‘ demographically and politically representative’, after the initial random selection screening interviews were carried out; I’m sure those allowed any with opinions that meant they were too likely to come to any conclusion other than the ones desired by the organisers to be weeded out.
and they are not "brainwashed" but provided with a comprehensive range of available research, arguments and opinions.
No, they were provided with a selection of available research, arguments and opinions. Selected by the organisers; and carefully curated to guide them towards the conclusions that the organisers wanted.
The new device of "deliberative democracy" need not be as cynical as the old. We should give it a try.
ReplyDeleteThe new device of "deliberative democracy" need not be as cynical as the old. We should give it a try.
DeleteBy 'give it a try' you mean take power out of the hands of the people and give it instead to the unelected, unaccountable organisers of these 'assemblies' so they can set them up and run them in such a way that they give only the answers the organisers want? No, we absolutely shouldn't do that.
The system seems to have been used successfully in Ireland. Is there any reliable evidence that it was abused in the way you suggest, or are you just suspecting that's what might happen?
DeleteThe system seems to have been used successfully in Ireland.
DeleteIt has been successfully used to push through the changes which those organising it wished to push through, yes. That’s the problem.
Is there any reliable evidence that it was abused in the way you suggest, or are you just suspecting that's what might happen?
It’s clearly the objective of those proposing it that it be used this way; everyone proposing it has changes they wish to see implemented, but that they have been unfair to gain democratic consent for. They are therefore attempting to find a way to have those changes implemented without having to get democratic consent for them.
But let me turn the question around. What safeguards do you suggest be put in place to stop the abuses I describe? Too whom would the organisers be accountable? Who would decide which materials are to be presented to the participants and if someone thought that some particular perspective or argument had been unfairly excluded, to whom could they appeal and who would have the authority to order that that perspective had to be presented to the assembly? Which body would have oversight of the selection process and be able to check that they weren’t, for example, excluding people who had expressed views supporting one side of an issue but not the other? Again, if someone did think that such unfair selections were being made, to whom could they appeal and have the assembly selection adjusted or overturned?
If there is no such oversight or appeals process, aren’t you putting far too much trust in the organisers?
In other words, purely supposition. You give no evidence
DeleteYou give no evidence
DeleteEvidence of what? I’m just explaining what could go wrong and asking what safeguards you would put in place to prevent these devices being used to launder and implement policies that could not gain democratic consent through the normal process.
Or do you really think it’s such a good idea to set up a mechanism to give unelected unaccountable people such a lot of influence over our laws?
I'd be interested in the views of a representative group of people who were fully informed
DeleteI'd be interested in the views of a representative group of people who were fully informed
DeleteBut how do you know that they are representative, and how do you know that they are fully informed? Surely you can’t be suggesting that we just take the organisers’ word for it that both of those are true?
So what safeguards do you propose so that we can know that the group is both representative (and the organisers haven’t stacked the deck by either deliberately or inadvertently favouring people with certain views over others) and fully informed (and that the organisers haven’t, say, excluded some viewpoints or arguments from those provided to the group)?
they will be subject to public scrutiny and meticulous "peer" style review.
Deletethey will be subject to public scrutiny
DeleteSo the records of everyone selected for the panel, as well as everyone rejected and the reasons for their rejection, will be available to the public for checking for any possible bias? And there will be a procedure for objecting? That would be good but I don’t think that’s how it worked in the Republic of Ireland, which you said was your model. Also I’m not sure how you could do it in a way consistent with data protection principles.
And that all materials and the backgrounds of those presenting to the participants would be available to the public, and there would be a process to challenge any who was, eg, presented as an independent witness who was actually promoting one side or the other, or to force inclusion of any relevant viewpoint or argument that had been excluded?
That would go a long way to addressing concerns; but in that case you have to ask, if the materials are available to the public, why go to the expense of setting up the assembly — why not just release the materials to the public and then have a public vote or referendum?
Do stop inventing imaginary difficulties.
DeleteDo stop inventing imaginary difficulties.
DeleteI haven’t invented any imaginary difficulties.
Thanks for being so open and honest with us in your posts
ReplyDeleteWell they don't look very real to me.
ReplyDeleteWell they don't look very real to me.
DeleteYou think that ‘How do we check that these people are doing what they said they would do, and not pushing their own agenda?’ is an ‘imaginary difficulty’? Really?
It seems to me that that’s, like, the most basic point to consider when you’re looking at constitutional affairs: where’s the oversight? Where’s the transparency? How can the public have confidence in what is being done with their money?
So far from being an ‘imaginary difficulty’, it’s the most concrete, most fundamental question of all.
In the Irish example given, I am not aware of any of the jiggery-pokery you suggest having taken place. The elected politicians, suitably informed, took the final decision, to the satisfaction, it seems of the overwhelming majority.
DeleteIn the Irish example given, I am not aware of any of the jiggery-pokery you suggest having taken place.
DeleteWell of course if there's no transparency then you won't be aware of any jiggery-pokery taking place, will you?
You can't trust the process just because you're not aware of any jiggery-pokery taking place; you have to have confidence that if there were jiggery-pokery then it would have been discovered.
So, how can the public have confidence in your system that the procedure has all been done properly? how can they be sure that if there had been any jiggery-pokery, it would have been noticed and corrected?
Where, in other words, is the transparency and accountability?