Could Wales be poised to devolve health? Asks @CllrRobJames
February 20, 2016
The integration of health and social care has become a buzzword for politicians on the left, yet Wales could provide the perfect test case for how it could be delivered.
Last year, then Shadow Secretary of State for Health, Andy Burnham, launched a 10-year plan for health and social care. Much of the proposals were a continuation of the White Paper he produced in 2010, including the development of local authority-led health and well-being boards managing a single health and care budget. This vision has yet to be tested in the UK, although that could all be about to change, with Wales now in a position to deliver a truly integrated health and social care service.
It was never intend for devolution to stop in Cardiff Bay and the next Welsh Labour Government need to embrace the idea of localism. Critics of the Welsh Government’s proposed local government reorganisation have pointed to this as an example of further centralisation, however it is this proposed reorganisation that presents an opportunity for Wales to lead the charge towards integration of health and social care.
Currently, seven local health boards are mandated to manage the NHS in Wales, whilst twenty-two local authorities provide community care. It is proposed by the current Welsh Labour Government that, after the elections in May, the number of local authorities will be reduced to around eight on similar boundaries to the current health boards. This provides an ideal opportunity to tackle the complex governance arrangements in Wales.
In an attempt to integrated health boards and local authorities, the Welsh Government has created three separate funding streams – the Intermediate Care Fund (ICF), the Regional Collaboration Fund (RCF) and the Delivering Transformation Grant (DTG). The ICF, RCF and DTG goes onto fund several regional collaborative committees that has no executive powers and no finance and six regional programme – each with their own partnership forum, leadership group, programme team and soon to be citizen’s panels. The Welsh Government last year also invested £6.7m in a new IT system for health and social care practitioners in Wales to share information.
Despite the aspiration of greater integration, there still remains a strong division between local authorities and health boards. Arguments between health boards and local authorities concerning the funding of individual care packages, a lack of dialogue between health practitioners and social workers on the ground, and a national government carrying the can for the failures of a health board, illustrates the desperate need for change.
The Welsh Labour party needs to remove the bureaucracy involved in delivering health and social care, and inject accountability into the system. The reduction in local authorities enables them to take on additional responsibility, such as delivering health services in their local area. The Labour Party has rightly praised the unequivocal rejection of markets in the NHS in Wales, yet much work needs to be done to tackle the growing privatisation of care.
In local authorities across Wales, the majority of community care is now being delivered by the third sector and for-profit organisations. Profiteering from the vulnerable is at a staggering high, with an estimated 40% of the £32 million spent by one local authority, going towards shareholder profits. With local authorities delivering health and social care under one budget, Councillors will be in a better position to tackle the care companies profiteering for the vulnerability of children and adults.
Despite health and social care being a policy area close to the hearts of many in the labour movement, UK Labour’s integrated health and social care plan lacks vital details, such as the new role (if any) of clinical commissioning groups under the new system. Wales’ future handling of health and social care will provide valuable food for thought for many Labour MPs.
Could the next Welsh Labour Government map out the right course for future Labour Governments to remove the marketisation of health and social care, integrated under a single budget? Much will depend on May’s election results and the will of future Ministers, although this could be a once in a generation opportunity to deliver a national health and care service fit for future generations.
Not So ‘Super Thursday’ – Lets Give Mark Carney Some Real Targets : By @rwscarter
February 18, 2016
Yet another consecutive meeting of the Monetary Policy Committee has kept the base rate constant at 0.5%, a phenomenon that’s fast become the norm having stuck at this historic low since March 2009. The base rate is the rate that the Bank of England (BoE) decides it’s willing to lend to other banks. Following the fall out of the economic crisis in 2008 the BoE appointed Mark Carney, the ‘Rockstar Bank Governor’ who brought in the notion of ‘Forward Guidance’ and amalgamated the banks announcements into a once a month event dubbed ‘Super Thursday’ (exciting stuff). But forward guidance has waned of late as it quickly became a movable goal post, this has cost the bank the euphoria surrounding ‘super Thursday’ meaning it has now faded into just another day of the week for many a pundit and commentariat it passes almost without notice.
Forward Guidance’ has been neither guidance nor useful for planning the future, with every target that is met another target is set. Endlessly moving the goalposts may be good stewardship, but it diminishes the credibility of the Monetary Policy Committee and the Governor himself. There is room to criticise but it would be unfair to criticise Mark because the bank has rather a limited scope and power. This begs the question what levers does the BoE have power over, and what could it lay claim to in the future?
It could do big things with the base rate but it cannot only have the one lever but in situations such as now the interest rate is detached from economic realities and so movements are subtle and backroom. Backroom moves over for example capital and reserve ratios have ramifications but tweaking is its limit. Then the BoE has Quantitative Easing (QE) aka ‘super loans’ by buying financial bonds though this has ground to a halt recently in the UK (though refinancing of these loans remains under reported). It begs the question what is the use of the BoE in these times and can we give them more levers?
There is serious scope for following the path of the FED and to ask the central bank to focus on growth, jobs and wages as well as the current ask of targeting inflation. This could be achievable, however, it is worth looking to give more tools to allow the bank to pursue policy objectives that take into account more than merely inflation changing their model to encapsulate other variables as inflation has detachment from growth and the level of unemployment of Foreign Direct Investment.
Following Jeremy Corbyn’s acceptance of Tax Justice Campaigner Richard Murphy’s idea from for People’s Quantitative Easing as part of the Corbynomics. This has since fallen flat as there is perceived to be no need for more Quantitative Easing but it did get considerable coverage and backing from some serious names in the macroeconomic sphere. This would involve buying bonds from a ‘State owned or backed Investment Bank’ that could invest into long term economic infrastructure at rock bottom interest rates within a political or apolitical way depending on preference. Governments cannot reach its targets using only fiscal policy and not monetary and by applying these targets and powers I would argue do not encroach on democratic mandates of governing parties and targets. As the targets would be set by the party in power and a Committee can decide who gets what say, taking it out of the hands of the ruling party.
Passing a target for growth and the powers to reach this may actually help close the democratic deficit that has the potential to foster when giving more power to an unelected bodies. This is because if there is a shift from inflation to real GDP targeting the central bank could respond in a more reasonable way to supply or demand shocks, such that, it might consider loosening rather than tightening monetary policy in response to a shock such as the Oil price. The ability to pursue a policy that does not run opposite to the ruling party but alongside it would mean better results for both employment and growth and the economy’s health as a whole.
The BoE would be better equipped going forward, and have more options if it had to respond to a crisis like 2008. There would also be no threat of encroaching on the democratic mandate of governing parties If it had to answer to the Chancellor and or the Prime Minister on growth as well as or instead of merely inflation for example. It would also create an environment whereby it could have a more adequate response, both sharper and better targeted. Not one of these proposals would require changing greatly the original mandate for an independent and nonpolitical Bank of England enshrined a little over 18 years ago. It is also time to get a better deal from and for the BoE recognising its need for renewal is vital for the economy and democracy.
For more on this visit my website : rwscater-the-archive.uk , drop me a tweet on @rwscarter or email me on email@example.com .
Is there positive power held in negative interest rates? By @rwscarter
February 18, 2016
Firstly, what is a negative interest rate?
It is a bond issued by the government or a corporate bond (though less likely and less common) that offers a negative yield. As an example, if a bond cost £100 and the interest rate was negative 1% for a yearly bond, the money you’d get back at maturity would be £99.
Japan has recently gone deliberately negative and Germany’s 10 year government bonds are currently at negative rates, with the UK’s being around 0. The real fallacy in my mind however isn’t people investing in negative yields. There’s a variety of reasons why they would, as I set out in this piece, but by the governments being so ideologically wedded to deficit reduction, in the most counter intuitive way they are contracting demand with threats of deflation and wage stagnation, and across Europe at least chronic under investment and unemployment.
How do negative rates come about and who buys them?
This is both a deliberate attempt by a central bank or government policy, but it can also be due to the nature of people buying the bonds at any one time too.
Some institutions and banks hold bonds as an asset to offset a liability. The intrinsic value of a bond can be seen as the value at maturity plus or minus the interest rate. The central banks have also been buying up government bonds as part of the QE process which has driven the price up and the yield down.
There are also those whom buy bonds with negative interest rates, as they are deemed to have positive returns when held in different currencies, where currencies trade at different prices. The value of currencies changes based on confidence, import/export differences (balance of payments) and interest rates in a country, as every deposit in a given country is held in that currency. This is why I predict that if and when the Euro finally stops printing and issuing €500 notes, that the consequence for the Euro-zone will be a reduction in the interest rate for government bonds.
For more on this and negative interest rates visit my website on rwscarter-the-archive.uk ,drop me a tweet on @rwscarter or email me on : firstname.lastname@example.org.
On the subject of bullying in the Labour Party, by @BevClack and @MagsNews
February 9, 2016
Respect! Or.. The Art of Listening.
Reference is often made to Labour ‘being a broad church’. Essentially, that means that Labour is a voice of many, for the many. But it has often taken much soul searching and debate to be able to reach the one voice with which the Party, eventually, speaks.
There is a strong history of us listening to each other.
There are times when we agree and times when we disagree.
If we agree: all well and good.
But there are times when it is difficult to reach agreement.
Then we need to take time to talk with each other, to share our views and listen to what the other person is saying. This works well when we feel able to say we disagree. This works well when the views of ourselves and others are treated with respect.
And here we get to the problem with the tone of current discussions within the Labour Party.
Of late there have been too many examples of impatience, an unwillingness to understand, an unwillingness to try to co-operate with each other, and even, at times, there has been downright rudeness in the way we communicate with each other.
Last week one account on Twitter caused a fair bit of unhappiness by targeting one of our oldest members *yet again*. Various accusations were being made. Mags was concerned that some of the comments directed at this member were ugly and uncalled for, and she made a point of calling this behaviour out. She was not alone, and others joined her in calling such behaviour unacceptable. Later, the Zelo Street Blog busted some of the stories that were being spread. The truth came out. Twice. (Perhaps better not to give the opposition the opportunity to bully too!)
This incident led to Mags receiving a number of messages which told her that this kind of bullying within the Labour community wasn’t only online, but was also happening in Constituency Labour Parties.
Such behaviour is also going on within the Parliamentary Labour Party, and, at the time of writing, the behaviour of a few MPs towards Emily Thornberry at a meeting of the PLP suggests that proper debate is difficult even for those selected to be the voice of the party at Westminster.
This kind of aggressive behaviour is unattractive and unacceptable, regardless of the part of the party from which it comes.
It’s time to stop!
Bullying occurs when people are unhappy, when they feel frustrated. We are well-aware of the poisonous effect of such behaviour in schools and the workplace.
To see it happening within the Labour community is heart-breaking.
Some people in the Party seem only prepared to see one way forward: their way. They see no room for compromise. And yet it is only through conversation, debate and compromise that we will be able to act together to create the fairer society we all seek.
So what can we do about this?
Most importantly, we should not accept such intolerant behaviour. On Twitter this is easily solved: we can block those remarks and we can call them out In ‘the Real World’ it can be more difficult, but bullies should always be called out, and if that doesn’t stop them then some kind of mediation or action from ‘authority’ may be necessary.
Fortunately there are still many of us around who value open discussion and debate. Many of us do show respect towards each other, and, in fact, only a few people are behaving in such negative ways.
But the number of bullies appears to be growing.
We have read about the bullying of Elliot Johnson in the Tory Party, and we have seen the pain that his parents are suffering. The bullying he was subjected to began a long time ago. We all know the details and the very sad outcome. A police investigation is now being undertaken. Our motive in raising this sad case is to point out that bullying in political parties needs to be recognised, acknowledged and nipped in the bud quickly before it gets out of hand. In extreme cases it can have detrimental effects on the lives of the victims. At the very least, it makes lives very miserable.
So if you are a victim of bullying – don’t stand for it! Call them out! And keep doing so. Others will take notice and assist.
And if you feel the need to lie about people and/or target them with nasty comments then perhaps it’s time to sincerely question your motives and your actions. Why would you wish to do this? It’s unnecessary and it’s cruel. If necessary seek some help.
No one’s life should be made miserable as a result of bullying or aggressive behaviour within the Labour community.
The day we stop caring about each other, the day we stop seeing each other as comrades, is the day when we might as well pack it in, because at the end of the day each other is all we have.
We have a lot of work to do and elections to win. People out there are depending on us to fight for them in the face of a government determined to destroy the Welfare State that we all depend upon in one way or another. We need to put our energies into developing policies that show we care and we can only do that if we show respect for each other’s views as we work at establishing a consensus within the Party.
We all know what acceptable and unacceptable behaviour is: we are, after all, adults! If you would rather spend your time making personal attacks on people within the Party than perhaps you should seriously consider whether the Party is for you.
It’s time to start respecting one another again and to cultivating that most difficult of skills: the ability to listen.
If we don’t do this then *we* shall end up becoming a ‘nasty party’, and the day that happens will be the day when Labour has nothing positive to offer the British people.
There is more to bring us together than to divide us. We have many wonderful people within the Labour Party. Times are changing and we have new challenges. We are a growing party. There is much positivity across the country within Labour, good work being done within our communities. You might be speaking from the benches in Parliament, working within our Town and Civic Halls, pushing leaflets through doors, organising, keen to share your thoughts by writing, tweeting – and indeed some manage to do a combination of all of the above.
You do those things because you care.
Economist Thomas Piketty says he would vote for Corbyn and McDonnell
December 15, 2015
French economist Thomas Piketty sat down with Newsnight host Evan Davis to discuss the wealth inequality caused by capitalism and the importance of taxes, as well as philanthropy. He also spoke about his support for Labour under Jeremy Corbyn. Piketty will join the economic advisory panel assembled by John McDonnell to shape Labour’s future economic policy.