UK Politics

The Ugly Face of 'Muslim' & 'Christian' Patrols

7 Feb 2014 at 12:26

Yesterday on my LBC Drivetime Show we talked about the rising tide of extremism in some areas of Tower Hamlets in the East End of London. Last year there was a lot of publicity about the so-called ‘Muslim Patrols’ who were seeking to impose Sharia Law by ordering people to stop holding hands in the street, to stop drinking alcohol etc. Several members of these patrols were arrested and charged. But there is now a worrying development. So-called ‘Christian Patrols’ have now been formed by a man called Paul Golding who says he is the leader of a radical right group called ‘Britain First’. They hang around outside the East London Mosque, holding cans of Stella Artois, trying to provoke confrontations with muslims in the mosque.

On the programme I started off by interviewing Matthew Collins from ‘Hope Not Hate’, which provoked Paul Golding to phone in. A little later we took a call from Abu Remaysah, who says he is the founder of the ‘Muslim Patrols’. Both conversations became a little heated, as you will hear if you listen to these two Audioboos.

All a bit ‘Life of Brian’, if you ask me!

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LBC 97.3: Iain Dale talks to Peter Hennessy

Professor Peter Hennessy discusses his latest book DISTILLING THE FRENZY

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Are You a Gay Homophobe?

6 Feb 2014 at 08:00

Stick with this till the end.

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Geoffrey Robertson talks about his new book on Stephen Ward.

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UK Politics

Why the LibDem Seats Will Win 30-35 Seats in 2015

5 Feb 2014 at 08:07

There’s a lot of speculation about the number of seats the Liberal Democrats will win at the next election. Some people expect a virtual wipeout, while LibDems themselves cling onto the hope that incumbency will help them win seats they might otherwise lose. The truth will probably lie somewhere in between. So far quite a few very popular LibDem MPs have announced they will stand down, something which could not come at a worse time for the LibDems. The question is how many more there will be.

I got myself into a lot of trouble on election night in 2010 when I promised to run down Whitehall naked if the LibDems only won 59 seats, which was the BBC projection. When I interviewed Danny Alexander he said he’d join me. They actually only won 57, albeit with 23% of the vote. I have yet to fulfill that threat, and won’t be doing so! I think the only way to gauge how many seats the LibDems will win in 2015 is to go through their MPs, seat by seat, and analyse the probable result. So here goes…

Detailed analysis below, but here are the results. Of the 57 seats, I predict 35 will remain LibDem, 14 will fall to the Conservatives and 8 to Labour. But of the 35 LibDem Holds, I reckon only 13 are dead certs, 9 are hot bets, 8 are probable and 5 are rated as possible, but by no means definite.

In the predictions below I have assumed that Labour will be the beneficiaries of most of the decline in LibDem votes across the country but that the Conservatives might benefit a little in the south and south west. The big unknown factor here is how the size of the UKIP vote might affect existing Conservative vote levels in many of these seats. I have tried not to make these predictions through blue tinted spectacles, but it maybe that I will have underestimated the impact of UKIP. I have also assumed that the LibDems will not win a single one of their top 20 target seats. Even if that proves to be wrong, looking through the list it is hard to see more than a handful of even remotely possible gains based on the way things look at the moment.

I wonder how many LibDems would settle for 35 seats now, if they could.

Do leave comments to explain why you disagree with individual seat predictions. Here they are, together with brief explanations.

INVERNESS, NAIRN, BADENOCH & STRATHSPEY
Danny Alexander
Majority: 8,765 over Labour
Prediction: DEAD CERT LIBDEM HOLD

LEWES
Norman Baker
Maj: 7,647
Prediction: PROBABLE LIBDEM HOLD
If Labour takes enough votes from the LibDems it could let the Conservative in, and Lewes used to be a safe Tory seat. Baker’s local popularity should see him through but with a much smaller majority.

BERWICK UPON TWEED
Sir Alan Beith (retiring – Julie Pörksen selected)
Maj: 2,690 over the Conservatives
Prediction: PROBABLE CONSERVATIVE GAIN
The Conservative candidate Anne Marie Trevelyan stood in 2010 and if her vote holds up, she only needs Labour to take a small proportion of the LibDem vote. Beith’s incumbency will also disappear.

BURNLEY
Gordon Birtwistle
Maj: 1,818 over Labour
Prediction: LABOUR GAIN
Birtwhistle is a straight talking northerner and speaks out against what he views as wishy washy Liberalism. He’s very popular but it would be a major shock if he held on to the seat he snatched from Labour in 2010.

CARSHALTON & WALLINGTON
Tom Brake
Maj: 5.260 over the Conservatives
Prediction: POSSIBLE CONSERVATIVE GAIN
Somewhat charismatically challenged Brake is nevertheless a very good constituency MP and this could seem him through, but the Labour vote here is bound to recover. However, I’d say this was a 50/50 prediction and could easily go the other way. This would be the sixth time Brake has fought the seat and that counts for a lot.

MID DORSET & NORTH POOLE
Annette Brooke (retiring – Vikki Slade selected)
Maj: 269
Prediction: CONSERVATIVE GAIN
It was a shock this seat didn’t go Tory last time. With Annette Brooke standing down the LibDems will have to perform miracles to keep this seat.

TAUNTON DEANE
Jeremy Browne
Maj: 3,993 over the Conservatives
Prediction: POSSIBLE CONSERVATIVE GAIN – 50/50
Boundary changes last time increased Browne’s majority from just over 500. I don’t know how popular he is locally. Seen as a very good minister it was a shock when he was sacked by Clegg. Might he stand down? I’d say this was a 50/50 call.

GORDON
Sir Malcolm Bruce (retiring – Christine Jardine selected
Maj: 6,748 over the SNP
Prediction: 100% LIBDEM HOLD

SUTTON & CHEAM
Paul Burstow
Maj: 1,608
Prediction: PROBABLE CONSERVATIVE GAIN
The Labour vote has halved to 7.7% since 1997 and will inevitably rise in 2015. Paul Burstow is standing again and incumbency could play a vital role if he is to retain his seat, but if the Tory vote holds up, he may have a problem.

SOLIHULL
Lorely Burt
Maj: 175
Prediction: CONSERVATIVE GAIN
Lorely Burt did very well to hang onto her seat last time (she won it in 2005 with a majority of 279) and confounded all expectations. The Labour vote has gone down from 25% to 8% and if Labour takes just a thousand votes from the LibDem the Conservatives will win a seat many think they should never have lost.

TWICKENHAM
Vince Cable
Maj: 12,140
Prediction: DEAD CERT LIBDEM HOLD

NORTH EAST FIFE
Sir Menzies Campbell (retiring)
Maj: 9.348
Prediction: LIBDEM HOLD
The Conservatives will be targeting this seat but it’s a remote hope for them. The new LibDem candidate may suffer a dent in their majority but unless Ming Campbell’s personal vote is more than the norm, this seat should stay Liberal Democrat.

ORKNEY & SHETLAND
Alistair Carmichael
Maj: 9,928
Prediction: DEAD CERT LIBDEM HOLD
None of the other parties come close, with the LibDems winning 62% of the vote in 2010. Jo Grimond’s legacy is safe!

SHEFFIELD HALLAM
Nick Clegg
Maj: 15,284
Prediction: DEAD CERT LIBDEM HOLD
This used to be a Tory seat, but it would take a political earthquake for them to take it off Nick Clegg. Interestingly the Labour vote has started to rise, but not enough to cause the LibDems to panic.

EDINBURGH WEST
Michael Crockart
Maj: 3,803
Prediction: PROBABLE LIBDEM HOLD
This seat went LibDem in 1997 and although the LibDem majority plummeted by 10,000 last time it is difficult to see them losing. Prior to 1997 it was a Tory seat but last time Labour beat the Tories into second place. A Labour victory is not impossible to imagine, but still rather unlikely.

KINGSTON & SURBITON
Edward Davey
Maj: 7,560
Prediction: LIBDEM HOLD
Ed Davey won this seat in 1997 with a wafer thin majority of 56, which rose to more than 15,000 in 2001. But since then the Conservative vote has been on the rise. Davey has only managed to win with such handsome majorities because he has squeezed the Labour vote from 23% down to 9%. If that trend reverses, the Conservatives could squeak it, but it’s highly unlikely.

WESTMORLAND & LONSDALE
Tim Farron
Maj: 12,264
Prediction: DEAD CERT LIBDEM HOLD
Tim Farron has 60% of the vote and while the Conservatives held this seat as recently as 2001, they have zero chance of winning it back in 2015. Why? Because it’s a two horse race. In 1997 the Labour vote was more than 20%. In 2010 it was 2%.

HORNSEY & WOOD GREEN
Lynne Featherstone
Maj: 6,875
Prediction: POSSIBLE LIBDEM HOLD
Since 1997 Lynne Featherstone has built up the LibDem vote from 5,000 to 25,000 so as a constituency campaigner she is hard to beat. Meanwhile the Labour vote has declined from 31,000 to 18,000. Meanwhile the Conservatives have gone down to 21,000 to 9,000. This is a difficult one to call, but on balance Lynn Featherstone will probably retain the seat.

BATH
Don Foster (retiring)
Maj: 11,883
Prediction: LIBDEM HOLD
The Conservatives have been desperate to win this seat back since Chris Patten lost it in 1992, but it’s extremely unlikely to revert to the fold despite the fact that Don Foster is standing down.

ST IVES
Andrew George
Maj: 1,719
Prediction: POSSIBLE LIBDEM HOLD
The Tories got a 10.39% swing last time and took a huge chuck out of Andrew George’s 11,000 majority. This time George will be hoping UKIP’s vote reduces Tory potency. His incumbency and local popularity should see Andrew George home, but it may be a close call.

ST AUSTELL & NEWQUAY
Stephen Gilbert
Maj: 1,312
Prediction: POSSIBLE CONSERVATIVE GAIN
This seat could go either way. Labour are nowhere with only 7% of the vote. If UKIP does well in the South West, the LibDems win here, if they don’t, they won’t.

CHELTENHAM
Martin Horwood
Maj: 4.920
Prediction: PROBABLE LIBDEM HOLD
A Liberal Democrat seat since 1992, this is one which the Conservatives had expected to take back in both 2005 and 2010, but it wasn’t to be. The Labour vote has been squeezed to just 5%. Martin Horwood is extremely popular and will have built up a high personal vote. On a catastrophic night for the LibDems it’s easy to see Cheltenham falling, but not otherwise.

PORTSMOUTH SOUTH
Mike Hancock (deselected)
Maj: 5.200
Prediction: POSSIBLE CONSERVATIVE GAIN
This seat has never had a huge LibDem majority since it was won by Mike Hancock in 1997. It’s always ranged between three and six thousand. It’s difficult to assess the impact of the groping scandal, but on top of their national woes, it could be that the Tories win back what was once for them a safe seat. Hancock has failed to squeeze the Labour vote as much as some of his colleagues, and not so long ago they managed a healthy 25%. If they return to those levels the Tories will win.

NORTH DEVON
Nick Harvey
Maj: 5,821
Prediction: PROBABLE LIBDEM HOLD
Ever since this seat was wrested back from the Conservatives in 1992 pundits have predicted it would return to the Tories, but astute constituency campaigning by Nick Harvey has prevented this from happening. I don’t see this changing. This seat has a strong UKIP vote which inevitable depresses that of the Conservatives.

SOMERTON & FROME
David Heath (retiring)
Maj: 1,817
PREDICTION: PROBABLE CONSERVATIVE GAIN
LibDem HQ must have bee tearing their hair out when David Heath announced his retirement as he stood the best prospect of retaining this seat. His current majority is the larges he has ever enjoyed, but that is largely because at the last election the UKIP vote doubled to nearly 2,000. If they do the same in 2015 they could deny the Conservatives a gain they thought they had in the bag last time.

BIRMINGHAM YARDLEY
John Hemming
Maj: 3,002
Prediction: PROBABLE LABOUR GAIN
Hemming is a maverick and I wouldn’t bet against him pulling off a surprise, but if Labour is to form a government it’s this kind of seat they need to take back.

CHIPPENHAM
Duncan Hames
Maj: 2,470
Prediction: POSSIBLE CONSERVATIVE GAIN
Although is majority isn’t big, Duncan Hames has dug himself in since winning the seat in 2010 and will be difficult to shift. But the Tory candidate Michelle Donelan is a good campaigner. Yet again, her success depends on warding off UKIP and encouraging LibDems to vote Labour.

BERMONDSEY & OLD SOUTHWARK
Simon Hughes
Maj: 8,530
Prediction: DEAD CERT LIBDEM HOLD
No comment needed.

EASTLEIGH
Mike Thornton
Maj: 1,771
Prediction: POSSIBLE CONSERVATIVE GAIN
The Conservatives thought they would win this seat back at each of the last two general elections, but each time Chris Huhne pulled through. At the by-election they came third, with UKIP almost pipping the rather monochrome Mike Thornton. It’s highly unlikely UKIP’s vote will hold up so the outcome of this seat may depend on where UKIP’s voters put their cross. If enough of them return to the Conservative fold, it could be enough to see the Conservative home.

CHEADLE
Mark Hunter
Maj: 3,272
Prediction: PROBABLE LIBDEM HOLD
Apart from a narrow majority in 1997 of 33, the LibDems have had a majority of three or four thousand in this seat ever since. As long as the slightly resurgent Labour vote doesn’t gain too much traction, I think Mark Hunter will be safe.

CAMBRIDGE
Julian Huppert
Maj: 6,792
Prediction: POSSIBLE LIBDEM HOLD
If you look at the size of the LibDem majority here, Julian Huppert ought to be considered very safe, but this is a seat which swings with the wind, and if the wind is blowing towards Labour you can see it returning to them. It obviously has a high student vote and this may determine the outcome. However Huppert has been a strong performer both locally in Parliament and if anyone can hold this seat for the LibDems, he can.

ROSS, SKYE AND LOCHABER
Charles Kennedy
Maj: 13,070
Prediction: DEAD CERT LIBDEM HOLD
Out on his own, and despite an invisible presence in this Parliament, there would need to be a miracle to shift Charles Kennedy.

NORTH NORFOLK
Norman Lamb
Maj: 11,626
Prediction: DEAD CERT LIBDEM HOLD
Lamb’s majority was even bigger than the one he had over me in 2005. Although I think it will reduce in 2010 due to the crumbling LibDem local organisation and the resurgent North Norfolk Labour Party, he will still win handsomely.

YEOVIL
David Laws
Maj: 13,036
Prediction: DEAD CERT LIBDEM HOLD

MANCHESTER WITHINGTON
John Leech
Maj: 1,894
Prediction: LABOUR GAIN
Although John leech trebled his majority last time, I fear the bell tolls for him unless UKIP can take a lot of votes from Labour.

EASTBOURNE
Stephen Lloyd
Maj: 3.435
Prediction: PROBABLE CONSERVATIVE GAIN
Won in 2010 from Nigel Wateson, Steohen Lloyd may hang on, but I’d expect the Labour vote to at least double at the expense of the LibDems, so yet again, a lot depends on how many votes the Tories lose to UKIP.

BERWICKSHIRE, ROXBURGH & SELKIRK
Michael Moore
Maj: 5,675
PREDICTION: LIBDEM HOLD
David Steel’s old seat – never been 100% safe, but it would be a major shock for the Conservatives to take this seat.

LEEDS NORTH WEST
Greg Mulholland
Maj: 9.103
Prediction: DEAD CERT LIBDEM HOLD
A Labour seat as recently as 2005, Labour has now slipped to third place. With a classic split opposition situation it would be a brave man who would vote against a third term for Greg Mulholland.

WELLS
Tessa Munt
Maj: 800
Prediction: PROBABLY CONSERVATIVE GAIN
The former seat of David Heathcoat-Amory Tessa Munt won Wells in 2010. The Tories will make every effort to regain it and will be devastated if they don’t pull it off.

SOUTHPORT
John Pugh
Maj: 6,024
Prediction: LIBDEM HOLD
It’s difficult to see this as anything other than a LibDem win.

ARGYLL & BUTE
Alan Reid
Maj: 3,431
Prediction: POSSIBLE LIBDEM HOLD
A four way marginal, this could go to any of the main parties. If the LibDems lose my guess is that it would go to Labour, even though they were in third place in 2010.

NORTH CORNWALL
Dan Rogerson
Maj: 2,981
Prediction: PROBABLY CONSERVATIVE GAIN
A seat where the LibDem majority has been on the slide in every election since 1997’s highpoint of more than 13,000. If UKIP hadn’t existed, the Conservatives would have won this seat in 2010. So the key question is whether they will eat further into the Conservative vote in 2015. If so, the LibDems will hang on. Otherwise this is a pretty safe bet for the Tories.

COLCHESTER
Sir Bob Russell
Maj: 6,982
Prediction: LIBDEM HOLD
Difficult to see anything other than another home run for Sir Bob!

TORBAY
Adrian Sanders
Maj: 4,078
Prediction: POSSIBLE LIBDEM HOLD
Regarded as a surefire Tory gain in 2010 it didn’t happen, and in all honesty Adrian Sanders has built up a string personal vote which may carry him through once again.

WEST ABERDEENSHIRE & KINCARDINE
Sir Robert Smith
Maj: 3.684
Prediction: PROBABLE LIBDEM HOLD
Although the LibDem majority was halved last time, it’s difficult to see anything other than another victory for Sir Robert Smith.

HAZEL GROVE
Andrew Stunell (retiring – Lisa Smart selected)
Maj: 6,371
Prediction: PROBABLE LIBDEM HOLD
The LibDem majority has fallen in every election since 1997 but the Tories haven’t been able to capitalise. And I don’t see them bucking the trend in 2015.

REDCAR
Ian Swales
Maj: 5,214
Prediction: LABOUR GAIN
This was a very surprise result last time and was in large part to massive job losses on Teesside. On that basis the seat may return to its natural fold.

EAST DUNBARTONSHIRE
Jo Swinson
Maj: 2,184
Prediction: LABOUR GAIN
Jo Swinson is popular but all the political portents are against her. She will be a major loss to the LibDems.

BRENT CENTRAL
Sarah Teather (retiring)
Maj: 1,345
Prediction: DEAD CERT LABOUR GAIN
If the LibDems retain this seat it will be miracle of all miracles.

CAITHNESS, SUTHERLAND & EASTER ROSS
John Thurso
Maj: 4,828
Prediction: LIBDEM HOLD
A small electorate, Thurso should hold the seat he won in 2001.

BRADFORD EAST
David Ward
Maj: 365
Prediction: DEAD CERT LABOUR GAIN
One of the nastier LibDem MPs, few will shed tears at his demise.

THORNBURY & YATE
Steve Webb
Maj: 7,116
Prediction: DEAD CERT LIBDEM HOLD

NORWICH SOUTH
Simon Wright
Maj: 310
Prediction: DEAD CERT LABOUR WIN
Student fees will do for Simon Wright due to the large university vote. Of all the seats the LibDems are slated to lose, this is the deadest certs of dead certs.

CEREDIGION
Mark Williams
Maj: 8,324
Prediction: DEAD CERT LIBDEM HOLD

BRECON & RADNORSHIRE
Roger Williams
Maj: 3,747
Prediction: LIBDEM HOLD
A Conservative gain here is not out of the question but it is difficult to work out where their extra votes are going to come from.

BRISTOL WEST
Stephen Williams
Maj: 11.336
Prediction: DEAD CERT LIBDEM HOLD

CARDIFF CENTRAL
Jenny Willott
Maj: 4,576
Prediction: PROBABLE LIBDEM HOLD
Labour have their sights in this one. It may prove out of their reach.

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Quote of the Day

Quote of the day: Michael Gove

3 Feb 2014 at 11:43

One of my favourite books is the Strange Death of Liberal England.

Michael Gove

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18 Doughty Street, Brought to Book

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Quote of the day: Ayn Rand

2 Feb 2014 at 23:37

Individual rights are not subject to a public vote; a majority has no right to vote away the rights of a minority; the political function of rights is precisely to protect minorities from oppression by majorities (and the smallest minority on earth is the individual).

Ayn Rand

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Media

Who Will Be The New Sky News Political Editor?

2 Feb 2014 at 14:19

This week applications close for the position of Sky News Political Editor. There has been much speculation about who the runners and riders are, with some ludicrous names being put forward by some of the betting companies to succeed Adam Boulton. I would say this is one of the top three jobs in political broadcasting, Nick Robinson and Andrew Neil occupying the other two. So I thought I’d spend a few minutes of my Sunday mulling over who the real contenders might be, and perhaps who they ought to be.

Let’s start with the internal candidates. While Sophy Ridge has impressed since she joined Sky News, it’s probably a bit to early for her to be a serious contender. Joey Jones and Jon Craig have the strongest claims and both have a right to be considered very seriously. Craig has scored brownie points with Sky bosses for not throwing his toys out of the pram when Jones got the coveted ‘Deputy’ post, although he was clearly miffed. He’s an old fashioned journalist and can sniff out a story others might miss. He’s good on screen and popular across the parties, something which is an important prerequisite. Joey Jones is a superb analyst, rarely makes a wrong call and took to the Westminster beat like a duck to water. As Deputy he may well have the strongest internal claim, but it has to be said that deputies rarely inherit the crown. The rumour mill suggest that Sky want a political editor with a bit more ‘sizzle’ than Jones may be able to offer, but this is not a showbiz role, and substance ought to triumph over style.

I’d throw three other Sky names into the ring. Niall Paterson left the Sky Westminster Office a couple of years ago and was moved to the defence brief. He now covers media and technology. I was very sad to seem him go from politics as I thought he was the most brilliant exponent of the ‘live to camera’ art of reporting. I hope he has thrown his hat into the ring, and could be worth an outside bet. Dermot Murnaghan may feel that the time might be right for a move from the studio to get his teeth into day to day politics, something you can see he relishes from his Sunday morning programme. And Sky stalwart Stephen Dixon, who presents the weekend Sunrise show, should not be discounted. He is very well plugged into Westminster politics, is good on camera and has a wicked sense of humour.

Tom Bradby who has had the ITV News Pol ed job for nine years now. By the election next year it will nearly be ten years. He wouldn’t be human if he wasn’t thinking of what’s next. He’d be brilliant on Sky but with a young family, living outside London and his book and film exploits, it’s difficult to think he would relish putting in the hours that are a basic part of the Sky job. As an on screen presence he is hard to beat and he clearly loves his politics.

Chris Ship and James Mates from ITV are also outside bets. Shippy always has a wicked glint in his eye and I’d love to see him on a 24 hour news channel as I think he’d be highly entertaining outside the straitjacket of a half hour news programme. Mates would also do a good job, although may not like the hours. Last but not least there are many people who think Andy Bell, Channel 5’s political editor would slot into the Sky job very easily. Likeable and polished, he has a great on-camera look and is quick on his feet.

Let’s look at candidates who currently work for the BBC. Had Laura Kuenssberg not already just signed up for Newsnight I think she would have been the candidate to beat. She is one of the best political reporters on TV at the moment and I am so glad she will be a key part of Newsnight’s future. I’m told she was tipped off about the Sky job becoming available but still pressed ahead with Plan A to leave ITV for the pasture of Newsnight. That’s a clear indication, I’d have thought, that she sees her long term future at the BBC and maybe has half an eye on the BBC Political Editor’s job after the election. So that brings us to Nick Robinson. What a coup it would be if Sky could tempt him. I can’t see it happening, even though I think it’s a job Nick would revel in and excel at. It wouldn’t surprise me if discussions had taken place, but if he did it, it would be a political media earthquake. James Landale is one of the bookie’s favourites and it is easy to see why. He’s got a print background, is brilliant at ‘lives’, has a good screen presence, little fazes him and he has a brilliant sense of humour, as evidenced by his piece on THIS WEEK a couple of weeks ago. I often feel that he would come into his own if he was given a bit more freedom, and the Sky job would do that. Some say his background as an Old Etonian may provide a hurdle, but if it does, it shows what a perverse world we live in.

John Pienaar is a great live broadcaster and has a superb contacts book, but I’ve always seen him as very much a BBC man. The fact that for some years now he has concentrated on radio rather than TV may count against him. Jon Sopel may also be applying on the basis that he has been more or less frozen out of BBC political coverage and is restricted to presenting on the News Channel, after many years walking the Westminster beat. My penultimate BBC tip, and it’s very much an outside bet, is Robert Peston. If he calculates that the BBC is unlikely to allow him to succeed Nick Robinson, he might well apply for the Sky job, as I am told he is desperate to join the political beat that he last walked at the Financial Times.

My final BBC candidate would be Jeremy Vine. He’s one of the finest political broadcasters of our time and may feel that ten years in the Radio 2 lunchtime hotseat is enough. He’d add some vitality and pizzazz to the Sky output and it would free him from having to dress as a cowboy on the BBC election night show. If I were him, I’d be seriously thinking about applying for it. Or when you get to his level, maybe you don’t apply for things – they come looking for you.

There’s a story doing the rounds that Adam Boulton left his computer on and someone walking past spied a memo he had written to Sky News chief John Ryley where he recommended a candidate with ‘bottom’. The two names he suggested were apparently James Landale and Gary Gibbon, Channel 4 News’s political editor. Gibbon certainly ought to be in the running. He’s authoritative, respected and very much in the Michael Brunson mould of political journalists. Gary’s problem may be that he mainly does packages rather than breaking news reports into Channel 4 News and hasn’t had the chance to show his wares live on his toes. If you see what I mean! His newsreading colleague Cathy Newman has also been mentioned as a favourite. Like Gary, she knows a good political story when she sniffs one, but again, suffers from a lack of breaking news reporting experience in her current job. One man who certainly doesn’t suffer from that is Channel 4 news chief political correspondent Michael Crick. He might be regarded by Sky News suits as too awkward to manage, but if they want someone in the Adam Boulton mode, they could do far worse. His plebgate scoops are proof that he’s still ‘got it’.

It’s not easy to make the transition from print media to TV. Robin Oakley never quite managed it, yet James Landale and Jon Craig took to broadcasting like ducks to water. You never can tell. So in many ways it would be a big risk to pluck someone from a newspaper and put them straight into the top job. The Sun’s Tom Newton Dunn was an early favourite with the bookies, but his odds have lengthened. His role in the Plebgate story may count against him until the court cases are put to bed, so it may be wrong time, wrong place for Tom. Had Tim Shipman not just moved from the Mail to the Sunday Times I would have tipped him as a good outside bet. He doesn’t do much TV but there are few better story getters in the lobby than Tim. George Parker from the Financial Times is said to be keen to throw his hat in the ring and is the subject of some heavy betting. He has upped his broadcast presence and is doing quite a lot of radio.

Andrew Rawnsley ought to be in the running, but his name hasn’t been mentioned anywhere so far as I can see. Although he is seen as on the Blairite left, he is popular across the political spectrum and has a huge amount of broadcasting experience. Those of us who are a bit long in the tooth will fondly remember A WEEK IN POLITICS which he co-presented with the much missed Vincent Hanna. He’s got great political nouse and has a very good turn of phrase. I think he’d be great at the job.

However, if I were to nail my colours to the mast and put forward one candidate from the print media I have no hesitation in saying I would plump for The Guardian’s Nicholas Watt. How he is not political editor of one of the broadsheets is quite beyond me. His spot on THIS WEEK and his films for the DAILY POLITICS have allowed us to see what a great political brain he possesses and what a good broadcaster he is. If he doesn’t get the Sky job, he will surely be snapped up soon by one of the broadcast media.

Whoever gets the job has a very hard act to follow. Adam Boulton is a political broadcasting colossus. He’s one of the few people who have truly changed the terms of trade in political news TV. He really blazed a trail. It’s been clear for some time that he had itchy feet. His few months in the US before the presidential election bore testimony to that and I can see him doing a lot more of that sort of thing. He and Sky have both been quick to maintain that he will still have some sort of political role and I imagine he will present their election night coverage. But how much of a back seat driver will he be? Will he still have an office at Millbank, for instance? If I were replacing him I’d want some pretty good guarantees that he wouldn’t be looking over my shoulder the whole time. Think Michael White at The Guardian and Trevor Kavanagh at The Sun. It wasn’t easy at all for their successors with both retained by their respective papers even after they stepped down as political editors.

I wondered whether to write this blogpost at all, seeing as I know virtually all of the contenders and it’s a bit invidious to choose between them, but in the end that’s what Sky have to do.

So apologies to everyone else, but if I were Sky I’d be picking Nick Watt. Which almost guarantees they won’t. Sorry Nick.

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It Shouldn't Happen to a Radio Presenter 14: When Bob Crow's RMT Lies To You

1 Feb 2014 at 16:25

Yesterday we rang to RMT to invite Bob Crow to appear on my radio show. Boris Johnson had just made an offer to meet him to talk about ticket office closures. His press people said they’d get back to us but Bob was a bit busy. “There’s a lot going on,” they said. Yes indeed. Today the Daily Mail tells us that this was going on.

I don’t begrudge anyone a holiday, but to take three weeks off on a luxury £7,000 holiday in the days leading up to a 48 hour tube strike is surely a bit much. I am sure RMT members will be very impressed.

And if the RMT press office is reading this. I don’t like being lied to, and nor do my producers and more importantly, nor do my listeners. I think an apology is appropriate.

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LBC Becomes a National Radio Brand

30 Jan 2014 at 10:09

It’s just been announced that LBC is going to go national on February 11th. We will be transmitting on the National Digital One DAB platform meaning that for the first time all our programmes can be heard all over the country. You can imagine what massive implications have for the station both in terms of audience building and content. The announcement came on this morning’s edition of CALL CLEGG and I imagine there was a collective cheer in the Global Radio newsroom.

Global is a massive player in the radio industry. In our building we have the studios of Capital, Capital Extra, Gold, Smooth, Classic FM, XFM and Heart. LBC now joins those stations as national brands. Only four months ago LBC celebrated its 40th birthday. This relaunch on February 11th means we change from ’London’s Biggest Conversation’ to ‘Leading Britain’s Conversation’ as our strapline.

It seems unbelievable that Britain hasn’t already got a national talk radio station, but ever since Talk Radio became Talk Sport there has been a massive gap in the market. 5 Live has phone-in elements to it, as do BBC local radio stations, but with LBC it’s 24/7. We know there’s a real appetite for it as our audience in London has doubled in recent years. I remember the reaction from listeners in some parts of the country when LBC was taken off the local DAB transmitters. I think we had something like 4,000 emails from Yorkshire alone. Well, all those listeners can now enjoy us on the national DAB platform once again. Of course we are already on Freesat and Sky (channel 0112) and people can listen online via the LBC app, so there has always been a sizeable national listenership but it will be great to be taking more phone calls from Cornwall, Birmingham, Llandudno and Auchtermuchty.

Global founder & executive president Ashley Tabor said…

LBC has been a pioneer since it began broadcasting as the first commercial radio station 40 years ago, challenging traditional formats and producing innovative shows. Under Global’s ownership last year we introduced a first in UK radio with the Deputy Prime Minister hosting his own weekly show on LBC, ‘Call Clegg’ giving LBC’s listeners, the public, a chance to hold a senior political figure directly to account for the first time every week. From February 11th 2014 Global is investing further in digital radio, and in speech radio, to create the UK’s first national commercial news talk radio station, giving listeners across the whole of the UK a voice and a forum to engage in the issues that matter to them. I’m incredibly proud to bring the winning LBC formula to listeners across the UK and for Global to lead the way in the development of UK media brands."

This is how my colleague Nick Ferrari announced the news this morning…

#VeryExcited

More on this on the LBC website</a from The Guardian and Radio Today

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Lecture: The NHS - Things That Need To Be Said

27 Jan 2014 at 14:39

This is the text of a 45 minute lecture I gave today to an audience at Queen’s Hospital in Romford. It is the annual Leslie Oliver Oration. Every year the hospital celebrates the works of one of pioneers in Neurosurgery in this country. Leslie Oliver founded the Neuroscience unit at the hospital when he began Neurosurgery there in 1945. It is more than 7,000 words long and covers a lot of ground so you are forgiven if you don’t read it all! For those that don’t have the time, there follows a short executive summary of the main points.

1. You can’t take politics out of the NHS when it spends a sixth of all government spending.
2. Health secretaries are in office for an average of just over 2 years. That’s not long enough.
3. Politicians must be able to criticise and critique the NHS without being accused of wanting to dismantle it.
4. The ‘public good, private bad’ mentality must go.
5. The private sector is already an integral part of health provision (dentistry, pharmacy etc) and should be embraced.
6. The issue of charging for some treatments will need to be properly debated, but where should the line be drawn?
7. Should we pay a nominal charge for a GP visit?
8. We don’t have a truly NATIONAL NHS and we should stop pretending we do.
9. Primary Care Trusts were a brave effort to make things more local, but they were doomed by debts and lack of democratic accountability.
10. Community hospital and bed closures are too often driven by financial concerns, rather than clinical ones.
11. Drug licensing and provision needs to be looked at properly.
12. If people use their own money to pay for drugs the NHS is not providing, they should not be penalised for it.
13. The extra money put into the NHS has been eaten up by unwarranted pay rises for GPs and consultants, and NHS inflation.
14. NHS procurement methods need to be sharpened in order to reduce NHS inflation. Its buying power should be utilised more.
15. Standards of nursing care have fallen below what is acceptable in some hospitals.
16. Nursing training needs to be changed and improved, and nurses should not be required to have a degree level qualification.
17. The 48 hour week should be abolished in the NHS.
18. Nurses need to be able to work on the same ward in order for continuity of care to be maintained.
19. The word ‘care’ needs to be the first, second and third priority for nurses.
20. Doctors and nurses need to be made more accountable.
21. We need to be more careful about recruiting nurses and doctors from foreign countries. Those countries often have more need of them than we do.
22. Not enough planning is being done to prepare for an increase in the UK population of ten million.
23. We need to integrate primary and social care.
24. Have we planned to cope with the increase in the elderly population?
25. NICE has failed and needs drastic reform if the postcode lottery is to be ended.
26. We need a 7 day NHS, where more GP surgeries are open when people are free to visit.Operating theatres need to be used at weekend.
27. A&E departments should not be employing GPs.
28. Cuts in the mental health budget should be reversed.
29. GPs are often not equipped to deal with patients with mental health issues. Training must be improved.
30. Mental health facilities are provided by too many different bodies and few people understand what they are.
31. There should be more support for dementia carers, especially more Respite Care.
32. Preventative healthcare initiatives are too often expensive gimmicks.
33. We can’t have a rational debate about the future of the NHS until we accept that it can’t meet all the demands made on it.
34. If we were to set up a new NHS from scratch, would it bear much relation to the NHS we have today?

FULL LECTURE

I don’t think I have ever given an Oration before! Thank you so much for asking me to be here today. Looking through your previous list of speakers I am afraid what I am about to say bears little relation to what you will have heard in previous years, mainly because I know nothing about neurosurgery. And I am not about to embark on a change in career!

Agreeing to give a lecture to an eminent group of people who inevitable know far more about the subject than you do is perhaps not the wisest thing for a political pundit and broadcaster to do. So in the next half an hour or so I don’t intend to tell you how to do your jobs.

What I am going to attempt to do is identify some issues which I think will dominate the health agenda over the next decade. I want to challenge orthodox NHS thinking and say a few things which I think need to be said, but don’t always seem to form part of the current debate.

In many ways, senior health professionals like yourselves and those in government and opposition have much in common – even if that thought might fill you with a degree of horror.

You’re all trying to wrestle with the demands of an empowered, knowledgeable twenty first century consumer base while you are all operating within a structure designed for a mid twentieth century command control system of healthcare provision.

There is another communality of interest – you all have a fair idea of what needs to be done but no one in politics is courageous enough to articulate either the problems or the solutions. And sadly I do not see that changing either under this coalition government or a government led by Ed Miliband. No one is prepared to think the unthinkable, say the unsayable, much less implement the do-able.

POLITICS & THE NHS

Politicians treat the NHS as a political football – insisting on initiative after initiative – to prove that there really is ACTION THIS DAY, and yet consistently fail to plan for the long term. They seem to think that structural reform and targets will yield results – and sometimes, in the short term they do, but who can really say that they can think of a single Health Secretary who has been able to plan for the long term – of either party? During the 13 years of the last Labour government there were six different Health Secretaries.

The Conservatives under Margaret Thatcher and John Major did a little better and managed only seven in 18 years. The coalition government has had two different health secretaries so far. So a Health Secretary serves for an average of a little over two years.

Of the fifteen holders of this post since 1979 very few had any direct experience of health policy before they took on the job. So they spend six months reading themselves into the job and the last six months trying to save themselves from being sacked. This gives them each just a year to make an impact. A few years ago, the Adam Smith Institute published a report which opened with these words.

Secretaries of State and their junior ministers come and go with sometimes breath-taking frequency. But the one thing they all have in common is the desire to make headline-grabbing changes to advance their careers. As a result the NHS is besieged by a bewildering array of initiatives from one minister, only for him or her to be replaced by another minister with their own (often conflicting) ideas. Politicians tend to think that they can improve the health service by simply giving orders, or setting targets. But such measures always have perverse effects, distorting clinical priorities and encouraging creative accounting. NHS policy should be determined by medical priorities and not by political ones.

Bearing in mind the NHS is one of the world’s largest organisations, this way of running it is utter madness. If IBM or Glaxo changed their chief executive every two years their share prices would plummet and within a short time the company would be considered a basket case.

And so we constantly hear pleas to take the politics out of the NHS. Liam Fox, when he was Shadow Health Secretary, said it. Various Labour Ministers said it. Andrew Lansley said it. Jeremy Hunt actually believes it. But surely none of them can be so naïve.

After all, the fact that the Health Service eats up £115 billion – a sixth (!) of public expenditure means that the way that money is spent has to be made accountable, and that has to be through the political system. The trouble is that half of this sum has, according to the Wanless Report, gone on price inflation and extra pay – 25% to consultants and 23% to GPs.

Was that the right thing to do? Voters will be judge and jury on that point. It had to be a political decision, not one made by a faceless independent board. So any politician who calls for politics to be taken out of the NHS is likely to be doing it to get a cheap round of applause of Question Time and can safely be ignored. It ain’t gonna happen, and nor should it.

That’s my view, but interestingly the think tank, the Adam Smith Institute begs to differ. Its briefing paper documents the bewildering and counter-productive range of political initiatives and interference which, it says, has wreaked havoc on our nation’s healthcare system.

The paper’s proposal is for a distinguished panel of health professionals to be appointed to run the NHS, to allocate its budget, determine its priorities, and operate it according to medical needs rather than political aims. A YouGov poll taken on the subject showed massive popular support for precisely such a proposal, with 69 percent in favour and only 12 percent against.

The NHS budget would be set by Parliament every five years, and up-rated each year in line with inflation. The ASI’s YouGov poll showed that this idea, too, enjoys widespread popular support, with 74 percent in favour. The suggestion that “the NHS has become a political football” receives 72 percent backing.

Whatever the merits of the Adam Smith Institute’s proposals or those of the Conservatives, an independent NHS it certainly isn’t going to happen when we consummate political brains in Number Ten. Think back to the Gordon Brown government.

I’m told that the Deep Clean initiative wasn’t thought up in the Department of Health. It came direct from the Number Ten Policy Unit, who gave the Department of Health a few hours in which to consider how to make it work. It was duly announced by the Prime Minister who made it sound as if this would be the only measure needed to eradicate MRSA and C.Difficile from our hospitals. Indeed, when I heard it I thought it sounded a deeply sensible measure.

That is until I switched on a 5 Live phone in and heard a succession of health service professionals slam it. Not a single one of them thought it would work. Not a single one of them was taken in by it. It was at that point I started to wonder if this gargantuan political brain was actually as formidable as we’d all been led to believe and that if his administration wasn’t just as driven by spin as the previous one.

Just as a Transport Secretary is judged on whether their tenure of office is free of a major rail crash or transport disaster, a Health Secretary is now judged on whether they can keep NHS stories off the front pages. That’s why Andrew Lansley had to go and was replaced by a politician with a far better bedside manner.

So that’s my first thing which needs to be said: You can’t take politics out of the NHS, and nor should you. In fact, as I shall explain later, I think we ought to be having a big debate about the NHS, but we are being denied that debate because whenever any politician on the right or left, but mainly the right has the temerity to criticise the NHS he or she is jumped on and warned about the consequences of having a go at a beloved institution.

If you point out that outcomes in the NHS are in most areas way below other comparable nations you are accused of denigrating people who work so hard in the NHS or advocating privatisation even when you’re not. If the NHS can’t stand up to robust critique, it says an awful lot about the arguments of its very vocal defenders.

PRIVATE SECTOR V PUBLIC SECTOR

Nowhere is this more apparent than in the private sector versus public sector debate which has bedevilled health policy for some time. In my view, this is at the very core of the failure of politicians to provide the leadership the NHS needs.

The public good, private bad mindset which bedevils politicians on the left is equally matched by the private good public bad attitudes often prevalent on the right. Only in this country could this happen. Even in these days of supposed consensus these attitudes still prevail.

Do any of these politicians think people care if people are treated privately or in an NHS hospital if they get the treatment they want, where they want, when they want it? Of course not. Yet people who use BUPA are made to feel as if they are somehow being elitist, rather than being praised for taking responsibility for their own healthcare and not burdening the NHS with their demands.

Beveridge and Bevan never meant for the NHS to have to meet every single demand ever made of it. Two systems can work happily together as long as each respects the other. For too long in this country Labour politicians have seen private medicine as a class enemy and Tory politicians have viewed the NHS as something for other people to use, not them.

David Cameron makes great play out of the fact that he is a regular user of the NHS. He had a disabled son whose fits made regular overnight stays in a local hospital a normal occurrence for him. His view was shaped by his experience. He put the NHS at the top of his agenda. He says his three priorities can be summed up in three letters. N. H. S.

One of Cameron’s first acts was to abolish the Tory policy of encouraging private sector healthcare. George Osborne said in opposition: “We are having no truck with ideas for some alternative funding mechanism like social insurance. Nor are we looking to help fund escape routes from public services for the few who can afford it, which is why we have moved away from the idea of the patients’ passport.”

All very well, but where are we going to get the capacity from if the private sector is not embraced in a way it hasn’t been before?

Let’s not pretend that private sector involvement in the provision of healthcare is anything new. Most people use private sector dentists. GPs are effectively in the private sector, as are most osteopaths and physiotherapists.

Drugs are provided by private sector suppliers. Chemists and dispensaries have never been in the public sector and no one has ever suggested they should be. It was recently reported with some horror in the Guardian that 70% of NHS contracts are with the private sector. They put this down to the Lansley reforms, omitting to say that the private sector has always played a major role in health provision.

Opponents of the private sector also raise the spectre of the NHS introducing charges, conveniently forgetting that patients already pay prescription charges. From time to time, the issues of charging for hospital food, or GP visits are floated, but quickly ditched once the howl of public outrage subsides. However, on radio phone-ins such as my own, the idea of charging for NHS services is quite popular in some areas. For example, people ask why the taxpayer should pay for the treatment of people who bring their own misfortune on themselves.

People who binge drink on a Friday night and end up in A&E. Why shouldn’t they be charged? People who regret getting a tattoo and can apparently have it removed courtesy of the NHS. But where do you draw the line? Charge smokers for lung cancer treatment? Charge obese people for diabetes drugs? Another one for the too difficult box, I suspect.

TARGETS

People questioned whether the Conservatives would also embrace the target driven culture which so obsessed the previous Labour government. It seemed to be the only way to increase throughput, although NHS managers continued to try to convince us that we can do with fewer and fewer beds and various management consultants still try to hypnotise us into really believing their reports that people prefer to be treated at home, no matter what their affliction.

The Conservatives professed to want to abolish the target culture yet have so far failed to explain how this can improve capacity. Because the truth is that weakening targets has led to capacity issues in many areas of the NHS.

This brings me on to structural issues. I was interested to see Chris Huhne say before the advent of the coalition, rather courageously, I thought, that the NHS needed to be broken up into local units. Quite what he meant by local, he didn’t say, but you and I know that turning round the NHS is like turning round an oil tanker.

It takes years, sometimes decades for structural and organisation changes to come into effect. And by the time you’ve worked out whether they were right in the first place, it is too late or we have different priorities.

So we’ve had various forms of local accountability over the past twenty years, none of which have proved satisfactory. In theory the smaller versions of Primary Care Trusts ought to have provided that, but were often so saddled with debt that they could not respond to local needs.

They therefore had to embark on a rationalisation process which local people just could not buy into. They felt they were being hoodwinked and that elaborate consultation exercises were generally a sham and that the decision had already been made. I saw this at first hand in North Norfolk, where I was a candidate at the 2005 election.

People kept being told that everything was done in their best interests but they just didn’t believe it. It even got to the point where people were even less likely to believe the words of a PCT official than those of a politician.

People just didn’t buy the argument that Community Hospitals had to close and that the same level of care could be provided in people’s own homes. They couldn’t see why a local alzheimers’s unit had to be shut, only ten years after it had been built specifically for that purpose. Local people weren’t convinced and local politicians weren’t convinced either. And even if they had been, could they, could I, as one of them, have had the courage to say so?

This culminated in Labour Party Chairman Hazel Blears joining a protest in her constituency against the closure of a maternity unit her own government wanted to shut.

What had brought this about? Was it really all about medical advances meaning that maternity care needed to be concentrated in one place, or that Community Hospitals were no longer relevant due to the level of care being provided at major hospitals?

Or was it more a question of funding, and the NHS was being forced to cut its cloth according to its funding? Most people suspect that many of the closures are being forced by the latter rather than the former – and this despite health funding having more than doubled since 1997.

People are rightly asking where the money has gone. They blame politicians, but they also blame so-called NHS bureaucrats who seem happy to accept a situation where a hospital has more managers than beds, more managers than nurses.

They see an organisation which is top heavy with middle management and a cadre of politicians who seem powerless or lack the will to do anything about it.
And the thing is, in this ever less deferential society people simply will not sit there and be told that others know what’s best for them.

On another level GPs see it every day in their surgeries. Patients engage in self diagnosis at a level undreamt of. They look at the internet and wonder why, if a drug is available in Texas, they can’t be prescribed it locally at their surgery. Some patients even turn up with their laptops to explain to their doctor how they have arrived at a particular conclusion. Now doctors realise what politicians have had to put up with for decades!

FUNDING

I want to return to the issue of funding, because it permeates all other concerns in the NHS. As I said before, a huge amount of money has been channelled into the NHS in recent years, but it’s not just politicians who are failing to see an outcome – its patients. Even though nearly half of it has gone on meeting inflation and pay increases, a doubling of financial input ought to have led to a double figure rise in productivity.

It has not and people want to know why. There will soon be a funding shortfall of £7-15 billion a year. How can this be? Is it a problem of acute financial mismanagement? Is Health Service inflation really so high? Why are efficiency savings so hard to make?

The Wanless report rightly highlighted a real fear that if the NHS does not prove it can use its money better taxpayers will no longer be willing to cough up for it.
Wanless said: “Such an expensive service could undermine the widespread political support for the NHS and raise questions about its long-term future.” This is perhaps unnecessarily apocalyptic, but it is something which politicians would do well to take note of.

We are already seeing in the area of constitutional issues, Europe and the devolution settlement, that if voters think they are being taken for granted they react accordingly.

CARE & THE PATIENT EXPERIENCE

We all make judgements on the NHS depending whether we work for it, we are patients ourselves or we have family or friends who use the NHS. All our judgements are based on our own experience or those of those close to us. Indeed, doctors, surgeons and nurses are not immune to this, with survey showing that in some hospitals 70% of those that work there wouldn’t want their family members to be treated in their own hospitals.

It’s all anecdotal evidence, but that’s the only evidence an individual has got. So when learned academic studies are published that are at variance with our own experience we tend to speak out. Clearly, people always tend to highlight the negative rather than the positive, which is why whenever I host a phone in on my radio show about a particular aspect of the NHS I am always careful to solicit positive as well as negative callers.

Ann Clwyd, the Labour MP, became a bit of a bête noir for some in the medical profession when she told of the terrible care her husband had received courtesy of a hospital in Cardiff. He died. She made a tearful speech telling of their experience and was later asked by David Cameron to head a review looking into complaints against the NHS.

Her report made very sad reading for all concerned with the standards of nursing care in this country. I regret to say it chimed with me, for my mother went through a terrible experience at Addenbrookes Hospital, after which she sadly died. It was a horrible experience for her, for my father, for my sisters and myself. Throughout it all, we felt powerless. It turns out that she was put on the Liverpool Care pathway. We were never told about it. No one seemed to be able to tell us what was happening to her.
She was put on the wrong drugs. She kept telling us “they’re trying to kill me”. We put it down to the effects of the drugs, but in the end perhaps she was trying to tell us something that we were too deaf to hear. We put our trust in the hospital and they let us down. More importantly they let her down.

The standard of nursing care was lamentable. Different nurses every day. I reckon she had 150 different nurses in the three weeks she was in that ward. I’d love anyone to tell me how there can be any continuity of care in such circumstances.

I queried why whenever I visited there was never a nurse that I recognised. Oh, it’s the 48 hour week that’s to blame, one said. And we get put on different wards each day.
Half of them seemed to be agency nurses, some with a variable grasp of English – never a good thing when dealing with older patients. They kept trying to feed her totally inappropriate food, when a cursory look at her notes would have told them it was wrong.

She was left sometimes for hours in soiled sheets. In the end my two sisters and I operated a shift system because we couldn’t let her be alone. We ignored the visiting hours, and the nurses allowed us to because it took work away from them.

And the thing is, it wasn’t because there weren’t enough of them. There was. When we eventually realised that my mother was going to die, we decided to take her home. The thought of her dying in that place was too awful for us to contemplate. But even then they were so incompetent that I was forced to book a private ambulance to take her home because the NHS ambulance consistently didn’t turn up.

She spent two weeks at home, and it was here that the NHS came up trumps with her wonderful GP visiting at least twice a day and providing just the support that she, and we, her carers needed. I shall never forget what that wonderful GP did that week. My mother died at home looking out on the garden she loved, surrounded by her family.

I should have made an official complaint about Addenbrookes. I should have raised merry hell with the hospital bosses, but you know what, I am ashamed that I didn’t.
I just couldn’t bear the thought of reliving it all. I let my mother down, and I let all those who followed her down.

While she was lying in there, unable to do anything for herself, I kept thinking about other patients who had no family to care for them. We were in a position to do things, but there are many older people whose families can’t or won’t support them in the way we could.

It was only when I read about Ann Clwyd’s experience, that I actually did something about it. She had thousands of letters and emails from people who had gone through the same thing. Blame is easy to ascribe, but it is often misplaced.

I have thought long and hard about how these things are allowed to happen. In truth there is no one single person or group of people who are to blame. And let’s face it, blame rarely gets us anywhere. But there are clearly questions to be asked about current standards of nursing care in some of our hospitals.

So when I heard Jeremy Hunt say, almost on his first day in the job as Health Secretary, that he was concerned about the fact that nursing care was becoming increasingly depersonalised, my ears pricked up.

But when he suggested that nurses should do a year’s on the job training before embarking on degrees he was met with a hailstorm of abuse from the usual vested interests.
“A really stupid idea” said the RCN. A truly pathetic response, which one might expect from a trade union but not from a Royal College. The very same Royal College which failed to spot any problems at the Mid Staffs hospital, or if it did, it kept them to itself with the consequences we know only too well.

It seems to me that aspects of nursing training is not fit for purpose. Just a fortnight ago Jeremy Hunt said this ‘culture of defensiveness’ must cease and doctors and nurses must ‘say sorry’ when things go wrong in the NHS. Administrators blanche at that saying “think of the legal consequences”, but surely he’s right.

Of course things will go wrong. In any organization the size of the NHS and with the risks involved in most medical procedures, there will always be mistakes and things will always go wrong on occasion. The challenge for the NHS is to find a way of acknowledging this in a way which doesn’t undermine the whole system.

I think we also need to look at who we are recruiting into the nursing profession. It seems to be ridiculous that all nurses are now expected to have degrees or the equivalent. Surely we need a mix of abilities and aptitudes. Where are the good working class girls who used to be the backbone of the nursing profession? They may not have had an ‘O’ Level between them, but they knew all about providing fantastic care. They weren’t too proud to do the dirtier jobs that some nurses seem to think it is isn’t their job to do nowadays. I don’t know what proportion of nurses in the NHS come from other countries, but how rigorously do we check their backgrounds and qualifications – or even linguistic abilities?

The NHS would collapse without foreign nurses and doctors, but I have always been slightly queasy about overtly recruiting them from countries which frankly are so poor that the best form of international aid we could offer them is not to steal their most capable medical staff.

CHALLENGES OF POPULATION GROWTH

One of the reasons the NHS has required an ever growing budget is to cope with the challenges of population growth. Over the next couple of decades the population will grow by 10 million, in large part to immigration but also due to a higher birthrate among many immigrant communities.

The planning for that should already be underway, but I wonder if it is. Coupled with the added burden of an ever growing older population it is no wonder that the NHS is already creaking at the seams. But how far can the taxpayer’s patience be stretched?

We already spend one sixth of our public spending on the NHS. If that proportion is to increase beyond a sixth, some incredibly difficult decisions will have to be taken elsewhere. But what should it rise to? It’s a question even the new NHS Action Party can’t or won’t answer.

Why not? A fifth? A quarter? At some point decisions will have to be made about a) scope of treatments b) restricting the scope of NHS functions and b) cutting ever burgeoning costs.

And it is here that I wonder whether the NHS can continue as a truly National Health Service. But let’s be honest. We’re deluding ourselves if we truly believe it is even now, a NATIONAL health service. Scotland and Wales run their own NHS’s. And the English NHS contains such wide variations that it can’t be said to be truly national. Treatments that are available in one area, are not in another. Outcomes vary so widely that the use of the word national becomes laughable, if not redundant.

So why don’t we ditch the sentiment and recognise that the costs of running a national institution may sometimes outweigh any benefits there are. The main benefit ought to be the massive purchasing power that such an organisation enjoys, but we all know that NHS procurement procedures are almost as much of a joke, and almost as inefficient and incompetent as those in the Ministry of Defence – and that’s saying something.

Suppliers and drugs companies run rings around NHS purchasing managers and get away with imposing what is laughably called ‘NHS inflation’. So let’s stop pretending. About the single benefit of primary care trusts was that they didn’t pretend at all. They were proof positive that everything is local.

SOCIAL CARE

With a growing elderly population, how will we cope with the mounting demands on geriatric care in hospitals and social care outside. The challenge for the government, and indeed NHS planners, is how to integrate the two. Otherwise we have to try to find bureaucratic ways of achieving a separation of health from social care in terms of costs and resources.
There are far too many geriatric patients who take up bed space in hospitals because there is nowhere for them to be discharged to.

Successive governments have failed to plan for the future and although the coalition has announced a plan of action in this area I wonder how many of us are convinced by it. Until politicians finally have the courage to tell people “yes, you’ll have to sell your home” to pay for social care, the debate will remain somewhat stagnant.

The state can’t be able to meet every demand that is made of it in the area of social care and people should not be misled into thinking it ever will. Just look at the statistics. The number of people aged 90 or over has trebled in the last 30 years. The number of people who live to 100 has gone up fivefold in the same period. Over the next 25 years the number of 80 year olds will double. The number of centenarians will rise from 13,000 at the moment to 111,000.

ONS projections say that increases in lifespans – attributed to improving medicine, growing wealth, healthier lifestyles and less physically demanding work – will lead to a society where more than one in five people is a pensioner. Think about that.

To the government’s credit, they are reforming the pensions system to take into account these demographic changes, but where is the forward planning in the health and social care systems?

NICE

Very few people have anything nice to say about NICE, the National Institute for Care Excellence. And let me be no exception. It was set up by the Labour Government with the best of intentions. Part of its mission was to to end the variation in medical treatment across the country and ensure that if a drug was found to be effective, patients should not have to fight to get it. Clearly there needs to be a body which licenses drugs but there is a huge suspicion that too many drugs are still licensed through budgetary consideration rather than clinical need.

And in turn, drugs which are available in some parts of the country are not in others – for much the same reason. And if a cancer patient should have the temerity to decide to use their life savings to fund their treatment using a drug which for budgetary reasons is not available via the NHS, what does the NHS do?

Instead of saying ‘thank you very much for helping us out and paying for your own drugs’, it refuses to continue any treatment for that patient. See? Public good, private bad. It’s the politics of socialist envy and basically says that just because everyone can’t have it, you can’t either. So people die. Is that really what should be happening? I don’t think so.

It’s an exemplification of the kind of dogma which has bedevilled our public sector thinking over many decades.

This is what happened to one of my listeners who emailed me this week.

“My 23 year old son, has just been turn down for a course of drugs, for his acute Vasculitis, which he has been waiting around 5 months for. Costs around �4,000 for the course. His consultant has stated that it’s one of the few drugs that would really make a difference. He had to go back into hospital in the early hours of Tuesday morning, and they have probably spent half that amount, running more tests, and keeping him in under observation, when he could have been back at work, earning a living, paying taxes, and with a reasonably pain free outcome, how short sighted can you be ?

Well it’s a good question, isn’t it? I am surprised that no one has yet taken the NHS, or NICE, to the European Court of Human Rights over issues like this. I suspect it is a matter of time. Perhaps then the postcode lottery may forcibly be brought to an end.

THE SEVEN DAY NHS

One thing I noticed when my mother spent those three awful weeks in hospital was that the place more or less shut down at weekends. As do GP surgeries in large part. How odd. Are people not supposed to get ill at weekends? Surely we should be moving towards a 7 day NHS, with equality of service provision throughout those seven days.

If we are to get better outcomes, surely that has to happen over time? It comes back to the point I made earlier about 21st century medicine operating within the straitjacket of a 1940s system. Why is it that GP surgeries offer appointments at times a majority of the population isn’t available to go to them?

Why isn’t there more evening and weekend opening? I run a publishing company and I reckon I lose hundreds of man hours of work a year as my employees say “Oh, I have got a doctor’s appointment”, as if that is a reason why they should be allowed time off to the detriment of the company. That may sound harsh, but multiply that all over the economy and we’re all losing out just because GPs have always worked that way and seem immune to the changes of a modern day economy.

I don’t blame them for negotiating the GP contract back in 2004 which allowed their pay to rocket for working fewer hours. Who wouldn’t? Quite what the then Health Secretary Alan Milburn was thinking of, God alone knows, and it is this government which has been left the legacy.

And that legacy, at least in part, is A&E departments which are bursting at the seams with patients who shouldn’t even be there.

We now have the frankly ludicrous scenario of A&E departments employing GPs to see all the people who visit A&Es because they have no way of seeing their GP at weekends – or at least, that is their perception.

These GPs are employed for one reason, and one reason only – to allow the A&Es to meet their waiting time targets.

MENTAL HEALTH

The final area I want to cover this morning is one which is not an afterthought, but possibly one of the most important challenges the NHS faces. It’s become almost a cliché to describe mental health as a ‘cinderella service’. It’s a subject too few people take seriously and one that some still find difficult to discuss. While the stigma of mental health has been eroded it is still undoubtedly there.

When I started presenting on the radio three and a half years ago I never for one moment thought I would become known for my programmes on mental health, let alone be shortlisted for an award by the mental health charity MIND.

But I can remember the heartbreaking calls I took when I first did a phone in on depression. Frankly I could have devoted this whole speech to mental health and the problems associated with it, and after listening to me so far, you may wish I had.

Mental health covers a multitude of issues and when you look at the statistics on mental health you wonder why more resources are not devoted to this area of health provision. 1 in 4 of us will suffer from some sort of mental health condition – not just in our lifetimes, but each year.

But a quarter of those won’t visit their GP. But the real question is what happens if they do visit their GPs. Anecdotal evidence from my listeners suggest that not enough GPs are equipped to deal with mental health issues. Maybe older GPs didn’t have the same kind of mental health training which is available today, I don’t know, but time after time people tell me that their GPs seem out of their depth on these kind of issues. And perhaps this explains why the prescription of drugs seems to be the automatic default for so many GPs.

But part of the problem is that people suffering from mental health problems, or their families face a bewildering system which is so complex that even those who are familiar with it find it baffling.

OK, we have mental health trusts, but there are also actute trusts which provide liaison psychiatry services and some A&E services for mental health patients. Ambulance trusts may or may not be commissioned to provide mental health conveyancing services outside of emergencies, whatever they may be.

Clinical Commissioning Groups commission some services while specialist trusts commission others. And then of course there are GPs who provide primary mental health care to some 83% of mental health patients. And then finally you have local authorities who oversee and/or directly employ Approved Mental Health Professionals – or at least those who are not employed by or seconded to the NHS.

I can’t begin to cover all the aspects of mental health here, and I’m not going to try, but I do want to touch on dementia care. This is where the NHS and the social care system need to interact far better than they do at the moment. No one seems to have got to grips with the demands that the increasing number of people suffering from dementia are placing on both systems. Everyone has good intentions, but so far, it has to be said that not a lot has changed recently. The trouble is that to provide a proper care system for people with dementia will mean that huge amounts of extra money needs to be spent, but where is it going to come from?

Indeed, the mental health budget is experiencing a 2% cut. Beds continue to be closed and we are constantly told that it is far better to treat people in their homes. Really? The true heroes are the relatives who end up being carers for people with dementia.

What we really need to do, even as a short term fix, is to provide far better support for carers, especially more respite care. In effect family carers are saving the NHS or the social care system hundreds of millions if not several billion pounds each year.

The Mental Health Action plan which Nick Clegg announced a week ago was a welcome recognition that the current system isn’t working, but it was really a list of aspirations rather than firm commitments.

But things are moving in the right direction. It’s great to see professional sports people be open about their mental health problems. It’s great that politicians have confronted their own issues surrounding their own mental health. It’s great that programmes like mine discuss this issue openly and without hesitation. None of those things would have happened 10 years ago. If even just one person is helped by our discussions, and they realise they are not alone, I feel I have done something worthwhile.

CONCLUSION

So in conclusion, let me give you some predictions. First, that all politicians will tell you that the NHS is their number one priority. The NHS has achieved the same status as the Queen Mother in the nation’s affections.

But I do not see an appetite to change it fundamentally and as a consequence I think over time it will become a much hotter political potato than it may be at the moment, as expectations increase, performance will lag behind. The challenge facing all politicians will be how to square this unsquareable circle. The truth is that they will abdicate responsibility to health professionals and then blame them if it all goes wrong.

In future most government initiatives are likely to be centred around preventative measures rather than structural ones. Preventative healthcare has grown in visibility in recent times. An anti-obesity drive is always guaranteed to and provoke big headlines in the mid-market newspapers as well as intense discussion on radio phone-ins.

Such initiatives give the appearance of action, even if they can be incredibly expensive in PR costs. Politicians love them. They are great for photo opportunities, soundbites and gimmickry.

So expect a lot more of Anna Soubry exhorting us in her best nanny-like tones to eat less, drink less and exercise more. I think I need a lie down.

There needs to be a national and rational debate about the scope and extent of the NHS. Should it cover illness, injuries or both? Should people insure against injury – probably a small cost – as opposed to illness. But I pity the first politician to even suggest such heresy.

Can we afford to maintain the ‘cradle to grave’ scope that Beveridge established, although I doubt that he foresaw the range of treatments currently available and their cost. I doubt also he foresaw a health service where 2,600 people earn more than the prime minister, and 7,800 people earn more than £100,000 a year.

The bald truth is that until we accept that the NHS can’t and never will be able to meet all the demands made on it, we can’t actually have a proper and rational debate.

The pity is that no-one currently on the NHS scene seems to have much idea of the questions, let alone the answers. Parliaments drift by and the issues, questions remain the same: expensive reorganisations take place with little or no real benefit. And anyone who dares to criticize or critique the NHS gets their head bitten off by people who profess to LOVE the NHS.

So the real, overwhelming question is this: if we were in a position to set up a health service now, from scratch, what would it look like? Because I suspect one thing is certain – it would bear little relation to the NHS we have today.

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26 Jan 2014 at 14:52

A truly hilarious stunt!

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