Reforming the NHS and the laws of politics

Many years ago as a young local councillor, I discovered that politics is bedevilled by the sheer irrationality of our electors.  London Transport (as it then was) proposed to make some perfectly sensible changes to the bus network in my area, and held a public consultation.  A woman rose and made an impassioned speech in two parts: 

(A)  the current bus service was shit;  and 

(B)  it mustn't on any account be changed, in any particular.

I was very glad it wasn't me in the chair, because I find it really difficult dealing with stuff like that ( - the same motive that caused me to recoil from being foreman of the jury on which I sat recently; and was heartily grateful someone else accepted that solemn duty).

The public's attitude to the NHS is the same, only on a truly monstrous scale.  Here's an extract from a piece in LabourList last week: 

Normal people are very capable of holding contradictory views in their heads, especially in subjects about which they know little but feel strongly ... paradoxes, which have regularly been witnessed in opinion research ... are of profound importance as Labour thinks about how to frame its NHS offer running into the next election. They are:

- Everyone loves the NHS and yet in focus groups it quickly becomes apparent that absolutely everybody has a personal horror story about waiting lists or botched admin. These stories flow from them like a public policy fever dream.

- Everybody knows that the NHS is in desperate need of reform – and yet in focus groups almost nobody believes such reform will work. Getting people to imagine a high-performing NHS is very, very hard.

- Everybody knows that the NHS is in desperate need of investment – they see it with their own eyes every time they visit a hospital. And yet nobody believes it will make any difference to the service they are experiencing.

The piece goes onto say that "[Wes] Streeting’s speech at [Labour party] conference seemed to try to reflect these paradoxes and even solve some of them."  He's also recently told the Royal College of GPs that Labour "won’t entertain requests for blank cheques", which is rather what they have in mind.

Assuming he & the rest of Labour are seriously preparing for power (as well they might), I very much hope this all means they have taken heed of Drew's Laws of Politics #1:  Never buy off anyone at a higher price than absolutely necessary.  Virtually no voter will change their allegiance based on the precise nature of Labour's NHS policy next year.  But Labour could get itself into needless trouble by promising the earth, tempting though that must be.  Now one might say: Satrmer is such an accomplished liar and shameless U-turner, he can say whatever he will and then renege on it as PM, just as quickly as he always has with any other pledge or promise he made to the Labour faithful since 2019. 

Still, he'd probably rather not.  Might Labour then be the first party to come to power with a bit of a free hand on the NHS?  We do all really know it can't go on like it is.

ND 

The future price of electricity

Round these parts we often have a bit of fun at New Year, predicting prices etc.  We've even been known to suggest a few punts that might be taken.  That said, solemnly forecasting commodity prices etc as if it's a science is a fools' game.  The track record of "respectable" price forecasters is truly appalling - and that's not just because we're waiting for cleverer chaps to come along - it's because it is impossible.  Of course, they fact that plenty do it anyway is a tremendous boon to liquidity and commercial life generally: you always need to find someone to take the other side of a bet.

Having registered those points, we now turn to electricity.  From the Green corner (and indeed Miliband in the Red corner) there is currently a mighty howl going up: if we want to get the price of electricity down, we must accelerate "investment" in renewables.

Well, no.  This belief in "renewable electricity = cheaper electricity" is based on a couple of things, neither of them worthy of being the basis of policy.  First, there's the naïve view that because wind and sunlight are "free", this means the resulting electricity must be pretty cheap, too.  For those arguing in that way we can even helpfully chip in that sometimes, wholesale prices of electricity go negative!  All of this is true, but it has very little bearing on what the long-term, sustained wholesale price will be, when very costly capital equipment is required on a vast scale to intermediate between (e.g.) "free wind" and the consumer who wants power on demand, 24/7, every day of the year - and who finds himself being forced to "invest" in that capital equipment at exactly the same time everyone else in the world is buying the same stuff.

Secondly, and perhaps based on the first point, there's the entirely religious view that of course it will be cheaper because it's virtuous and clean and generated locally and that nice Caroline Lucas says so and, errr, well it must be.  To me this bears strong resemblance to those who argued that of course we'd be better off financially after Brexit, because, well, because.  It is of course perfectly fair to espouse the political view that Brexit is the way to vote - I espoused it myself - but please don't tell us it'll be cheap.  And exactly the same holds for renewable energy.

The underlying reason is similar in both cases.  Absent a subsidy, any time businesses and individuals are constrained to do something in the economic sphere that runs counter to what they'd do given the freedom to make their own informed economic decisions, that is prima facie gonna wind up costing more.  Of course there are exceptions: once in a blue moon there is genuine market failure (e.g. in energy, the practical inability of tenants and some householders to do the economic thing as regards short-payback insulation etc); and sometimes an economically viable new technology just hasn't become socialised yet (LEDs). 

Governments make people do more expensive things than they might choose to all the time, for policy reasons sometimes sound, sometimes not (and in any case, political policy is frequently politically contestable).  To me, the key is that politicians shouldn't lie about these things.

Now governments could choose to manage many of these types of policy intervention via general taxation.   That's what they do in the case of, e.g., the policy decision "we need nuclear submarines".  But mostly, they try to offload the cost onto the punter in various ways.  And that's certainly the case with most aspects of Green policy, in this country and elsewhere.

This being the case, all the evidence is there that wholesale electricity prices will rise, and continue to rise, over the very lengthy period over which it is intended - by almost all political parties -  we will aim towards "net zero".  This is so glaringly obvious, it barely needs explaining in detail: just sit back, watch and point.  But put on the ear defenders, because the Milibands of this world will continue to bellow that it'll be cheap ...

ND

Diversity to the nth degree

One of the leading professional bodies in the energy sector is, errr, the Energy Institute.  (Formerly known as the Institute of Petroleum, but they clearly saw the writing on the wall a long time ago ...)

I think we can guess what the average profile of the membership looks like.  So here's the Membership page from the www:

Pretty funny, huh?  Is there any point in asking: "now aren't we told that when someone looks at a body of people in authority etc, and is forced to say 'I don't see Anyone Who Looks Like Me', then that's a jolly bad thing - ?"   

No, there's no point whatsoever.  What we can say is that if you need energy in any shape or form (as some of us do), on average it will be provided to you by a supply chain of hairy-arsed people who aren't remotely represented above.

ND

RWC: England not too badly placed

OK, so England beat Fiji on muscle-memory, as predicted.  But overall, I'm more optimistic than I would have expected to be at this stage.  Partly, that's because England have a history of building to the later stages of the RWC rather uncertainly (2007 etc, and even including 2003): but mainly because, notwithstanding 2019, South Africa isn't a bogey team for England.  Let me explain.

In a given period of time, most teams seem to have a semi-irrational bogey.  For years, France couldn't get past England in any competition whatsoever.  Australia often seem to freeze against England.  And France themselves have lately done the job on England.  (England would also fancy New Zealand rather than they would have Ireland ... but let's not, *ahem*, get ahead of ourselves.) 

So - back to Saturday last: what did we witness last week?

Farrell:  for about 10 minutes towards the end, Farrell more-or-less earned his pay - at long last.  (Right up until his crazy knock-on right near the end, which might easily have seen him in the bin at the very death.)  That's a pretty thin return on the many years of undeserved England pay he's drawn.  We'll never know whether Ford + a different captain could have done the same job over that 10 minutes: but then again, the alternative combo might well have closed Fiji down even earlier.  Counterfactuals are like that.  So I'm unrepentant: Farrell shouldn't have played.

Smith:  well, he didn't pick himself at 15, and he gave it everything he'd got.  But, as they say, a good big'un ...  Anyhow, it's irrelevant now; and tomorrow, Steward it will rightfully be.

Tuilagi:  we've all heard the tired old saying, uttered continually over more than a decade - "if Manu's fit, he's in".  Well, by some miracle he's managed to stay fit.  But how many more times is it deemed satisfactory that he storms into a match and grabs a dynamic early try, then fades into the background?  If that's his MO, take him off after 30 minutes. 

Lawes:  how many more times can he be expected to go to the well and draw performances like that?  Unless he has truly superhuman powers of recovery, I don't like to imagine the shape he'll be in after Saturday - whatever duties might be sought of him beyond that point.

Earl:  speaking of super-human ...

ND

Footnote: apologies for the garbled early draft of this post for those who encountered it. 

Farrell / Part 3

Alright, so Farrell now has his record points tally and sentimental indulgence has been granted (well done that lad) - can there be any remaining reason why he isn't given the shove?  If his abject performance on Saturday isn't enough to have him dropped, Borthwick deserves everything that follows.  Fiji might just about be sufficiently shaken that they can be beaten in the quarters using muscle-memory alone: but an England appearance in the finals seems highly unlikely with Farrell on the pitch in any other capacity than water carrier.

Farrell père, now that's a different matter.  No obvious sign that the Irish have peaked too early, is there?

ND

Wars and rumours of wars

The Hamas attack on Israel is quite astonishing - shock, and maybe even awe.  To pull off coordination and surprise like that in a space so confined and - as we are given to believe - so intensively, comprehensively and 'intelligently' monitored, is little short of impressive.  (And on Putin's birthday, too ...)  So much so, that it can easily trigger all manner of speculation - but for now we must wait for more data and developments.

However, some very broad comments can be essayed.  From the start of Putin's war upon Ukraine, it was obvious that the implications for Taiwan would be uppermost in the minds of some important actors.  Several leading commentators assumed that Ukraine would provide a distraction that allowed other 'geo-political initiatives' to kick off, with Taiwan heading the list (by dint of the seriousness of the global implications) but with the middle east also very much in mind, alongside the Balkans, the near east and central Asia.  In point of fact, for many months nothing much really happened.

Maybe the waiting is over.  In the runup to the Hamas offensive we've seen Armenia humiliated, Serbia stirring the pot, Syria being brought to the boil, Putin meeting the Wrong'Un ... and there are no doubt other things I've overlooked.  Players like the latter, Turkey and Iran are always looking to manoeuvre purposefully for advantage, in contexts of expansionist policies.

Coordinated?  Woah!  - down that rabbit-hole, lunacy lies (e.g. "The flywheel of WW3 is spinning faster and faster ...").  For now, let's just say "opportunistic".  Sometimes, though, just because you're paranoid, doesn't mean they aren't out to get you ...

ND

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Footnote:  we don't choose to let this blog be, how shall we put it, a forum for "partisan middle east rants".  Some do, we don't.  All our regular BTL commenters have respected this over the many years, for which our thanks.  Any, errr, newcomers / anons wishing to flout this policy will not be hosted.   

Gordon Brown's aircraft carriers - looking sillier than ever

'Silly' is too light a term for Brown's costly pork-barrel folly.  He lumbered us with two ocean-going white elephants that wouldn't last 10 minutes against the Chinese.   ('Prince of Wales' !  What cynic came up with that? - as we've joked before.)

That prediction of fragility in combat might have been conjecture until very recently, albeit fairly universally endorsed.  But now ... well, now we've seen Ukraine defeat Russia's much vaunted Black Sea Fleet with little more than naval drones, aerial drones and some helpful, accurate intelligence from its friends.  Quite literally, that fleet is no longer a combatant: reduced to ignominious retreat to more distant ports.  Maybe - just maybe - US Carrier Groups have so much air-defensive firepower that they stand a chance of defending the mighty jewel at the centre of the protective ring.  But maybe not even them.  And certainly not the RN.  Asymmetric warfare at its apogee.  Like the advent of the torpedo, before destroyers were invented.  Think what anti-capital-ship effort even Iran could mount these days, let alone China.

Did I say a costly folly?  The expenditure alone - past and ongoing - on the UK's aircraft carriers is bad enough.  But the way that the very possession of the carriers drags UK defence policy into deep and distant waters will probably be more costly still.

ND