I love this time of year. Each day as I look out of the window, drive to work and back I notice that the leaves have a little more blossom, a few more leaves. The daffodils are now in full flower and to top it all we have been experiencing highly unusual sunny and warm weather. It makes you feel good. Spring is a time of new beginnings a time to clear out the cobwebs, to clean the house, to get ready for the summer ahead. This year I approach spring feeling refreshed because I have recently had 3 weeks off work; 2 in USA and 1 at home. I have taken a break from work, and from concerning myself with the problems of the NHS. Now though I am back in the mix and raring to go.
The Government must also be glad that with the advent of spring, they have finally got their Health and Social Care Bill through; it will receive royal assent within the next couple of weeks. Mind you I believe they have other worries (a budget that many felt favoured the ‘haves’ rather than the ‘have nots’, scandal over dinners with David Cameron and an impending fuel tanker strike to name a few).
Next week we start a new financial year, the last of the PCTs. This is going to be an interesting year as we head towards transition towards the new world of healthcare commissioning and provision. Already our PCT is getting ready to become a Commissioning Support Unit. Local Clinical Commissioning Groups are preparing to be ratified or whatever the process is called and everyone without exception working in the health economy faces the reality of doing more for less money (that’s just the budget but personally we face similar challenges).
I don’t agree with the Bill but enough is enough. We have to move forward, we have to prepare for new beginnings. I fear things won’t go completely as the Government would like and in a perverse way I am quite looking forward to seeing how it all pans out. It would be fun if this wasn’t public money, real lives and real jobs. What is worse is that this is healthcare; mistakes can lead to people missing out on the care they need and it can lead to death. We watch and wait.
Meanwhile I’ll enjoy the good weather while it lasts; it will turn cold by the weekend and eventually it will rain!
No one doubts the need for deficit reduction. If I think about the difficult decisions I had to make 5 years ago or so, when I realised that my personal debts meant that my monthly payments to creditors practically outstripped my income. Something had to give, and that something was my credit cards and loans. The experience was painful, and sacrifices were needed. But today I have just a small amount of remaining debt (other than the mortgage and every month I have money to spend. Christmas, which used to be a time to dread has come and gone and I owe no more today than I did last month.
The nation’s debt is thankfully much greater than anything I could conceive personally, but the principles are the same. The causes of this are well written about, but in my opinion not worthy of mention since it can’t help us now. The Government takes an interesting approach to trying to balance the books. Reducing the size of the public sector I can understand; it hurts me to say but a lot of jobs were created and money was wasted. You need to be careful about the ways in which you cut services and with them jobs, it creates uncertainty and fear and leads to risk aversion. More jobs are lost and less created because of this. If jobs and services don’t spring up elsewhere then some of those people become unemployed or else take lower paid, lower status jobs. This in turn means that those who might have taken those jobs are shifted further down the pile. The most vulnerable in society suffer most from this approach.
In turn the Government has taken a look at the growing benefits bill and decided that this can and must be reduced. dependency on the state needs to be reduced (even as someone who believes in the welfare state) I can hardly argue with this desire. But by starting with the most vulnerable in society this Government risks the label so often given to the Tories of the past. It feels nasty to target benefits to disabled children and those with cancer. Especially in a week when Cameron has said that he would like to see the 50% tax rate for those earning £100k to be abolished even though it is bringing plenty of tax revenue into the exchequer.
Tonight the House of Lords has shown it’s worth and voted for changes to the Welfare bill associated with these elements of cuts. It is a shame that they haven’t shown the same approach with the Health and Social Care Bill!