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Wednesday, October 31, 2007

Watching both candidates 

Two candidates it is then - and clearly both have strong and compelling (and strongly Liberal) cases to make.

It will be easier for me to keep in touch with what Chris Huhne is saying as I have decided to support him, and signed on for e-mail updates on his campaign. If I was a Nick Clegg supporter I could still get those updates as Chris' website offers the option of just signing on to get more information as it arises without making a declaration of support. However as far as I can see Nick's website only offers the option of signing on as a supporter. This would be untrue for me in the context of this election, so I have not done so.

No doubt LibDemblogs aggregated will help me keep in touch with Nick's campaign.

And I intend to look very carefully at what each of them says and perhaps comment from time to time. One is going to be leader of this party and I want him to be the strongest possible leader he can be, whoever he is. I am hoping that an honest and rigorous debate will strengthen both of them and make each better able to contribute to our work whatever the role they assume after the count.

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So-called Medical Tourism and the NHS 

More NHS bashing from the Daily Mail on 'medical tourism', the numbers of Britons going abroad for hospital treatment, to Thailand and India for example. And not 'just' for cosmetic surgery but for vital treatments. More condemnations of our creaky system and the implication we should adopt another.

But as this US blogger post points out the development of facilities serving Medical Tourism industry is driven by the huge numers fleeing the excruciating US healthcare system. Medical refugees rather than tourists. This is what is funding the hospitals in India and Thailand. UK patients are just piggybacking on the new provisions.

Ezra Klein says in part:

We can talk about the 50,000 Americans who go to Bumrungrad hospital in Thailand every year for cheaper surgeries. We can go into this article, about the Indian hospitals primarily serving Americans, or this one, about the waves of Americans traveling abroad because they're unable to afford heart surgery. Indeed, there are more Americans -- 100,000 -- traveling abroad for cosmetic surgery alone than there are Britons seeking any type of services in foreign lands.

America is actually driving the medical tourism industry that some Britons are taking advantage of. The growth of foreign treatment centers aren't a result of the failings of the British health care system (of which there are many). They're a result of the cost of American health care, and the huge numbers of sick individuals we price out.



Lets keep a few facts straight in this healthcare propaganda war. I can recall a few years ago when the Medical Tourism problem was supposed to be people coming to the UK to enjoy our facilities...

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I wonder how many Europeans from countries with sensible health care systems are taking part in medical tourism, though? Probably not as many.

We all know the US has a useless health care system, but why should that stop us from looking at better-functioning European ones?

As for people coming to the UK - I live in the Czech Republic, and I know that Czechs going to live in the UK worry about having to use the NHS because of its terrible reputation.
 
The reality is that regardless of how many have or will engage in the practice of medical tourism or transplant tourism the fundamental issues driving it are:

1) Cost: High health care costs in the US is making it an attractive and reasonable option for the uninsured and the underinsured.

2) Quality: A full 25% of physicians in the US today are foreign born. Many, many more have been trained in the US and then return to their home countries to practice. That means that there are a lot of really, really good physicians outside the US and if you have the means and the desire, why not go international to get health care. So, now the wealthy (www.transplanttourism.info) will find it attractive (and trendy). I have a list of 50+ 'medical tourism' and 'transplant tourism' companies and that barely skims the surface.

3) Acceptability: HCA International has recently announced a relationship and access to a facility in Pakistan. HCA subscribers will soon be routed offshore to receive elective, non-emergency care and it will cut the cost of health care. It will result in higher profits by HCA. It will also put some physcians in an interesting position because as this trend continues they will be replaced one-by-one to some degree by those that can deliver the same or better quality services at a lower overall cost.

In summary, this means that it will attract the rich and the poor, the insured, the underinsured, and the uninsured regardless of what country you come from. I'm guessing, but in my mind that just about covers everyone.

It's a big world folks. It's hard to not imagine this as a natural event.
 
Hello Edis,

You ended your remarks with this: "In summary, this means that it will attract the rich and the poor, the insured, the underinsured, and the uninsured regardless of what country you come from. I'm guessing, but in my mind that just about covers everyone."

I could not agree more! I am not rich and am one of the hundreds of thousands in the US who does not have health insurance. I am also one who cannot afford ordinary health care in the US. Three times I have used a company in India who freely gives helps to find the right doctor and hospital for what ever ails you. Again, they do not charge a penny for their helps and if I were to get sick again, (1) I'd crawl to India if I had to, to get the kind of care I've received there three times before, and (2) I'd use America's Medical Solutions (www.americasmedicalsolutions.com) which is owned by Americans who live in Bombay, India. Their help takes all the concern out of going to a foreign country.
 
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Monday, October 29, 2007

Like it or not defence policy must be debated again 

Our current so-called ‘Trident’ policy is not a fudge. It is an acid drop, and we need to suck on it. That includes the current leadership candidates.

The implications for our policy are clear. We voted in Parliament to delay Vanguard renewal (and were defeated). We now have an obligation as a party to carry out the clearly implied next stage of the agreed policy. That is, to debate now the position the UK should take at the upcoming negotiations and bring forwards firm recommendations. That is the acid logic of our position.

The treaty reviews are in the year 2010 – and in the meantime in 2009 we are due to have a general election in which nuclear arms policy can hardly fail to be an issue.

We therefore need to revisit this issue in 2008 at the latest, and the current leadership contest is an inevitable part of the introduction to that debate. It would be the height of irresponsibility for any leadership candidate to brush this issue aside.

We should for example:

1 Look at the way the debates on this are put into ‘defining frames’ that shut out important questions and make sure we bring in some neglected frames and themes. Please, no more tribal ‘unilateralist or not’ hot-button posturing.

2 Insist that the whole question of expenditures on AWRE Aldermaston is put in the public domain, at least to equal the public accountability enforced on equivalent establishments in the USA.

3 Insist on a complete review of the way all our weapons procurement policies are managed especially on whether purchasing decision are made to subsidise industries rather than to meet vital defence needs.

4 Make clear the connections between the procurement mess and the corruption allegations about the dealings of BAe and certain foreign customers.

5 Examine the evolution of new non-nuclear high-destruction weapons that may make nuclear devices an expensive obsolescence in the next couple of decades.

6 Above all, insist on a clear strategy for armed forces evolution and for equipping our forces actually to do the jobs we say they must.

The party needs to get on with this and our leadership candidates need to give some indication on how this should be done. The choice of leader WILL frame part of our ongoing debate, there is no escaping that fact.

I have argued some of these points in more detail elsewhere

Framing the debate with link to a paper on ways to do this

Aldermaston costs and hiding facts from the public (with link to a Daily Mail expose)

Procurement polices and problems

Corruption and specifically BAe

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Saturday, October 27, 2007

A difference on defence? 

Rugby hustings... and at last a couple of subjects that seem to differ between the candidates.

As coat-trailed in the David Steel endorsement, Chris Huhne raised the question of 'Trident Renewal' in the context of the huge demands on the armed forces, their equipment, the tasks we ask of them and the welfare of our service people. His statement that we have to question whether spending billions on Trident is the best way to spend our defence money provoked the only round of applause for either candidate in the middle of their set speeches.

Nick Clegg (who spoke first) did not mention any defence related matters and was not (as far as I heard) asked about this during the question period.

Other matters I'll maybe comment on later.

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language, language 

Guys could we break the mould on 'Breaking The Mould'? Find a less moldy metaphor to cheer us all up.

Not that I am objecting to the idea, mind, just that for some of us the phrase is a smelly bit of rhetoric from the less successful days of The Alliance.

A random thought from the Rugby leadership hustings...

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Friday, October 26, 2007

You lucky lucky undecideds 

Congratulations to everyone genuinely undecided in the leadership poll!

This is a rare opportunity to find out how the rest of the world (or at least the persuadable parts of the population) experience an election.

As activists we are greatly experienced at dishing out the leaflets and so on. Not so experienced at seeing how effective (or not) a particular approach is.

For example what is it actually like to get a FOCUS aimed at you in earnest out of the blue?

Those of us with an active favourite to campaign for are missing out on this. I hope the real undecideds -especially those who stay that way right up to voting time- can take some notes and let us all know what works and perhaps what does not work in campaigning.

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Wednesday, October 24, 2007

"Tell me the time not how the clock works" 

An old Buckinghamshire saying apparently (well as old as clocks if not as old as Buckinghamshire). Basically a version of the seven second rule for FOCUS writers.
Make your point so the message gets across before it is binned.

The 'soundbite' is the pornographic version of this. Ming probably never gave a soundbite in his life - one of his character strengths and a reason why he would have been an excellent Prime Minister but not a good guerilla leader.

One feature of the current leadership dance is an (apparent) attempt to claim for each candidate the positive discipline of the FOCUS without falling into the trap of soundbite snappery.

Dissertation on campaign rhetoric snipped - you know the time of day.

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Friday, October 19, 2007

Trivia by any other name 

For those who don’t make politics a central interest in their lives, decisions about who to support in elections (or even to notice who is who) can turn on quite odd little things. Marketing isn’t everything but still…

One disadvantage we had under Ming was that there were two Scottish names in the mix. Outside of Scotland, ‘Cameron’ and ‘Campbell’ look about the same in a headline. In Scotland of course the names come with red hot historical tags attached which jump off the page.

I suspect many people in England – and Wales - had to stop and think ‘is this the Tory guy or the Libdem?’ when confronted by a CEEFAX headline saying ‘Campbell attacks Brown’s dithering’. Or rather they didn’t stop and think and just assumed it was The Tory unless specifically prodded otherwise.

Now we have emerging a line-up of (apparently) two potential leaders with very short and recognisable headline-friendly names. Both ‘Clegg’ and ‘Huhne’ will fit nicely into big type and at 5 letters give room for more words in the rest of the message on Ceefax.

Chris of course may suffer a little from having a slightly foreign-sounding name while Nick has the marginal (?) advantage of an archetypical Northern handle. Interesting therefore that Nick is playing up the ‘Northern Real World’ line with his campaign launch. Of course with his mother being Dutch by origin we can confidently expect some Tories to claim he is really an interloper operating under a flag of convenience.

Incidentally if UK Law was on the same lines as Dutch Law Nick would officially be ‘an Immigrant’ here as ‘immigrants’ in the Nederlands (Allochtoon) are defined as being people with one parent born outside the country regardless of where they themselves were born.

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Wednesday, October 10, 2007

Against executions 

Today October 10th is the “World day Against the Death Penalty

This is in support of the proposed UN General Assembly initiative for a global moratorium capital punishment.

As the admirable idiot/savant (in New Zealand, which kicks off October 10th as it does every day of the year) says:

“The global struggle against the death penalty has been long and hard - but it's one we're winning. Since the last world day against the death penalty, two countries have abolished the death penalty for all crimes: Albania and Rwanda.
In addition, Kyrgyzstan abolished the death penalty for ordinary crimes, and significant restrictions were introduced in Kazakhstan.
Furthermore, legislation to abolish the death penalty is now under consideration in Burundi and South Korea, while Malawi's High Court has declared mandatory execution unconstitutional.”

Of course that still leaves the big holdouts of China, the USA and Iran to tackle…

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Monday, October 08, 2007

Is "Fixed Term Fixation" the best we can do? 

The ‘Fixed Term Parliament’ idea seems to be the latest constitutional panacea that will cure all problems from constipation upwards. Sorry, but I think this misses a number of important points.

For starters the real problem behind the recent undignified ‘Dance of The Seven Gordons’ is that the UK has not really abolished arbitrary Royal Powers. They have just migrated to the ‘Prime Minister in Parliament’. Tackling this complex of arbitrary ‘Henry VIII powers’ is the real constitutional challenge, and making Parliamentary election cycles absolutely rigid may be a bit of a distraction.

Rigid fixed term Parliaments have their disadvantages – as can be seen today in the desperate scrabbling in the US political system to cope with a totally discredited but essentially non-removable fixed term executive.

I hope we can have a proper debate on a flexible constitutional structure for our Parliament rather than a simplistic outcry on fixed terms. I do have a couple of suggestions in the back of my mind which I will mull over.

(For the record I think that the US Constitution is a remarkable document with some historic successes in carrying the US through extreme crisis, but which has serious design flaws some of which present real threats to US political health. Changing this is almost impossible.)

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IMHO, the American problem is that there is a fixed-term Executive rather than a fixed-term Parliament

And a non-fixed term doesn't really help with a discredited parliament that still has a majority. The Tories were inevitably going to lose the election whenever they called it after Black Wednesday, but they held on to the last second, because their majority held up and because they could.

If you want a recall provision, then argue for a recall provision, but that has little to do with fixed-term or non-fixed-term parliaments.
 
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Tuesday, October 02, 2007

The rumbling guts of Labour election decision making 

So what ‘gut feelings’ are likely to influence Labours (or Browns) decision on an election date? Well two possibilities are how they cope with a lack of experience in actually fighting elections on the grounds and the memory of the clothes-peg vote in 2005

Both gut reactions suggest that for key Labour decision makers Labour a quick winter election is desirable as such.

One of the key differences between the Royal Navy and the French Navy in 18th Century wars was that British officers worked their way up from junior ranks, learning by experience. French officers were more likely to be trained ashore and appointed from above. The difference showed in choices for battle strategy and detailed combat performance.

Liberal Democrats have by necessity had to learn how to fight and win elections from the ground up and this experience still lives on at National level. . However both Labour and Conservative national election decision makers are much more likely to have started at the grand planning level where elections are a matter of indoor rallies, billboards, paid-for delivery of literature and TV opportunities. In their guts Labour election planners may really not know what it means to have a winter election where you have to call on party worker to get soaked on the doorsteps, and they really may not give a damn. If they do think about it, perhaps they recon it will hit the LibDems hardest which is not a disadvantage in their eyes.

And there may be a more specific anti-LibDem element in their current calculations. In the 2005 election I happened to link onto an online discussion where agonised Labour supporters debated what to do. One faction famously said put a clothes-peg on your nose and Vote Labour. Then after the election Brown will succeed Blair and all will be well. Others argued that the situation with the Iraq war and various civil liberty issues was too serious and that Labour could not be supported at that election. A minority pointed out that the LibDem position was actually something deserving positive support.

My reading of the gut-rumbles after the 2005 poll is that anti-Blair Labour activists think there was indeed a considerable clothes-peg vote and that the LibDems did indeed succeed in picking up votes in unexpected places, snatching ‘natural Labour seats’ and ‘betraying’ others into Tory hands. Based on that gut calculation Labour now expects to turn out the clothes-peg vote which feels vindicated and regain the ‘waverers’ who ‘defected’ last time.

But they have to do this before people get a proper look at Brown and his long-term plans, while the illusions of the clothes-peggers are still unshattered.

There are broadly two election outcomes that would be a disaster for Brown. The terminal one would be to lose his majority even if the Tories did not get one in return. The second would be to see a substantial increase in the LibDem representation and thus an increase in effective and relevant Parliamentary opposition. A true nightmare would be the LibDems as Official Opposition – principled and relevant and with a breadth and depth of expertise the Tories can only dream of right now. That would really spell long term trouble for Brown and Labour.

Reading the current farts from labour guts I suspect Brown sees an election geared to maximising damage to the LibDems. He doesn’t really care what happens to the Tories provided they stay the official opposition and don’t increase their Parliamentary holding more than a dozen or so. A Tory opposition on the present lines he can handle easily.

For us it means ‘come three corners of the world in arms…’ and yes I now expect a Winter Poll.

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The problem for Brown is that he underestimates the sheer masochism of us Lib Dems which means that we are unlikely to be deterred.

We have an ex-Cabinet minister in our sights here and I for one am not going to duck the challenge!
 
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The rumbling guts of Labour election decision making 

So what ‘gut feelings’ are likely to influence Labours (or Browns) decision on an election date?
Well two possibilities are how they digest the lack of experience in actually fighting elections on the grounds and the memory of the clothes-peg vote in 2005

Both gut reactions suggest that for key Labour decision makers Labour a quick winter election is desirable as such.

One of the key differences between the Royal Navy and the French Navy in 18th Century wars was that British officers worked their way up from junior ranks, learning by experience. French officers were more likely to be trained ashore and appointed from above on criteria other than seamanship. The difference showed in choices for battle strategy and detailed combat performance.

Liberal Democrats have by necessity had to learn how to fight and win elections from the ground up and this experience still lives on at National level. However both Labour and Conservative national election decision makers are much more likely to have started at the grand planning level where elections are a matter of indoor rallies, billboards, policy stunts, paid-for delivery of literature and TV opportunities. In their guts Labour election planners may really not know what it means to have a winter election where you have to call on party worker to get soaked on the doorsteps, and they really may not give a damn. If they do think about it, perhaps they recon it will hit the LibDems hardest which is not a disadvantage in their eyes.

And there may be a more specific anti-LibDem element in their current calculations. In the 2005 election I happened to link onto an online discussion where agonised Labour supporters debated what to do. One faction famously said put a clothes-peg on your nose and Vote Labour. Then after the election Brown will succeed Blair and all will be well. Others argued that the situation with the Iraq war and various civil liberty issues was too serious and that Labour could not be supported at that election. A minority pointed out that the LibDem position was actually something deserving positive support.

My reading of the gut-rumbles after the 2005 poll is that anti-Blair Labour activists think there was indeed a considerable clothes-peg vote and that the LibDems did indeed succeed in picking up votes in unexpected places, snatching ‘natural Labour seats’ and ‘betraying’ others into Tory hands. Based on that gut calculation Labour now expects to turn out the clothes-peg vote, which feels vindicated, and regain the ‘waverers’ who ‘defected’ last time.

But they have to do this before people get a proper look at Brown and his long-term plans, while the illusions of the clothes-peggers are still unshattered.

There are broadly two election outcomes that would be a disaster for Brown. The terminal one would be to lose his majority even if the Tories did not get one in return. The second would be to see a substantial increase in the LibDem representation and thus an increase in effective and relevant Parliamentary opposition. A true nightmare would be the LibDems as Official Opposition – principled and relevant and with a breadth and depth of expertise the Tories can only dream of right now. That would really spell long term trouble for Brown and Labour.

Reading the current farts from labour guts I suspect Brown sees an election geared to maximising damage to the LibDems. He doesn’t really care what happens to the Tories provided they stay the official opposition and don’t increase their Parliamentary holding more than a dozen or so. A Tory opposition on the present lines he can handle easily.

For us it means ‘come three corners of the world in arms…’ and yes I now expect a Winter Poll.

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Another key difference was that the British did not guillotine many of their best Navy officers in a fit of revolutionary zeal.

The French then learned it's not easy to quickly replace a generation of talent and accrued knowledge.
 
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Monday, October 01, 2007

Doube Double Toil and Trouble - an election chaos nightmare 

I have been trying to make sense of the voter registration situation, and other worries, and come up with some troubling conclusions. If I have got it wrong, I think I am not alone in these conclusions so some public information needs to come out sharpish.

Voter registration. Forget the rolling registration. A LOT of people will be disenfranchised if we hold an election now. As I understand it, you needed to be on the register by September 1st to qualify for an election up to November 30th. So, for example, all those students going up to campus for the first time will therefore not be able to register at college for an autumn election… Cambridge, two Oxford seats, Chelmsford, lots of interesting seats affected. Any registrations now would be set aside to be processed after polling day and added to the register as from January 1st 2008

Is this so? Is the figure anything like the ‘million disenfranchised nationally’ that has started to pop up in backstairs conversations?

Those who were on the register anywhere before September 1st will be OK, but there could be confusion in store for many people who have filled in the registration forms for the annual registration check, and who are at a different address to their previous registration. Again as I understand it, forms received after 1 September are not counted as a ‘rolling registration’ so those people will not be on the register at the new address they expect to vote from, though they may still be able to vote as from their old address as that registration may still be valid. They would need to check the registers go to their old polling station or ask for a ballot paper from their old address to go to their new one. More work for Election Officer staff. Again is this so? Clear advice is urgently needed.

Postal Vote verification. New legislation requires the signatures on returned ballot envelopes to be checked. Or at least it does in England and in Wales (And in Northern Ireland?). In Scotland however legislation is required under devolved powers. I hear that this hasn’t happened so any Autumn election in Scotland will be under the old rules for postal votes. Is this so?

There are new machines coming into use that will read signatures on ballot envelopes automatically and compare to that given on the postal vote application form. Only a very few Returning Officers have even got hold of these machines yet. Even if rushed into service, there is no time for proper training and debugging of the system under realistic operational conditions. The old IT lecturer in me is drooling about an emerging case study in bad technology deployment, the practical politician and responsible citizen cringes at the possible chaos to come.

Northern Ireland. The election for the Westminster seats will of course be under the national FPTP system. This maximises the chances for disruptive campaigns aimed at destroying the current power sharing agreement undertaken by parties competing in Proportional Elections.. How robust is the governing agreement?

What a pity the system was not changed at least for the Westminster seats from Northern Ireland..


Postal Service
Two postal strikes are planned for the middle of the possible election period which could seriously muck up postal voting and also the FREEPOST deliveries of election material.

All in all there are excellent technical reasons for NOT having a General Election for the next couple of months.

Pity that the main opposition parties have herded themselves into an ‘election now!’ stampede and cannot offer calm advice in the national interest.

(And yes I do think we LibDems have made a serious mistake on this one, giving Gordon a free hand to exploit whatever advantages he can grab).

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Most of what you say is true except:
"As I understand it, you needed to be on the register by September 1st to qualify for an election up to November 30th"

Special rules come in beyond the normal rolling registration rules.
 
Yes, but only after an election is called and up to twelve? days before polling day - a window in the minimum campaign period of just nine days. Though if they think disenfrachising students is going to let them keep hold of Andrew SMith's seat they've got another think coming!
 
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