John’s Blog No. 136 – Pensions

It was reported that there are over half a million migrants lost in the UK and that it will take some 40 years to track them down, that is almost one percent of the entire population. Yet life in the UK today is littered with identity debris.
When born I am issued with a unique birth certificate and number, as soon as I start work, I have a National Insurance number used for this and tax purposes, when I marry a marriage certificate and when I die a death certificate and number. Then of course there is passport, driving licence, NHS number, Council Tax, etc. etc..
In this modern technological age with instant communication, I can use Google or any search engine and get thousands of matches within seconds and yet the State seems unable to do these simple tasks to find out who is legally registered in the system.
In the absence of a National Identity card and number (too expensive to implement), then the National Insurance number is the key identity tag, it shows that someone is or has been contributing to the economy as a working member of Society, with a complete record of such contributions.
It is a unique active identity number which can be readily tracked and verified and then cancelled at death, it is regularly up-dated by Employers and the Tax Office and therefore ideal for identity checks, if the basic information was available on a search database.
Applications for work, benefit or any form of identity could be checked out without costly searches to confirm only one individual exists and the latest address, work details and legitimacy to work and live in the UK, what could be simpler and a quick and ready method of tracking individuals, without affecting their rights.
The database exists and could be instantly available for identity checks and a legal requirement for any employment, it could also be used to establish the right to earned benefits above poverty levels and final pension rights. The information is there and should be used, giving a quicker and simpler method of tracking legal citizens.
We seem loath to implement any sort of controls on migrants, legal or otherwise, we cannot deport terrorists or prevent mass entry or visitors who enter the country purely to exploit the welfare system or health service or even for criminal activities. They export money out of the country affecting trade balance and undermining the economy.
We are hidebound by human rights and EU regulations, which we obey meticulously at great legal and other costs, whilst the rest of Europe ignore such limitations, shipping illegals back or better still on to us, regardless. Next year we can expect another wave of new EU members without restriction and who we will support, whilst our own citizens suffer deprivation, homelessness or poverty or if in work doing more for less return.
If you go to the US, Australia or other major country, you need a visa and cannot stay longer than a visitor period; you need a limited time period work permit and often need residency status to get a permanent job and certainly to claim any benefit or health care, even if it is available.
Immigrants play an important part in our work force, but they need to be part of that work force, contributing to Society and if they stay for a longer time need to become British in outlook. We cannot afford welfare migrants; need to be tough about dealing with them and enforcing border controls, even if they are European in origin.

It is all about plain common sense, which appears to be lacking in European bureaucracy and even in our own. I am not a secular, Britain for the British type of person, but they do need to be given priority when scarce resources are concerned in housing, welfare, health and social care.

We appear to be increasingly governed by minority interests, whether it be big business, the anti everything brigade or the goody goody idealists. They should be firmly put in their place with the interests of the Country and its real citizens as the first priority.

John’s Blog No. 135 – NHS

The NHS is in crisis and approaching the point where it can no longer be afforded, so that the aim must be to reform the service to make it viable. It has become a world service with health tourism to the UK very attractive, which we, with our limited resources, cannot meet.

Of course it is only a small part of the cost, but why should visitors or immigrants not take out Health Insurance; we need to when we go abroad and this is mandatory with the US and other countries.

The NHS should return to being a true health service and not an accident and repair service; it should be restricted specifically to UK residents who are ill and who pay all the costs of the service. It is not an indulgence for self inflicted health problems or a charitable organisation free for all.

We all pay motor and home insurance; Business have transport and accident policies; risk pastimes take out insurance as do major events organisers and anyone liable to risk, so why should this Insurance  not meet its full obligations. Of course premiums may go up, but no-claims bonus could restrict this to claimants, but the basis is insurance against accidents.

The self indulgence of smoking, drink, drugs and obesity is another  major cost area, but charges could be related to Mandatory rehabilitation courses, with even a health tax on major suppliers of offending products. There is the question of affordability, but they find the money to by the stuff in the first place.

Normal health care at point of need should not be affected with NHS number or Insurance detail (passport for tourists) as required. Record of treatment will be necessary, but this is being done anyway and billing could be from Central Trust on these records. Private hospitals and business do this as routine.

There would be a need for a set of standard charges, agreed with Insurers for accident claims, but the overall cost should not be too high and is rechargeable. The main change would be one of attitude.

There will be some grey areas and also social ones like childbirth, IVF etc which should be on NHS, but generally the position is clear cut, normal health risks or external causes. Food poisoning is one area, where it is commercial it would be part of compensation, in the home it would be health risk.

There is a lot of money being made on accident claims and it is right that this should include treatment costs. In many ways this could be interpreted as privatisation, but it is only in the areas that are already privatised, of Insurance and compensation.

The main objective should be to give health care to UK residents who pay taxes to finance it, anything outside normal health consideration should be paid for at the event. It is difficult to assess how much this would save, but non-health treatment is currently a major part of NHS costs and should be paid for when provided.

It is only logical and sensible that such a separation should occur for natural health issues and those arising from choice and controllable events; in the majority of cases the insurance exists and therefore should meet its obligations in full.

The boundaries are well defined in general, with very few grey areas and the laws on insurance accepted for all parties and exploited by some; they just need to be applied by the Health service. Most A & E and Ambulance service costs relate to rechargeable events, as do long term hospital treatments, whereas GP’s are primarily concerned with basic health, as are most out-patient care.

It is probable that most accident treatment would revert to the private sector, apart from A & E, once it was charged for on insurance, relieving pressure on the NHS. Why should the State or taxpayer subsidise the Insurance Companies or individuals who behave carelessly or live dangerously.

There is a stark choice, we either see the NHS steadily decline under forced savings to an ineffective service, with the drift towards private care for those who can afford it, or remain the excellent NHS it can be , but limited to true health care, free at point of need.

The basic care would not change, but the funding basis would, to the benefit of all who use the service, whether due to ill health, accident or misfortune.

John’s Blog No. 134 – NHS

Two weeks ago, for only the second time in my life I was treated to the delights of an overnight stay in hospital. It was not by choice obviously but by illness, which overtook me at the convenient time of midnight on a Sunday

I woke with breathing difficulties, which got steadily worse until my wife and I decided to call the out of hours service, found the booklet, the number and no longer available reply, tried 111 and received another number to dial, then was connected.

Of course in a normal emergency one would expect to be asked symptoms and questions to decide urgency, but not at that stage personal details from someone having difficulty talking. On hold while a nurse was contacted and then in good call centre practise, started from scratch again.

It was decided on an ambulance, which arrived fairly quickly and then the medical excellence started; efficiently working through their check list of tests, they then decided on hospital and took me out to the ambulance made me comfortable and carried out more tests, ECG etc before deciding to drive off.

One of their concerns, during the 30 mile journey, was of another emergency as they were the only crew on duty, but luckily this did not occur. At emergency a rapid transfer occurred, with no sitting about in the Ambulance as widely reported, again a wide range of thorough tests and then a wait for a doctor to become available.

In a cubicle with curtains open and passing staff checking you were alright, then an emergency next door and the curtains were drawn and isolation began, this is my only crtiticism, the lack of contact and communication and having to call out several times as someone passed, when I needed attention.

Things had improved since my previous visit many years ago, but I was stuck by the complete contrast between medical staff and management. The staff were helpful, cheerful, efficient and overworked, patients were difficult, with the usually lack of communication skills of doctors and consultants, but one had the overall impression of things being haphazard and disorganised.

There was a routine but it clashed at times with doctors rounds, cleaners and maintenance staff came and went at their convenience with the usual long mop pushing the dirt from the doorway round the ward and out again, although there was a full clean the next day.

After a fitful sleep, had just dropped off when the 6.30am medical check started plus a cup of tea, water jugs were collected , taken away and not returned until half an hour later, there was a lot of hassle, breakfast, cleaners orderlies etc., which disturbed the peace.

Visiting hours were restricted, but there was not a lot of activity in the afternoon, so it could have been continuous from lunchtime. There were no night rounds with a complete dependence on the panic button.

One couldn’t help thinking of the good old matron days, experienced when visiting parents and everything seemed quiet and efficient, with little escaping her eagle eye. The care problems now arising result from this lack of this overview and the patient considerate manner exercised on the spot by the matron.

There is no-hands on management occurring, with time taken in balancing budgets, meeting targets, planning and trying to fit two pints into a pint pot, whilst dictating what happens in daily routine, staff levels etc. This is a formula for chaos which is appearing steadily in our NHS.