The next PM...

[Nearly Sane]

After last night's 'debate' on the Beeb, and, having watched the cat fight;
In the immortal words of Han Solo;
"I've got a baaaaaad feeling about this".

I an amazed at your fortitude. I fear my TV would not survive me watching it.

[Aruntraveller]

After last night's 'debate' on the Beeb, and, having watched the cat fight;
In the immortal words of Han Solo;
"I've got a baaaaaad feeling about this".

I only watched the first half hour. Had to switch it off as I could not stand Sunak's constant interruptions.

If that is the effect it had on me I wonder how it played with the Tory faithful?

[Roses]

Whilst I am immensely glad  Johnson has been booted out as PM, I can't say Truss or Sunak fill me with pleasure. Their debates are like a couple of kids yelling at each other in the playground!

[Aruntraveller]

Whilst I am immensely glad  Johnson has been booted out as PM, I can't say Truss or Sunak fill me with pleasure. Their debates are like a couple of kids yelling at each other in the playground!

To be honest I think that is quite insulting to kids.

[Roses]

To be honest I think that is quite insulting to kids.

Yeh you are right about that.

[The Accountant, OBE, KC]

I watched it - the interruptions were irritating. But when people debate politics, interruptions seem par for the course I think based on what I remember from other election debates and on Question Time so I wasn't that bothered by it. E.g. see this clip about 32 minutes in, when Nicola Sturgeon and Rishi Sunak were discussing a no deal Brexit and interrupting and talking over each other and then Jo Swinson followed by Nigel Farage  interrupted and were talking over each other.

https://www.youtube.com/watch?v=lnZo1ZYcmtA

I am not clear where Liz Truss is planning on cutting costs in public spending or how she will cover the drop in tax revenue, especially as we need the money to care for an aging population. There are people who can afford the rise in cost of living (fuel and energy price rises) so they will be spending more if there are tax cuts, which means inflation is likely to go up. The Bank of England will raise interest rates to control spending and inflation, which affects homeowners with mortgages. Are people who took out mortgages going to be able to keep up with higher interest payments? https://www.theguardian.com/politics/2022/jul/25/liz-truss-trussonomics-tax-cuts-interest-rates

Lots of job vacancies at the moment and people wanting higher wages to do the jobs = inflation. Did Truss seem to think the government should have a hand in the Bank of England monetary policy to reduce money supply rather than raise interest rates i.e. Bank of England would no longer be independent of a government's election/ political agenda?

I am not clear on how Sunak is planning on helping low income households with the high cost of living.

Given over half the voters in the referendum wanted to take a risk with Brexit even though they had no idea how the promises made by Leavers would be delivered, voters might go with the same approach and risk tax cuts.

[Nearly Sane]

To quote my favourite economist: 'Controlling inflation by raising and lowering interest rates is like controlling the oven temperature by switching the light on and off'

[The Accountant, OBE, KC]

Yes inflation pretty hard to control - energy prices don't look like they are going to drop any time soon while war in Ukraine is going on. Also need increased supply of refined oil for petrol and diesel prices to fall, but companies don't want to invest in increasing production/ supply as demand is supposed to fall as we're supposed to be going greener. Oil companies also don't know if everyone is going to stop going out if Covid infection rates are going back up so demand will fall. So looks like prices will remain high for a while.

https://www.bloomberg.com/news/articles/2022-06-24/oil-s-dive-won-t-bring-any-immediate-relief-on-inflation#xj4y7vzkg

And price rise in fertiliser and Ukraine war has led to higher food costs.

Sunak is worried about paying for the Covid spending and emergency measures - including furlough and the Eat Out To Help Out scheme so I can see why he doesn't want to cut taxes.

[Udayana]

To quote my favourite economist: 'Controlling inflation by raising and lowering interest rates is like controlling the oven temperature by switching the light on and off'

Who's that?

[Nearly Sane]

Who's that?

My wife

[Udayana]

My wife

Jolly good.

Given the main drivers of the current burst of inflation it is unlikely that raising interest rates would help in controlling it. However, rapidly growing government debt could cause rates to rise - a weakened pound would itself help inflation.

Given the causes are temporary it should be possible to just wait it out .. but that would be very painful for the worst off. Best would probably be to manage it - by using carefully designed price controls and select windfall taxes, until the energy and food issues are resolved - as some EU countries are doing.

Just reducing taxes won't really help - what they mean is reducing taxes on business to encourage investment to grow the economy - not reducing taxes to help ordinary people cope with the inflation.

[Nearly Sane]

Aye

[The Accountant, OBE, KC]

Patrick Minford (the economist cited by Liz Truss as supporting her tax cuts) has now said he was misquoted by the Times journalist as saying interest rates will rise to 7%. He now says it is more likely to rise to about 3% and that is ok and what the Bank of England needs to do.

He also said that tax cuts and increased Govt borrowing is what the economy needs for economic growth. He disputed Sunak's idea that it is immoral to continue borrowing and expecting our children and grandchildren to repay. He said in the present circumstance it was necessary due to the current supply side constraints pushing up prices causing an unprecedented cost of living crisis. Others have also compared fighting Covid to the situation after WW2, when government debt was also at a record high and took decades to pay off.

I see Sunak has now agreed to cut the 5% VAT on household energy bills for 1 year if the energy price cap rises in October above £3000. He had previously opposed the one-year VAT cut when Labour proposed it in Jan 2022, despite Johnson etc having promised to get rid of the 5% VAT on energy imposed by the EU during the Brexit campaign, if Britain left the EU. Presumably because of the Covid pandemic spending? Shows you can't rely on any promises made by politicians as you don't know what the next shock to the economy will be.

Falling pound not having a bigger positive effect on UK exports. UK's relatively high cost of labour per unit of output not helping. 

[ProfessorDavey]

He also said that tax cuts and increased Govt borrowing is what the economy needs for economic growth.

Sure a fiscal stimulus involving tax cuts and increasing borrowing will likely drive economic growth - that seems to be economics 101, in principle.

The issue is that this will almost certainly further fuel inflation, which is already at levels we haven't seen for 40 years. And of course if pay rises lag behind inflation (as they have for years) then people will simply be poorer in the long run regardless of a temporary sugar-rush hit of tax cuts. And the standard approach to dealing with inflationary pressures is raising interest rates, which will hit people with mortgages hard who have become used to very low interest rates, and presumably have budgeted accordingly.

And there is another point - if tax cuts result in spending cuts and major job losses in the public sector this will act as a counteracting drag to economic growth as those people will have less ability to fuel that economic growth via spending on products and services. We saw this after the 2010 election when the austerity policies effectively choked off the ability of the UK economy to grow out of the economic shock of the global financial crisis.

And although inflation and growth is actually very helpful in dealing with debt repayment, higher interest rates aren't.

[Aruntraveller]

Truly transformational Rishi wants to fine people for not attending appts, scans, etc.

https://www.bbc.co.uk/news/uk-politics-62366197

No details, it's just going to happen. He clearly doesn't understand how the NHS works if he thinks this can be done without massive investment in systems and staff.

Plus how will this be collected?

Are they going to send out debt collectors for a tenner?

An ill thought out soundbite masquerading as a policy to try to feed his doubters some red meat. Beyond pathetic.

[Aruntraveller]

And MadNad doing her best to keep it classy:

https://www.thelondoneconomic.com/news/watch-dangerous-nadine-dorries-slammed-for-retweeting-sunak-stabbing-pic-331070/?

I do hope this is covered by the ministerial code.

[The Accountant, OBE, KC]

Truly transformational Rishi wants to fine people for not attending appts, scans, etc.

https://www.bbc.co.uk/news/uk-politics-62366197

No details, it's just going to happen. He clearly doesn't understand how the NHS works if he thinks this can be done without massive investment in systems and staff.

Plus how will this be collected?

Are they going to send out debt collectors for a tenner?

An ill thought out soundbite masquerading as a policy to try to feed his doubters some red meat. Beyond pathetic.

Agree it's a soundbite. Don't know if they are hoping it will have the same effect on people's behaviour as the 5p plastic bag charge - suddenly a large number of people became more organised and remembered to take a bag with them when they went to the shops. If you know you are going to get charged if you miss an NHS appointment without a good reason (something more than you forgot or you were disorganised), you might take more personal responsibility to make arrangements not to miss the appointment. Human behaviour seems to respond to such incentives - there are lots of people who change their behaviour if they know they will face a penalty for continuing that behaviour so it could be a useful tool, if it can be implemented.

Not sure how fines would be implemented but according to this YouGov poll the idea has a lot of support from healthcare workers https://yougov.co.uk/topics/health/articles-reports/2020/05/27/most-healthcare-workers-support-fines-those-missin

If Conservative MPs' tactics are to tell people what they want to hear i.e. advocate policies that appeal to enough voters to get them elected, and Labour have struggled to get elected to power because their MPs are not saying what voters in a constituency want to hear, isn't that down to how our political system works? They need to change the FPTP system before we will get a different style of campaigning.

If the media is to be believed, Sunak is unlikely to be elected leader by the members. I saw him being interviewed by Andrew Neil (apparently Truss declined a similar interview) and he was justifying the Rwanda pilot plan at a cost of £600,000 per migrant as he claimed it would have a deterrent effect on people trafficking. Hard to believe this cost per migrant is cheaper than the cost of going after and prosecuting the people traffickers or that it will work to deter people from falling victim to traffickers. Seems more the case that publicising the Rwanda policy and pandering to xenophobia is politically easier than the government being organised enough or having the resources to efficiently process migrants.

[Aruntraveller]

You'll get no argument from me on FPTP. this taken in conjunction with other reasons is why I am politically homeless.

I'm sure health workers do agree with charging for defaulting on appointments. If asked that question I'd probably agree. Did they ask them if they thought the policy was workable?

I would be concerned with the practicalities of it given the granular nature of the NHS it would be a nightmare to administer. Once those members of the public who are a) likely to miss an appointment, and b) likely to default on payment realise this, (also bear in mind there will be all sorts of exemptions) then the proposed charge is dead in the water.

The charging for plastic bags is not that good a comparison unless we all pay upfront for appts.

[The Accountant, OBE, KC]

Fining people for missing, as opposed to cancelling appointments, which would have freed the slot for some other ill patient, might work for GPs - a lady who works as a GP receptionist said on LBC she would be happy to take payment as she already takes payment for doctor's sick notes or reports etc. I think she said it would be a case of if the patient had missed a 1st appointment and then also a 2nd appointment, it would be flagged on the system and the receptionist would not book a 3rd appointment until the fine had been paid.

This is probably made easier by the triage system many GPs now have, whereby you can't get an appointment anymore just by ringing the GP or turning up at the surgery. When you call, you are booked in for a call-back from a GP, who will ascertain over the phone if/ when you need to come in for a physical appointment. My GP also operate an online system where you log in and send in messages, describe symptoms, upload photos of the problem if requested and the GP messages back. I actually prefer this, rather than having to trek to the GP to get an assessment.

Of course, the patient could just go to A&E instead of paying the fine, which then clogs up A&E. I don't think there is a perfect solution, but it seems that letting people off isn't working. I would support introducing fines for missed GP appointments and see what happens.

Not sure how it would work for hospital appointments. Considering you get text reminders of the appointment the day or 2 before and sometimes even a phone call reminder, with a number to call if you have to cancel the appointment, I don't think there can be any justification for so many appointments still being missed, which some other patient could have taken, especially as waiting times are so long. I don't think throwing more money at the NHS will fix this particular problem.

What I am curious about is that I thought if you miss a clinic appointment, you are sent a letter saying if you miss the next one, you will be taken off the patient list for that clinic and you will have to go back to see your GP and start again from scratch i.e. be referred to the clinic again by your GP and be put at the back of the queue. In which case your GP receptionist could require you to pay the fine for the missed appointment before they will refer you to the clinic again.

[Aruntraveller]

Still don't think it would work. All those initiatives for hospital appointments assume that everybody lives well-ordered lives. It just isn't so, unfortunately.

The proposal is that "reasonable excuses" would be exempt.

Who decides what is a reasonable excuse?

So from my direct experience of managing reception areas in a hospital, which of these are reasonable:

My washing machine flooded.

My daughter started being sick.

My wife took the house keys.

and my personal favourite:

My girlfriend had a very heavy period and I couldn't leave her.

How do you decide if the excuse is reasonable and furthermore do you go one step further and in effect accuse them of lying?

I'm sure some of the people I dealt with in the past were not telling the truth, but it wasn't my job to alienate them from the healthcare they had been referred for.

I just do not see it being feasible.

As I said it sounds appealing and a nice easy win. It isn't.

[The Accountant, OBE, KC]

I see your point about what you would feel comfortable charging people for. I had a NHS dental appointment I was late for so I said even if they could not fit me in because I was late, I would pay the charge for the appointment as it was my fault. The dentist did manage to fit me in but said he would not have accepted payment for the missed appointment if he had been unable to fit me in.

I would probably want a system where you charge people the fine regardless of the excuse but give them a form to apply for a refund for the fine along with a requirement for evidence and leave it up to someone else to determine if they had a reasonable excuse for not cancelling the appointment in advance or turning up to the appointment.

The person on reception could tell the patient it's out of your hands to waive the fine as it's a new policy due to the huge cost to the NHS and to other ill patients by people missing appointments. So with all of the excuses you listed I would have still fined them - as the price to be paid for having a free Health Service. Some people might be annoyed but most would understand - my experience is that when something is free people don't really appreciate it or start taking it for granted, to their detriment and the detriment of the rest of the community. So what starts as a good thing actually becomes a hindrance to the people you are trying to help - especially if it creates a dependency culture or a cavalier attitude towards waste. In my view you would be doing patients and the community a disservice by not fining patients who miss appointments.

Though I guess Good Samaritans on Reception who felt really bad for a patient could always pay the fine for them.

[ProfessorDavey]

Agree it's a soundbite. Don't know if they are hoping it will have the same effect on people's behaviour as the 5p plastic bag charge - suddenly a large number of people became more organised and remembered to take a bag with them when they went to the shops.

But it isn't like charging for a bag, which is easy to administer. If you go to the shop and don't have a bag you can buy one for 5p - simple. It isn't anything like as simple for people who do not attend an appointment, for the simple reason that they aren't there to be charged.

[ProfessorDavey]

Not sure how fines would be implemented but according to this YouGov poll the idea has a lot of support from healthcare workers https://yougov.co.uk/topics/health/articles-reports/2020/05/27/most-healthcare-workers-support-fines-those-missin

These kinds of surveys are highly dependent on the question being asked.

So ask NHS staff whether patients should be charged if they miss an appointment and they say 'yes'. I wonder what the answer would be if you asked NHS administrative staff whether they should be spending their time chasing people for unpaid fines for missing appointment - suspect you'd get a very different response. If you fine people you will need to have a system to administer those fines, collect those fines and chase up people who have not paid their fines. I can't see how that will fall to anyone except already overstretched NHS administrative staff.

[ProfessorDavey]

The person on reception could tell the patient it's out of your hands to waive the fine as it's a new policy due to the huge cost to the NHS and to other ill patients by people missing appointments.

But how is that going to work as the whole point about people not attending appointments is that they ... err ... do not attend the appointment so aren't going to be able to have any conversation with the receptionist because ... err ... they aren't there.

[ProfessorDavey]

Latest numpty proposal from the race-to-the-bottom tory leadership race - this time from Truss.

Apparently she wants all triple A* A-level students to be automatically given and interview for Oxbridge.

So let's unpack that for a moment.

So A-level results come out in August - at that point there will be no way that a triple A* student would be able to be offered a place for that year (unless there is a complete change in the admissions process so that all applications etc are made after A levels). So this would be for the following year - so a triple A* student getting their results in Aug 23 may get a place in Sept 24. The only exception would be for courses that have clearing places, but if the have clearing places then that student would get a place under the current system. And of course Oxbridge courses don't do clearing!

So that student will have to wait a year (see later for the impact of that) and need to apply to Oxbridge the following year. But the issue is that even the most competitive Oxbridge courses have offers lower that A*A*A* - the highest is A*A*A. So if a person is applying with actually banked down grades of A*A*A* as opposed to just a prediction of grades for exam not yet taken, will they get an interview under the current system? Well of course they will - so Truss' proposal will make absolutely zero difference in practice - knee-jerk click-bait cat-nip for the tory membership.

But there is another element here, even if it did result in students getting an interview who wouldn't have otherwise, you need to ask who would benefit. Well to benefit you'd need to be prepared to take a year out as any offer wouldn't be for the upcoming academic year but the year after. Fine if you can happily take a gap year or drop yourself into a nice internship etc. But that isn't the case for the kinds of students under-represented at Oxbridge, those who may come from highly deprived backgrounds, perhaps the first in their families to got to universities. It is much less likely that those students will be able to simply take a year out even if it meant being able to go to Oxbridge a year later. They simply don't have the means to fund that year out.