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Obsession with “private” involvement in Health is hypocritical nonsense

The equipment used by the Health Service is privately produced. The medicines are privately provided. The hospitals are privately built.

That alone – in addition to the fact school materials are privately published, roads are privately constructed, key public sector recruitment is privately delivered – should tell us what an absolute nonsense our politicians’ obsession with ‘privatisation’ of our Health Service is.

Politicians, particularly in Northern Ireland (but also notably in Scotland and Sweden currently), are experts at trying to pull the wool over our eyes by taking a stand on something they can’t deliver or focusing on something they know to be irrelevant to draw our attention away from the issues they could affect but aren’t competent enough to deal with. Yet again we see them failing completely to capture the key issues around Health (and indeed Welfare) Reform, while at the same time frothing at the mouth about “privatisation” in health care.

This would indeed be a scandal if it turned out that contracted private provision were actually costing more than public provision would. Self-evidently, however, it is costing less – otherwise it wouldn’t be contracted. The public sector doesn’t produce health equipment, or provide (and research) medicines, or build hospitals (or for that matter schools or roads etc) precisely because it would be more expensive and less efficient (generally – there are exceptions, particularly the dreadful PFIs). The reason is that the private sector can research and thus deliver specific, advanced, innovative expertise well beyond that provided by the public sector because the private sector can take risks while developing and researching this expertise that the public sector can’t. There is no particular reason that health care provision would be any different. That is why many countries have it – including right-wing hotbeds like Sweden and Denmark (where even the ambulances are private).

It is noteworthy also that the concern in this “debate” is not the patient (for not once has anyone suggested patients are receiving inferior care or placed in greater danger by private provision) and far less the taxpayer (who is receiving greater value). Oh no, we hear nonsense about “the private sector is only in it for the profit” – ignoring of course the point that public sector workers receive higher salaries and pensions, one of the likely reasons that private sector provision is better value and more efficient for the taxpayer. (One correspondent even condemned the notion of trying to provide services “on the cheap” – as if that’s a bad thing!)

What is happening here is a nonsensical and hypocritical “sector wars” approach which attempts to pull the wool over our eyes to protect a system which is bureaucratic, inefficient and expensive. Laughably, this is presented as “protecting the NHS”!

In fact, to “protect the NHS” (i.e. a Health and Social Care Service free at point of access which provides quality provision without an unbearable burden on the taxpayer) it will become increasingly important to shift to less bureaucratic, more efficient, more cost-effective means of service delivery. Unlike politicians who are actually endangering the Service with their hypocritical bluster, I don’t care which sector provides that as long as it is ultimately accountable – and, if you really care about the principles of the NHS, nor should you.

Northern Ireland vastly better than 20 years ago

One correspondent joked that I should be “more definite” in my blog pieces, so here’s another one: the notion that Northern Ireland isn’t multi-fold better (and more cohesive) than it was 20 years ago is complete drivel!

In the Northern Ireland of 20 years ago, with freakish exceptions, you never saw a different coloured face and you never heard a foreign language. No one wanted to come and live here; actually, no one wanted to come and holiday here. You did see plenty of army (and other) checkpoints; you did take ages crossing the border; you did face restrictions to where you went and when. And murders were more common than road fatalities are now.

Host a major music awards ceremony, or the start of a Great Cycling Tour, or a major golf championship? The notion would have had you in hospital laughing! This is a better country.

Promote an Irish language job freely in East Antrim, or park a car with a ‘GB’ sticker in Andersonstown, stroll into a political event in the Felons Club to mention your dad was in the Army in open discussion? That would have been cause for genuine concern. This is a more cohesive country.

The Troubles. What were the Troubles? People who will soon be driving and voting actually ask that. My 11-year-old stepdaughter condemned sectarian slaughter in Iraq on the grounds that “I mean, we have Protestants and Catholics but we don’t go around doing that”. To grow up in, this is pretty much a normal country!

Find the second highest and fastest growing identity here is “Northern Irish”? You know what, this is actually a country!

I suspect those who forget the obvious, vast advances are those who were anticipating something different. The notion of “peace” had perhaps always been of a “peace” solely on our own terms. We find one which is a mushy compromise a bit disconcerting – yet it is the only one available. And it is one which has improved things so immeasurably, that sometimes we forget to try measuring.

Is it imperfect? Look around the world and tell me somewhere that isn’t.

NI Corporation Tax reduction can’t happen

I was astounded to see media reports suggesting the UK Prime Minister is about to reduce Corporation Tax in Northern Ireland. This shows a basic misunderstanding of devolution – and of politics.

The UK Government has never claimed to have the power to reduce Corporation Tax in Northern Ireland. What is being considered is the devolution of Corporation Tax to the Northern Ireland Assembly. It would be for the Northern Ireland Assembly (Executive, in practice) to reduce Corporation Tax, not the UK Government.

This is important because, of course, that couldn’t possibly currently happen. For all their talk of lower business taxes (DUP) and all-island tax harmonisation (SF), the fact is the DUP and SF have brought the Executive to the brink of collapse over immediate spending reductions (necessitated by maintaining the current broken Welfare system) and ongoing real-terms spending reductions (necessitated by the UK Government’s determination to reduce the deficit). The idea that they would double this burden by adding hundreds of millions to the “savings” already having to be made to take a punt on the long-term benefits of a Corporation Tax reduction is laughable. Reduction of Corporation Tax, even if it were devolved, would merely go into the pot with all the other issues upon which the DUP and Sinn Féin are gridlocked – from the single education authority to the Maze.

A Corporation Tax reduction can’t and won’t happen any time soon. Don’t trust anyone telling you otherwise.

Time for Sinn Féin to “show leadership”

When Unionists of various stripes have been caught breaching the basics of the 1998 and 2006 Agreements and even engaging in hate speech, Sinn Féin has strolled up to the parapet of the moral high ground and demanded that the DUP and others “show leadership”.

I am not one for “whataboutery”, but I’m not one for hypocrisy either. So, after the appalling example of hate speech exhibited by a band at the Ardoyne Fleadh (cheered, note, by hundreds present), we are entitled to suggest that perhaps now is the time for “Ireland’s largest party” to, well, “show leadership”…

Let us be clear, the band was cheered because it expressed a sentiment hundreds of thousands of people in Ireland share – that the “British” have no right in any part of Ireland, that Unionists and other non-Nationalists aren’t really “British”, and that therefore there is no place for “Britishness” at all in contemporary Ireland. These sentiments are utterly unacceptable – partly because they simply are given the reality of contemporary Ireland, and partly because we all signed up to binning them in 1998. That includes Sinn Féin.

I have ranted ad nauseam about how the 1998 and 2006 Agreements – and, more importantly, basic common decency – require Unionists to come to terms with the Irish national identity and citizenship held and cherished by many of their co-citizens in Northern Ireland. However, that absolutely works both ways. Required also by those Agreements is respect for British national identity and citizenship, and also for the constitutional position of Northern Ireland within the UK. It is understandable that people who grew up fundamentally opposed to Britishness and all it stood for and believing that the constitutional position is the result of a terrible historical injustice would have difficulty with this, which is precisely why it requires those who signed up to it while recognising the need to compromise to “show leadership”.

What happened at the Belfast Mela, at the Cenotaph commemoration of the outbreak of World War One, and at Belfast City Hall’s Peace Vigil was a recognition of our different national identities but also of our common citizenship. What happened at the Ardoyne Fleadh was a disgraceful hate-filled rant which has no place in post-Agreement Northern Ireland, and which should probably be prosecuted for incitement to further hatred.  Let’s hear Sinn Féin say so – no ifs, no buts.

A “United Ireland” won’t happen. Ever.

I am pleased to see, over on Slugger, at least the hint of a real debate about a “United Ireland”. Most of the basic sentiments – that we need some economic reality and that Northern Ireland has to work for all its citizens – are spot on and conveniently are necessary to any constitutional preference. This is why my own politics were always based on those sentiments.

I have put forward various thoughts on how a United Ireland could operate – most obviously, like Australia (a federation with the current Monarch as Head of State). However, I have done so primarily to demonstrate that “Nationalists” are either so biased that they find this unacceptable, or so disinterested that they find this irrelevant. It is no surprise to me that the only threat to the UK comes from Scotland, not Northern Ireland.

The truth is this: a Unitied Ireland is not going to happen.

Why not? Let us go back to the Covenant. One of the main aspects of that document in September 1912 was the economic argument that splitting Belfast – its shipbuilders, rope makers, linen weavers and so on – from the rest of the UK would see tariffs imposed and thus create costs to exporting to the UK which would render them unable to compete with the West of Scotland and the North West of England in those key industrial areas. The point here is that in an era where there were tariffs imposed on trade between any two countries, it made sense to belong to a large country. There were two prime reasons for this: first, it gave you the biggest possible free trading zone; and second, it gave you the clout of a powerful government to negotiate trade deals with other large countries on your behalf. That is why the map of Europe at the outbreak of World War One consisted of a unitary British Isles, a larger single Germany, a huge Austro-Hungarian realm, a newly united Italy and large Russian and Ottoman Empires – alongside France. Spain and not much else (even Sweden and Norway had broken apart only in the previous decade).

A century later and we live in a vastly different Europe, where tariffs and many other trade restrictions between countries have been abolished. This makes it no longer necessary or even beneficial to belong to a large country. With the benefit of free trade, countries such as France and Germany are the exception in Europe – which contains a raft of countries at around 7-11 million (Belgium, Portugal, Switzerland, Austria, Hungary, Czech Republic. Serbia, Bulgaria, Greece, Sweden etc), another set at around 4-5 million (Ireland, Denmark, Norway, Finland. Slovakia, Croatia etc) and another lot at around 2 million (Slovenia, Latvia and Estonia). This is vastly different from what went before, but it is enabled by free and peaceful trade, and thus the pressure is for more break-up – perhaps in Catalonia, Venice or Scotland to give some obvious examples. After all, if Brussels is already handling everything from foreign trade to social regulations; and you are already handling domestic policies and laws, what role precisely do Madrid, Rome or London play?

Therefore it is no coincidence that, aside from Germany, there really is no precedent for uniting a country in modern Europe – the movement is all the other way.

Germany itself is not a useful precedent either. It consisted, legally and practically, of the dissolution of the German Democratic Republic (what the English-speaking world but not the German-speaking world referred to as “East Germany”) and the expansion of the Federal Republic of Germany (“West Germany”) to incorporate its territory. The equivalent would be the dissolution of Northern Ireland and the expansion of the current Republic of Ireland to include 32 counties not 26. Overnight, the Northern (NHS-style) Health system would be abolished, its laws would be replaced (e.g. the Rules of the Road would change) or repealed (e.g. laws on equality or animal cruelty, which are often markedly lacking in the Republic), and rafts of people would be out of work (most civil servants would be unnecessary; all lawyers now unqualified; and so on). This would be much more dramatic in fact than it was in Germany, where some “Eastern” systems were maintained by the new States (in their own policies and laws; unlike Ireland, Germany is a federation) and “Easterners” gladly underwent training in new “Western” systems accepting from the outset that they were inherently better. This is why no one seriously advocates such a method of unification for Ireland.

So there is no precedent. In fact, most Nationalists who think about it come to suggest that Northern Ireland would continue to exist, with its own separate laws, education system, accounting methods and so on. But that takes us back to the above question – if Belfast continues to manage the domestic policies and laws, and Brussels does the foreign stuff, what exactly would Dublin be doing? The answer to that, hypothetically, is it would be working out what to do with its new security headache and how it was to manage a mammoth subvention to Northern Ireland – a subvention to a place with half the population but the same number of public servants, for some reason. Hypothetically… it wouldn’t be daft enough to do it in reality, of course.

Even without that headache, the simple fact is the “United Ireland” thus created would consist of a legally separate unit, with its own laws, institutions, heritage and identities. That has been tried, of course – in 1707, when the Kingdom of Scotland was united with the Kingdom of England. How’s that one working out in the modern context explained above?!

So no, a United Ireland is not “closer than it’s ever been”. There was one chance of it ever happening outside the UK, and it was wasted at Easter 1916. Towards 2016, all the trends across Europe tell us there was more chance of a sovereign Northern Ireland than a sovereign United Ireland some time this century. What was that about making Northern Ireland economically viable and a fair home to all, Irish, British and neither…?!

Reality of poverty: the left denies it, the right ignores it

I was on BBC Good Morning Ulster last week discussing figures which show that two thirds of people in Northern Ireland (a comfortably greater share than in Great Britain) have pay-TV services – i.e. extra subscription channels of various kinds.

This is odd, of course, because apparently over half the population (vastly more than in Great Britain) suffer ‘fuel poverty’, and indeed are ‘unable to heat their homes’.

This leaves a minimum of 15% of all households in Northern Ireland who are opting to pay for extra TV services (over and above the already existing multi-channel Freeview) but are at the same time unable to heat their homes…

Herein again we approach the problem of tackling poverty. The Left deny the problem – arguing essentially that only rich people have pay-TV. The Right ignore the problem – arguing that such figures, essentially, give them justification for doing so.

There are a few home truths, of course, which we don’t much like talking about. Firstly, it is simply not true that over half of households in Northern Ireland cannot afford to heat their homes (it is merely true that energy prices are a bit higher here and thus take up a higher proportion of household income – but then we pay lower domestic taxes and no extra water charge). Secondly, poverty rates are no higher in Northern Ireland than in Great Britain (surveys by the National Policy Institute consistently put them at about level, although the precise make-up of those on low income is different). Thirdly (as per the point I made on the programme which people struggle with but is demonstrably the case globally), people experiencing low income and/or social isolation use a decision-making process far different from the one middle-class people (including anti-poverty campaigners) would expect, including placing a far higher premium on home entertainment than other people do.

I gave an example from this book of a North African who only worked half the year, and even then for the bare minimum. He could not afford to clothe his family and they were to all intents and purposes malnourished, and yet they had a television. The same story is found across the world, from Latin American favelas to Indian farms. Televisions are deemed an ‘essential’ (when asked, owners usually say this is because they provide entertainment to pass the time and perhaps even a sense of broad social belonging), whereas shoes or even fruit aren’t. Move that to the Western World and you will find pay-TV given a premium over books, courses and such like – not a completely ludicrous choice, not least because (as was pointed out on the programme) pay-TV may be part of a cost-efficient bundle with other services (most obviously broadband).

What this tells us, as I argued last week, is that we spent far too long tossing around meaningless statistics, and far too little time really grasping the decision-making processes of those facing choices on low income. It is easy some of us to miss the very obvious point that motivations and even emotions are involved in those processes which many of us (particularly professional people with wide-ranging qualifications and reasonable incomes) have never experienced. It is too easy to try to understand people on low income or suffering social isolation through charts and graphs and even having great conferences and documentaries about them. I do wonder if we shouldn’t spend more time actually speaking to them?

Progressives also need to learn to accept democracy

It is an obvious thing that for too long some Irish Republicans rejected democracy by pretending Northern Ireland could be bombed into a United Ireland without its people’s consent; and recently we have seen attacks on Alliance Party offices and general disturbances endorsed by Unionists on the basis of a democratic decision taken in line with long-established policy in an elected chamber. As I wrote on here, both Nationalists and Uniomists continue to have difficulty with even the basics of representative democracy – which involves acceptance even of decisions and laws you don’t like, and standing up for the application of those decisions and laws even when you oppose them. That’s how it works.

I’d love to say Northern Ireland’s third “pillar”, what I term “Progressives” (others prefer “liberals”), were absolutely committed to democracy. However, they too have an unfortunate record of attempting to work around the fact the voters chose the wrong people, rather than working together to provide a seriously electable alternative. They need to understand and focus on the fact that democracy is never going to work until people understand the direct link between those they elect and those who govern – something which is a relative innovation in Northern Ireland.

Last week, for example, some Progressives gratuitously attacked Alliance Leader David Ford after he opposed the NI Executive’s spending settlement as a “sectarian carve-up”. They suggested he should “do something”, as he is himself in that Executive. When asked precisely what he should do, few answers were forthcoming beyond perhaps bringing the institutions down. Let’s follow that logic – because the two parties which command a majority in the Assembly have agreed a spending settlement Progressives don’t like, Progressives should simply bring down the institutions?

Let us again be clear about what some people are suggesting here: a majority of a freely elected democratic Assembly take a decision, so a minority of the minority should bring the whole thing down because they don’t like that decision! Let us then be clear, this is the same logic used by flag protesters or even by Republican terrorists – “We are right, everyone else is wrong even though we’re a minority, therefore we get to act as wreckers”. This is the absolute opposite of democracy. It is frankly shameful that any democrat would suggest such a thing.

Too many Progressives still struggle with the basic problem that they are a small minority – I say that as a member of that minority! At election after election, when the religious zealots of the DUP and the terrorist apologist crypto-Marxists of Sinn Féin emerge on top, we hear the same old reaction from Progressives, along the lines that there is really a mass of Progressives out there who for some reason aren’t voting and therefore we effectively get to ignore the election result. We don’t!

We must respect the mandate of those who were elected, and respect their right to carry out and even block policies which they are mandated by the people to carry out and block. That applies even if they were elected to carry out a sectarian carve-up and deliver a vision of Northern Ireland completely at odds from ours. For as long as they are doing it by the ballot not the bullet, you know what? That’s democracy, folks!

We must not lose focus on road safety

Northern Ireland has had a proud road safety record this decade – per capita, it has had the lowest fatality rate in the world. However, that has changed this year. Already there have been as many fatalities by mid-August in 2014 as there have been in the entirety of other years.

It is foolish to race to too many conclusions based on one year’s figures. However, it remains the case that we are losing focus. For example, I have no objection to a 20mph limit in Belfast City Centre, but this is unlikely to save a single life – it is an extreme rarity for anyone to be killed on a city centre road. On the other hand, I have long advocated a reduction in the single carriageway secondary road limit, because it is on that type of road where a hugely disproportionate number of casualties takes place – yet no one seems to mention this.

Wesley Johnston is the expert here, but a few other points from this year’s comparatively poor record do stand out:

- proportionately, an unbelievable share of fatalities this year are male (thus far over 90%);

- a significantly disproportionate share of fatalities and casualties for some time now have been cyclists or motorcyclists;

- a significant cause of the dramatic rise in fatalities this year has been head-on collisions (sometimes, sadly, accounting for multiple fatalities in a single incident).

The first of these was already being looked at, because it was long the case that males were likelier to be killed on our roads than females. However, this year that has been particularly marked. We do need to target more of our road safety education to take account of this.

The second of these has been taken more seriously in Great Britain – for example through its ‘THINK!’ advertising. It is my impression that drivers consider other vehicles but do not pay proper attention to the likelihood of cyclists or motorcyclists being nearby (not that this is entirely car drivers’ fault either, by the way). Also, the “engineering” aspect of road safety needs consideration – where possible, for example, cycle lanes should be separated from the road, not just random add-ons with markings.

The third of these I have long been concerned about. I was struck many years ago by adverts in farmers’ fields in Germany which showed a car pulling out to pass another car approaching a slight bend, with the simple words “Ihr letzter Fehler?” (“Your final mistake?) underneath – a very effective message.

We have – as a society, to be clear – come a long way on road safety in the past few years and one bad year does not remove all those advances. However, I cannot help but think we are losing focus (through campaigns such as the 20mph one), and not looking at the things which are really seeing people killed and injured.

When it comes to road safety, we cannot afford to miss the things which matter, because they cost lives. It’s time for a re-think in our education, our advertising and our emphasis.

NI needs to drop “loser” mentality

Northern Ireland’s Commonwealth Games results were average; in fact, in sports not beginning with ‘b’, they were frankly poor. They compared markedly badly, even per capita, with Scotland’s and, particularly, Wales’. Other than in boxing, things haven’t improved much since the severe embarrassment of just two medals in Melbourne eight years ago, and we do need to assess why.

Boxing, of course, saved the day – Northern Ireland’s nine medals in boxing were comfortably more than any other country’s (although others won more golds). And boxing also probably provides the answer – summed up by team captain Paddy Barnes, who said effectively that the boxers simply felt they were better than anyone else (in marked contrast to both the past in boxing and the present in any other sport played at the Games).

I wouldn’t be foolish enough to argue with Paddy Barnes about anything (!), but I also happen to believe he’s right. There remains a mentality that we are innately inferior; that any medal, even at Commonwealth level, is to be regarded as a surprise; and that somehow we are fundamentally a bunch of losers. Thank heavens Paddy Barnes doesn’t think that way!

We can easily name three other Northern Irishmen who don’t think that way – Graeme McDowell, Darren Clarke and Rory McIlroy, through whom Northern Ireland has mustered more major champions in the past four and a bit years than any other European country has managed in the past forty and a bit. In golf, even more so than in amateur boxing, we are genuinely world class. So why should we not expect to be in other sports?

Indeed, why should we not expect to be in other things, generally? It’s time to follow Paddy Barnes, expect victory, and stop thinking everyone else is automatically better. In other words, it’s time we stopped being and accepting losers.

Nationalists in NI must recognise need for institutional reform

Mandatory coalitions can actually work. There’s been one in Switzerland of the same four parties since 1959, in effect. However, Northern Ireland’s doesn’t work – it is time for Nationalists to face that obvious truth.

Northern Ireland’s system delivers a modicum of stability – but it is an expensive stability which delivers nothing but gridlock.

Ministers who breach the Ministerial Code – say, by endorsing terrorism or racism – are left in office. Issues such as educational or welfare reform are left untouched at huge expense. What Sir Humphrey once described as ‘organisational atrophy and administrative paralysis’ has become the ingrained norm.

There is a serious long-term penalty for this. As the institutions increasingly look like the utter facade they actually are, people justifiably give up on them – either by electing to them communal mouthpieces or not voting at all in the immediate term, but more worryingly by losing general faith in democracy in the long run. The opposite of democracy is chaos – chaos in which, in NI more than most places, gangsters and terrorists are only too happy to roam.

Thus, it is simply not good enough for Nationalists to endorse the pathetic status quo. There is no rational reason not to support, or at least engage with, Alliance proposals at least. As it happens, looked at objectively, there are some perfectly reasonable Unionist proposals out there too. It is time for progress and reform.

In 1998 we opted for democracy over terror. Now it’s time we made that democracy work.


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