NHS complaints system criticised

The NHS complaints process needs a 'complete overhaul' as it is simply too difficult for patients to understand, claim members of the cross-party Commons health select committee. They say

NHS culture is too often defensive and the service remains to be persuaded to adopt a more open culture'

Well, quite.

They called on ministers to carry out an immediate review of the way trusts handle complaints from patients.

The number of complaints about the NHS is rising and tops one million a year.

Another NHS scandal - surgical instruments this time

Monday's Panorama showed the conditions under which medical instruments are made in Pakistan.

Two-thirds of the world's surgical instruments are made in the city of Sialkot in northern Pakistan, the BBC report said, and 70% of the UK's registered manufacturers are based in the city.

All surgical instruments have to meet regulatory standards but only one of the more than 180 NHS trusts and boards conducts rigorous tests on every tool - Barts and the London NHS Trust.

They reject almost 20% of tools as unsafe for use.

The regulator is the Medicines and Health Care Products Regulatory Agency (MHRA).

In a statement, the MHRA said "it has no evidence that non-compliant instruments are being supplied to the NHS", but added that if there were such evidence, it had "a range of powers and sanctions available to deal with the problem".

So, after the CQC, we now have another ineffective NHS regulator.

Professor Brian Toft, a government adviser on patient safety, told the programme that if procurement officers in both the NHS and private hospitals in the UK knew of the conditions in which the surgical instruments were being made, they would "faint at the thought of it".

"I cannot believe that anybody in the NHS knows this is going on," he said.

It's only too evident that they don't. They should. Here we have NHS management and regulator not doing their jobs, and putting patients at risk.

Again.

Major investigation into care at London NHS trust

A major inquiry has begun at an east London NHS trust following serious concerns about the levels of patient care, including in A&E and maternity.

The Care Quality Commission (CQC) has started a full investigation - only the second time it has done so - into the Barking, Havering and Redbridge University Hospitals NHS Trust.

In April it was told to improve its maternity services but the CQC said not enough has been done.

It follows a call from local MP Margaret Hodge for an independent inquiry into care at Queen's Hospital, Romford.

More

Who rules? Taxpayers or the NHS?

Daniel Sencier has made an FOI request of his local Northwest Cumbria University Hospitals NHS Trust.

They say they don't keep statistics specifically about their prostate cancer patients.

We do not have information specifically relating to prostate cancer and as it would take a manual search through patient records to obtain this information. This part of the request is refused on the grounds of Section 12 of the Freedom of Information Act.

And this cancer is a relatively common killer of men. If they don't track their performance in treating this disease, how would they know how well they were doing? Is it just a coincidence that Daniel was treated so badly?

They gave Daniel information about a sample of patients but he has no idea whether it is representative. Apparently nor have they.

So we can say that they are not doing this part of their job properly.

But that doesn't stop them getting on their high horse and showing just who they think is in charge.

You may re-use this document/publication (not including the Trust or NHS Logo) free of charge in any format for research, private study or internal circulation within your organisation. You must re-use it accurately and not use it in a misleading context. The material must be acknowledged as copyright and you must give the title of the source document/publication. Where we have identified any third party copyright material you will need to obtain permission from the copyright holders concerned. For any other use of this material please apply for a licence for core material by contacting the Freedom of Information Team at the above address.

Er ... aren't Daniel and his fellow citizens paying your salaries?

Too big to be accountable.

Britain braced for heatwave

That's the headline to a short piece in today's Telegraph. Here's the entire item in the printed version -

Parts of Britain will have a heatwave today and tomorrow, forecasters say.

Temperatures could top 90F (32C) across East Anglia, the East Midlands, and the South East.

The Met Office has warned of dangers for the very old, the very young, and those with chronic conditions.

So it's going to be hot for two days, and the Met Office thinks it is its place to warn the braindead it spoonfeeds that these two days of heat may be dangerous for some of us.

Of course all chronic conditions are aggravated by two days of heat, and no one with a relevant chronic condition realises that two hot days in a row may be dangerous for them.

Patronising, expensive, bad at their job.

Just give us accurate forecasts and go away.

Political interference in hospital practice

David Nunn is the consultant orthopaedic surgeon who famously ordered Cameron, Clegg and their film crew out of his hospital ward recently.

The "bare below the elbows" policy he was enforcing came into effect in NHS hospitals several years ago, writes Max Pemberton, in an attempt to reduce infection rates.

But, says Pemberton, there is no evidence to show that this policy does reduce infection. He adds:

I'd go so far as to say that it's actively dangerous, because it diverts attention from the real problems.

The research shows that the single biggest factor in the spread of hospital-acquired infections is bed occupancy rate. The quicker the turnaround in hospitals, and the more pressure on bed space, the more infections there are.

Scandalously, this link was emphasised six years ago, in a report funded by the Department of Health. Yet it was ignored by Labour because it did not fit in with its new NHS agenda of closing hospitals, introducing PFI hospitals (which typically have 30 per cent fewer beds) and "streamlining" services.

These policies have left us with some of the highest bed occupancy rates in the developed world, with hospitals often running at over 100 per cent capacity. It's this that is causing the spread of hospital-acquired infections, not shirtsleeves or watches. MRSA rates are more than 40 per cent higher in hospitals with 90 per cent bed occupancy than in those with less than 85 per cent. On the Continent, where bed-occupancy rates are lower still, they have far fewer outbreaks. Then there's the issue of the contracting-out of cleaning services to companies that often seem to be more interested in their own profits than the state of the floors.

By contrast, the "bare below the elbows" policy has "no scientific basis or tangible benefit". Pemberton sees it as a PR stunt to divert attention from tougher issues.

If Pemberton is right, politicians have fooled the public into believing they were doing something effective about hospital infections, and ducked tackling the real causes, because that would have been inconvenient.

Whyever was this a decision for politicians in the first place?

Southampton hospital fined

Succinctly and wittily reported by Ambush Predator.

Yes, Greece will default

Richard North has drawn together predictions that Greece is bound to default, from Andrew Alexander and Andreas Whittam Smith.

Commentators naturally want to distinguish themselves from the herd, so we have How much will it matter financially? (quite a lot, but no one has the faintest idea), Will Germany be blamed? (probably yes, but unfairly), Will the eurozone collapse? (no).

Still the politicians are behind the curve, stuck in what Redwood witheringly calls "Pretend and Extend".

But Greece will default - the feckless Greeks won't stand for continuing pointless economic discipline. They don't do economic discipline even when it does make sense.

What we don't know is how much more taxpayers' money the EU will throw at Greece first. Probably quite a lot, because Greece's politicians will cynically vote through the next required austerity package with not the slightest intention of putting it into practice, simply because they know that vote will bring them more of other people's money.

The only certainty in the eurozone crisis is that Greece will default, and will leave the euro.

Cameron calls for unity over EU strategy on Greece

So says the headline to a Telegraph report apparently not on line.

This is wrong on so many levels - for instance I hadn't noticed Cameron leading a united government (just today it's reported that Eric Pickles and Caroline Spelman aren't on speaking terms, and they're in the same party).

And when I last looked, we weren't in the eurozone.

But the best joke from flip-flop Cameron is that he intends to tell the eurozone leaders to "agree a plan and stick to it".

Pot...? Kettle...? Do as I say, not as I do.

Sheer effrontery.

NHS care for the elderly questioned

As evidence accumulates that elderly people suffer worse treatment than the young on the NHS, writes Martin Beckford, the Government and health watchdogs have devised a series of plans to tackle the problem. They range from making age discrimination illegal to carrying out spot checks on hospital geriatric wards.

However it has been claimed that the problem is down to the culture in the health service and the attitude of staff, and that new laws and more rigorous checks may only increase bureaucracy rather than improving care.

Next April, a provision of Labour’s Equality Act will come into force outlawing age discrimination in the provision of health services.

Meanwhile the Care Quality Commission, the (so called) super-regulator for health and social care, is publishing the results of 100 unannounced inspections it is carrying out into the standards of dignity and nutrition provided to the elderly on NHS wards. Trusts failing legal requirements can face fines or even having wards closed down.

The Nursing and Midwifery Council, which carries out disciplinary hearings for the caring professions, has started looking into more than 150 new cases over the past few months following media investigations into neglect of the elderly and vulnerable.

If problems in the NHS require legislation making age discrimination illegal ... if hospitals need to be frightened into providing adequate basic care for elderly patients by spot checks on their geriatric wards (for which we have to rely on the CQC, which is itself failing) ... if we need the media in order to expose these problems, what does this say about the culture in those hospitals among the nursing staff, and the management who don't grip it and reform it?

The NHS remains pretty impregnable in its fortress. 

Mental health services 'understaffed and overcrowded'

And here's another shortcoming.

The outgoing president of the Royal College of Psychiatrists says that failing psychiatric wards are discharging sick people back into society who remain a risk to themselves and to others.

There is a "huge, massive problem" of depleting numbers of mental health doctors in the UK because not enough British medics are choosing to train as psychiatrists and visa restrictions prevent foreign doctors filling the gap.

A survey by the royal college found that 14% of consultants' posts in the UK were either unfilled or filled by a locum, and an additional 209 consultants intended to retire or resign soon.

NHS failing stroke victims

Only four in 10 stroke patients receive potentially life-saving surgery to stop a recurrence within the recommended time frame, a report by the Royal College of Physicians and the Vascular Society has found.

No hospital trust in Britain currently meets the two week NHS guideline target, drawn up by the National Institute for Health and Clinical Excellence (Nice).

Furthermore, one in ten hospital trusts don't treat any stroke patients within that time.

Throwing good money at poor NHS services

The Department of Health says “poor quality” organisations will not be “propped up with subsidies” any more.

Eh? That's been the policy, then?

Currently, if NHS hospital trusts get into financial difficulties they can be bailed out with public money, with recent figures suggesting almost £1billion has been spent on emergency loans from Whitehall and support from local health bodies in recent years.

[The Department] states that the “failure regime” should be focused on “protecting patients’ access to essential services – irrespective of the type of provider – and avoiding bail-outs for poor services at the taxpayer’s expense”.

If that's been going on, it's hardly been transparent. It makes the NHS look like an impenetrable state within a state.

Too big to be managed, indeed.

Greece will leave the eurozone soon

Greece can't do all the asset sales it's being called on to complete within the short timescale it has surprisingly being given today. Actually it hasn't completed any yet at all.

Andrew Lilico thinks the eurozone powers will decide to hang in there. This is only a political manoeuvre. Today they've given Greece goals they know it can't meet, to show the world that it is Greece to blame, not them. Turmoil is inevitable.

Greece and its demonstrators deserve it. The Greeks want to keep not paying their taxes. They want to keep being feather-bedded, keep getting something for nothing. Repay debts? Not us.

The demonstrators in Athens may be helping to bring about the rocking of the euro (good), but that doesn't entitle these freeloaders to our approval.

Similarly, the Spanish demonstrators have no idea what they want, apart from a magic wand producing jobs from nowhere. No applause for them either.

Europe doesn't deserve its collection of complacent, self-interested clowns who still think they are in charge. But that's what you may get if you don't pay attention.

Roger Bootle discussed this morning the damage that a Greek collapse will do.

When you throw a pebble into a pond, as the ripples move outwards they gradually lose force and eventually fall away to nothing. By contrast, with a tsunami, what begins as a relatively small wave becomes enormous as it nears the land. What sort of disturbance would a Greek default be?

"The price of liberty is eternal vigilance." That's the price of prosperity too.

In control of the euro crisis? Whatever next? They'll be imagining they can control the climate.

The country's crying out for welfare reform

Frank Field has written an excellently provocative piece for The Telegraph today, arguing that the public would support root and branch reform of the welfare system.

He reports a recent survey by Policy Exchange showing that, "if they had their way, the electorate would poleaxe the two central pillars of the welfare state, which are the assessment of eligibility and the balance of responsibilities".

Overwhelmingly, voters reject the idea that the right to welfare should be decided on grounds of need. A vast majority insists that welfare should instead be earned. Voters are deeply uneasy with the direction of policy, begun in the early Sixties, that has seen Britain move away from its insurance-based system, where benefits were awarded only to those who had paid in, to a means-tested system that gives a universal right to benefits to anyone whose income is below a certain level. Especially since, under the guise of tax credits, a third of the country has been sucked into the welfare net.

Voters are equally hostile to the way social housing is allocated. The rules determine that those deemed to be in greatest need shoot to the top of the housing queues. The public fundamentally disagrees. It believes that those who have waited the longest, who have been good, reliable, decent tenants, who have paid their rent on time, whose children haven’t caused trouble, shouldn’t be pipped at the post for the best housing.

And as for people who refuse jobs:

Three quarters of the public – including benefit claimants themselves – believe that those who willingly refuse to seek work should lose all or a very large proportion of their benefits. Yet no government has shown any willingness to reflect voters’ views in the sanctions it imposes.

Field calls on Ed Miliband to move Labour in these directions. No hope of getting that past his left-wing, statist backbenchers.

If the country had a credible, right of centre party, they could preach these reforms and earn huge political benefit, as well as shifting the focus of the welfare debate.

But we haven't got such a party. Indeed, it's a sign of how far political debate in this country has become skewed that such popular and commonsense proposals should be outside the range of conventional political discussion.

Probably most people don't think we should be spending £12m a year on legal aid for immigrants either. The results appal even the Judges Council.

But we don't hear calls for that to be abolished either.

Democracy? What democracy?

P.S. This may also be of interest.

Not patient friendly

The Cynical Tendency discusses the inflexibilities of NHS administration, worsened by clunky computer systems.

Over the Atlantic a bunch of guys got together, hired a few people and looked at what was what. Because of the USA medical insurance system it is just as vital to have accurate up to date records that enable care and the relevant finance to pay for it. Yes it is money driven but given the USA legal system it is accuracy driven.

For a tiny fraction of the cost of our NHS efforts they have come up with a system, put together in four or so years, that meets many, if not all, of the requirements and allows a much more reliable way of dealing with patients. Critically, it involves the patient in the process and can be updated continually.

Down with state provision.

Down with statism

Edward Spalton highlights one example of the baleful effect of a local authority on a primary school.

And Demetrius discusses the inflexibilities of NHS administration, worsened by clunky computer systems.

By contrast

Over the Atlantic a bunch of guys got together, hired a few people and looked at what was what. Because of the USA medical insurance system it is just as vital to have accurate up to date records that enable care and the relevant finance to pay for it. Yes it is money driven but given the USA legal system it is accuracy driven.

For a tiny fraction of the cost of our NHS efforts they have come up with a system, put together in four or so years, that meets many, if not all, of the requirements and allows a much more reliable way of dealing with patients. Critically, it involves the patient in the process and can be updated continually.

Down with state provision.

Stress the economic benefits of shale

Voters polled in Pennsylvania want to see drilling for gas continue, and they want to see it taxed. A poll

found support for drilling and a tax on that production was strong across party lines and regions.

That's why I keep saying that shale gas proposers must focus on economic benefits too, not just on the environment, where they will always be on the defensive.

Well, usually.

The leader of the Welsh Assembly has called for the number of windfarms being built across Mid Wales to be restricted. First Minister Carwyn Jones made the plea.

He said large scale developments of windfarms were “unacceptable” and added his Government would not support the construction of pylons in rural areas to connect windfarms to the National Grid.

He has called for Westminster to allow the Assembly to make decisions about major energy projects affecting Wales.

Explorers need to promise economic benefits to communities where they want to drill. Not via various layers of government, who may or may not decide to let some of the benefits trickle down to them, but directly as a share of profits. Call it a partnership.

If it then seems likely that the immediate area will become better off than its neighbourhoods, why not? What would be wrong with that?

The benefits system is morally corrupt

This is not formally benefit fraud:

A scrounging father-of-two infuriated a judge yesterday after it emerged he has pocketed up to £16,000 in benefits – because he smokes cannabis.

Paul Holland explained he was on anti-depressants after taking the drug since he was ten.

But the 21-year-old’s addiction means he is able to rake in £60-a-week incapacity benefit on the grounds his depression means he is unable to work.

Despite his troubled childhood, he deserves to be famous, and to be reviled.

So who pays for benefits to this man, and probably to the Brighton squatters too?

"Patently" brings us this (doubtless pre-arranged) exchange in the Commons.

Question:

[...]In 2011-12, the pay-as-you-earn tax threshold will be just £7,475 a year. [...] the people paying tax—that is, paying tax to pay the benefits that others are in receipt of—are actually poorly paid and that a year’s pay on the national minimum wage is just £12,300? Will he join me in recognising that it is an issue of social justice that we should introduce the benefits cap?

Iain Duncan Smith

I agree with my hon. Friend. That point is also powerfully made by the fact that nearly half of all those who are working and paying taxes fall below the level of the cap. It is important to achieve a balance of fairness. I recognise that there are issues, and we have looked at ways in which the process of change in housing benefit can be done more carefully, for example. This is not about punishing people; it is about establishing a principle that fairness runs through the whole of the benefit system.

Recently Labour has favoured those already receiving benefits over others who deserve them more. But they're less visible.

So are those working, often earning less money than many on benefits get, and yet subsidising them.

Correcting this would be good morals, and good politics.

So there are at least three prongs:

1. Lower the benefit cap
2. Hit benefit fraud
3. Aggressively raise the threshold where people start to pay tax.

Squatters' rights

A cracking post by Ambush Predator about the iniquity of squatters' rights, and the squatters' smugness.

Were they going out to work each week to earn their keep? Somehow I doubt it.

Anyway, read and enjoy.

How not to manage any business

The chief executive of the University Hospitals of Leicester NHS Trust has sent an email to staff warning them of "catastrophic" money issues. He says he is not sure if staff will be paid in coming months.

Having sent the email, which is understandably worrying staff hugely, he then decided he would be unavailable for comment until Monday. The trust also declined to comment until then.

The email says:

The overshoot on our Income and Expenditure account lies somewhere between £5m and £6m.

This can only be described as catastrophic.

There's a real issue about whether we will be able to pay our staff by August or September.

According to the BBC, the University Hospitals of Leicester NHS Trust needs to make savings of £158m over the next five years due to "government spending cuts" (their words, not mine).

How does it come to this, that a state business thinks it will probably run out of money?

Citizens' votes and practical politics

In discussing his proposal for what he terms 'referism', Richard North has toyed with the idea that annual votes on budgets would have to be weighted.

When it comes to a referendum on the budget, if you add together the public sector, the private sector that relies on the public sector for its income (consultants, defence contractors, etc.,) and then add pensioners and diverse benefit recipients, you pretty much have a majority in favour of public spending. Add the status quo effect - plus the unwillingness of people to rock the boat - and you are fairly well assured that a popular vote under the current system will never reject a budget. The vote must be weighted.

This plays into one of my objections. Citizens would be first bored at the prospect of annual votes (most citizens don't 'do politics'), but then many of them would become worried at the prospect of becoming losers. Hence the upward budget bias.

Remember how many attended the London rally against the 'cuts', and how few attended the rally in support of them.

Our present system gives governments several years to enact the right but repulsive (such as slowing the increase in state borrowings), ahead of a quick burst of wrong but romantic before the next election.

Richard's proposal for annual budget referenda would eliminate this safety period. Mrs Thatcher, for instance, could never have introduced her changes. Voters in annual budget referenda would never have pored line by line over budget documents. They would just have voted against the unpopular government.

Whatever the history of voting systems, if referism required weighted votes in order to be practicable (and Richard is not saying this, just mooting it), that would be another reason to leave referism on the drawing board, where it will stay anyway.

Richard hazards that "the total cost of a referendum would be between £30-60 million".

In Italy in the last few days we've seen that referenda can make a difference. A guest poster at Subrosa suggests that in this day of electronic communication it shouldn't be too difficult to create ad hoc voting panels, based on the systems for identifying jurors.

These people would then be “referred” to by the government and the local MP/MSP/MEP and their views and electronic vote taken into account during the decision making process. Each issue would require different people chosen at random from each constituency being involved.

This would be cheaper than a referendum, though apparently consultative only.

But what would be the difference between this and an opinion poll? Except that it would cost taxpayers more money.

These proposals are diversions from the necessary quest for more referenda. Maybe this is one area of politics where Italy has something to teach us.

Labour disown the dispossessed

Grant Shapps, rising energetic housing minister but friend-of-the-earther, proposes that people earning over £100,000 a year in council accommodation should have to move out, to make it available for the poor.

We know high earning Bob Crow on £254,000 a year pays £150 a week for his 3-bed home in Woodford Green.

And Socialist dinosaur Frank Dobson, an ex-Cabinet minister earning £66,000 a year, whose wife is a university lexturer and who lives in one of the most expensive council homes in Britain, claims he could not afford to rent a flat privately.

Ed West thinks this is privileged lefties looking after their own.

A friend who worked in social services in a wealthier London borough once remarked that many of her impeccably Left-wing colleagues, many of them on upper-five figure salaries, lived in council properties. They considered it both a right and duty, because by using the council housing sector they were ensuring a two-tier housing system did not grow.

Of course the problem with that idea, as I once explained to a socialist, is that there will always be a two-tier system in housing. Someone has to live in Bloomsbury and someone has to live in Stoke – who gets the former address? I guess the answer is obvious: the socialists who run the system!

But it's wider than that.

Kieran Thorpe, Labour group leader on Welwyn Hatfield Council, has stood up for the rights of those on six figure salaries to remain in council homes. They don't even have to be left-wing!

Thousands of poor families are desperate for council accommodation. Time was when Labour stood up for the disadvantaged and dispossessed. No longer. If you're a fat cat whose housing costs are subsidised by taxpayers earning less than you, good luck to you. If you're a fat cat blocking the poor from getting decent cheap housing, good luck to you.

The Conservatives want to give more poor families a hand up. It's Labour who support the incumbent fat cats and disown the dispossessed.

Joined up government, anyone?

Helen has pointed to a cracking piece by one of my favourite commentators, Irwin Stelzer.

All he is doing is analysing - gently but devastatingly - incoherences in the government's policies. Enjoyable to read in full, the piece is long - but to judge by his three final paragraphs he was just getting started.

The government is groaning under the burden of its incoherence, he says.

[It] so often faces in opposite directions at the same time that it cannot move towards a solution to Britain's ills.

One of its best intentions is to devolve power from Westminster to local councils, says Stelzer.

(Actually Eric Pickles has claimed that localism is misunderstood, and that its aim is to push power out beyond councils, to local communities. But how could it work? And if it's misunderstood, whose fault is that?)

But the councils which will have to implement the cuts have priorities which differ from central government's - their own jobs, to start with.

If withdrawing some vital service prevents a cut in executive salaries; or funds construction of fancy, very green offices for councillors; or permits the hiring of a "head of strategic commissioning" at £79,000-£87,000 per annum, surely no one can doubt the wisdom of such a move. And if a civic group appears and volunteers to run a community centre on a self-funding basis, why permit such an intrusion on the government's sphere? Better to close it than to allow creeping privatisation.... You can't hand the power to distribute pain to politicians who value easing the social problems of transgender citizens over well-lit streets.

Then consider the government's economic policies. The City lays the golden eggs (as pre-regulation Labour recognised), but the government hems it in rather than creating conditions which would help it flourish in a climate of sensible regulation (that's now in the charge of a French EU Commissioner, by the way). Policies on the third Heathrow runway? Taxing non doms (£162m gained at the expense of £800m lost)? No steely-eyed concentration on important objectives there. Face the fact that the richest 1% of Britons account for about 25% of the tax take, and decide how to capitalise on that.

On SME's, the regional growth funds are (predictably) ill-directed, with big business actually favoured because it's administratively convenient. Government says it will belatedly address this.

Better news would be that the government has decided to use the money to reduce taxes, perhaps the surest way to create permanent jobs. But that would require a coherent rather than a programme-by-programme approach to economic growth.

In short, he says, the government is currently promoting an incoherent mix of economic policies designed to

• shore up the banks while draining them of capital
• reduce risky lending while forcing banks to lend to businesses at rates some analysts say do not reflect the risks involved
• encourage financial firms to set up shop in Britain while taxing their staffs more and limiting compensation
• foster small businesses while effectively precluding them from participating in the programmes aimed at helping them.
• failing to exempt them fully from excessive regulation andTreasury harassment.

For good measure he adds

• making war while cutting military spending (don't Democrats traditionally do this in the States?)
• trying to become more competitive in world markets while driving up the cost of energy in pursuit of unattainable green objectives
• trying to assert the primacy of Parliament while remaining a member of a European Union now dominated by 17 eurozone countries eager to dip into Her Majesty's Treasury, while the Chancellor cries poverty and the Prime Minister promises never to go along with increases in the eurocracy budget (apart from when they ask).

"You get the idea", he says. Indeed we do. And the list is lengthening. State spending levels? - telling voters we can't afford to fill potholes and then raising overseas aid. Alan Milburn would add: ducking reform of the NHS when you need to save money for the extra demands it will surely have to cope with.

Interesting, with this in mind, to watch PMQs yesterday. All that Labour backbenchers seemed to want was more spending on this, more spending on that. Government backbenchers just wanted to praise one government programme or another, with no thought of how it might fit an overall policy framework.

Assuming that there was one, of course. "In which of the several opposite directions that the government are currently travelling do they really wish to go?", Stelzer asks.

He thinks they will "just have to do what politicians least like to do - decide".

That could be for the good of the country.

But I'd expect the government to continue to prefer fudge. Consistency is for the slop bucket.

Where next for the eurozone?

What will the eurozone look like in twelve months?

There are two answers to the cruel questions posed to Greece by the single currency and the Euro wars, writes John Redwood.

The simple and best one would be for Greece – and a few others – to leave the Euro, re-establish their own currencies, devalue and price themselves back into work. This remains unlikely, given the huge political capital invested in the Euro scheme.

The second, he says, is for the Euro zone to press on with the creation of a country called Europe.

It’s double or quits time. Either German and French taxpayers accept their obligation to subsidise Greece, or Greece has to leave. It also means the EU(euro section) needs to develop its rapidly emerging control over Euro member economies even faster. If rich areas in the zone have to subsidise poorer areas, they will expect control over the budgets and borrowings they have to subsidise.

True from an economic standpoint. But the Greek voters certainly won't stand for it. And eventually, when their governments run out of ways to fudge the truth, German and French voters won't either. And that's before the anti-bailout parties in Finland and The Netherlands start raising the roof.

So contingency planning in Berlin and Paris (Brussels has scarcely a walk-on part here) will be concentrating on a smaller eurozone, because Greece will have to leave.

One issue: how do they force out the weaker members in one hit, to convince the markets that a smaller eurozone will survive? Because the speculators will look for the next weak link. In this scenario of course Ireland and Portugal will "be resigned".

Spain? Italy? Belgium?

The politicians will probably take a deep breath and decide to include them in the new, smaller eurozone. With closer integration and control?

No, they'll continue to fudge that.

Down with Greece (and the BBC)

A strange night at Newsnight last night, when Paxo introduced an item about the latest Greek crisis by saying that the action wasn't mainly about demonstrations, and then we got detailed coverage of ... a demonstration. Only deep into Paul Mason's report did we get the political news that the attempt to form a government of national unity had failed (no surprise there) and that there would be a vote of confidence in a few days which the government wasn't certain to win.

Mason did point out that the demonstrators were demonstrating against paying their debts and had no ideas about what they might be demonstrating for, or even what would happen if they got their way. And then, just as we might be getting to the meat of the problem, it was off to the next item.

This is heavyweight reporting? And why does the BBC think it worthwhile to send an economics reporter abroad to cover demonstrators being teargassed when they have a longstanding reporter based in Athens in Malcolm Brabant?

Maybe Helen Boaden would say it is etiquette that programmers should be allowed to waste our money this way. Mason could have done a better piece from the studio.

Richard is right that The Guardian is giving Greece the sort of prominence it deserves. But they can't stop themselves snootily referring to

anti-bailout populists making big gains in Finland and the Netherlands.

Don't get bogged down in the state of French banks' balance sheets. We truly just don't know. Watch Athens.

Surely the Greek government will disintegrate within a month, if not a week. They have a (falling) majority of four, and the WSJ reports that a forthcoming cabinet reshuffle

is likely to claim the head of Finance Minister George Papaconstantinou, the architect of the austerity measures who is widely respected by European officials but has become a key target of Greeks' ire....

The biggest gap in [Greece's] finances has opened up because private investors have refused to buy new Greek government bonds at interest rates the government can afford.

We can be sure that Greece has no contingency plans ready, and in any case there would be no government able to implement them.

Those vulgar populists will be able to say, We told you so ... and by the way how much of our money have you chucked away on the feckless Greeks?

The world does not owe Greece a living.

Italians do referenda

Never mind the results, Italians got the chance to vote on specific laws. Voters were asked whether they wanted to overturn government laws on reviving nuclear energy, privatizing Italy's water supply and giving top government officials partial immunity from prosecution.

57% of Italians went to the polls and over 95% of those who cast their ballots voted "yes" in each referendum, overturning the four laws in question.

Referenda in Italy are usually aimed at repealing a law. In that case, for an referendum to be valid, more than 50% of the voting population must cast their ballots. Referendum decisions in Italy last five years.

A much more precise tool than the bludgeon that would be referism. Referism could not be guaranteed to change anything.

Italy is the only member of the G8 that does not produce nuclear power, says The Guardian:

Supporters of nuclear energy argue that it is the key reason for the country's exceptionally high electricity bills. The high cost of electricity to both private consumers and business is also cited as a prime cause of Italy's low economic growth in recent years.

Remind you of anywhere?

Not all Italian homes are connected to sewers, and pipelines lose about 38% of the water they carry. Italy spends about 10-15 euros per capita annually on water-system investments, compared with about 85 euros annually in northern European countries.

Another south European economy adrift of the northern pack.

But we can learn from them on referenda.

Why those overseas aid donations are wrong

Cameron pledges another £814m towards vaccinating the world's poorest children (on top of £2bn we are already going to donate). We all know the story.

It's wrong because huge amounts of aid go missing - to the NGOs who pass it on, and to governments who spend it on things like space programmes or private jets.

It's wrong because DFID has been pathetic at monitoring the aid programmes it sanctions.

It's wrong because DFID is a poor chooser of projects in the first place.

It's wrong because we are being told that state spending in the UK has to be cut (we can't afford to fill in potholes, for example), but taxpayers have no choice about spending more money abroad.

It's wrong because it goes against current Conservative philosophy. The BIG SOCIETY means people making choices about what to support. LOCALISM is about driving decisions outward to citizens and away from the centre. Not hard to list projects on the internet that people can contribute to and get tax relief. Democracy in action, the most popular projects get the most money. Localism in action, individuals take the decisions. Big Society in action, people channel their generosity the ways they want to.

But Cameron wants to be the leader of a big spending government. Does it feel good, spending our money?

UPDATE - Richard North has written on this here.

Strange how they can say this in France

The vast majority of street robberies in Paris are now carried out by the children of Romanian immigrants, France’s Interior Minister has claimed.

Mr Gueant, one of the most hardline French Interior Ministers in recent history, has not only pledged to deport immigrant criminals, but also wants to reduce the amount of legal immigration into France.

Doubtless grandstanding. You just can't go around doing that. I mean, don't they have a family life?

The BBC gets up its paymasters' noses

Does the BBC go out of its way to alienate taxpayers, or do they just not care?

It's almost too easy a target. The BBC has appointed a chairperson. This time it's someone to train BBC staff on how to use the new chairs.

They are also running ‘transport in Salford’ training days, to teach BBC staff which bus or tram they need to catch and how to find the office by car or bike.

Correct me if I'm wrong, but when I worked in a commercial organisation we were expected to find our own way to the office and sit in the chair we were given.

This is more serious. We all know the BBC wastes money by sending presenters to front news stories on the ground. Martin Bell writes that these people don't sit at the back of the plane. I bet they don't. And, he adds

There is also the question of what did they actually know?

Enter Helen Boaden, Director of News, who according to the Mail "is regarded as a contender to be the first woman director general of the BBC".

She has said that the measure had become ‘etiquette’ on major news events but confessed that in some cases it had been unnecessary.

Etiquette? Is that the depth of thinking from a candidate for Director General? Lazy, complacent woman.

She says they will still send presenters to big stories when it is appropriate, such as the Egypt uprising. She also defended the decision to send Naughtie to Japan saying he ‘added quite a lot’.

The BBC executive added: ‘In the end the public does expect us to treat these stories in a serious way with big experts there'.

Naughtie's big expertise in Japan and earthquakes was ... what? If he could add 'quite a lot' to the efforts of their Japan team, did they not have the wrong team?

And if I had one rule of thumb, it would be that sending Huw Edwards anywhere never adds anything.

MP Cairns says no to prosperity

The cost of energy is going up.

Ofgem has said that it would see over the next decade a dual fee bill going up by about £500 a year for a typical consumer,and that's related to decarbonisation rather than market forces.

£500 a year? Just to pay for 'decarbonisation'? On top of rising wholesale prices, which just recently rose 20%? That's an astonishing number. Who says so? None other than Sir Roger Carr, chairman of Centrica and new president of the CBI. Presumably he should know.

Oil's going to get dearer too. Brent crude is now 25pc more expensive than at the start of the year. Last year the economies of China and India, where a third of the world's population live, expanded by nearly 10%. Demand for oil will keep growing, pushing up the price.

So this must be good news?

Enough natural gas to meet the UK’s demands for four years and transform the Welsh economy could be trapped beneath South Wales, a new report has found.

Academic experts said this could lead to the creation of a major new industry in South Wales. Hm, jobs too. One says

What they are saying is that the total amount [of gas] in the ground is about half of what is proven in the US. This is huge – totally enormous.

If proven, it could open up a huge industry in the UK, there is no doubt about that.

This is going to put hundreds of people into jobs and the Government will receive a huge amount of revenue.

So protests begin in gas fight.

Claims shale gas could bring a potential economic boom last night served to strengthen the objections of those fighting to stop its exploitation in South Wales.

Eh? Yes, Vale of Glamorgan Conservative MP Alun Cairns called the findings "alarming". He wants the application to explore rejected.

The time to reject the application is now.

Significantly more jobs and wealth, he says, could be created in and around the Western Vale through tourism and environmental projects. Let them be jolly, subsidised yokels. And who will pay for them? Who will spend the money to use these facilities? More English subsidy for a chippy Welsh theme park?

Any area fortunate enough to have such deposits should benefit significantly from the profits when the resources are exploited. No need for all the tax take to go into Westminster and then out to Wales again and then out to the locals (if there's much left by then). The local area should directly get a designated proportion to spend as it wants, on public projects, or even by cutting local taxes.

If the neighbourhood then becomes wealthier than surrounding areas, what's wrong with that?

Especially as some of the gas may be under coal fields.

No, Mr Cairns is content for his constituents to get gradually poorer.

And if subsidised communities refuse to take up good fortune when it's presented to them on a plate, why should the subsidies continue? It would be like ... hm ... continuing to pay jobseeker's allowance to someone who keeps refusing jobs.

Now, this energy resource is far less intrusive than the wind turbines which Mr Cairns probably favours. It's cheaper. It's far more reliable. It can make his constituents better off.

What's not to like?

Vote blue, get stupid.

Badly treated cancer patient leant on by NHS trust

The Mail reports on Daniel Sencier, a cancer patient who wrote a blog highlighting failings in his hospital care. He has now been threatened with legal action by North Cumbria University Hospitals NHS Trust:

The Trust will monitor the content of your blog and if it contains information that is not factually correct or which contains unsubstantiated criticism of the care you received at the Trust, the Trust will have no hesitation in considering taking legal action against you.

Another example of unaccountable NHS managers bullying the citizens who pay their salaries,

The Mail does not trouble itself to link to Daniel's blog, but it is here and in the sidebar.

The bullying letter from the Trust's solicitors is here, together with Daniel's reply.

All power to him.

Balls and greenballs

The political writers are excited about the Balls revelations (with Miliband E in a walk-on role). Most woundingly, the mighty Balls, the big beast, gets mocked. Don't forget to enjoy Andrew Neil's interview with him again. But the gentle mockery is way more wounding ... you don't tease a dangerous animal that way.

For me the political event of the day, though, is the anti-green backlash. The Mail has given space to Nigel Lawson - and he delivers. The degree of any warming caused by increased emissions of CO2 is uncertain; and cutting CO2 output can only have an effect if it's done globally. China, India and the US won't sign up to any international effort; so

For the UK, responsible for 2 per cent of global emissions, to go it alone is futile folly.

The policy is already making people here poorer and increasing fuel poverty. The renewables obligation is costing families £200 a year on average, and rises in the carbon floor price will increase this burden. At the same time the economy will shrink as our ever higher energy prices make our industry increasingly uncompetitive with competitors in the rest of the world, where energy will be cheaper.

The Coalition likes to boast, as did its Labour predecessor which initiated this damaging policy, that the UK is the only country in the world to impose severe and legally binding carbon reduction requirements on its economy.

While this claim is well-founded, ministers might do well to ask themselves why the UK is the only country to do this. The answer, of course, is that no other country has the slightest intention of incurring such pointless and self-inflicted economic harm.

Lawson also torpedoes the claim that these policies will create 'green jobs'.

As the great 19th-century French economist Frédéric Bastiat pointed out, if jobs are your yardstick, you might as well go round breaking windows so as to create jobs for glaziers.

And if 'energy security' is the concern, let's exploit our shale gas - as the developing world surely will. Wind, Lawson points out, just can't supply our energy needs.

The Mail's own leader takes as its theme that Britain cannot afford this green madness. The paper comes out bluntly against the government's policy.

Sadly, the suspicion is that – as with his crazy, politically-correct commitment to increase international aid – Mr Cameron is expecting the country to foot a heavy bill for his own personal obsession with ‘detoxifying’ the Tory brand.

This is total madness at a time when families are already finding it hard to pay their bills, and the economy is struggling to emerge from a deep recession.

Opposition from the Mail is bad news for a government of the right.

To make it worse for the government, Charles Moore is writing on the same theme, mocking Prince Charles.

In total, our climate policies add the equivalent of four pence in the pound on income tax to domestic consumers' costs. This week, Scottish Power announced price rises of 10 per cent for electricity, so the swingeing increases are coming fast. The carbon floor price will make them greater still.

As Moore points out, the damage to the UK economy is already visible. None of the Cabinet ministers concerned is stupid, he says. All must be aware of the problem.

George Osborne, the Chancellor, the most astute member of the Government ...

God help us.

... has shown the first signs of shifting.

But, Moore points out, like Lawson, that will be far too late to avoid great economic harm.

These simultaneous fusillades may turn out to be hugely significant. Maybe, just maybe, the discussion is starting to tilt back toward reason, and opposition to green policies will start to become respectable.

Not before time. Greenballs is far more important than Ed Balls.

Some obscene costs of the greeny fallacy

The Global Warming Policy Foundation has pointed out that

So called green stealth taxes are already adding 15 to 20 per cent to the average domestic power bill and even more to business users.

So families are being forced to pay an average of £200 a year in taxes on their energy bills to fund Britain’s investment in wind and solar power.

All taxation should be transparent. This is no exception.

As Lord Turnbull says:

By blindly following the green agenda, the Government has hit hard-working families with a range of costly policies.

Yet there are only two or three MPs who question this. The establishment expect us to suffer in silence and pay in silence.

We should be very angry indeed.

Tackling energy security

The unlamented Blair is saying that energy security will become as important as defence as emerging economies swallow up ever-increasing proportions of the world's fossil fuel supplies.

Better crack on with that shale gas pronto, then.

And more whining

TV gardening shows blamed for loss of greenery, reports The Telegraph, in a report not on line.

Television garden programmes are to blame for a sharp decline in lawns and vegetation, a report claims.

The report was compiled for the London Wildlife Trust. Hm. The author, Chloe Smith, seems to have told her paymasters what they wanted to hear. She appears to have cited Ground Force in particular - the paper notes that Ground Force was last broadcast in 2005.

You see, people blindly follow the lead of celebrity gardeners. It's not that the programmes open viewers' minds to new possibilities which they decide to go for - they just can't think for themselves, dumb brutes that they are.

What tosh. If people want to cover grass with decking, that's their choice.

Whining about life expectancy

The latest ONS study on life expectancies has brought out the special pleaders.

Tim Worstall deals with the geography argument.

One academic, a Dr Simon Szreter, professor of history and public policy at Cambridge University, puts this (spurious, as Tim shows) North-South divide down to “class”.

Life expectancy has a long-standing correlation with social class and income.

In previous centuries, the poor lived in unsanitary conditions, and couldn't afford a decent diet, or healthcare. That's no longer true. If life expectancy is lower in poor parts of Glasgow than elsewhere in the country, it's because they spend their money on booze and fags and don't take enough exercise. They are not imprisoned by class, they are making individual choices.

Yes, healthy living may not be the norm around them, but there is plenty of information in the media. How far should the rest of us have to go to stop people making lazy victims of themselves?

Another whine against benefits reform

Subrosa has published a guest post about housing benefit which is well off the mark.

Like many objections to welfare benefit reforms, it ignores the circumstances of people who don't enjoy housing benefit, and concentrates on those who are privileged to receive the bounty at taxpayers' expense. If under the new rental formula you have to move somewhere else, it is naturally "into a one bedroom slum". Naturally that is government policy.

It also majors on one case which was arguably bungling. Yes the implementation must be fair. One bad implementation does not damn a policy. These diatribes never ask: is the strategy fair, to both receivers and payers?

People whose rent is subsidised by the rest of us must be prepared to move if changed circumstances mean their accommodation is now too large for them. This is not victimisation, it is having due regard to those thousands of families who do not have anywhere suitable to live.

As usual, this angry protester wants to preserve the rights of those benefiting now, without considering taxpayers, or those whose needs might be greater.

You can almost see the the chip on this man's shoulder as he types his whining protest in favour of the status quo.

Of course the government can sort out the NHS

Cancer survival rates in the UK rank amongst the lowest in the Western world and show little sign of catching up, a damning report warns.

Late diagnosis and a lack of life-saving treatments are blamed for patients being more likely to die here than elsewhere in Europe, Canada or Australia, Norway and Sweden.

And the elderly are routinely denied surgery or drugs to remove tumours because doctors think it is not worthwhile.

On the very same day another report has revealed that nearly 200 patients dying from cancer have been denied life-extending drugs because they live in the wrong areas.

They were turned down by the Government’s much-heralded Cancer Drugs Fund, even though almost half of the £50million pot was untouched.

In "NHS South Central", which covers Berkshire, Buckinghamshire, Hampshire and Oxfordshire (who knew?), a quarter of applicants were rejected, but after six months the trust still had £1.7million left – nearly half of what was allocated.

Yet in "NHS North East", covering the Durham, Newcastle and Middlesbrough area (again, who knew?), all the patients who applied were given funding.

Yet again the unaccountable NHS exercises its power invisibly and continues to kill people.

This huge sprawling, unaccountable organisation is unmanageable. Politicians keep pretending they can sort it out. Is it vanity? Stupidity? Or do they really know that public opinion won't let them do what is necessary?

Green abuse is alive and well

If you want to make higher education institutions restrain their carbon emissions, use the price mechanism, suggests Tim Worstall.

That's quite an "if", though. Let’s just remember it’s unlikely that AGW exists, if it does it’s also unlikely that carbon dioxide is playing a significant role, and if it is, the UK is under 2% of world output.

So the right policy on this is NOTHING.

Just sixteen minutes after this observation, one William M. Connolley commented

Its a shame you’ve still got the denialist nutters infesting your blog.

Abolish overseas aid

Lavish spending on foreign aid is making Britain a ‘development superpower’ and voters should take the same pride in it as they do in the Armed Forces and the Queen, a senior minister said yesterday.

International Development Secretary Andrew Mitchell admitted the Coalition was facing ‘bracing’ criticism over its decision to increase aid spending by 34 per cent to £12billion at a time of austerity at home.

This is from the ministry which had no grip of its spending under Douglas Alexander, and thought it was fine to give taxpayers' money to Dr Pachauri's Teri Europe and to foreign dance troupes. Did anyone mention the Afghan fairgound or Indian and Pakistani armament programmes?

How proud we should be.

Even if Mr Mitchell's ministry suddenly started doing its job properly - pretty unlikely - there are two main reasons why it would still be wrong to spend taxpayers' money on overseas aid.

1. Overseas aid is good for despots but bad for their subjects. Trade, not aid.
    
2. Even if the charity was beneficial, it shouldn't be a compulsory levy on taxpayers. Donations should be voluntary and attract tax relief. Wouldn't that be the Big Society on an international scale? Oh, and it would empower the citizens.

Foreign dance troupes or local libraries? You should be able to choose.

Another useful crisis

EU agriculture ministers are to hold emergency talks, as efforts continue to find the source of an E.coli outbreak which has killed 22 people.

Why?

It's a German outbreak affecting overwhelmingly Germans.

Those NHS guidelines

MPs say more than 70% of NHS trusts and care providers are ignoring official guidance on offering infertile couples three chances at IVF, reports the BBC.

First, guidance is guidance, not orders. Second, they're probably not doing that out of spite or through an oversight, but because they think they can't afford to observe the policy.

Do the MPs know that the trusts following these guidelines are following all the other many guidelines handed down to them? Or are they just choosing to economise in other areas? I bet they didn't check.

Why is it acceptable for anonymous, unaccountable managers to make these decisions?

And if the NHS is going to be increasingly short of money to treat illness - as we're regularly told - IVF treatments - a 'nice to have' - shouldn't be a priority for taxpayers' money.

So it's the guidelines that are wrong.

More referenda?

Oops. Just after Denis MacShane, he of the many laptops, called for an end to referenda, a coalition minister suggests that Scottish independence might require not one, but two of them.

What's sauce for the Scots is sauce for the eurosceptics.

Ask the audience

Subrosa raised the question of citizens' initiatives, and now Witterings has helpfully picked up Denis MacShane's effusion against referenda. MacShane has produced a pretty perfunctory piece - maybe he kept forgetting which of his many laptops his latest draft was on. If he's hoping to make a career as a commentator, in case he is kicked out of the Commons, he'll have to do better than this.

Witterings charitably accuses MacShane of "lack of knowledge". MacShane of course knows perfectly well that referenda take place in California and other US states - he's just practised at suppressing inconvenient truths.

However, Witterings is bang on the money when he says it might just be possible to accept the banning of plebiscites "if the occupants of the Commons actually listened to the people". Listened and acted as participants in a representative democracy, that is.

So why was a referendum required for Scottish devolution? Because it suited the political establishment. Neither side wanted the responsibility for the final decision, so it suited them to ask the audience. Never mind on that occasion that the issues were complex.

Under the surface of national politics, Richard North has dug out some examples of local referenda on council tax levels. Flawed? Sure. Does this bolster the case for annual national votes on the state budget (referism)? No, because it's easier to understand the tax impact of spending increases at a local level. But these local votes do further undermine MacShane's odd case that letting people vote on a particular issue is somehow anti-democratic.

Or maybe it is that MacShane shares Richard's view that one person one vote democracy is inherently dangerous.

But the biggest gap in McShane's argument is the question: what are voters to do if their representatives club together to ignore their views. EU? Greenery? Stronger punishment for criminals? Richard North might say, Aux armes, citoyens. One could certainly construct an argument that any arrangement which makes lawmakers' lives comfortable is probably wrong.

And ... could or should Scottish independence happen without a referendum?

On some questions you just have to ask the audience. But then - horrors - the audience might start demanding to set the questions.

Preserving the eurozone

The BBC tells us that the Portuguese are voting "amid austerity".

It's a bizarre notion that austerity in Portugal has got off the ground. The economy "is expected to contract by 2% this year and next".

Of course their politicians have the easy answer of politicians everywhere.

We are going to cut state waste and excesses while finding a way for the needy to get what they need.

Right. Increasing spending then.

Andrew Lilico has a pungent piece in The Telegraph about Greece (read it all), reminding us that

The Greeks have a long tradition of defaulting, having been in default for about half of the years since the modern Greek state began in 1830. Lending money to Greece is not an investment. It is an act of cultural charity, a participation in the myths of Athens and Sparta.

Myths, we may add, with a diminishing grip on other countries' rulers. Greeks, says Lilico, are unlikely to feel a moral obligation to repay their debts, and even if they did they couldn't manage it.

The only question of default isn’t whether Greece itself pays – that ain’t gonna happen. It’s whether Germany and France decide to pay Greece’s debts for it, as a way of bailing out the German and French banks. For a while that seemed plausible. But what seems much more likely now is not that Germany and France pay off the debts; merely that they help Greece meet its interest payments for a while so as to put off the formal moment of default until it seems like the German and French banks might be able to take the hit.

Returning to Portugal, they are down a hopeless hole too. The core eurozone countries will be seeking a relatively painless (to them) way to throw out those on the margins. Italy may well make it through - whether Spain will is anyone's guess.

The longer the eurozone core can delay before marginal countries have to peel off, the longer the markets will have to get used to the idea that it's inevitable, and the smaller the political convulsion is likely to be. Indeed by next year the defaults may be greeted by shrugs of inevitability. It's about managing expectations, as well as banks' balance sheets.

On the other hand.... If you are leader of a eurozone country in trouble, why would you push your country into a pointless recession now, ahead of the inevitable default and devaluation? Why would it not be better for your country just to bite the bullet now?

Citizens' Initiatives, and some housekeeping

Delighted to see citizens' initiatives being mentioned in Subrosa, an established blog but one new to me (and for that, thanks to Richard North's Referism Blogs list).

By way of explanation, the list to the right of "Some Referism Blogs" originally contained the first hundred Richard listed. The "Some" doesn't indicate any independent creativity on my part. If I chance to look at a blog because there's been a recent post when I happened to pop in, I will delete it from my list if it doesn't happen to interest me.

So it's no longer the full official list, and I'm still not convinced by referism anyway. Back to that later, maybe this weekend.

Meanwhile, the idea of citizens' initiatives is thought provoking. One problem: the proliferation of anti-EU petitions shows what happens when the ego's can't agree to co-operate. They stamp their feet and sulk because the petition wasn't their own, and then off they go and start another one. To some politicians it's more important to have their own name prominent than to get things done. (Nigel and Dan, anyone?)

Meanwhile, this is as good a time as any to say public thanks to Richard North for putting more bloggers in touch with each other, and hopefully each other's readers.

That won't stop me disagreeing with him. But then he wouldn't want it any other way.

Referism misunderstood?

Richard says I misunderstood referism. I wrote that

As I understand Richard North's idea of referism, the state's budget would be subject to an annual referendum.

Richard has written that

Referism is a political philosophy which states that, in the relationship between the British people and their governments, the people should be in control. The state is the servant not the master. Control is primarily achieved by submitting annual state budgets to the people for approval, via referendums. The catchphrase is: "it's our money and we decide". Governments are thereby forced to refer to the people for their funding, hence the term "referism".

And in the referism comments thread he wrote on 9 May that

If the electorate refuse the budget, then we have a full-blown political crisis ... what fun! Logically, the referendum would then have to be held on a recast budget ... unless there is provision for an emergency budget and the government elects to work with that. A government could, instead, decide to resign and trigger a general election ... thereby giving the people the effective power of a mid-term vote of confidence.

I would anticipate budget rejections being very rare. One would assume the referendum would have a significant deterrent effect.

That won't work. Voters aren't that interested, voters will be scared, how do they make clear which parts of the budget they like and which parts they don't? If they think they may lose the items of spending they like, they will probably vote for the budget.

I favour smaller government, greater accountability etc. But this instrument looks too blunt to deliver them.

Instead let's have binding referenda on issues which citizens choose because those issues are important to them and the political establishment is out of step.

I'd like us to liberate ourselves from the EU. A referendum on that would have a good chance of carrying.

(Actually I'd like England to secede from the UK too, leaving Scotland, Wales and Northern Ireland to subsidise each other. With our secession we would also be walking away from the UK's EU membership. But I doubt there's public appetite for this ... yet.)

My objection is not to the underlying philosophy that government should be servants of the people. They are not, and of course they should be.

But annual budget referenda just won't deliver that.

Is referism any good?

As I understand Richard North's idea of referism, the state's budget would be subject to an annual referendum.

And, er, that's it?

First off, it's a blunt instrument. You could only vote Yes or No. So it would become an annual popularity contest.

If budget's rejected, what then? Can the incumbent party try again, or does there have to be a general election? What, another vote?

There's no sense that people want lots of blanket votes - which anyway would achieve nothing.

If I've misunderstood, I can trust Richard North to put me right.

A far preferable reform would be for people to be able to require a referendum. Would the Swiss or Californian models work here? Where the establishment was out of step with the citizens on a subject the citizens felt strongly about, they would be able to require a vote which would bind parliament - a more precise tool, and a reform which it would be much easier to campaign for.

Or have I misunderstood referism?

Government bodies unfit for purpose

We all know by now that the Care Quality Commission isn't fit for purpose. They ignored a whistleblower's claims about Winterbourne View - not once, but three times. Then he gave up on this state organisation that we pay for and went to the BBC.

It's not as if this is a minor part of the Commission's job - this is its central purpose. At the very least the Commission's culture is wrong. This is, of course, the responsibility of its senior management.

The UK Border Agency has also failed.

Out of a backlog of 403,500 asylum cases dealt with since 2006, 161,000 applicants have been allowed to stay in the UK, in what was "in effect an amnesty".

Another 74,500 cases have been shelved as officials have no idea where the people are. Only 38,000 failed applicants - nine per cent of the total - have been removed from Britain.

The Agency is also locked in a "binding arbitration" process with Raytheon after the IT supplier was sacked from the failing £1.2bn e-Borders immigration programme in July last year.

Until being removed from the e-Borders contract Raytheon had been paid £188 million, out of its £742 million contract.

Much of this is, of course, the responsibility of its senior management. So what's happened to them? Have they been sacked? Lin Hamer, the boss, who was said to have "presided over chaos", has been promoted. Oh good.

So no one's to blame?

The weedy Damian Green blames the Labour governments.

Why?

Greece is still on a path to nowhere

For Geoffrey T Smith, dealing with the Greek debt problem is "overwhelmingly an economic issue".

The gleeful I-Told-You-So's of commentators in New York and London don't really add much to the discussion, and if the euro zone should grant them their wish of unravelling in chaos, then they and their economies will live to rue the day.

Tossing Greece a mere tens of billions more euros would be "distasteful". But "does anyone really think the economic losses from undermining sovereign debt issued in the world's second-most-important reserve currency would be smaller?"

Isn't there more to the world than economics? Yes the economic convulsion from default would be huge. But it would probably last months rather than years.

Smith's alternative? Greece will experience a very significant loss of sovereignty over economic policy. Oh, and more power for central EU institutions. Oh, and a new treaty, "one that finally forces governments to tell their electorates how illusory the notion of national sovereignty is in the modern world".

That will be the hardest battle of all.

Hm. If Merkel is prepared to u-turn and give up nuclear power just like that (arguably democracy in action), what appetite will she have for telling German voters that their national sovereignty is illusory?

And the Finns will just love it.

To those in Smith's ivory tower this may look like just a necessary political inconvenience. Out in the real world, it's an impassable roadblock.

Pesky things, these temperatures

Worldwide, the first four months of 2011 have been exceptionally cool.

But there's always l'exception francaise. France has had the hottest, driest spring [March - May] in memory.

So carbon dioxide is up in France but down worldwide?

Last year the El Nino boosted temperatures. This year La Nina has cooled them. This did not stop some claiming that 2010 would be a record year because of global warming. I predict that if 2011 turns out to be exceptionally cold it will be because of the La Nina. It seems that to some if it’s hotter than average it’s man-made global warming, but if it’s cooler it’s a natural fluctuation.

There's more to temperature than CO2 then? Temperature trends aren't the same everywhere?

And this is the political establishment's basis for pauperising us with their "low carbon" policies?