Book Review: Short Cuts: Life expectancy

Short Cuts

Danny Dorling

The first English Life Table was based on data collected around the census year of 1841 and gave female life expectancy as 42 and male as 40. By the sixth table, in 1891, life expectancy for women in England and Wales was 48 and for men 44. Many people lived longer than this, but so many babies died in their first year of life that it brought the average down. Public health reforms during the 1890s meant that by 1901 life expectancy was 52 for women and 48 for men. Four years each, gained in just ten years. The turn of the century brought a dramatic drop in infant and childhood mortality as sanitation and living standards improved. By 1921 women were expected to live to 60 and men to 56. Eight years each, gained in just twenty years. By 1951 women’s life expectancy was 72 and men’s 66. Women gained 12 years to men’s ten over this thirty-year period as a result of better maternity care, partly due to the new NHS, and a higher proportion of women being non-smokers. This rise, of more than a year every three years, took place despite war, rationing and austerity.

Improvements slowed in the 1950s. Most of the easy victories had been achieved. In 1956 the Clean Air Act was passed, four years after the Great Smog caused excess deaths that Harold Macmillan tried to blame on influenza. By 1971 life expectancy for women was 75 and for men 69. Three years more each, achieved in twenty years. In the 1970s the rate of improvement in life expectancy accelerated again. Social progress in that much maligned decade meant that despite cutbacks in healthcare and public services in the 1980s under Margaret Thatcher, by 1991 women were living to 79 and men to 73. Four years each, achieved in twenty years.

Over the next twenty years, men caught up a little with women: since more men smoked there were more male smokers who could give up. By 2011 women were expected to live to 83 and men to 79. In those twenty years women gained three years and men five. The six-year gap that had opened up by 1951 was back to four.

Since 2011, under David Cameron and Theresa May, life expectancy has flatlined. The latest figures, published by the Office for National Statistics in September, are for the period 2014-16. Women can now expect to live for 83.06 years and men for 79.40 years. For the first time in well over a century the health of people in England and Wales as measured by the most basic feature – life – has stopped improving. Just as Macmillan had done, the government initially tried to blame the figures on flu deaths. But as the years have passed and life expectancy continues to stall it has become clear that flu isn’t the culprit. The most plausible explanation would blame the politics of austerity, which has had an excessive impact on the poor and the elderly; the withdrawal of care support to half a million elderly people that had taken place by 2013; the effect of a million fewer social care visits being carried out every year; the cuts to NHS budgets and its reorganisation as a result of the 2012 Health and Social Care Act; increased rates of bankruptcy and general decline in the quality of care homes; the rise in fuel poverty among the old; cuts to or removal of disability benefits. The stalling of life expectancy was the result of political choice.

The first to be affected were elderly women living alone in the poorest parts of the UK. Their areas had been targeted by the last Labour government for interventions aimed at improving health. All those schemes were cancelled in the years after 2010. By 2016 cuts in welfare spending, especially those affecting older pensioners, had been linked to a rise in deaths. Public health experts writing in the British Medical Journal called for an inquiry, but the government refused. Instead officials continued to claim that ‘recent high death rates in older people are not exceptional.’ An even higher rise in the death rate was recorded for Scotland, but again there was no serious response. By July 2017 Michael Marmot’s Institute of Health Equity was linking NHS cuts to the rise in deaths among those with dementia and to faltering life expectancy. A paper I co-wrote with researchers at Liverpool, Glasgow and York connected the rise in mortality rates with delays in discharging elderly patients from hospital because appropriate social care was not available. The Financial Times reported that the slowdown in life expectancy had cut £310 billion from British pension fund liabilities, and these figures included only a few pension schemes.

Life expectancy for women in the UK is now lower than in Austria, Belgium, Cyprus, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Liechtenstein, Luxembourg, Malta, the Netherlands, Norway, Portugal, Spain, Sweden, and Switzerland. Men do little better. In almost every other affluent country, apart from the US, people live longer than in the UK, often several years longer and the best countries are pulling away. Between 2011 and 2015 life expectancy rose by a year in both Norway and Finland. It rose by more than a year in Japan, despite the Japanese already having the highest life expectancy in the world.

In the UK official projections have now been altered because of the tens of thousands of people who have died earlier than expected. If you subtract the latest ONS figures from the figures published two years ago, you can see that a further one million earlier deaths are now projected in the next forty years (the ONS itself doesn’t publish this number). What has happened is no longer being treated as a decline; it is the new norm. On 26 October the Office for National Statistics announced that it estimates that, by 2041, life expectancy for women will be 86.2 years and for men 83.4. Both figures are almost a whole year lower than projected in 2014.

Superficially this might appear a small adjustment that will only have an effect many years in the future. But its implications are huge. Already in the year from July 2016 to June 2017 an additional 39,307 people have died. Seven per cent of them were people between 20 and 60: almost 2000 men and 1000 women. Well over four-fifths of the premature deaths projected by the ONS will be of people who are now in their forties and fifties.

These extra deaths are not linked to more migration to the UK: the ONS now projects less in-migration. They are not due to a rise in births: the ONS now projects lower birthrates. They are simply the result of mortality rates having risen in recent years. The ONS believes this will have a serious effect on life expectancy and population numbers for decades to come. It does not say why the change has happened or even point out how exceptional it is.

The UK government accepts that air pollution, a reversible cause, results in 40,000 premature deaths a year. There are complaints and headlines about that, but not about the fact that there were almost 40,000 more deaths than expected in the year up until June 2017. It is projected that there will be an extra 25,000 deaths between July 2017 and June 2018; an extra 27,000 in the year after that, more than 28,000 extra deaths in the 12 months after that, then another 30,000. And on and on and on, and still the government has given no explanation.

Whatever has happened has happened in a country where the official statisticians feel they can only point out in the seventh note attached to a press release that some figures have been adjusted. It is not difficult to guess the likely cause of the sudden deterioration in the health of the nation. If we do not address the policies that have caused these changes, the ONS projections will become reality.

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Ireland: ‘Deal only possible if DUP and British Government uphold equality’

– O’Neill
Sinn Fein Newsroom
12 November, 2017

There can only be an agreement to restore the Stormont institutions if the DUP and British Government are prepared to uphold rights and equality, Sinn Féin Northern Leader Michelle O’Neill has said.

Addressing the annual Edentubber commemoration, Michelle O’Neill also accused the British Government of putting its own electoral survival ahead of the interests of citizens here.

“It is clear that the Tory government’s priority at this time is to sustain its political pact with the DUP,” she commented.

“Theresa May and her party have acquiesced in their own self-interests to the DUP blocking the equality agenda and denying rights which are the norm in all other parts of our islands.

“Sinn Féin remains committed to the restoration of the institutions and the Executive.

“However, they only have value if they enjoy the confidence and support of the people they were established to serve.

“They only have meaning if they are delivering fairly for all our people based on the principles of equality and mutual respect on which they were founded.

“If the DUP or anyone else wish to exercise political power in Government in the North of Ireland now or in the future, then the cost is to embrace a rights-based society and equal partnership government, which works for everyone.” Full Remarks of Sinn Féin Leader in the North Michelle O’Neill Speech at Endentubber Commemoration, Sunday 12th November 2017

INTRODUCTION

A chairde agus a chomrádaithe, is mór an onóir dom labhairt anseo inniu.

It is an honour to have been asked to speak here today, as we gather to commemorate, remember and honour on this 60th anniversary, Volunteers Oliver Craven, Paul Smith, George Keegan, Patrick Parle and Michael Watters who died in a premature explosion in the early hours of Monday 11th November 1957.

These tragic deaths occurred during the course of ‘Operation Harvest’ — in what became known as the ‘Border Campaign’ waged by the IRA between 1956 and 1962.

These republicans – the Edentubber Martyrs – included the owner of the cottage, 54-year-old Michael Waters, Paul Smith, 19 years old, from Bessbrook; Oliver Craven, from Newry; Patrick Parle and George Keegan from Wexford.

As republicans have done so every year since 1957 – we gather here today to honour and commemorate their memory and affirm our determination and commitment to the achievement of an agreed, new and united Ireland built on equality and social justice.

Three of the Edentubber Martyrs – Michael, Paul and Oliver – came from this area – a community defined by its strong, vibrant and tenacious commitment to the republican struggle. Patrick and George came from Wexford, a proud county with a strong republican heritage stretching back to 1798.

Tháinig siad anseo chun an tír a aontú.

These men came together with common purpose; to bring about the reunification of this island – a vision that binds us all here today.

They knew that there is nothing more important than freedom and an end to the partition of Ireland, and they were killed in pursuit of Irish freedom.

They had an inner strength, determination and courage to stand up against injustice and oppression and to demand the rights and entitlements of the Irish people.

They believed that the continued division of our country was an affront to the ideals, which inspired them, the ideals of the Proclamation of 1916.

These patriots represented the republican spirit of Connolly, Pearse, Markievicz and Tone, and together took a stand to end injustice and achieve equality, peace and freedom in our country.

Many ordinary brave republican men and women have died for our freedom before the ‘50s campaign and since.

Many were executed, fell in battle, or died on hunger strike.

Thousands were hounded and jailed on both sides of the border and in England where both they, and their families endured great hardships for the cause of Irish freedom.

These were difficult times to be a republican.

Different times and circumstances require different political strategies but our primary goal and commitment to Irish freedom remains the same.

Agus níl an obair seo furasta.

But the journey of course is never easy.

It requires increased effort to mobilise people at home and abroad in support of republican objectives towards a united Ireland.

We have a unique opportunity to be the authors of a new, peaceful, and democratic future – where our freedom will be won.

It is our job to change the political and constitutional conditions and transform and unite this island and its people.

It is 19 years on since the Good Friday Agreement.

I am thankful that after decades of conflict and division that many people, including the republican leadership worked tirelessly to develop and build the peace process that a new generation enjoy today.

We want to ensure that no one else suffers as a result of conflict; that no other family is bereaved; that the political conditions of discrimination and inequality are fundamentally changed, that everybody belongs and nobody feels alienated from their own country, and that the experience of war and of loss and injury is never repeated.

This does not mean we forget our past.

It means that we address the causes and the aftermath of conflict and division in a mature, sensitive and political manner as a society.

POLITICAL TALKS

This year so far has seen the collapse of the political institutions, we have fought two election campaigns, we have been involved in stop start negotiations and of course we lost our friend and comrade Martin McGuinness.

Ag tús na bliana seo d’éirigh Martin as a phost.

At the start of this year Martin resigned his position of Deputy First Minister.

He did so amid a catalogue of allegations of financial scandal associated with our partners in government, the DUP, and their deliberate disrespect for Irish culture, identity and language.

The Sinn Féin leadership have worked tirelessly to defend our peace process, to advance the reconciliation of our community and to build a better future for our young people.

The DUP after ten years in government have failed to embrace the principles of equality, parity of esteem and mutual respect, which are cornerstones of the GFA and subsequent agreements.

Mar sin, rinne Martin an rud ceart, ag an am ceart agus tá muid buíoch dó.

So Martin did the right thing at the right time, and we are indebted to him for his courage, his guidance and his leadership.

In both elections the public overwhelmingly endorsed the stance taken by our party.

The support for the Sinn Féin party in both the Assembly and Westminster elections was an endorsement of a demand for absolute respect, integrity and common decency and rights for all – a demand for power-sharing as it was originally agreed.

Since then we have been engaged in negotiations to restore the power sharing institutions on the basis of equality, respect and integrity.

Sinn Féin entered into these negotiations in a positive and strategic way strengthened by our recently renewed and increased mandate.

Our leadership has worked closely with the DUP and the British and Irish governments to find solutions to the current impasse to restore power sharing and the political institutions.

Rinne muid ár ndícheall.

We were flexible and willing to stretch ourselves in an effort to achieve a breakthrough.

However, despite our best endeavours the discussions were unsuccessful.

I would like to get the political institutions – an Executive, Assembly, All-Ireland Ministerial Council restored – but it has to be on the basis of rights, equality and integrity.

The peace was hard won.

And therefore the principles and values of the Good Friday Peace Agreement

– the foundation stone of the peace process, must be honoured and fully implemented – not renegotiated by political unionism.

Commitments must be delivered and it is the duty of both the Irish and British governments to fulfil their part.

They have undermined the process of change by refusing to honour agreements, refusing to resolve the issues of the past while imposing austerity and Brexit against the wishes and best interests of people here.

I believe a political breakthrough is entirely possible, but only if the DUP grasp the opportunity to guarantee the right of every citizen to their democratic civil and political rights – rights that are realised and enjoyed in the rest of these islands.

That includes an Irish Language Act, which provides the right to use the Irish language for official purposes in interacting with the State. The right to access coroner’s inquests; equal marriage; a bill of rights; and a commitment to tackle sectarianism.

Without doubt the DUP support for Brexit and for the Conservative Government poses real challenges.

It is clear that the Tory government’s priority at this time is to sustain its political pact with the DUP.

Theresa May and her party have acquiesced in their own self-interests to the DUP blocking the equality agenda and denying rights which are the norm in all other parts of our islands.

Níl sé seo inghlactha.

This is absolutely unacceptable.

Sinn Féin remains committed to the restoration of the institutions and the Executive.

However, they only have value if they enjoy the confidence and support of the people they were established to serve.

They only have meaning if they are delivering fairly for all our people based on the principles of equality and mutual respect on which they were founded.

CONCLUSION

Finally, our message to the British Government and the DUP is that it is now time that political unionism accepted that the old certainties are gone.

The Unionist State is gone. Citizens do not want majorities or minorities – they want equality.

I have made clear to British Prime Minister Theresa May as recently as Thursday that Direct rule is not an option, and failing Agreement both Governments must implement those outstanding rights and equality issues.

We are entering a new political era and these issues are not going away, and greater challenges will lie ahead.

So, If they are not dealt with now they will have to be dealt with up the road; and sooner rather than later.

If the DUP or anyone else wish to exercise political power in Government in the North of Ireland now or in the future, then the cost is to embrace a rights based society and equal partnership government, which works for everyone.

Because one thing IS for certain – there will be no return to the status quo!

Go raibh míle maith agaibh go léir.

 

 

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What is the EU defence union PESCO?

Sertan Sanderson

With 23 of the EU’s current 28 member states joining the Permanent Structured Cooperation (PESCO), there seems to be a great deal of consensus among member states but a few remain on the fence. The new defence union is expected to address immediate threats without having to rely on NATO for all of the EU’s defence needs.

High expectations

European Commission President Jean-Claude Juncker had been campaining for PESCO for several years. He expects the new military pact to deliver a “European Security and Defence Union (which) will help protect our Union, which is exactly what EU citizens expect.”

A ‘new era’ for European security

EU Foreign Affairs and Security Policy Chief Federica Mogherini welcomed the establishment of PESCO as the dawn of a “new era.” Mogherini further described the initiative as “an inclusive framework to facilitate the joint investments and projects that we so much need to strengthen the ability of the European Union to be a credible security provider for its citizens and globally.”

Franco-German foundations

French Foreign Affairs Minister Jean-Yves Le Drian and German Defense Minister Ursula von der Leyen are among the chief supporters of the PESCO defense union. Von der Leyen stressed that with the United States taking a critical stance on NATO, launching Europe’s very own defense initiative was “important – especially after the election of the US President,” referring to Presiden Donald Trump.

A new direction

NATO Secretary General Jens Stoltenberg (pictured left) welcomed the launch of PESCO in the face of those fears over US President Donald Trump’s commitment to the transatlantic defense alliance. Stoltenberg said that PESCO will “strengthen the European pillar within NATO” adding that it will be “good for NATO” as well.

Left outside

The majority of EU states signed up to PESCO. Three states are still mulling over it, Denmark has opted out for the time being, and the UK is expected to reject the proposal, as it is set to leave the EU by 2019. Prime Minister Theresa May is free to join PESCO at a later date however – even after Brexit – if the terms of that cooperation would benefit the entire EU.

EU soldiers?

It is unclear to what extent there will be concrete military cooperation between EU states, as is the case with the EUFOR peacekeeping mission in Bosnia and Herzegovina. The signing of PESCO initially provides only the framework for expanded collaboration and more efficient spending of military funds.

Three years in the making, the signing of PESCO marks a new chapter in the EU’s self-reliance when it comes to defense. But what does the Permanent Structured Cooperation actually entail?

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UK minister Priti Patel secretly urged aid for al-Qaida via Israel

Asa Winstanley

Lobby Watch The Electronic Intifada

Israel’s anti-BDS minister Gilad Erdan and UK aid minister Priti Patel meeting at Parliament in September. Violating rules, Patel did not disclose the meeting to civil servants.

The UK government was in chaos on Wednesday as the prime minister was accused of covering up her knowledge of secret meetings one of her ministers held with Israelis in August.

International development minister Priti Patel was forced to quit on Wednesday evening saying her actions “fell below the standards of transparency and openness” expected of ministers.

The meetings were arranged by a prominent Israel lobbyist. Patel had already apologized on Monday, admitting she had held 12 such meetings.

She met with Israeli Prime Minister Benjamin Netanyahu and other politicians and business people in Israel without informing officials in her own department, the UK Foreign Office or the office of Prime Minister Theresa May.

Patel was forced into the apology after the BBC’s diplomatic editor James Landale broke the story on Friday. It was exposed after Israeli politician Yair Lapid tweeted a photo of the two meeting.

Patel then belatedly informed the Foreign Office while her meetings in Israel were already underway, her deputy told parliament on Tuesday.

According to UK government rules, ministerial meetings discussing official business should be attended and recorded by civil servants – whose role is to serve the government in a nonpartisan fashion.

Theresa May accepted Patel’s resignation after coming under pressure to sack her from opposition lawmakers on Tuesday, who said she had violated the ministerial code of conduct.

Patel claimed she had been in Israel “on a family holiday paid for myself,” but admitted the meetings were “arranged by” Israel lobbyist Stuart Polak, a member of Britain’s unelected upper chamber, the House of Lords.

He is a leading member of Conservative Friends of Israel, and attended all but one of the Patel meetings.

According to the original BBC report, Polak has access to wealthy Conservative donors, and some ministers and members of Parliament “accused Ms. Patel of trying to win favor with wealthy pro-Israeli Conservative donors who could fund a potential future leadership campaign.”

“This is outrageous. She is a Cabinet minister. She just cannot do this,” a government minister told the BBC, “This is about donors and influence.”

In addition to sitting down with Netanyahu, Patel met with the Israeli leader’s close ally Gilad Erdan – Israel’s “strategic affairs” minister who has been put in charge of combating BDS, the boycott, divestment and sanctions movement for Palestinian rights.

But in her Monday apology, Patel did not disclose two further meetings she had with Israeli ministers without the presence of officials.

Al-Qaida have “not attacked Israel”

Another BBC report on Tuesday stated that after returning from Israel, Patel “suggested some of Britain’s aid budget go to the Israeli army” for “humanitarian operations” in the Golan Heights – part of southern Syria which Israel occupied in 1967 and annexed in 1981 in violation of international law.

During parliamentary questions, Patel’s deputy Alistair Burt confirmed she had suggested that UK aid money intended for relief be sent to Israeli army units in the occupied Syrian territory.

He said that their department had ultimately concluded that this was “not appropriate,” since the UK government does not recognize Israel’s annexation of the Golan Heights.

But Burt defended the mooted proposal as “humanitarian,” saying it was an “entirely reasonable” question for her to ask.

Underreported, but well-documented, the Israeli army occupying the Golan Heights uses its field hospitals to treat anti-government fighters involved in the war in Syria – including members of factions linked to al-Qaida.

Israel’s alliance with such groups is part of its effort to hold back the influence of Hizballah, the powerful Lebanese resistance organization that defeated the Israeli army when it invaded Lebanon in 2006.

Belying “humanitarian” claims, the known al-Qaida-linked extremists are allowed back to fight in Syria after being treated. In an interview with Al Jazeera last year, the former head of Israel’s Mossad spy agency denied that there would be blowback after Israel had gotten “into bed” with the al-Nusra Front – for years al-Qaida’s formal Syrian affiliate.

“The rules of the game in Syria,” said Efraim Halevy, mean that “you can do anything that is not able – is not possible to be done anywhere else.” He defended the group saying, “Al-Qaida to the best of my recollection, has up till now not attacked Israel.”

Tel Aviv newspaper Haaretz revealed on Wednesday that Patel had “visited an Israeli military field hospital” in the Golan during her “family holiday.”

This visit was not disclosed in the list Patel released alongside her apology on Monday. Undisclosed meetings

An Israeli military spokesperson told The Guardian that Israel’s foreign ministry had arranged Patel’s visit.

The paper reported that the Israeli army field hospital “assisted both wounded civilians as well as wounded rebel Syrian fighters, some of whom have been accused of being members of jihadi groups fighting the Assad regime.”

The two further September meetings Patel failed to disclose were with Yuval Rotem in New York, director of Israel’s foreign ministry, and another with Erdan in London. Erdan Tweeted the meeting in both English and Hebrew.

Erdan praised Patel in Hebrew as “a brave and sincere leader who supports Israel with all her heart.”

The BBC reported on Wednesday that Conservative Friends of Israel’s Stuart Polak is thought to have been “present at both meetings.”

According to the Conservative Friends of Israel, on 7 September Erdan held meetings with Patel and with communities minister Sajid Javid.

The lobby group said that the Javid meeting was to discuss “steps to counter anti-Israel delegitimization and BDS” and the Patel meeting aimed at advancing “UK-Israel development cooperation, and counter[ing] attempts to delegitimize Israel in international institutions.”

“Delegitimization” is the Israeli government’s propaganda term used to discredit the Palestine solidarity movement, especially BDS.

Israel’s “black-ops”

The Department for Communities and Local Government did not respond to a request for comment, but according to Sky News political editor Faisal Islam, the Javid meeting was correctly disclosed and attended by civil servants.

As extensively reported by The Electronic Intifada, Erdan’s ministry is leading “black-ops” against the Palestine solidarity movement, reportedly including death threats and harassment of Palestinian lawyers in Europe.

Erdan was also implicated in the Israeli embassy scandal in January, after revelations from Al Jazeera’s undercover film The Lobby led to the forced resignation of “senior political officer” Shai Masot.

Erdan’s strategic affairs ministry is staffed by recent members of Israeli spy agencies, including the Mossad, and has a budget of more than $40 million.

What did Downing Street know?

On Wednesday morning, the crisis threatened to engulf the British prime minister herself.

Despite earlier briefings to the press that she had not been informed about Patel’s meetings, a report in The Jewish Chronicle claimed on Wednesday that May’s office had in fact been told about some of the meetings as early as August.

The report also claimed that May’s office even asked Patel to remove a meeting from the list she published Monday, so as not to “embarrass” the Foreign Office.

But 10 Downing Street quickly denied the story, saying both claims were “categorically untrue.”

An anonymous source in May’s office went further, telling The Guardian that the entire report was “complete bollocks.”

The Guardian noted that the prime minister’s office did not explicitly deny The Jewish Chronicle’s claim that in advance of September’s UN General Assembly, May and Patel had discussed “Patel’s plan for UK aid to be shared with the Israelis.”

Regardless of who knew what and when, it seems the Conservative government has deeper questions to answer about the influence of the Israel lobby.

As Labour lawmaker Naz Shah put it in questions to Patel’s deputy Burt on Tuesday, “it seems that British foreign policy on Israel and Palestine is being run by a Conservative-linked lobby group rather than by an independent civil service and an elected government.”

Shah added that this was “just another example of a government who are in disarray as lobby groups, not Downing Street, run our country.”

With translation by Ali Abunimah.

Updated since initial publication.

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TUC to warn business leaders that ‘fourth industrial revolution’ requires a revolution in workers’ rights too

Speaking today (Monday) at the CBI annual conference to introduce a session on ‘Ensuring automation works for everyone’, TUC General Secretary Frances O’Grady will call on business leaders to work with unions on the challenges ahead.

On technological change and the future world of work, Frances will say:

“At a time when working families up and down the country are already worried about what Brexit means for their jobs and livelihoods, a tech revolution could make or break them.

“Quantum computers could make today’s super computers look like a pocket calculator, and we simply don’t know what that means for jobs.

“We do know that opportunities are there. In manufacturing alone, digital technologies could deliver tens of thousands of new jobs and help cut carbon too.

“’Jobs will be lost, jobs will change, new jobs will emerge. Factories could be run by robots and AI, and office jobs could vanish into the cloud. So we have to create a path from the old jobs to the new.

“We need to make sure that tech poor communities aren’t left behind, and that all staff are supported and skilled-up to ride the wave and share in the rewards.

“If government, business and unions work together and make creating good jobs the priority, we can all be winners from the fourth industrial revolution. Workers will have nothing to fear from the tech revolution if there’s a revolution in skills, rights and social protection too.”

Calling on business to work with unions and sign up to three principles, Frances will say:

“For today’s workers, it may look like a rocky road ahead, but it doesn’t have to be that way. We know this is coming, we can prepare. Business, government and trade unions must work together to pave the way and smooth the journey.

“Firstly, in a rapidly changing world of work, every worker should have the right to reskill and upskill throughout their working life, and to receive free training for new work. New jobs need new skills, so we must invest in a personalised training budget for all workers.

“Secondly, workers must get a fair share of the wealth these technologies generate – through wages, pensions, career support, and improvements to public services.

“And thirdly, workers must have a voice in the future shape of the economy – including policy priorities and regulatory safeguards to make sure technology is a force for social good, not workplace tyranny.”

On using the government’s industrial strategy, Frances will say:

“The success of the business secretary’s industrial strategy depends on government, business and unions working together. So I’m asking businesses here today to join us in letting the government know that we both need a seat at the table. A commission on the future of work, which both the TUC and CBI have called for, would be a great start.

“Let’s see it in the white paper the government will publish soon. Let’s work together and map out a path that makes sure Britain is at the forefront of new technology. And let’s do it in a way that gives everyone a fair and secure path to a great working life.”

Editors note

– Frances O’Grady will deliver the introductory speech at the CBI annual conference session on ‘Ensuring automation works for everyone’ at 4.20pm. For more information about the conference, go to: www.cbi.org.uk/events/events/annual-conference/
– The Trades Union Congress (TUC) exists to make the working world a better place for everyone. We bring together more than 5.6 million working people who make up our 50 member unions. We support unions to grow and thrive, and we stand up for everyone who works for a living.

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Fragmentation of the NHS:

Geographic reform of the NHS is not new: region, district, area, and locality are all familiar terms in NHS history, and notions of “place” as an organising principle retain an intrinsic appeal for policy-makers.  Recently, the English NHS has now been reorganised along spatial lines with the creation of 44 geographically-defined STP (Sustainability and Transformation Plan) footprints, to ‘deliver the right care, in the right place, with optimal value’. This is in the spirit of the King’s Fund argument that “place-based systems of care offers the best opportunity for NHS organisations to tackle the growing challenges that they are faced with.”

Critics have argued that far from being a neutral, technocratic process, the creation of arbitrary geographies delivers “spatial closure,” shutting down argument and marginalising debate about the fundamental political choices which determine the nature of our public services. Recent research examining STPs goes further, suggesting their geographic focus enables the “highly resource-constrained management of health systems.”

It is argued here that, unlike previous reconfigurations, STPs deliver outcomes which systematically undermine the national in the national health service. In contrast to Beveridge-era concerns with equity, fairness, and collaboration, STPs privilege the superiority of “local choice” over national ambition which, in the context of austerity,  enhances and accentuates the geographic variation of care provision,  undermining the principle of universality.

The NHS should ensure the achievement of equitable access to health care regardless of region of residence. Policymakers have sought to minimise geographic variation, but it remains a persistent and ubiquitous problem, and the NHS Atlas of Variation maintains that much of this variation is “unwarranted.” However, rather than identifying NHS funding restrictions, geographic fragmentation of the NHS, or the disruptive role of the private sector as causative, it argues that “limited professional knowledge” and “disparate organisational performance” are the drivers.

The reality is that STPs areas are forced to make hard choices about the services they provide, and to whom, and they make these choices without regard to national consistency. Responding to fixed financial resources and increasing demand their approach has been six-fold, characterised by the King’s Fund: Deflection; Delay; Denial; Selection; Deterrence; and Dilution, each of which can be seen in action within STPs.

GP referral management schemes  delay, defer, and deflect patients away from secondary care; the explicit exclusion of certain groups (smokers, the obese) denies care; blaming patients for presenting inappropriately deters the future expression of need; the tightening of referral criteria (for hip replacementsIVF, or continuing healthcare funding) selects patients; and increasing variation in the funding of community nursing services dilutes quality.

Rather than making transparent the boundaries of care and seeking national agreement on acceptable variation, risk, or quality thresholds, STPs are developing and implementing their own local criteria and priorities, the effects of which compound geographic variation and institutionalise the postcode lottery of care: the decision whether care is “warranted” or “unwarranted” is one fully for local determination.

Further, this variation has been exacerbated by the marketisation of the NHS. Expedited by the “any qualified provider” test , the application of competition law, and the diffusion of accountability which has made effective public challenge more difficult, local markets in healthcare  have been exploited by private providers, specifically in community services  and  primary care.  As Birch and Siemiatycki note, private contractors negotiate deals on a case-by-case basis, and this splintering leads to uneven development: some places end up better served than others.

Evidence from Italy’s decentralisation of healthcare suggests the end result is a zero-sum game, where the gains for the stronger are counterbalanced by the reductions in performance of the weaker, which can lead to greater inequalities. In England, there is emerging evidence from the Care Quality Commission that spatial variation has intensified, variation which will only be intensified through the new regime of inter-spatial competition for funding, with funding held back until health systems develop acceptable plans.

The NHS in England can now be viewed analytically as no more than a set of contiguous places, in each of which problems that were forged nationally are required to be owned and solved. Variation raises important policy questions: within a marketized, fragmented NHS how will policies and governance tools ensure that the reduction of unwarranted variation is prioritised? When the mantra of local choice is paramount, how will solutions to critical, national problems such as the care of the elderly be found when parts of the system are owned by different actors, each with competing goals and values, and the assessment of local needs is separated from the provision of services.

Increasing “warranted” variation in care provision across England challenges the idea of a national health service providing universal coverage through a universal funding system (taxation). In a multi-speed, variegated, health service where national accountability is constrained and national funding limited, localised funding solutions to meet local needs may be sought. Do personal ‘year of care’ budgets, and Greater Manchester’s consideration of local funding for social care portend a plural healthcare funding regime?   There is a need for future research to investigate the impact of NHS fragmentation and local choice upon accountability, equity, and variation across the NHS, and for citizens concerned about the survival of the NHS to be alert to the wider impact of these upon the founding principles of the NHS.

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Vestas shifts investment from the Isle of Wight once more:

New MHI Vestas facility to open at Fawley

A wind turbine blade at MHI Vestas.

Wind turbine blade at MHI Vestas.

The Danish, MHI Vestas, monopoly will now invest in Fawley, away from the Isle of Wight, into a “state-of-the-art” facility for its wind turbines blades. It is doing it to cut costs and claim more of the added value from workers’ there.

The site will be used for blade painting and logistics, with an estimated 50 jobs.

On the Isle of Wight 80m blades are manufactured.

MHI Vestas executive, Jens Tommerup, said:

“As we saw in the recent CfD auction round in the UK, the cost of offshore wind continues to fall”.

It was predicted last time when the company upped sticks and left the island that they would return. The company was supported by all and sundry in the Westminster cartel who said that it was up to them stating “commercial considerations”.

It was at that time when the workers at Vestas famously occupied the factory and demanded public control and a say in the decision making process. Workers received international support for their militant stand.

The monopolies enjoy “free movement of capital” and imperialist export of capital so that they can move wherever they want without consideration for labour or the local economy . They can go to the other end of the planet if they want to and Vestas has.

“Our new paint and logistics shop at Fawley will improve our competitiveness
worldwide and strengthen our UK industrial footprint.”

So it is clear about their intentions from their own mouthpiece,

The Government concoct cock and bull stories to support their monopoly capitalist friends by referring to their “environmentally friendly” economics.

Energy Minister, Richard Harrington MP, said: “This new facility in Fawley, developed by MHI Vestas, is a further sign of the growth of the offshore wind sector in the UK.
“Our Industrial Strategy and Clean Growth Strategy set out the opportunities for Britain in moving from fossil fuels to a cleaner future”.

Workers have been kept out of the decision making process as usual and forfeit jobs on the island as a consequence. Workers will have to modify their relations by restricting monopoly rights in the country if they are to control the economy and their own destiny. This requires a political movement with an outlook that gives workers the opportunity to make such a change.

 

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