Lansley gives us a nudge
David Blackburn 6:01pm
Andrew Lansley’s rhetoric is strident: ‘It’s time for politicians to stop telling people to
make healthy choices. Rather than lecturing people about their habits we will give them the support they need... we will support leadership from within communities.’
One could be forgiven for thinking that the Health White Paper will inaugurate a completely new dawn. It doesn’t. Many of Lansley’s initiatives are resuscitated Labour policies: taxes on alcohol and tobacco and incentivising healthy living through choice are tried and tested formulas that have had limited past success in every field bar raising revenue.
Lansley’s White Paper is not a testament of radicalism, but it is quietly revolutionary nonetheless. Of all government ministers, Lansley has the best lines in the language of decentralisation. His actions realise his words. He has already taken GPs commissioning from central NHS Trust managers. Now he has decided to take responsibility for public health from the NHS and give it to local councils. Alas, the money is to be ring-fenced, so there is no immediate incentive for local government to improve both delivery and efficiency. ConHome’s Councillor Harry Phibbs bemoans this state of affairs.
There is the age old irony that Lansley has had to centralise to decentralise; and the fundamental structure of British healthcare remains sacrosanct. But, essentially, the Department of Health is embarking on what used to be termed the post-bureaucratic age.



Previous






Verity
November 30th, 2010 6:17pm Report this comment"Rather than lecturing people about their habits we will give them the support they need... we will support leadership from within communities."
So, community organisers, then?
I know of one who is about to be out of a job in around a couple of years' time. And he's the right colour to be employed by the government. He was born elsewhere - where is a matter of some dispute - but at least he is foreign and without papers and is the right colour, so fits the bill.
Tarka the Rotter
November 30th, 2010 6:25pm Report this commentIt is not the purpose - or business - of government to interfere in the way people choose to live their lives. No nudging required, Mr. Lansley, thank you. Just get on with defending our islands and restoring ancient liberties, including national sovereignty, thank you. Anyone else think this lot are the same as the old lot?
Rhoda Klapp
November 30th, 2010 6:25pm Report this commentDoncha just love those paywalled links?
He's not going to tell me what to eat or adjust my lifestyle like a health nazi. But he has a policy on it. Based on what? A load of scientific papers no doubt. And he is going to nudge me with taxes and handing one more thing to the council so it can badger me while not getting its core duties right. Hooray.
Puncheon
November 30th, 2010 6:53pm Report this commentI wonder why today's politicians, and their media hangers-on, just can't concentrate on their own lives and leave the rest of us to get on with ours? Just what has it got to do with Lansley and all the other busybodies in the HoC what and how much I drink in the privacy of my own home? They have destroyed all the public houses and now they are intent on pursuing us into our private dwellings with their ghastly puritan bilge. Away with the lot of them, I say.
frosty the polar bear
November 30th, 2010 6:54pm Report this commentThese politicos just don't understand that an essential part of freedom, is the freedom to make bad/unwise/silly choices.
If one lives as healthily as one can, it may extend your life by a handful of years.
However, you only get these extra years at the end of your life,
when, in all probability, you're already in the nursing home, sitting your own excrement, wishing for death.
Hardly a great deal, is it?
with most serious economists accepting that the demographic time-bomb caused by the increase in life expectancy is about to explode in the near future, one might have thought that encouraging people to smoke, and drink alcohol, both of which are heavily taxed pastimes, which will help shorten their consumers lives somewhat, thereby reducing the length of time they are a cost to the health services, plus of course, the saving in pension payments, never mind the freeing up of housing stock, would be welcomed?
As for any problems caused by over indulgence in the imbibing of alcohol,
surely it would be far fairer to enforce,the existing laws on public drunkenness, with increased penalties. Rather than simply increase the prices, which actually penalises moderate drinkers too?
If only the politicos inhabited our planet, they would'nt suggest such mind-numbingly stupid ideas.
TGF UKIP
November 30th, 2010 6:55pm Report this commentApparently £4bn is to be diverted out of the NHS into a new quango, Public Health England, thence to be distributed, following of course a healthy deduction of quango overheads, to local councils many of whom will then be turning Labour in May next year.
God knows what looney schemes they'll then spend taxpayers money on in the name of public health and "wellness" but you can bet your bottom dollar that "climate change" proselytizing will feature prominently.
Other than Dave himself, no one personifies this nauseating government better than this Nudging Nanny.
Noa
November 30th, 2010 7:19pm Report this comment"the Department of Health is embarking on what used to be termed the post-bureaucratic age...".
Which seems to be remarkably like the second, bureaucratic age, but nothing like the first, pre-bureaucratic age.
In that first age I used to eat well and go to the gym, following the tax increase necessitated to fund the second age I could no longer afford my preferred exercise and moved to a cheaper, less healthy diet.
In the third age the requisite forms for treating the adverse effects of the second, have been abolished.
Verity
November 30th, 2010 7:20pm Report this commentWhat about the adults who don't want a "nudge" from Lansley? Can they "nudge" him back?
JR
November 30th, 2010 7:24pm Report this comment"Nudging" is not based on financial incentives. That is simple classical economics. It's frustrating most of the media do not know that.....and many of the Government Government Ministers are similarly ignorant.
For all it's weak points I'd prefer people actually understood the perceived incites of behavrioual economics.
local local
November 30th, 2010 7:47pm Report this commentMust be a sneaky part of new cuts strategy to pass "public health" to local authorities, who are useless at most things.
That should push up smoking, drinking and obeseity, thus raising taxes and reducing pension liabilities.
Smart!
daniel maris
November 30th, 2010 7:48pm Report this commentEr - it's called the Nanny state.
At least that's what Tories call it when Labour are doing it.
Fergus Pickering
November 30th, 2010 7:48pm Report this commentI don't care if the lower classes die sooner than I do because they smoke too much and drink too much and eat too much. What's that to me? Let them live the lives they choose. They like that and I like that. For God's sake let it alone. However, all this looks pleasantly lony and unlikely to 'succeed'.
Rosie
November 30th, 2010 7:54pm Report this commentAs one who as a senior medical consultant in a hospital Trust until recent retirement, and was involved in initiatives (by management) to consult and discuss with the local council, I can tell you that they know absolutely nothing about the NHS, health or Public Health. What will happen is that they will have to employ the public health doctors (employed up to now by PCT's) and will take their advice uncritically (they have no choice) and there will be hundreds of mad schemes, mostly intrusive and again telling people how to live.
Holly ......
November 30th, 2010 8:01pm Report this commentAnother thing for us 'grown up's'to wail about,while the next generation eat junk,
binge drink and smoke,take god knows what so they can 'get high' to block out all the pleasures in their lives,bestowed upon them by.....us 'grown up's.
Instead of educating children to live a healthier live from a young age,we have given them trainers,computers & TV's in their bedrooms.
The parents brains not registering that one cancels out the other.
Some kids today think they are 'active'
because they drink 'sports drinks'.
Bananas are cheaper than crisps.
Chicken,fish and vegatables are cheaper than take away.
Take away the junk food and many people would not have a clue what to eat.This knowledge is forced onto their children,who one day will pay the price.
Maybe if more of these 'modern day' mothers acted more like nannies,the government would not have to 'nudge' them.
Cogito Ergosum
November 30th, 2010 8:27pm Report this commentThe verses below appeared recently in readers' comments to a piece in the Telegraph. I take the liberty of passing them on to Coffee Housers.
One for the lads
I never drink beer on a Monday,
Cos Monday's the day fer mi health
An' the wife's got me countin' them units,
I've just got to take care o' miself
So I merely have wine wi' mi supper,
An' just the one litre OK?
Then a rather large rum in mi coffee
An' I calls that mi sensible day
I never drink wine on a Tuesday,
Cos Tuesday's mi weightwatchin' club
It's the day when I eat nowt but cabbage,
The day I don't go much fer grub
Now a diet demands plenty fluid,
Summat light an' completely fat-free
So I've chosen that strong German lager
An' I just have five pints wi' mi tea
I never drink lager on Wednesday,
Cos Wednesday's the day fer mi jog
It's tracksuit an' trainers at mid-day
Then I'm off up the road wi' the dog
First stop's at the Globe fer some Guinness,
Three swift ones'll get me to grips
Then I carry on round to The Shepherds
Fer three more an' a burger an' chips
I make sure that I'm suitably rested,
Then I sprint back to our garden wall
In a time of under twelve minutes,
An' it's four 'undred metres an' all
I never drink Guinness on Thursday,
Cos Thursday's mi day to relax
I likes to sit out in t' back garden
In mi brown zip-up cardie an slacks
After lunch I might stroll by the river,
Breeze in at the Fisherman's Drop
Where I lounge on the terrace all lordly,
Sippin' shandy, but beawt any pop
Then cos I've been good through the day like,
She'll allow me to waver a smidge
So mi evenin's spent watchin' the footy
Wi' a few packs o' Boddies from t' fridge
I never drink Boddies on Friday,
Cos Friday's mi night on the razz
An' we meet in The Firkin at seven,
Owd Nodger an' me an' Fat Baz
Oh The Firkin's a beer-drinker's heaven,
Wi' fifteen real ales from the jug
An' we start wi' the ones in the tap-room
An' we works our way round to the snug
By midnight we're all talkin' gubbins
An' we're off fer a curry up town
But there's summat not reyt about curry
Cos I never seem t' keep the stuff down
We 'ave a good laugh wi' the waiters,
An' Baz moons his bum fer a joke
Then I'm home fer a nightful o' passion,
Cos I'm known as a passionate bloke
I never do much on a Sat'day,
Cos Sat'day's mi time fer a think
Cos me an' the wife are not speakin' today,
I'm a drunken, fat pig an' I stink
So I sit near the lavvie pretendin'
That really I'm feelin' just great
But I'm goin' right off that Indian food
If it leaves me in this bloody state
It's later I make the decision,
On my forty-third trip to the bog
There's only one thing cures an upset like this
An' they call it the 'air o' the dog
I ring Nodge an' Baz on mi mobile
An' both of 'ems likewise in pain
So we're back in The Firkin at quarter-past-six
An' we do it all over again
I never say Firkin on Sunday,
Cos Sunday's mi day to repent
I'm ashamed of all o' that boozin' I've done
An' all o that money I've spent
I begs the wife fer forgiveness
An' I promise I'll alter mi ways
An' she gives me a kiss an' a cuddle,
Like she did in our newly-wed days
We watch Songs of Praise on the telly,
Then a nice pot o' tea an' some cakes
An' I swear now I've climbed up the ladders,
I'll never slide down any snakes
But it's borin' on telly on Sunday,
An' I can't say I'm ever impressed
So I 'ave a walk out round the village
An' stop off at the Collier's Rest
Now the beer's a bit crap in The Collier's
So I leave an' pop round to The Swan
Where I flatten a shed-load o' Tetley's
An' I'm bloody well back to square one
So I never drink beer on a Monday,
Cos Monday's the day fer mi health
An' the wife's got me countin' them units
I've just got to take care o' miself
[Electronic Telegraph 24-Nov-2010; reader's comment]
Verity
November 30th, 2010 9:01pm Report this commentCogito Ergosum - I had my head down on the computer laughing. Am drying the tears on my cheeks. Thanks so much. Duly forwarded to all good drinking Brits that I know (two). I'd send it to American friends, but they wouldn't understand the Yorkshire.
Cjamesk
November 30th, 2010 10:33pm Report this commentAnd yet the State increases evermore.
Is there any real difference between the parties other than the implementation of the same policies.
Just Interested
December 1st, 2010 6:27am Report this commentWhat's the difference between telling someone to do something and a 'nudge'?
Ron Osmond
December 1st, 2010 11:03am Report this commentTarka the Rotter urges Lansley to "Just get on with defending our islands and restoring ancient liberties..".
Which ancient liberties were these then, Tarka? Freedom to clean chimneys at the age of 6,.. Freedom to visit Australia after a spell of poaching,....Freedom to avoid the tedious voting process?
Yes, indeed...the list of these ancient freedoms is endless.
2trueblue
December 1st, 2010 11:47am Report this commentIt's all about the money. Oh! and job creation!
alexsandr
December 1st, 2010 1:24pm Report this commentproblem I have is that the people who abuse their bodies end up needing NHS treatment, which we all pay for. Remember the obesity time bomb on the way.
So do we nag people to behave differently or do we deny treatment to smokers, boozers and fat and sugar junkies?
Rhoda Klapp
December 1st, 2010 2:59pm Report this commentalexsandr, don't you believe in universal health care free at the point of treatment? For all? I'm shocked. If you don't treat the people of whom you disapprove, is there an option for them not to pay? Because they are the poor sods who pay in all their lives then die early, if health nazis are to be believed.
Verity
December 1st, 2010 3:41pm Report this commentRon Osmond, your post is a little confused. Transportation to Oz was only about 150 years ago, wasn't it? I mean, that's within the memory or around five generations. Not "ancient times", surely?
Likewise, little boys were employed as chimney sweeps during Charles Dickens's time ... the Victorian age. Are you seriously proposing that that is "ancient times"?
It must be awful to be historically illiterate and easy prey for mean-spirited people like me.
Tarka the Rotter
December 1st, 2010 4:20pm Report this comment@Ron Osmond
May I respectfully urge you to read the 1689 Bill of Rights
Children up chimneys? Was that ever a right, or is it just leftist rhetoric? Ah, yes, of course... Please don't be tedious, there's a good chap
LibertarianLou
December 1st, 2010 4:53pm Report this commentSometimes I think we should get rid of the entire NHS, and just have a health insurance fund, which anyone too poor to buy health insurance could get a grant, or a loan, for essential treatment if approved. (I.e. for actual healthcare, not boob jobs and stuff). But no-one would do it.
daniel maris
December 1st, 2010 7:16pm Report this commentWell health vouchers would be another approach we could look at - with maybe a rebate for non-use of the NHS (weighted at various ages) to be provide some incentive to stay healthy.
However one does have to understand that health insurance admin is v. expensive - one of the reasons the USA spends so much more on health.
Tarka the Rotter
December 1st, 2010 8:44pm Report this commentthanks for that, Verity
Ron Osmond
December 2nd, 2010 10:46am Report this commentTarka,
You haven't answered my question.
If we take the 1689 Bill of Rights as a benchmark, which "ancient liberties" contained therein have we lost?
What others NOT contained in that Bill have we lost?
However many you come up with there are many more liberties that we have gained since 1689. I refer you to this excellent website:- http://www.britsattheirbest.com/freedom/f_time_19th_century_1850_1899.htm
Tarka the Rotter
December 2nd, 2010 3:21pm Report this commentMMmm well now let's see... the right to be tried by a jury of one's peers seems to be disappearing; the right to privacy ( CCTV cameras et al, plus of course the increase in the number of government agents who can gain entry to your property at any time under numerous intrusive bits of legislation); the right, as a subject (now citizen) not to be shipped off to a foreign power for judgement and possible imprisonment and so on and so on. Actually, Old Holborn puts it rather neatly in his strap line:
"You can stick your CCTV, Police State, wheelie bin Stasi, DNA, WMD, “Social Cohesion”, benefits for all, guilty until proved innocent, don’t do that it’s illegal now, can’t say that, ID cards for all, where are you going, what have you been saying/doing/reading, can’t photograph that, how very dare you, golliwog banning, we know where you live, we’re watching you Soviet Utopia up your arses. Sideways."
I thank you...
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