The TaxPayers' Alliance - Better Government

Public Sector Strikes

Strikes are back in the news, with industrial action in the past week by oil refinery workers and school teachers. As a result, there is growing public concern at the cost of these strikes and the interruption to vital services.

New TaxPayers’ Alliance research reveals that workers in the public sector go on strike far more than their private sector counterparts:

• Over the last five years public sector workers have gone on strike for over 20 times as many days on average as workers in the private sector (see Table 2).
• Over the last twelve months public sector workers have gone on strike for 895,000 working days, more than 100 times as many days on average as workers in the private sector (see Table 1).
• This is despite public sector workers being paid more and being far more likely to enjoy benefits such as a final salary pension scheme.

Mike Denham, former Treasury economist and TaxPayers’ Alliance expert,said:

“Public sector workers have learned from past cave-ins that this government is willing to compromise taxpayers’ interests in the face of strikes. They know that politicians are far too ready to spend our money to avoid political embarrassment. And with the public sector four times more unionised than the private, strikes have increased sharply, leaving ordinary taxpayers facing untold inconvenience and expense, as well as the prospect of even higher taxes to buy off the strikes.”

Download the full report (PDF)

Too many laws

The Telegraph report that the definitive guide to British laws has doubled in size over the last twenty years:

This is a crushing burden of new regulation.  Ordinary people and businesses have an ever-expanding variety of laws that they are expected to obey.  The vast complexity of the legal system is costly to comply with and hard to predict as people are unsure which of the million pieces of legislation they could fall victim to.

The problem is inexperienced political leadership.  A lack of clear objectives leads to a mish-mash of many regulations that achieves little but complexity and inconvenience.  Beyond that, politicians with little experience of the problems regulations create for private industry do not see the problems they create coming.  Finally, they are only in office for a short period of time so are unable to really appreciate the vast amount of regulation that builds up over time with new legislation year after year.

Crime mapping

New Conservative plans, reported in the Telegraph, for detailed, public crime mapping could do great things for the relationship between ordinary people and the police.  Particularly if they are combined with the election of local police chiefs:

"The maps would have to be updated each month, while police would have to hold quarterly "beat meetings" where residents can raise their concerns with local police commanders.

Local residents could enter their postcodes and click onto the map, where the different crime types are represented by differently coloured pins.

Eleven categories of crime - ranging from burglary and vehicle theft to violent assaults - will be detailed on the maps. For sensitive crimes, like sexual assaults, then map will only detail a 300 yard street area."

With such detailed information local people would be able to hold the police to account.  The police would then have to really work for the public.  There might be resistance in the ranks to such accountability but hopefully the police will realise that, if it is a choice between working for politicians and working for the public who see the results if they do a good job, the latter is more rewarding.  The public will, rightly, have more trust in a police service that caters to their priorities than one that follows absurd government targets as it does now.

The National Programme for IT's expensive new bosses

We've already responded to the story that two new bosses for the failing National Programme for IT are going to be appointed at a cost of nearly half a million pounds a year in salaries alone, from the Telegraph report:

"Matthew Elliot, the chief executive of The TaxPayers' Alliance, said: "The direct, centralised management of the NHS is a massive task that no individual can seriously manage, and that flawed structure has undoubtedly contributed to the disastrous mismanagement of large-scale NHS projects.

"Centralisation has created a behemoth that is simply unmanageable - and patients and taxpayers are paying the price.""

The NHS is so large, centralised and full of quangoes that it is essentially unmanageable.  The unmanageable NHS has given birth to a monster of an unmanageable project; the NPfIT.  Thought to be the largest IT project in the world and coming in at a mighty £12.4 billion (up from £2.3 billion when the project was being sold, as set out in our report (PDF) on big government projects).  Despite all that money, only 9 per cent of doctors are optimistic about the programme's potential to improve the NHS and Foundation Trusts have serious concerns about its functionality.

The signs are not good that these new staff will improve things:

"One individual is responsible and accoun-table for the vision, linking with policy, and also the strategic leadership, and one is focused working in partnership with the NHS in the delivery of [IT] programmes."

A lot of the problems with the NPfIT are rooted in the fact that the structure was imposed from the top-down and didn't really address the needs of doctors.  In that context, is splitting the "vision" and "partnership" roles into different jobs really the best idea?

3.9 million pupils since 1997 have failed to reach an acceptable standard at GCSE

"Almost one million teenagers have failed to achieve even the lowest possible passing grade, G, in five GCSEs since Labour took power in 1997.

The report by the Bow Group found that the number of pupils failing to achieve five GCSEs rose last year to 90,000 - the highest figure since 1998. While a G grade is a pass, most employers view a C grade as the minimum acceptable standard of GCSE.

The report found that in England between 1997 and 2007 there were 3.9 million pupils - almost 60 per cent of the total - who failed to get five GCSEs at C or above, including the core subjects of English and maths."

The Telegraph reports a Bow Group study showing that billions of children are being let down by our education system.  Politicians have been claiming that serious improvement is just around the corner for the hundred and thirty years they've been in charge.  It is high time we thought again and put control back in the hands of teachers and parents.  That way we might not just see improved results but results that people believe in.  Schools would start to cater to parents who want to see their children earn meaningful qualifications rather than politicians that fail to meet diluted targets.

Refusing to accept the facts

Ed Balls, the Children and Schools Minister, announced yesterday that head teachers from successful grammar and faith schools will be ‘encouraged’ to take a more active role in the management of failing schools. This ‘encouragement’ will come in the form of new system of ‘rewards and incentives’, with the potential for some of these ‘super-heads’ to earn over £200,000 a year.

The logic behind many political decisions is often confounding, but this must rank as one of the most depressing examples. It also confirms the suspicions that Ed Balls is a dangerously inadequate Secretary of State.

Needless to say, the unwritten law of public sector pay dictates that once the bar is raised in this way, the pay of all will steadily rise. But what is more important, and more worrying, is that presented with the fact that grammar and faith schools do better than other state schools, Mr Balls has chosen not to consider why this really is – the fact that such schools represent the most independent part of the state education system – but to focus instead on ‘rewards and incentives’ for 500 individuals.

There is no question that successful head teachers offer a valuable resource, and their experiences and methods should be shared.  But luring them into more active involvement in the administration of failing schools is not the answer to the UK’s education problems. The reason why these head teachers are able to be successful is that they run those schools that are most free from the obsessive meddling of both central and local government – grammar and faith schools. These head teachers are the nearest thing the state sector gets to genuine ‘head-teachers’, to a chief executive of a school, rather than an embattled bureaucrat struggling to implement the endless stream of government initiatives.

The sub-text of Mr Ball’s announcement is that there is a shortage of decent head-teachers. In this he is right. But simply relying on stretching the few successful ones we do have over multiple schools side-steps the real and pressing issues that cripple the education system.  Head-teachers need more independence, not more money, and the governments’ refusal to accept this ensures a continued sub-standard education for thousands of children. 

Who is in charge?

The police today are complaining that their role is 'not recognised' as the Home Secretary didn't honour the results of their pay arbitration.  It really says something that they are looking to the politicians for validation.  The very idea of the police as public servants has been undermined by political management that means the police are actually serving the politicians - catering to their priorities.  If the police were freed from political management and made accountable to local people, the ones who really face the economic and social costs of crime in their area, then they might feel genuinely valued.

We would all get better services.  Another story today is the news that PCTs have been advising GPs to minimise their time with patients:

"Concerns over the quality of out-of-hours care were raised after doctors were told to cut down on home visits, speak less to patients and make fewer referrals to try to save money."

We all lose out because consumers have no power over a health service run by unnaccountable quangos like the PCTs.  Politicians dictate the objectives, quangos provide the detail and the views and needs of doctors and patients are largely sidelined.

HMRC double standards

"HM Revenue & Customs has been accused of "double standards" after the disclosure that its 83,000 staff do not have to submit receipts to cover claims ranging from meals to hotel accommodation and travel and are entitled to expenses without forking out any money.

[...]

Clive Gawthorpe, a UHY Hacker Young partner, contrasted the "generous" policy with the way HMRC handled expenses claims from individuals or companies.

He said: "Accountants who frequently face challenges over expenses for as little as £10 will find it ironic that HMRC runs such a liberal 'no questions asked' system for its own employees."

Unfortunately this new outbreak of double standards is part of a broader pattern.  Politicians and civil servants rarely think of their own behaviour when launching some new crackdown.  Politicians are putting in place corporate manslaughter laws while the NHS they run is killing thousands through hospital infections every year.  Housing for 'key workers' always seems to mean housing for those working for the Government rather than in the private sector.  The Government insists that electricity companies do something about the effect of high prices on ordinary people while putting in place regulations like the Renewables Obligation that push prices up.  It really is one rule for them and another for the rest of us.

Biofuel folly

The Government must be feeling pretty hard done by this morning.  They kowtowed to the green movement when they were pushing for more use of biofuels.  Now that the Renewable Transport Fuels Obligation (RTFO), which requires all car fuels to include at least 2.5 per cent biofuel - rising to 5 per cent by 2010, is coming into existence they are attacking it on Sky News.

Their new position is rather more sensible.  Biofuels aren't very efficient - a Cornell University study found that many biofuels take more energy to produce than they produce in a car's engine.  Even when relatively efficient biofuels are used they don't add a lot to carbon efficiency.  The simple caculation offered on the Department of Transport website that 1.25 per cent of road transport emissions will be saved rising to 2.5 when the full obligation comes into force per cent is a bit suspect.  It depends on a lot of assumptions about the type of fuel used and may not capture all the energy used in the production of biofuels (this problem has afflicted many studies).  Even if the Department of Transport estimate is right the amount of carbon saved is tiny - 0.7-0.8 million tonnes of carbon.  That is just over a day of Chinese emissions growth (XLS) between 2005 and 2006.

Beyond that, bio-fuels push up food prices.  This has two nasty consequences in particular:

1. People go hungry and there is social unrest.  New problems, particularly in Haiti, are reported in the Telegraph.
2. There is more pressure to put wilderness environments to the plough.

All these problems are caused by inexperienced politicians who weren't able to understand how weak the arguments in support of biofuels were.  So weak that even the green movement has now given up on them.

Politicians should tend to their own responsibilities instead of spending their time hassling business

Two stories from the Telegraph today that have a common theme.  The Government have 'negotiated' a plan for energy companies to help certain householders with their fuel bills:

"An extra £225 million will be provided by the six biggest energy firms over the next two years to help those who are struggling to pay, said John Hutton, the Business Secretary.

He estimated that the money could remove up to 100,000 people from fuel poverty - where 10 per cent of household income is spent on heating."

And, Internet service providers might be taxed to support unprofitable programmes:

"Internet service providers could face a new tax to help pay for unprofitable programmes shown on ITV and Channel 4, which may in turn lead to higher broadband charges for consumers.

The levy could be imposed by the Government on the service providers and websites within the next few years, under proposals published yesterday about the future funding of "public service" programmes which make little or no money for commercial broadcasters."

In both cases the private sector is being forced, either directly or through threat of regulation, to tend to Government priorities rather than getting on with its own job of trying to obtain a return for its shareholders by providing for its customers.  If the Government hadn't put in place green regulations that constitute 8 per cent of the cost of energy far fewer people would face fuel poverty.  Why broadband companies are responsible for current affairs programming on TV is a mystery.

So often politicians fail to deliver quality public services that people would use even if they had a choice.  They should stick to their own jobs instead of spending their time hassling businesses in competitive industries that successfully provide the services or products their customers want.

The Cost of Crime in London

A new study by the TaxPayers’ Alliance has discovered that the cost of crime in London in 2006-07 was a staggering £3 billion, equivalent to £400 for every person in London. Using Home Office calculations to take into account the economic and social cost of various types of crime, TPA researchers were able to provide an in-depth breakdown of the cost of different types of crime borough-by-borough.

Using the estimated costs of different types of crime gives an appropriate weighting to crimes such as violent or sexual offences that are more serious and more worrying to the public than petty theft from a shop.

The report reveals a wide inequality in the cost of crime among different boroughs, ranging from Westminster (£154.8m, or £620 per capita) and Islington (£109m, or £590 per head) to Harrow (£50m, or £235 per head) and Richmond (£39, or £215 per head).

Download the full report (PDF)

Matthew Sinclair, Policy Analyst at the TaxPayers’ Alliance, said:

"Ordinary Londoners, particularly those in the poorest boroughs, pay the price for high crime rates every day. Whether we have been victims of crime, are afraid to go out at night or are just paying ever more to protect and insure ourselves, crime has big economic, emotional and human costs for us all. We urgently need politicians to end the excuses, show real civic leadership and enable the police to take action and replicate the radical reductions in crime seen in other cities such as New York."

Matthew Elliott, Chief Executive of the TaxPayers’ Alliance, said:

“Crime is set to be the big issue in the Mayoral elections. Londoners are looking for a Mayor who will tackle the crime epidemic in the Capital. The Government should devolve full powers over the Metropolitan Police to City Hall so whoever is Mayor after May 1st has the power to sort out this menace.”

TPA Interviews...John Redwood MP

John Redwood, MP for Wokingham, has been prominent in the field of centre right politics since his days as Margaret Thatcher's Chief Policy Officer, championing privatisation around the world. Since then he has been a cabinet minister, shadow minister and author - and is also one of Britain's leading blogging MPs. He is currently Chairman of the Conservative Party's Economic Competitiveness Policy Group.

John kindly agreed to be interviewed about TPA's Better Government campaign, and the way in which we can improve how public services are delivered.

If you were in charge of any ministry which one would it be and why?

This is a matter for a future Prime Minister to decide.

What are the three most successful policies you can think of in the post war era?

Council house sales – giving many more people the opportunity to own a home of their own. It gave people pride in ownership, granted them freedoms to change their properties or to sell them and move somewhere else, and allowed them to acquire an asset which could be used to help  finance businesses or family  purposes.

Introducing competition into former public monopolies. In each case prices came down, innovation increased and quality went up. The transformation of telecoms thanks to competition made possible the growth of the City as the world’s leading financial centre. It is unlikely the City could have grown as well and as fast as it did if we had kept on with the inadequate and rationed phone system we experienced under a nationalised monopoly. The changes in electricity not only cut prices, but led to the UK hitting its Kyoto greenhouse gas targets thanks to the dash for gas replacing dirtier coal fired stations which the nationalised monopoly insisted on building.

Floating the pound. The UK economy suffered devaluation crises under Labour in the 1940s and 1960s, and suffered from the ERM crisis in 1992. In each case the requirements of the managed exchange rate led to  stop-go policies, wealth destruction and slower growth. Floating the pound removed that artificial constraint on economic growth and ushered in a more successful era for UK prosperity.

What are the 3 worst policy mistakes you can think of in the post-war era?

1. Nationalisation. The nationalisation of post, coal, electricity, phones, trains and other leading sectors held the UK economy back. The nationalised industries charged people more, provided a less good quality of service, and ended up sacking all too many of their staff. They did untold damage to labour relations, pillaged the taxpayer for subsidies to pay the losses, and did harm to customers.

2. Damaging the Bank of England in the 1997-8 reforms whilst wrongly claiming the government was making the Bank of England more independent. Gordon Brown took away the power of the Bank to manage public debt and to supervise the day to day activities of the clearing banks. This left the Bank without the minute by minute market information it needs to manage money markets well, and left the regulatory system much weakened to deal with a crisis when it struck. Unfortunately a crisis struck in the form of Northern Rock, the first time for well over a century that there has been a run on a UK bank.

3. Transferring too much power to the EU. The substantial transfers of power under Nice, Amsterdam and the proposed Constitutional reform Treaty represent a big change in how we are governed, shifting too many things from democratic control here in the UK to bureaucratic control in the EU.

Who do you think has been Britain’s most successful post war minister and why?

Margaret Thatcher, for reforming the trade unions, cutting the rate of strikes and improving labour relations, transforming the nationalised industries and selling Council houses. Her reform made the UK more a nation of owners, creating more families and individuals with a stake in the nation. It took  much of the bitterness out of industrial relations, and moved the UK on from strife to society where training, participation and ownership all had a stronger role to play in creating a unity of purpose between mangers and employees.

Who do you think has been Britain’s least successful post war minister and why?

James Callaghan, for presiding over the trip to the IMF to bail out the UK economy in 1976 and the  winter of discontent in 1978-9.

What do you think of moves by Gordon Brown and David Cameron to bring in outsiders to government?

Only Gordon Brown is able to bring outsiders into government. His moves have shown he needs to be much more careful if whom he chooses. Admiral West has made mistakes and had to execute a humiliating U turn about detention without trial, whilst the former DG of the CBI has peppered the record with all sorts of unhelpful comments about the government prior to taking office which makes it difficult for him to be effective within the framework of collective responsibility.

If you were Prime Minister who would you bring in from outside Parliament to help you and why.

I would use the talent available in Parliament.

Do you think it is important that ministers have experience in the subject area they are appointed to?

An experienced Minister can go to any department and succeed. Ministerial skills include understanding and handling Parliament, chairing meetings successfully, assimilating large amounts of complex information and reaching a decision, thinking sceptically about professional advice advanced and checking official advice against commonsense and the testimony of people outside government. The essence of being a good Minister lies in using the professional advice well, and keeping in touch with public opinion and Parliamentary pressures. It does make the job easier if you also happen to have professional expertise in the area of the department, but it is important not to cloud your general Ministerial judgement with your own professional judgement, as you are paying others to offer that.

What lessons do you think Britain can learn from other countries about the structure of government?

That those countries with the lowest tax rates and the best controlled patterns of government administrative expenditure perform better. We should learn from the experience of the richest countries of Western Europe, Switzerland and Norway, that keeping EU costs and demands down helps create a prosperous country. We need to negotiate a better deal for the UK within the EU to get closer to that enjoyed by Norway and Switzerland outside the EU.

What lessons do you think Britain could learn from other countries about how to deliver public services?

Where more choice, local determination and local management is allowed public services are better. The important thing is to ensure access to care or education using state cash to ensure fair access. It is not important to run or control everything in the state sector needed to provide the service.

If you were setting up a system of government from scratch would you choose the British model or that of another country?

I would choose to keep single member constituencies and a powerful Parliament elected by first past the post from the UK system. PR systems break the link between an MP and a particular group of constituents in a particular place, making MPs less accountable. It also encourages people to form more extreme parties, as PR allows them to get people elected to influence the policy of the resulting coalition government.

I would not want the EU to have such power over fishing and agriculture as granted by the Treaty of Rome nor such power over social and employment policy, foreign affairs, criminal justice and the other important areas that this government has transferred. Too many layers of government creates over-regulation, and blurs democratic accountability, against the interests of taxpayers and voters.

I would not allow regional government in England, as England does not break up into natural regions and there is no need for this unnecessary layer of government.

Do you think Britain can realistically move towards  such a  system?

Yes.

'We need more consultants' say the BMA

The Telegraph reports a BMA call for more consultants in the NHS.

This is supported by research finding that consultants, the most senior and experienced doctors, produce better results in a number of areas.  No one is going to dispute that, it seems pretty obvious that if your doctors are more experienced they will offer a better standard of care.

However, the reason why we don't have as many consultants as in other countries isn't that we've been stingy with the health service.  Funding has gone up rapidly and we now spend just about exactly at the OECD average.  It is that increases in funding have been soaked up by a healthcare system unable to turn that new money into results.

What the BMA don't mention in its discussion of the number of doctors is how expensive they have become.  While we don't have a lot of consultants, our doctors are among the best paid in the developing world.  This can be seen in the OECD's Health at a Glance 2007 statistics on physicians remuneration (XLS).  Our GPs are the third best paid of the 23 OECD countries relative to GDP per capita, our specialists are also paid well above the average (the eighth best paid).  Pay has been rising rapidly despite falling hours due to the Working Time Directive.  Unfortunately, it seems unlikely that the BMA will acknowledge that the problem isn't a lack of resources but the direction of resources into things like big pay increases instead of areas more conducive to improving results and the patient experience.  The money to pay for all this is taken from hard pressed taxpayers who have been forced to foot some extravagant bills in recent years.  If our doctors are to enjoy such high earnings there will probably have to be fewer of them than we might like.

This is just one of the pressures pushing up costs in the NHS, we identified several drivers of NHS inefficiency in our report Wasting Lives: A statistical analysis of NHS performance in a European context since 1981 (PDF).  The Kings' Fund reported that 73 per cent of additional spending in the NHS in 2004-05 was consumed by cost pressures; the number of managers and senior managers grew twice as quickly between 1999 and 2004 as the number of clinical staff; endless reforms and then reversals have been massively disruptive.  Instead of offering the rather obvious bromide that things might be better if we had more expensive consultants, it would be nice if the BMA would reflect on the fact that the NHS has seen little result from a big increase in spending and direct their campaigning attention towards seeking serious reforms in the way the health service operates.  In Wasting Lives we set out what the priorities should be: ending political management, ensuring proper competition and delivering real decentralisation.

After all, this story provides more examples of how politicians fail to effectively manage the health service.  They weren't able to properly control pay and other costs when resources were plentiful.  Spending shot up at a clearly unsustainable rate and, instead of delivering similarly radical changes in results, built up momentum in various cost pressures.  Now that money is relatively tight pay deals are going to have to be more restrained and staff are upset but still highly paid due to past profligacy - we've got the worst of both worlds.  In order to avoid a financial crunch in organisations that had got too used to plenty NHS Trusts took radical, destructive steps like cutting back on nursing (contributing to hospital infection epidemics) or freezing consultant recruitment.  This is a fiasco that patients and staff pay for every day and is the direct result of politicians, with experience in neither healthcare nor managing large organisations, believing that they could easily translate resources into results and dictate improvement via targets from the centre.

More evidence that dysfunctional public sector management contributes to the hospital infections crisis

Stories today, and over the weekend, illustrate how the problems with public sector management undermine attempts to keep hospitals clean and hygienic and control scandalous levels of hospital infection.  There is no reason to trust politicians to deliver high quality healthcare.  Control needs to be returned to professionals and patients with decentralisation, competition and an end to political management as set out in our report Wasting Lives: A statistical analysis of NHS performance in a European context since 1981 (PDF).

Lack of accountability

In the Byzantine public sector it is rare enough that there is a single organisation and person clearly responsible when things go badly wrong.  When that does happen there is often, briefly, accountability to the public.  However, it doesn't last as the issue doesn't stay in the public eye for very long.  After the breathtaking loss of personal information on millions child benefit claimants the head of HMRC, Paul Gray, did resign.  This was hailed as a triumph of accountability.  However, he kept getting paid his £200,000 salary and was quickly engaged in a new project advising on, somewhat ironically, "transformational government".

Now it emerges that despite a payoff of half her annual salary Rose Gibb, the NHS Chief Executive who oversaw Britain's worst superbug outbreak with over 90 deaths, is launching a legal claim for even more.  Gibb was responsible for shockingly poor management and hygiene conditions at the Trust.  Her own leadership style was cited as a significant factor in the Healthcare Commission report (PDF) on the crisis.  She should consider herself lucky that she received any payment; a company director responsible for such dire safety standards might face a substantial jail term under corporate manslaughter laws.

Inexperienced leadership

Gordon Brown and Alan Johnson haven't spent their careers working in healthcare.  They've spent them as politicians.  However, healthcare professionals have to, in the end, respond to the politicians' priorities.  They're the ones holding the purse strings.

Deep cleaning is a classic example.  From the day it was announced experts, including the Lancet medical journal and the companies hired to actually carry out the deep cleans have suggested that could make a minor contribution at best and could prove an expensive gimmick; a poor substitute for good hygiene delivered by effective management.

Sure enough, the critics of the scheme appear to have been proved right.  The Mail on Sunday has reported that one hospital has suffered a C. difficile outbreak just days after it was deep cleaned.

Youth crime up

"The figures show that over the past decade the number of persistent young offenders (PYOs) in England and Wales has jumped by two-thirds from 9,868 in 1997 to 16,512 in 2007.

A persistent young offender is defined as "a young person aged 10 to 17 years old who has been sentenced by any criminal court in the UK on three or more occasions".

The human cost of this rise in youth crime, reported by the Telegraph, must be hard to overestimate.  This highlights how overall crime figures, distorted by a fall in the number of thefts from a vehicle, miss the true social and economic costs of crime.  More young people getting trapped into a life of crime.  More of those crimes, like violence against the person, which do the most to blight the lives of ordinary people.

Number of NHS complaints increases

The Telegraph reports a big increase in the number of complaints about the NHS:

"The Healthcare Commission, the independent watchdog, investigated more than 10,000 cases last year. Complaints included cases of patients left in soiled bedding and allegations about rude nurses.

The commission upheld 20 per cent of complaints, more than twice as many as the previous year. Almost a third of complaints about hospitals involved lapses in basic nursing care.

Patients reported that they did not receive regular baths or showers and, in some cases, were left for hours in soiled bedding or clothes."

So long as we're just complaining to an organisation which is, in the end, accountable to politicians we won't get anywhere.  Only if patients are given the power to take their business elsewhere when ill-treated by hospital staff will there be the right incentive for improvement.

Tackling inequality

There is room for debate on whether reducing inequality is a proper goal for government.  Too often attempts to tackle inequality substitute petty attacks on 'the rich' (usually the middle classes are the ones actually affected) for meaningful attempts to help the poor.  However, as reducing inequality has been a central objective for the Government for over a decade it is important to look at measures of equality just to see if they are succeeding in their own terms.

They aren't:

"Karen Dunnell, head of the Office for National Statistics, said the income gap between high- and low-earners was not affected by the measures introduced while Gordon Brown was chancellor to raise the living standards of the poor."

It isn't just that we might differ with the Government on questions of priorities.  Even on the issues they have set up as central concerns for their government our present Ministers have failed dismally.  Clearly,  we need to look at the ability of our present system of government to get things done.

(Un)happy Red Tape Day

Despite public services, managed by politicians, failing in so many areas politicians are still trying to further their control over the rest of us.  The rate at which new regulations are imposed is even increasing - hurting Britain's competitiveness and creating endless new frustrations:

"Red Tape Day looms this week with business owners facing a raft of new employment regulations and tax changes.

In total 82 new rules, including corporate manslaughter legislation and rules to protect staff from sexual harassment by customers that impact on businesses will be implemented on April 6. This is a 12pc increase on last year, according to Sweet & Maxwell, the legal information provider.

The day is one of two chosen by the Government as so-called common commencement days to make it easier for employers to track new regulations. The other date is October 1.

Sweet & Maxwell said that the ensuing week will see the introduction of even more rules for businesses to get to grips with, giving a total of 128 compared to 81 introduced around the April Red Tape Day last year."