I'm sure that most thinking people are in general agreement with this critique of journalists but I have to ask: Melanie, where do you fit into this picture? I generally agree with your comments (I do, however, have occasional reservations) but as someone else has already said elsewhere, we have a tendency to be less critical if the expressed viewpoint coincides with our own.

Despite occasionally nodding my head in agreement with an expressed view, I have an intense distrust of journalists, politicians and lawyers. I doubt very much whether we know the truth about anything of any significance and I can understand why a number of my friends simply refuse to get involved in any thought processes involving the aforementioned professionals.

I on the other hand have a thirst for the truth but now, in my seventies, I realise that it is most unlikely that I will ever find the truth about anything in my lifetime.

Nice to see that the Guardian 'balances' Kettle's admirable piece with an article by IRA mouthpiece Danny Morrison. Morrison has Hutton down as an establishment stooge - which comes as no surprise as Hutton sent Morrison down for eight years when their paths last crossed.

Osama bin Laden, Danny Morrison... the Guardian's guest columnists are a rum lot.

Liddle is not without some virtue. Here's an intelligent piece he wrote about a controversy that's been mentioned on this site from time to time:

http://www.guardian.co.uk/race/story/0,11374,685668,00.html

Henry Kaye

Having almost completed seven deades myself, I enjoy your balanced and sagacious contributions to this blog. But do you not, in these troubled times of concentrated cultural upheaval sometimes get a visceral urge to support those journalists who represent decency, common sense and consistency in their views; opinions which are based on upholding law and order and fair appraisal, regardless of party political interest. And isn't it a fact that unless we support the writers who fit this bill, then mendacious gutter snipes like Rod Liddle, Andrew 'verbals' Gilligan et al., will call the shots and drag us all down to the gutter with them. Bending over backwards to accommodate all shades of opinion can lead to falling on your backside and getting trampled to death by the Philistine hordes. I deeply resent the fact that the Speccy has, in fairly quick succession, hired two rejects from the Today programme. I hope the new proprietor, when he emerges, has a quiet word with Boris about his recent proclivity to give stray dogs a home, particularly those of the mendacious and Machiavellian breed. Particularly as I have just renewed my subscription (and by direct debit,too!)

Martin Kettle wrote a surprisingly good piece: Michael Gove is lightweight and not especially succinct; no Bernard Levin.

Yes Melanie, speaking of being loose with language, subject to hyperbole, writing provocatively rather than factually; yes melanie you are guilty.

Frank,

I am sure that there are some journalists of integrity who do not sensationalise, twist the facts to fit their opinion or deliberatly attempt to mislead. I just have difficulty in distinguishing between them!

Frank,

Further to my posting above, I should say that there are many columnists who, as you say, are attempting to hold back the tide of moral relativity and the associated destruction of a stable society. I read them and enjoy them - as I said in my first posting: "nodding in agreement". So, I suppose I'm not quite as cynical as I make out!

"Yes Melanie, speaking of being loose with language, subject to hyperbole, writing provocatively rather than factually; yes melanie you are guilty."

Coming from the forum's token Jew hater that really is quite laughable.

Well, I don't believe I have yet been labelled as "the forum's token Jew hater" and I couldn't agree more with Romulus' opinion.

It does amaze me how daft Liddle comes across. I mean the bloke has a knee-jerk defence of the BBC that sometimes does not even make any sense. I am amazed a nitwit such as Liddle was in charge of the Today program. For what we have seen of him lately, this furure was inevitable.

Charles,

"Coming from the forum's token Jew hater that really is quite laughable".

For goodness sake! I have seen Romulus write many things on here - varying in quality from highly original and insightful to slightly off-the-wall - but, nowhere have I seen him write anything that deserves your description of him above. Please don't use that kind of language unless you can provide evidence.

"Yes Melanie, speaking of being loose with language, subject to hyperbole, writing provocatively rather than factually; yes melanie you are guilty."

Coming from the forum's token Jew hater that really is quite laughable"

Stick with the Seroxstat Charles old son, you are obviously posting from a secure unit in a psychiatric ward.......is it paranoia or dementia that they diagnosed.

You are one bizarre individual, but I shall continue to humour you on this site because I think your doctor advised you to try to interact with people as a means of overcoming your phobias against mankind in general.

Please continue to rant and rave, I think you allow a wider audience to see the severe adjustment problems you have with regard to verbal reasoning, rational debate, and coherent thought.

On another thread, Charles thought my view that only a minority of people in occupied Europe carried out the holocaust was "depraved" and the equivalent of holocaust denial - so he does fling these allegations around indiscriminately.

Let's be charitable Sean, Charles is not accountable for his wild assertions, and we must let him act out, it is probaly part of the therapy and with such deep-rooted paranoia - he thinks people hate him,rather than pity him, he throws out unfounded and wild accusations in the hope of attracting comment so he feels he exists. He probably is someone with a fragmented personality who thinks in black-white dimensions; I was reading up on such personalities, and it is difficult, so we should try and let him express himself without worrying too much about the persecution monomania in his rather limited postings.

Charles -
I know exactly the same about Romulus as you do, having read his posts on this blog. I cannot understand why you call him a "Jew hater". From time to time he has disagreed with your simplistic view of history, but he has always backed up his arguments with evidence.

I think you should apologise for your unpleasant name-calling. I don't know if you are in therapy, as some of the posters imagine, but I have often wondered whether you need to be. You appear to have a great deal of anger, which has an undue influence on your judgement.

I lived in the UK for six years and was astounded at the levels to which institutions such as the BBC and NHS are defended. It seems that once an institution has been established as benevolent in the minds of the majority, that opinion is almost impossible to change.

The defence of the NHS is fanatical. The only solution ever proposed to any problem is to throw more money at it and anybody who dares to suggest that the NHS is a fundamentally stupid idea is shouted down. Yet everybody whinges and bitches about it. The same goes for the BBC.

The mentality is very similar to that of the Islamic fundamentalist, where the solution to failure is to embrace a purer form of Islam, or the die-hard Marxist, where the solution to the failure of the last five year plan is to attempt to implement another.

Murph,

Your comments about the fanatical attachment we English have for the NHS echoes my own thoughts when I returned to this country after living in Bermuda for 32 years. Bermuda's health care is insurance based and the hospitals are run by professionals with minimal government interference. Charges are negotiated between the hospital boards and the insurance companies and the costs are met by employers and employees. Those costs are not unreasonable and everyone accepts the system with no complaints.

If you dare to suggest that something along the same lines could work here, you get laughed out of court. "Too expensive" is the cry when, as far as I know, nobody has ever identified the current cost per capita.

The BBC is not quite the same situation but I think there have been enough arguments advanced to question whether or not the BBC is still a valid institution. My own concern is that of biased reporting of social and political affairs. I make no claim that the BBC is or is not representative of public opinion, merely that as a public service it should not reflect ANY viewpoint.

The point is that the BBC has such a powerful influence over its audience that it must not be seen to support ANY ideology or philosophical bent. I really don't wish to see the BBC done away with but I feel strongly that their editorial leanings must be muted.

Murph -
Part of the problem is that those who call for "reform" of the NHS or the BBC often have a hidden agenda. The most vociferous critics of the BBC are the newspapers owned by Rupert Murdoch, including (in years gone by) the Sunday Times under the editorship of Andrew Neil. The latter was highly critical of the principle of having a BBC funded by the TV licence - yet Mr Neil was reported (in John Birt's memoirs, if I remember correctly) as having applied for the job of Director General. It seems that matters of principle are not involved after all, merely common envy.

In the case of the NHS, many of those who oppose it want to pay for better private care for themselves and their families, but don't wish to pay through taxation so that everyone else can have the same benefits.

This does not mean that there are not valid criticisms of the BBC or the NHS: merely that the debate is poisoned by those who have a financial interest in their dissolution.

KJN,

Don't dismiss good arguments because you disagree with the motives of some of those who advance them!

There are very good arguments that can be advanced in favour of abolishing the mandatory licence fee for the BBC. Such as 'it is not an essential service' (why therefore should it be funded as if it were?). Even those who love the Beeb have to admit that we now live in a society in which there are a huge variety of ways in which we can - through our pluralistic media + the internet) 'inform, educate and entertain' ourselves - and that the BBC is just ONE of several service providers from between which people can choose.

This was not the case when the BBC was established.

Equally, there are many ways in which the UK's health service could become more effective at doing what it should be doing: serving the needs of the patient. Some of these include a new mix of private-public health provision which is already a matter of daily life in several continental European countries. Some of these include a greater use of insurance schemes and systems for paying up front for a consultation with a doctor and then re-claiming some of the cost later.

Unfortunately, there is a taboo in the UK on openly discussing these issues - for a variety of reasons - and the loser is the patient.

A strange way of running a health care system, don't you think, when adherence ideological dogma acts as a barrier to the introduction of new ideas that might improve efficiency and patient care?

Finally, as the BEEB can in no way be defined as an 'essential public service' there is absoltely no justification for funding it as if it were.

David, there is not an insurance-based healthcare system on earth which is not in crisis.

Germany has introduced top-up fees on top of the insurance system, ignoring the fact that it spends TOO MUCH on heaklth care already. France is insolvent with an £8 bn in the Health Fund.

The US is a nightmare with people steaming to Canada for pharmaceuticals.

There is no perfect health system and ALL are in deep trouble because of longevity and the incompetence of insurance companies, which in Britain cannot even provide endowments or pensions. The private insurance system is folding and Germany now talks of a Buergerversicherung and abolishing the Health Insurance Funds.

Most countries are trying to converge on the NHS system to see how to manage costs. There is NO system which can provide all healthcare needs, the US spends 16% GDP and still cannot service its population...it has horrible infant mortality figures and no mass-screening programs.

It is not NHS = bad, Germany and France = Super......they cannot afford their healthcare any longer, we can in Britain.

Romulus,

"David, there is not an insurance-based healthcare system on earth which is not in crisis".

I think that's an exageration although I do understand where you are coming from.

However, the UK system is in more of a crisis than the French or German systems.

This is all part of a much deeper problem - that European countries (including Britain) are not creating enough wealth to support their future infrastructure (inc health, transport, education, law and order) AND that, due to the 'demographic timebomb' wherein a smaller proportion of wealth creators will support a larger number of dependants who live longer..it is going to get much more serious.

Politicians in all western countries are in the know on this but none of them are giving it the attention it deserves because of the 'Catch 22' - that to advocate the kind of measures really needed to tackle these problems would ensure that those advocating the measures would fail to get elected...hence, politicians don't 'go there', the electorate don't want them to 'go there'....but we are all going to 'be there' in a few years...and by then very radical measures will be needed to undo the damage (and undo the fall-out from the avoidance of facing the stark choices that are not being made now)....

Meanwhile...Gordon Brown...spends (and pledges) money as if it grows on trees...including on all the ludicrous layers of bureaucratic time-wasting that in the health service fails to improve health provision, in education, fails to improve the level of education, and in law enforcement, fails to reduce crime...

So, as the NHS continues to fail to deliver (and patients continue to be exported to France, Germany and Belgium to avoid waiting lists - umm, you didn't answer that one, Rommy)...Brown fiddles...

PS: FYI economic comparison between UK and France: average GDP per person in UK is higher; average GDP per employee in France is higher...

Actually David it is a different problem - the NHS has been subverted into lifestyle medicine and away from acute and palliative care - it now has a catalogue of gender-reassignment, abortion, IVF, cosmetic surgery, and illnesses related to illegal narcotics, smoking and alcohol.

Demographics are not a problem at all if productivity is high; but Gordon Brown is subsidising low-wage, low-productivity service sector jobs with Tax Credits, and destroying hish-value added technology jobs by taxation and regulation.

They are importing low-skilled labour and try to convince themselves that The City is creating high-valued added jobs, whereas it is just that they are overpaid...rather than producing marketable products with technological improvement factored in.

There are not many companies like Rolls-Royce producing jet-engines, and these are increasingly built in Brandenburg or at the Allison factories in the US. It is productivity that matters, and for that you need high-value-added industries; very few Service sectors are high-value-added,

Making wings for aircraft is technological supremacy; but EADS is spread around Europe rather than concentrated in Britain. Without Chemicals, Cars and Engineering Germany would look very sick....and the Greens might drive all away.

David and Romulus,

In the context of the NHS debate which seems to have arisen from the one on the BBC, I would endorse David's views about the possibility of an insurance based system of health care and question that of Romulus that insurance based systems are failing world wide.

I have previously posted my comments about the system that prevails in tiny Bermuda. Up until four years ago, it was functioning in a perfectly satisfactorily fashion. What has happened since then, I don't know but I repeat that no argument can be entered into unless the costs per capita of the current NHS system are known.

The important factor in my view is that governments should not be involved; the health care business should be left to the professionals with the government filling a "watchdog" function.

There needs to be much more INFORMED debate on this subject and I would very much like to get some input from the health professionals who seem to be very quiet on the subject - unless I'm missing something somewhere.

Perhaps Henry we could move on from Bermuda. I find it somewhat farcical to compare a nation of 60 million with a small Caribbean Island, esp. one where you no doubt enjoyed an above-average standard of living.

There are very few comparable countries, but I think if you want to check any German newspaper you will get a flavour of the state of German healthcare, which is just about to start hospital consolidation and reducing beds.

There are so many books and sites on healthcare economics that you will not need to read up as I do, but simply visit Google for a tour of the subject which is quite simple.

Perhaps looking at US elections might be interesting, as health care and the cutbacks of major employers on retirees benefits are putting the frighteners on many older citizens.

You see the era of economic growth is over as China undermines the budgets of Western economies by undercutting the labour market on which all health-insurance systems are based.

You will probably find good articles by Alan Maynard, Kaiser Permanente, The King's Fund etc. Insurance-based systems are in deep trouble as inflation makes companies seek to cut back cover, as with BUPA etc in the UK. Healthcare is the next biggest cost item after pensions; and cost-cutting means both will be cut back

Romulus,

"it now has a catalogue of gender-reassignment, abortion, IVF, cosmetic surgery, and illnesses related to illegal narcotics, smoking and alcohol".

I agree with you...and this, coupled with the demographic, will cause increasing strain on precious resources. There is an urgent need for a proper debate on what should and should not be covered by a national health service and what should be covered by personal insurance or purely out of someone's pocket. Fat chance of that debate taking place properly until there is a lot more strain on the system because politicians and vested-interests will be unlikely to want to take a moral stance.

David, Barbara Tuchman put it well when she said that "human beings only act wisely once they have exhausted every other alternative."

None of Western Europe's demographic/economic problems is insoluable, but they do require hard decisions. People won't tolerate hard decisions until the system is visibly failing. To an extent, that was the case in the UK in 1979 and Ireland in 1987, and so people were prepared to accept radical economic policies which they would previously have rejected.

Actually David, if you look at the new GP Contract and the funny clauses the Govt is sliding in, you can see they have decided to go for a Big Bang before the election. Turning GPs into "Contractors" carrying full personal liability towards the PCT Management Companies, which can transfer their contracts to other groups, but which GPs cannot transfer, and must indemnify the PCT for any legal consequences, are designed to drive GPs out of the NHS.

The plans of John Reid, 'ex'-Communist to advertise and encourage patients to shop around for Consultants and Jospitals should explode the PCT Budgets nicely, and move toards a system of freelance consultant teams charging directly for spot-priced operations based on timing and need.

New Laour seems committed to deconstructing the NHS before the next election, I suppose KPMG and Grant Thornton want to take over the PCTs, and the property-groups want to buy up hospitals and GP surgeries.

Is Norwich Union still funding Government 'blue-sky' thinking on Health ?

Viz:

473. The Contractor shall indemnify the PCT and keep the PCT fully indemnified against all claims, actions, losses, damages (including any
damages or compensation paid by the PCT to compromise or settle any claim), costs (including legal costs), expenses and any other
liabilities incurred by the PCT arising out of any act or omission of the Contractor (whether by itself or by its agents, employees or
sub-contractors) which constitutes a breach of the Contract. This clause shall survive the expiry or termination of the Contract.

http://www.bma.org.uk/ap.nsf/Content/__Hub+GPC+contract

After all patients will NO longer be registered with a doctor but with the PCT so there is no individual link to the doctor.

There will be no more cover After April from 6pm until 8am unless the PCT can find private companies to take over.

Certain GPs will only offer core treatment and patients will be directed elsewhere for any other medical tests, examinations, or screening.

Nurses will be the filtering mechanism for most patients who will not see a doctor; presumably in time that will be fee-paying extra for patients.

http://www.guardian.co.uk/theissues/article/0,6512,956635,00.html

where GPs decide to opt out of providing 24-hour care, immunisations, contraceptive care or chronic disease management, PCTs will be obliged to find alternative providers.

if more GPs opt out of providing out-of-hours care and more private companies get involved in delivering primary care, this could mean the end of the traditional doctor-patient relationship. Patients would see a range of healthcare professionals rather than being registered with a specific family doctor

Romulus,

You are quite right in saying that Bermuda (which, incidentally is not in the Caribbean) cannot be compared with the UK or any of the other major countries of the world. It was, perhaps, wrong of me to use it as an example but I still maintain that an insurance based health care system MAY prove more economic than our present NHS. There is no doubt that health care costs are growing - even beyond normal inflationary trends, because of medical advances which, it is felt, cannot be denied to any individuals. This cost inflation affects both the NHS and insurance plans and I am merely of the opinion, based on my personal experience, (albeit in a small arena) of acting as the administrator of the health insurance for the company of which I was the finance director, that private enterprise can manage these matters better than government.

I say that insurance MAY be more economic but would dearly like to see what the UK costs of health care per capita actually are and have them compared with submissions made by some of the leading insurers in this field. The comparison would be very difficult but it would at least give an initial indication as to whether or not there was a basis for consideration.

"There is no doubt that health care costs are growing - even beyond normal inflationary trends, because of medical advances "

This is complete twaddle Henry. There are very few operations using this Space Age Medicine the media rabbits on about; and British hospitals are NOT full of the latest equipment - some is 20 years old, and very little is cutting-edge. So that argument falls down.

If you do long-division Henry you can take the NHS BUdget and estimate a per-capita monthly contribution of £60 or thereabouts which covers all medical care - I don't know of any private insurance system which can match this....BUPS cannot even cover pregnancy; and its small-print is laughable. One problem is the number of ICU beds in NHS hospitals used by those whose operations took place in BUPA hospitals; and these once used slow down the operations in NHS hospitals since there are only 5-8 such beds in a hospital the cost being so high.

Having spent a great deal of time looking at such data, your approach Henry is a little dilletantish and you really should get to grips with the numbers. I think private insurers should be prohibited from refusing patients on grounds of age or health, and that premiums should be level; ie. not rise with age, or differentiate by gender. This would be fair.

Romulus,

Sorry to keep this subject alive but I feel the need to say a few more words.

Firstly let me say that I'm somewhat bemused by the extent of your knowledge on so many different subjects - you clearly have spent far more time then I in researching complex matters.

Having said that, however, I would say firstly that if your estimate of the NHS cost per capita is reasonably correct than I would have to point out that the health care insurance plan for which I was responsible offered COMPLETE coverage for about US$35 per month for a single person (shared between employer and employee). This rate was the same for all employees regardless of age or sex and included a pregnancy benefit. Neither was there any bar to coverage for a pre-existing condition.

My second point concerns the increasing costs that can be attributed to the wider range of surgical procedures and treatments that have become available over the years. This point was made to me by the head of one of our Health Trusts with whom I spent a couple of hours discussing the problems of the NHS a couple of years ago. He and his finance director claimed that patient expectations (their words) had risen enormously in very recent times. I felt that this was a reasonable comment.

Feel free to comment further if you wish but I think we've probably spent enough time on this subject. Once again, however, I compliment you on the high intellectual content of your postings

Correction to the above: the cost of a single person in the insurance plan to which I refer was US$70 per month not US$35.

Henry, the research has been done extensively over many years which is why I laugh when politicians do fact-finding tours....they only need to buy a book. GM spends more on healthcare than on steel; when you see what % of a US postage stamp is actually for health insurance you would cringe.

Most of the problem with 'patient expectations' is that it has been hyped by politicians into expecting private-care standards from public provision; and we know from education this is impossible. We can ensure more for fewer; but not as the government is doing by turning the NHS into the International Health Service free for all-comers.

I have experienced insurance-based systems in more than one country outside the UK - the dentistry in particular was scary; as was the A&E which is profit-making in most US hospitals outside DRG controls.

I am not going to say the NHS is the acme, but I do not see the insurance-based systems as ideal, esp. as the demographics and cost-base in a globalised world make BUPA another reason to move all semi-professional jobs, and many professional jobs out to India without health cover...when McKinsey, IBM, HP, etc move design and research to India, it is hard to believe that $100.000 jobs plus health cover are any longer a certainty in Britain or the US with English being a global language.

In short, I do not look at it ideologically, but rather how do we run health care in future and then how do we finance it......as a payroll cost it destroys jobs (Germany is discussing using VAT as financing...not a bad idea)....and most recipes for efficiency gains require abandoning universal coverage.

If you restrict health cover to the healthy you can save a fortune; but it is weird things Henry like why Germany uses more heart catheters than the whole of Europe that are interesting; simply because of the insurance-based profit-maximiser medic.......Germany never controlled budgets, as it fails to do throughout German business...there is no cost culture.

The GP has more patient contact than anywhere else in the NHS but a small budget; the hospitals soak up budget to service deficits accumulated over years; PFI will force bigger deficits over the coming years and in 20 years time they must buy back the hospitals financed on HP.

So 2003/4 NHS BUdget £68,7 bn. Population 60 million = pc spend of £1145 annually or £95.42/month. The figures are 40% higher than 2000 AD.

Probably it is fairer to compare it across employed population of say 26 million remembering then that this is covering families not individuals, and that the NHS is financed from general taxation not payroll taxes.......so on employed population it would be £220/month.

If people actually paid this as opposed to it being averaged out they would start to fret. Nowhere else provides 24-hour GP cover plus hospitals + dentists (if lucky) and in the past long-term care for such a rate.

I think however it is all over any way and both parties are committed to user-fees for health, the student tuition business being a warm-up for bed-charges, fees to visit the GP etc. Germany just started with a £7 fee each quarter when you visit doctor or dentist; which is in addition to enormous monthly health insurance rates which increase with age and are 50% higher for a woman than a man.

Henry, I don't know the answer; but there are a lot of countries considering the NHS model to control costs - Germany is experimenting with a GP system just as ours is collapsing.