Clegg hits out at Cameron over NHS reforms

Deputy PM attacks Cameron for undermining the NHS while declaring that he loves it.

He may once have boasted that the government's NHS reforms were in the Liberal Democrat manifesto, but Nick Clegg is now chipping away at Andrew Lansley's masterplan. The BBC has obtained a copy of a Lib Dem policy document signed by Clegg which demands that Monitor, the health regulator, should have a duty to promote NHS colloboration rather than competition.

The document states: "We cannot treat the NHS as if it were a utility, and the decision to establish Monitor as an "economic regulator" was clearly a misjudgement, failing to recognise all the unique characteristics of a public health service, and opening us up to accusations that we are trying to subject the NHS to the full rigours of UK and EU competition law."

It's a demand that has been echoed by the British Medical Association and by the independent-minded Conservative MP Sarah Wollaston, and one distinctly at odds with Lansley's original vision of a market-based NHS. In his address to Lib Dem MPs and peers last night, Clegg said:

There must be no change in the way competition law operates in our NHS. No to establishing Monitor as an economic regulator as if health care was just like electricity or the telephone, and no to giving anyone in the NHS a duty to promote competition above all else.

But it's Clegg's coded criticism of David Cameron that is most striking. He is reported to have said:

People get confused when one day they hear politicians declare how much they love the NHS and the next they hear people describing themselves as government advisers saying that reform is a huge opportunity for big profits for health-care corporations.

The Deputy PM doesn't mention Cameron by name but it's clear who he has in mind. After all, it was the Prime Minister who declared in a speech on Monday: "[I]t's because I love the NHS so much that I want to change it." And it was his adviser Mark Britnell (recently appointed to a panel of senior health policy experts by Cameron), who told a conference for health-care corporations:

The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years.

One legacy of the AV referendum campaign is that Clegg now feels liberated to speak out. Cameron's failure to block the vociferous attacks on his deputy by the No to AV campaign means that Clegg is a lot less willing only to air his grievances in private.

George Eaton is political editor of the New Statesman.

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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.