we have explained that we will improve the NHS by trusting professionals and devolving power, not through more state control, national targets and top down interference – David Cameron

Yesterday, David Cameron presented the first of no doubt many new policies on the NHS. He was quoted as saying, “”We will put GPs in the driving seat by introducing proper commissioning so that the NHS is geared to the needs of patients, rather than the consequence of bureaucratic decision making.” These proposals to place control of budgets with GP practices neatly fit in with the desire of those of us who have called for localisation and depoliticisation of healthcare in England & Wales.

The depoliticisation of the NHS has been much talked about of late. This blog has added to the chorus of voices calling for the removal of national politicians from the daily running of local healthcare services. I recently spoke on the subject in St. Albans, emphasising that it would have both political and health benefits. Political in that responsibility for healthcare would be devolved to local hospitals and practices. And in doing so, local decisions could then be made to suit local health needs, thereby benefitting people’s health.

I fully support the approach to develop healthcare delivery in this country from the bottom up. If the last ten years of Labour mismanagement teaches us anything is that ‘top-down’, centralised healthcare does not deliver value for money, and more importantly, does not suit the very people paying for it. Hospital closure programmes should have local area responsibility and accountability. Management of the provision and rationing of services should be made more public, so that local people can be engaged in the process of what can often be difficult decisions. The more that people ‘own’ their local hospitals and practices, the happier they will be. Happier people tend to be healthier people.

Today’s Guardian has a shocking report on the apparent political interference in major transport projects over the last year. According to the article, during the last 12 months, 75% of big transport projects approved in England have been situated in Labour-held constituencies. Transport minister Gillian Merron (who she?), in answer to a Commons question tabled by the Conservatives, said that the big schemes were approved in 118 constituencies held by Labour, 23 by the Conservatives and 17 by the Liberal Democrats.

Apparently, a similar political bias can be found with the National Lottery awards process. If one adds to this the “heat map” controversy over hospital closures and schools, is it any wonder that politicians are held in such low esteem by the public? Decisions on funding, for whatever government programme, should be based upon genuine need, not the need to collect votes. This shameful government should not be allowed to get away with such disgraceful behaviour.

On Saturday, I attended a meeting of the four MEPs who represent the South East Region. It had been arranged so that each could inform senior constituency representatives of their responsibilities and continued efforts within the European parliament. To be honest, I expected a rather ‘dry’ meeting. I was wrong. Each presentation provided an insight into a whole array of issues from the European viewpoint: environment, budgets, energy security and immigration, to name but a few. I went away assured that the European ‘project’ could deliver positive outcomes for Britain. In particular, that the hot political issues of environment, immigration and energy security undoubtedly all required an agreed European approach.

Most Conservative supporters are Eurosceptic. The majority of Conservatives activists are against the Constitution, the single currency and the federalisation of Europe. This is not news. The British electorate knows where the Conservative Party stands on these issues. So why the concern about the potential for UKIP to ‘steal’ votes on the right, and hence prevent Conservative candidates from becoming MPs at the next election?

Elections in Britain have always been won on the centre ground. There have been times when that centre ground has been moved, most recently in the 1980s, when it was adjusted to the right. Those who believe that a further shift to the right is imminent are misguided. In my opinion, UKIP’s electoral attraction is limited. Their membership base is small and decreasing. Some of their candidates have been shown to harbour ignorant, out-dated views. This is hardly surprising in view of the “little Englander” image they have generated. An image which is clearly of the past (evidence above), not the future. To suggest that the Conservative Party should pander to these people and their supporters (actual or potential) is remarkable. Who do we think has not been voting for us over the last decade? Have we not learnt anything from the 2001 General Election campaign? UKIP, at best, is a single issue party. It is not credible for a party that seeks to be in national government to engage with, or seriously acknowledge, a party of such narrow appeal.

In my judgement the British people are sceptical about what Europe presently achieves. Their scepticism is well-founded. When one looks at the CAP, the poor economic growth and high levels of unemployment, and the apparent lack of democracy within the structure, it is hardly surprising that Europe’s image in Britain is tarnished. However, the ‘average’ Briton also recognises the potential benefits: agreement over environmental policy, cooperation in combatting terrorism and access to a common market (however imperfect). I suspect if a referendum on membership took place, the British people would back staying within the Union. What they want from their national government is constructive engagement in Europe with a view to securing the best settlement for Britain. Hence, to advocate withdrawal from the EU is not an effective approach and certainly not a credible option.

For credibility is everything when it comes to being the Opposition. The Conservative Party has to convince the electorate it is ready for government. Numerous polls are indicating that the British people are increasingly dissatisfied with the present Labour government. That, however, is not enough to secure Conservative victory. For those of you who doubt that, I suggest you ask Neil Kinnock for his opinion.

I think if we anticipated this business of GPs taking a higher share of income in profits we would have wanted to do something to try to ensure that the ratio of profits to the total income stayed the same and therefore more money was invested in even better services for patients. – Patricia Hewitt

It is rather sad, indeed pathetic, to see Patricia Hewitt criticising the income of general practitioners today. Such a blatant attempt to distract the electorate from the poor management of the service as whole cannot be allowed. The idea that GP wage inflation is the reason for the NHS’s present woes is plainly inaccurate. And yet, this is not the first time that Labour ministers have targeted doctors for the ills of the NHS.

Today, they have further claimed that they could not forsee the overspend on the new GP contract. That hardly makes me feel confident about any other government contract they negotiate. What has happened is that GPs have succeeded in improving their clinical data collection beyond that expected by government. That is because they could see that by doing so they would achieve greater personal financial gain. That was the expected outcome of a contract based upon the the principle of incentivising good clinical practice. How can the government now complain when family doctors have delivered what they asked for? Indeed, what is so wrong with trying to maximize one’s income?

It should be noted that I did not vote for the GP contract. I was a member of the minority group who thought that practising by numbers and losing 24-hour primary care cover was a regressive step for the profession. Interestingly, this group tended to have a younger age profile. Even though it was easy to see that income would have an initial sharp increase, the long-term future of the profession, to my mind, was going to be undermined. Sadly some of my older colleagues concentrated on losing ‘out-of-hours’ cover commitments and generating larger pensions. As a consequence, I suspect time will tell whether the profession will be such an attractive proposition for newly-qualified doctors in decades to come. The sad reality is that those who voted for it will be long gone.

Declared Interest: I am a full-time GP locum who does not get directly paid by the new GP contract.

Regardless of how the Government try and spin these figures, the reality is that working families and pensioners will see their council tax bills hit £110 a month – Caroline Spelman

Council tax is not a sexy political issue. The environment (thanks mainly to David Cameron), combating terrorism and the state of the NHS are all issues that get bigger profiles in the daily news. Local taxation, however, is very relevant to local people who are increasingly finding it difficult to balance the family finances. In April, the average annual council tax bill in England is likely to grow to £1,300. Similar council tax bills were only £688 when Labour came to power in 1997. That is a dramatic increase, particularly when one bears in mind that household incomes fell last year in real terms¹, and have only risen by £2.25 a year on average since 2001.

In response to this family hardship, a number of Conservative Councils have been trying hard to address the increasing burden of local taxation. Croydon Council has announced that it is to reduce its annual expenditure by a further £5million, just months after cutting its budget by £15million. East Hampshire District Council has recently announced its intention to freeze the authority’s share of the local tax until 2010.

Local decisions such as these will contribute towards the Conservative Party’s chances of electoral success in May. Not just in Croydon and East Hampshire, but in every part of the country where Conservative councillors are delivering services that are good value for money.