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Jenny Jackson: A winning Conservative NHS manifesto would focus on life’s first thousand days

Jenny Jackson is a health consultant. She was previously a Special Adviser at the Department of Health, and Director of Women and Child Health at University College London Partners.

I remember working on the Conservative health manifesto in 2007 for an election that never happened. Osborne pulled inheritance tax breaks out of the hat, and Brown bottled calling a poll.

Today, as Brexit speculation grips Westminster, I can’t help thinking that Labour is bottling it once again because they lack imagination. They’ve zero to offer people beyond their duplicitous EU policy. Right now, there’s probably some poor spud-faced nipper in Labour HQ piecing together the health sections of their manifesto from Socialist Worker back copies.

Meanwhile, the Conservatives have already laid the cornerstone for their manifesto: more NHS funding. The public backs raising taxes for this purpose, including a majority of Conservative Party supporters. The other abiding issues remain access to primary care and waiting times.

But beware the latter. One top pollster disclosed to me his unpublished findings, which show repeatedly that, if you talk about waiting times, the public is always left with a negative impression. Even if the waits are going down, there’s still a wait.

Beyond these key building blocks, what should be our focus? I think we should begin at the beginning.

Every new administration has a plan for the first hundred days of office. During this time, the tone is set for the duration of that term. A strong start sticks. And so it is with each one of us.

The first thousand days, from conception to two years old, frames the rest of our life in terms of health and prosperity. Clinical academics have also shown the benefits of maternal preconception health as a determinant in the lifelong health of children. Public policy needs to catch up with this new body of evidence. But how do we translate it without creating the mother of all nanny states?

The key is to empower people with information that doesn’t suggest blame, but is matched by a range of solutions, tailored to their preference. The current mistrust about MMR is a classic case in point. Despite campaigns to counter misinformation on MMR, many are still sceptical about its benefits. So we should conduct a cost benefit analysis to give parents a choice between single doses or the all-in-one vaccination. If it means sustaining herd immunity, it’s worth a shot.

Choice should extend to the range of services required post-birth. The NHS is good at offering expectant mothers a choice of birth location, and so it should be after birth. If mothers were empowered to exercise choice over their health visitor for example, it’s likely they’d be more responsive to advice and to more visits. This is especially important when it comes to supporting mothers with post-natal depression because of the social stigma attached to it.

The NHS offers free prescriptions, including for health supplements, to expectant mothers and in the year post-birth. This option should be extended to parents planning a pregnancy, given the evidence between maternal health pre-conception and a child’s long-term prospects.

Suggestions like these, designed to make the NHS more responsive to an individual’s choice at the most important juncture in our life cycle, would sit best in our Conservative manifesto. Corbyn’s Labour doesn’t understand about choice in public services. And no-one knows what the Liberal Democrats stand for beyond the repeal of Article 50.

A focus on the first thousand days is compatible with the progress we’ve already made with early years initiatives. In particular, the work of Tim Loughton strikes at the core of our compassionate Conservative values in terms of supporting the most vulnerable families. And Andrea Leadsom’s leadership on innovative cross-departmental partnerships, in order to provide a more holistic and seamless service to parents and children, is key.

Our approach could also draw judiciously on the recommendations set out in the recent reports from the Health Select Committee and the Science and Technology Committee, which have both looked at the evidence base for interventions in the first thousand days of life.

The upcoming election will centre on Brexit. The health manifesto will rightly front up NHS spending. But beyond that, I hope the Conservative health ministers and their advisers, with their wealth of expertise, will prioritise policies that support the first thousand days of life. That is how we will make the biggest gains in national prosperity for the long term and start to regain the debate beyond Brexit.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Richard Short: Willink would have approved

Richard Short is the Deputy Director of Conservative Workers and Trade Unionists, and was Parliamentary Candidate for Warrington North in 2015.

Labour are very fond of reminding anyone who wants to hear that they created the NHS in 1947. Conservatives are just as fond of bursting that bubble when they point out that the very idea for the National Health Service was that of the Conservative Health Minister Sir Henry Willink in 1944.

This is all good political fun, but there are important and serious differences between Bevan’s and Willink’s NHS, and these differences, debated in the 1940s, are being rerun in the post Brexit debate on a US/UK trade deal. Nye Bevan would have been outraged at any thought of foreign interference in his version of the NHS, but to Sir Henry, the debate on US businesses being able to access the NHS would have been welcomed with open arms.

To understand why, rewind to Labour’s 1945 General Election manifesto. This was an openly stated socialist agenda. The party’s view was that mass nationalisation of our industrial infrastructure was exactly what the country needed in post-war reconstruction, and the country agreed, delivering a shock landslide victory to Clement Attlee.

With Labour firmly in the driving seat, the NHS, that all parties were now talking about, was going to be Bevan’s version. It was to be full nationalisation of health care. Hospitals were then owned and run by charities, local authorities and other not-for-profit voluntary organisations, and provided, by the standards of the day, excellent health care. There was little debate on the quality of care, just on access to it regardless of means. On this all parties were united.

The Conservatives, led by Sir Henry Willink, were absolutely against the NHS owning hospitals fearing it would break the personal bond between the individual and their health care. To create a huge single property-owning and managing entity would not be in the best interest of the patient, and so it has come to pass culminating in scandals like Mid Staffs, where impersonal treatment was a watchword for the worst run NHS hospitals.

Despite reforms to create NHS Trusts, Foundation Trusts and CCGs, (Clinical Commissioning Groups), the state remains a provider of health care while WIllink’s vision was of the Government being an enabler of health care free at the point of use regardless of provider.

Conservatives did indeed vote against Nye Bevan’s proposal to take ownership of hospitals, but remained committed to the NHS provided through the existing network of hospitals without transferring ownership to the state. Ironically the fiercest opponent to any principle of a National Health Service was the BMA which organised protests and non-co-operation even after the NHS was formed.

If he had been alive today, Sir Henry Willink would have been an enthusiastic supporter of a comprehensive US/UK trade deal where the skill and expertise of American health professionals could be brought in to improve our NHS. American access to the NHS is not new with billion-pound contracts for peripheral services handed to American giants Accenture and CSC as long ago as 2003.

In recent years, clinical services have been awarded to providers, but the market needs to be opened fully to get the full benefit of competitive tendering. Allowing US business to compete in this way will potentially allow access for better outcomes for patients, and, more broadly, make the way clear for a full and comprehensive trade deal.

In a post-Brexit US/UK trade deal, the NHS should have an increasingly enabling role rather than a provider. In this role it has a very important part to play in this vision.

Just as a company franchising its brand will defend its reputation to the death, so the NHS must be the defender of clinical excellence and hold providers feet to the flames to maintain them. It would deliver for the first time a fully Conservative vision for the NHS fought for and lost during its birth in the 1940’s. And, above all, it’s what Sir Henry Willink would have wanted.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Rachel Wolf: When voters say their priorities are the NHS and schools, politicians ought to believe them

Rachel Wolf is a partner in Public First. She was an education and innovation adviser at Number 10 during David Cameron’s premiership, and was founding director of the New Schools Network.

The prospect of another general election inevitably brings back nightmares of the last. I know that elections can be a bit like being a parent – you either copy your own parents or try to do the opposite of what they would have done. But I do think there are some lessons to learn which should affect how Boris Johnson approaches policy and a campaign, and which have been relatively under-discussed.

When people say their top priorities are the NHS and schools they actually mean the NHS and schools

Most of us remember knocking on doors, being told to talk about strong and stable government, only to find voters wanted to talk about the NHS and schools. And many of them were visibly furious.

And that was before the manifesto arrived. Interestingly, I remember that the first comments on the manifesto from many in Westminster was how beautifully written, how intellectually coherent, how correct much of it was. Just as they have in the last couple of days, Westminster swung very rapidly from believing Theresa’s team were strategic geniuses to certified morons.

The Conservative Manifesto had a lot of things to say about fixing the broken private sector. It proposed interventions on tech companies, worker protections, energy price intervention. It was reasonably close to Ed Miliband, if not willing to go quite as far as Jeremy Corbyn.

This approach is increasingly part of Westminster convention. It flips everything the public complain about into commentary on a broken market system. When people say they’re unhappy with immigration, the response is ‘oh actually they mean they’re worried about being left behind in a globalised world.’ If they say they’re unhappy with school funding:‘oh actually they mean they don’t think their children will have lives better than theirs’.

What in the last few years – in fact until Johnson became Prime Minister – we have been terrible at is saying ‘if people say they think NHS funding is a disaster and there aren’t enough police maybe we should listen to them and fix those things. Specifically.’

The manifesto was a lot less compelling on the public sector than the private sector. That’s what I, at least, got asked about campaigning. On this I think Johnson has made an unequivocally strong start.

No one is sown up

I and a number of other candidates had a phone call early on in the campaign with a professional member of the team at Central Office. At one point she said ‘you have to understand: if Theresa May could personally stand and campaign in every seat in the country, she would win. You are Theresa May’s Conservative Party.’ (I am quoting from memory).

I don’t think most of the people working on the election would have sanctioned this claim – even in the early days when it looked like impossible seats might be won. But it is a reminder of how strong she seemed.

It is easy to see why – from their seemingly unassailable position in the polls going into the election – the Conservative 2017 manifesto was so focused on winning a mandate to make difficult decisions. Theresa May had been governing for several months and had been visibly frustrated by the constraints of the previous manifesto, written by her predecessor David Cameron. She wanted to have free rein when she won what seemed – then – like it would be a big majority.

And a slightly puritanical liking of difficult decisions and hard work was a big part of her public persona. As she said in the foreword to the manifesto “[These policies] do not offer a quick fix…it is the responsibility of leaders to be straight with people about the challenges ahead and the hard work required to overcome them.”

This assumes a reliance on a trust in politicians and parties that simply doesn’t exist. This is an opportunity – if you have the most attractive programme for voters you’re able to win them over – and a loss. You can’t assume they’ll just swallow bad news.

Fairness remains the central value for people and policy needs to reflect that

At one of my hustings I was asked by an 18-year-old boy why his granny was going to suffer so badly under our dementia tax proposals. It’s not fair, he said. So much for inter-generational war.

Why did the social care policy enrage people? Because it cut at their sense of fairness. If something terrible happens to me – to my health – through no fault of my own, my family suffers. Worse, if I’ve done the right thing and built up savings, I’ll be penalised more.

We’ve done a lot of work recently on welfare reform and this sense of fairness is unbelievably strong with voters. We shy away from moral judgements on people – with good reason: it’s hard to do it as a central state looking at millions of people’s lives. But people have no such issue. From their point of view, if you have worked hard and done the right thing you should be rewarded. If bad things happen to you – disability, or ill health – that you could not possibly have avoided, you should be looked after. It’s that simple.

From this, you get the inverse of the social care policy.

The new spending review has been all-but-ignored in a conversation about Brexit. The public care about leaving the EU. But they also care about health, schools, and fairness. This is a chance for the Conservatives to get the messages on those right.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Ryan Bourne: In America, public spending conservatism is being lost. It could happen in Britain.

Ryan Bourne is Chair in Public Understanding of Economics at the Cato Institute.

Austerity is over. Theresa May told us so after the 2017 election, and again at the Conservative Party Conference last year. Philip Hammond tried restraining her from a blitz of high-profile spending announcements. Yet Team Johnson has now picked up the baton anyway. Today’s spending review from Sajid Javid will reportedly confirm significant money injections for schools, hospitals and the police. The Prime Minister said Monday it will be “the most ambitious spending round for more than a decade.”

Restraining government spending was always said to be a temporary deficit repair tool, of course. Those “tough choices,” added to net tax hikes, have helped bring down the budget deficit to just 1.3 per cent of GDP, from a gargantuan 9.9 per cent in 2010. Once near-balance, a spending squeeze was never envisaged to continue year after year. Despite Nick Timothy’s fear of libertarians under the bed, no recent Conservative leader has been ideologically committed to shrink the size and scope of government. Absent “thinking the unthinkable,” one eventually must release the spending grip given voter demands for high-quality services.

And yet…the zeal with which the Tories have turned heel on their spending narrative is surprising. Whatever one’s view on the efficacy or composition of “cuts”, they were central to the party’s offer through 2016, including the 2015 election win. Balancing the books was said to be about unburdening the next generation from dumping more debt on top of the iceberg associated with an ageing population. Any intergenerational justice message has now gone the way of the Titanic.

For the Government is not promising gradual targeted spending increases in these areas – a natural uplift from a reset baseline after years of restraint. No, proposed hikes in education funding would virtually reverse any real schools’ spending cuts over the past decade. May’s extra money for the NHS is a big step-change too. The spending review is celebrated as the “biggest, most generous spending review since the height of Tony Blair’s New Labour,” no less – a far cry from denouncing that era’s profligacy. In one swoop, the Treasury has undercut its long-held opposition to raising borrowing and junked the idea that public service reform trumps showering public services with money.

Javid attempts to thread the needle by arguing that more spending is still consistent with keeping the debt-to-GDP ratio on a shallow downward path. That maybe true. But a stated goal of policy was always to balance the books overall, even if George Osborne and David Cameron continually pushed back the deadline. A former Treasury fiscal policy director now says that borrowing will in fact start rising again, and soon be above two per cent of GDP. Manageable, yes – but a clear change in direction.

The public discourse effects of this reversal should worry fiscal conservatives. Cameron and Osborne’s consistent messaging helped entrench two crucial contours in discussions about government spending. First, that there was no free lunch (every Labour proposal for years was met with the question “how will you pay for it?”) Second, that what you did with the money (the organisation of public services) was as important as spending levels. After years of Tony Blair’s money throwing, the public were receptive to such apparently grown-up thinking. Now, both those claims-cum-restraints that ensnared Labour have been removed.

If large, real increases in education funding are synonymous with better schools, as Tories imply, Labour can coherently ask “why did you cut real funding beforehand?” Such corrective spending hikes look an admission of a past mistake. Doubly so if funded through borrowing that was previously considered intolerable.

Couching this as “an end to austerity” brings similar peril. These particular decisions don’t imply “we are going to return to affordable spending increases consistent with a low deficit.” If large spending hikes for education are seen as reversing austerity, then obvious questions arise: what about local authority funding? Prisons? Criminal justice? Have these not suffered more from the pain you admit was damaging?

Of course, Brexit is the important context here. It is sucking oxygen from normal economic debates – one reason why the logjam needs to be broken. A slowing economy, induced in part by uncertainty, means an obsessive near-term public finance focus is probably unwise. The very process of extrication requires budget flexibility, not least because the underlying public finances could look very different when future trade relations crystallise.

But all this would be a case for relaxing or suspending fiscal targets through the choppy Brexit seas, not bold new announcements.

No, it’s difficult not to conclude there’s not something bigger happening here. Much of the party has embraced a simplistic “left behind” narrative of the Brexit vote – that it was a cry for investment in public services. They are egged on by former government advisors, armed with polling, who see an opportunity to steer the party towards a “bigger government” vision for the party they’ve always spoiled for.

Academic evidence in fact shows new Brexit voters affiliating with the Tories quickly adopt traditional Tory views on other issues. There’s no need to pander. Yet when you see John Redwood railing against austerity, you realise how strong this view about the changing party voter base has set.

Whether Johnson shares that interpretation is less clear. Perhaps he sees funding boosts now in three major non-Brexit policy areas as short-term deck clearing before an election. Polling strength from these “good news stories” might even firm up pressure on the EU and rebel MPs on his central task. If it helps finally deliver Brexit, many of us will accept fiscal jam tomorrow.

I want to believe this, but the noises aren’t encouraging. And living in the US, where Republicans have gone from a Tea Party anti-spending force to delivering unprecedented deficits for peacetime, in just a decade, I’ve observed just how easily spending conservatism is lost.

Here, it started with big spending increases on priorities too. Republicans cut taxes, yes, but huge cash increases for defence were delivered, greased by money for some Democrat priorities. Once that dam opened though, the money poured. July’s budget deal threw off the last vestiges of spending caps delivered by the Tea Party Congress. Promises of Republican spending restraint in Donald Trump’s potential second term ring as hollow as claims he’s using tariffs as a path to freer trade.

Here’s the worrying consequence. As US conservatives have learned to love deficits, or at least use them, the left’s spending demands have only gotten more extreme. With constraints stripped away, Democratic Presidential candidates feel liberated to propose mammoth programmes and spending hikes – the Green New Deal, a jobs guarantee, universal childcare and more. When asked how the country can afford this, they point out to the red ink spilled for Republican priorities. There is no answer.

UK Conservatives are far from the Republican point of no return on spending, as yet. But the mood music has changed dramatically. America shows that when conservatives abandon spending constraint, they legitimise the left’s spending wild demands, to taxpayers’ detriment.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Ryan Bourne: In America, public spending conservatism is being lost. It could happen in Britain.

Ryan Bourne is Chair in Public Understanding of Economics at the Cato Institute.

Austerity is over. Theresa May told us so after the 2017 election, and again at the Conservative Party Conference last year. Philip Hammond tried restraining her from a blitz of high-profile spending announcements. Yet Team Johnson has now picked up the baton anyway. Today’s spending review from Sajid Javid will reportedly confirm significant money injections for schools, hospitals and the police. The Prime Minister said Monday it will be “the most ambitious spending round for more than a decade.”

Restraining government spending was always said to be a temporary deficit repair tool, of course. Those “tough choices,” added to net tax hikes, have helped bring down the budget deficit to just 1.3 per cent of GDP, from a gargantuan 9.9 per cent in 2010. Once near-balance, a spending squeeze was never envisaged to continue year after year. Despite Nick Timothy’s fear of libertarians under the bed, no recent Conservative leader has been ideologically committed to shrink the size and scope of government. Absent “thinking the unthinkable,” one eventually must release the spending grip given voter demands for high-quality services.

And yet…the zeal with which the Tories have turned heel on their spending narrative is surprising. Whatever one’s view on the efficacy or composition of “cuts”, they were central to the party’s offer through 2016, including the 2015 election win. Balancing the books was said to be about unburdening the next generation from dumping more debt on top of the iceberg associated with an ageing population. Any intergenerational justice message has now gone the way of the Titanic.

For the Government is not promising gradual targeted spending increases in these areas – a natural uplift from a reset baseline after years of restraint. No, proposed hikes in education funding would virtually reverse any real schools’ spending cuts over the past decade. May’s extra money for the NHS is a big step-change too. The spending review is celebrated as the “biggest, most generous spending review since the height of Tony Blair’s New Labour,” no less – a far cry from denouncing that era’s profligacy. In one swoop, the Treasury has undercut its long-held opposition to raising borrowing and junked the idea that public service reform trumps showering public services with money.

Javid attempts to thread the needle by arguing that more spending is still consistent with keeping the debt-to-GDP ratio on a shallow downward path. That maybe true. But a stated goal of policy was always to balance the books overall, even if George Osborne and David Cameron continually pushed back the deadline. A former Treasury fiscal policy director now says that borrowing will in fact start rising again, and soon be above two per cent of GDP. Manageable, yes – but a clear change in direction.

The public discourse effects of this reversal should worry fiscal conservatives. Cameron and Osborne’s consistent messaging helped entrench two crucial contours in discussions about government spending. First, that there was no free lunch (every Labour proposal for years was met with the question “how will you pay for it?”) Second, that what you did with the money (the organisation of public services) was as important as spending levels. After years of Tony Blair’s money throwing, the public were receptive to such apparently grown-up thinking. Now, both those claims-cum-restraints that ensnared Labour have been removed.

If large, real increases in education funding are synonymous with better schools, as Tories imply, Labour can coherently ask “why did you cut real funding beforehand?” Such corrective spending hikes look an admission of a past mistake. Doubly so if funded through borrowing that was previously considered intolerable.

Couching this as “an end to austerity” brings similar peril. These particular decisions don’t imply “we are going to return to affordable spending increases consistent with a low deficit.” If large spending hikes for education are seen as reversing austerity, then obvious questions arise: what about local authority funding? Prisons? Criminal justice? Have these not suffered more from the pain you admit was damaging?

Of course, Brexit is the important context here. It is sucking oxygen from normal economic debates – one reason why the logjam needs to be broken. A slowing economy, induced in part by uncertainty, means an obsessive near-term public finance focus is probably unwise. The very process of extrication requires budget flexibility, not least because the underlying public finances could look very different when future trade relations crystallise.

But all this would be a case for relaxing or suspending fiscal targets through the choppy Brexit seas, not bold new announcements.

No, it’s difficult not to conclude there’s not something bigger happening here. Much of the party has embraced a simplistic “left behind” narrative of the Brexit vote – that it was a cry for investment in public services. They are egged on by former government advisors, armed with polling, who see an opportunity to steer the party towards a “bigger government” vision for the party they’ve always spoiled for.

Academic evidence in fact shows new Brexit voters affiliating with the Tories quickly adopt traditional Tory views on other issues. There’s no need to pander. Yet when you see John Redwood railing against austerity, you realise how strong this view about the changing party voter base has set.

Whether Johnson shares that interpretation is less clear. Perhaps he sees funding boosts now in three major non-Brexit policy areas as short-term deck clearing before an election. Polling strength from these “good news stories” might even firm up pressure on the EU and rebel MPs on his central task. If it helps finally deliver Brexit, many of us will accept fiscal jam tomorrow.

I want to believe this, but the noises aren’t encouraging. And living in the US, where Republicans have gone from a Tea Party anti-spending force to delivering unprecedented deficits for peacetime, in just a decade, I’ve observed just how easily spending conservatism is lost.

Here, it started with big spending increases on priorities too. Republicans cut taxes, yes, but huge cash increases for defence were delivered, greased by money for some Democrat priorities. Once that dam opened though, the money poured. July’s budget deal threw off the last vestiges of spending caps delivered by the Tea Party Congress. Promises of Republican spending restraint in Donald Trump’s potential second term ring as hollow as claims he’s using tariffs as a path to freer trade.

Here’s the worrying consequence. As US conservatives have learned to love deficits, or at least use them, the left’s spending demands have only gotten more extreme. With constraints stripped away, Democratic Presidential candidates feel liberated to propose mammoth programmes and spending hikes – the Green New Deal, a jobs guarantee, universal childcare and more. When asked how the country can afford this, they point out to the red ink spilled for Republican priorities. There is no answer.

UK Conservatives are far from the Republican point of no return on spending, as yet. But the mood music has changed dramatically. America shows that when conservatives abandon spending constraint, they legitimise the left’s spending wild demands, to taxpayers’ detriment.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

A UK-US trade deal. Never mind the economics (at least for a moment). Feel the politics.

“While trade deals have taken on an important political and symbolic value in the context of Brexit,” Dominic Walsh of Open Europe wrote recently on this site, “their economic benefits are typically smaller and slower to materialise than many realise.” This is the place to start when considering a possible UK-US agreement on trade.  Boris Johnson’s enthusiasm for one is as much political as economic: a successful deal would show Britain, as it moves a bit further from the EU, also moving a bit closer to America.

Such a rebalancing is a strategic consequence of Brexit, at least in the eyes of many backers of leaving the EU.  Future trade deals were a Vote Leave EU referendum priority – though it may be significant that the United States was not one of the headline countries named.  Perhaps the reason was a wariness of anti-American sentiment among a section of the voting public.  None the less, the prospect of a trade agreement with the United States was mooted during the 2016 campaign: hence Barack Obama’s line, written for him by Team Cameron, of Britain being “at the back of the queue” for such a deal.

The obstacles to one are formidable.  For while the Prime Minister is bound to view it through the lens of politics, Donald Trump is more likely to do through that of economics – though the one admittedly tends to blur into the other.  America’s approach to such matters as food safety and animal welfare, environmental protection and intellectual property rights is different from ours in any event.  Never mind the red herring of chlorinated chickens – so to speak – or autopilot claims from Corbynistas about NHS selloffs. The real action is elsewhere.  The United States has long had a protectionist streak, and is resistant to opening up its financial services markets, for example.

The conventional view is that Trump is the biggest America Firster of all; that he would drive a hard bargain, that he has the muscle to do so – and that he wouldn’t be in control of an agreement anyway.  Congress could block one if it wished, and might well do so in the event of No Deal, since the Irish-American lobby is as well-entrenched as ever.  It has been a headache for British governments over Ireland-linked matters before: remember the McBride principles.  A different take is that politics may win out in the end, because both Trump and Congress will want a UK trade deal in order to put economic and political pressure on the EU: we will publish more about that later this week.

John Bolton, Trump’s National Security Adviser, is visiting Britain.  He said yesterday that the UK will be “first in line” for a trade agreement post-Brexit – a deliberate counter to Obama’s line.  Bolton will be dangling the prospect as an inducement.  He will want Johnson to take a more resistant line to Huawei than Theresa May did, and for the UK to move closer to America’s position on Iran.  But the possibility of early sector deals – or at least the exclusion of Britain from new pro-protection moves – seems to be real enough.  As with the NHS, policing, immigration and stop and search, so with trade.  Johnson wants progress towards a quick win as a possible election looms.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

WATCH: Cleverly – Extra NHS funding comes from economic growth

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Peter Bottomley: We have a great opportunity to wipe out Hepatitis C

Sir Peter Bottomley is MP for Worthing West.

As the member of the House of Commons with the third longest continuous service, I know how illuminating it can be to look back over a career and take stock of how far things have come. Many MPs have worked to bring the truth about the infected blood scandal to light via a public inquiry, a battle that took decades. It has exposed the plight of the thousands of people – haemophiliacs and others who received blood transfusions on the NHS prior to 1991 – who were infected by HIV and hepatitis C as a result.

Thankfully public awareness of HIV has grown dramatically during my time in Parliament, in large part due to the efforts of Norman Fowler, to whom I was parliamentary private secretary during his time as Secretary of State of Health and Social Services. The public service advertisements which appeared in national newspapers, on leaflets and on the nation’s TV screens (with a voiceover by John Hurt) became notorious for their hard-hitting slogans, including: “AIDS. Don’t die of ignorance.” The campaigns on HIV and AIDS in the 1980s were highly successful in addressing a major public health issue, and they have become iconic.

Public awareness of the hepatitis C virus (HCV) remains low. I met recently with Professor Ashley Brown, Vice Chair of the Hepatitis C Coalition, which campaigns to eliminate the virus. When he talks about the opportunity to eliminate the hepatitis C virus (HCV) he talks about it in relation to his medical career. When he first started working as a doctor, hepatitis C didn’t even have a name. Once the virus had finally been isolated and identified in the late 1980s, it had gained a logical title: hepatitis C, after the A and B that had been identified earlier. That was the time in which the fight against HIV and AIDs was at its zenith.

Following World Hepatitis Day on Sunday, raising the profile of hepatitis C remains a timely act. There are an estimated 200,000 people across the UK living with chronic HCV infection. The virus is sometimes known as the ‘silent killer’ because it often has no symptoms until the liver is very damaged, and, if left untreated, it can cause liver cancer and death. Yet it can now be easily treated and cured by simply taking a medicine for a few weeks, a transformative development for patients.

The Government has signed up to the World Health Organisation’s target to eliminate HCV by 2030. The NHS has announced it is aiming to go one further and eliminate it in England by 2025. Having concluded a ground-breaking deal with industry, the NHS will work together with companies over the next three years to find and treat the tens of thousands of people in England who are living with HCV but unaware of their status, as well as all those who have been tested but who remain untreated.

The benefits for the NHS could be huge. Already there is evidence from Public Health England that the death rate from hepatitis C-related liver diseases has already fallen by more than 16 per cent between 2015 and 2017. The NHS is also seeing cost savings from a fall in liver transplants for patients with hepatitis C, with a reduction of almost 40 per cent in 2017 compared to 2015. While the potential for a very positive public health story for both the NHS and the Government is within reach, we have our work cut out to find the estimated 50 per cent of people who do not know they are infected.

Awareness is a huge piece of the puzzle, as well as tackling the stigma that persists around blood borne viruses. Many people don’t know what hepatitis C is, and even those who do often don’t know that it can be cured. Up until the last five years, the only treatment was by injections, had horrible side effects and often didn’t work; now hepatitis C is curable with a short treatment course for the majority of people. Then there are the risk factors. While it’s true that the majority of cases arise through injecting drug use, there are other risk factors to consider. Some patients may have been born or raised overseas, used drugs when much younger, had a tattoo while travelling abroad or, of course, if they have received a blood transfusion in the UK prior to 1991. You don’t have to fit into a high risk category to have been exposed to the virus. While HCV is usually without symptoms, some patients experience non-specific symptoms such as fatigue, fever and joint pain.

I know from speaking to Professor Brown that he would love to see this disease that was only identified at the start of his career to be wiped out before he hangs up his white coat. Having spent so long campaigning for the victims of infected blood over the course of my long parliamentary career, I would be similarly delighted to see this come to pass. Lord Fowler would too, as well as my colleagues on the All Party Parliamentary Group for Haemophilia and Contaminated Blood.

It is very rare that we have the opportunity to wipe out a virus, eliminating it as a major human disease, but we have the opportunity to do that here. It’s an opportunity that our Government should seize with both hands.

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What is the real benefit of joining an honor society in high school?

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From SAT prep courses to admissions counseling, the ways in which high schoolers prepare for higher education in NoVA are extensive. On top of academics, students are expected to participate in extracurricular activities, such as athletics, clubs and community service.

For those students who stand out at their respective schools, there will be an offer to join an honor society or two. There are many in existence, including those specific to topics in academia like math or science, as well as broader, commonly known institutions, including the National Honor Society (NHS), with a common perception that joining a prestigious society will have an impact on a student’s admission into a university.

Yet as academic achievement in youth grows across the board in the US, just the title of a scholarly organization won’t have much of an impact, according to Dave Bergman, director of content for College Transitions, LLC, a company that provides admissions counseling to students across the country.

“Colleges need to see what each kid did in the organizations they’re involved in,” says Bergman. “It can motivate students to keep a certain GPA, to be among a certain peer group, things like that. But in terms of college admissions and any effect it would have, it is very limited, because the criteria to join aren’t very high.”

Each school across the US has varied qualifications for acceptance into an honor society. With NHS, for example, the process is complex, in that a school first has to apply for a charter to start a chapter, there must be a principal in charge, a faculty adviser and five faculty members. Those individuals then select students who stand out among their peers across the board.

NHS, which was created in 1921, considers itself a recognition program, focusing on four core pillars for the high school level: scholarship, service, leadership and character. According to Director of NHS, Nara Lee, the program has nothing to do with college acceptance, but rather serves as a chance for young adults to be lifted up and recognized as role models in their schools.

“It is not a checkbox for college applications or a resume,” says Lee. “That is not our view at all.”

In recent years, NHS has put a greater emphasis on alumni relations through the 600-plus scholarships annually offered to top scholars within the society. According to Lee, the organization is in the process of growing alumni engagement for current students to take advantage of when they move on to colleges and universities.

Lee Styles, owner of college counseling company Admission Styles, based in Leesburg, feels as though honor societies have become far less relevant for graduating high schoolers, yet some families still put heavy emphasis on the organizations. Bergman agrees, as he has seen parents hold a false assumption that being rejected by an honor society is “make or break” for the student’s admission into a university.

Whether in an honor society or not, it is essential to actively participate in activities that align with their interests and passions, according to both Bergman and Styles. Some examples of extracurriculars Bergman, Styles and Lee have seen include tutoring elementary school students in math if in a math-focused society, raising awareness on relevant issue such as the opioid crisis and leading a dance marathon to benefit children with cancer.

“Colleges don’t like serial joiners who are padding their resumes; they want to see that students have a passion in something,” says Styles.

The key is to not overdo it or pressure your kid and remember that he or she is still developing into a young adult, Bergman explains.

“Students often feel overwhelmed by the 10 spaces on a common app, but they really don’t need to fill them all out,” says Bergman. “It is better to fill out three that really align with your interests and show how you ascended the groups in high school.”

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James Frayne: The new Prime Minister won’t triumph on Leave votes alone. Here’s how he can win some Remain supporters over.

James Frayne is Director of Public First and author of Meet the People, a guide to moving public opinion.

It’s not impossible that the Conservatives will need to fight both a general election and a referendum in the next year. It was therefore vital that the Party picked a candidate with a record of successful campaigning – and who believes in the Brexit cause. Jeremy Hunt ran a decent campaign and deserves a serious job, but Party members have chosen the right candidate.

While I’ve been making the case for Boris Johnson’s appointment on these pages for two years, his arrival in Number Ten complicates the Conservatives’ electoral strategy – and the Party must be considering how best to adapt it. They should be exploring full, Clinton-style triangulation.

I stress “explore” because the truth is, we don’t have a clue about where public opinion is at the moment. It would be an understatement to say the polls are a mess. We only know a few things: that the public remains completely divided on Brexit; that the broad Conservative base (activists plus regular voters) has fractured since the Government missed its own self-imposed Brexit deadlines; that there is a risk this broad base will remain fractured if the Government doesn’t deliver Brexit “on time” (although this timetable is probably more flexible than people have said), and that, until recently, the Party has been polling strongly amongst working class and lower middle class Leave voters in the Midlands and North – more so than amongst Remain voters in large cities and across the South.

Everything else is clouded in doubt. As Johnson arrives with his Eurosceptic reputation, we don’t know, for example, if the Southern and urban Remainers who have reluctantly stuck with the Conservatives will now peel off in great numbers to the Lib Dems; we don’t know if Johnson’s record will be enough to keep Midlands and Northern working class and lower middle class Leavers onside, or whether they will be watching the antics of Hammond, Gauke etc and now proclaim “they’re all the same”; we don’t know if there are particular, non-Brexit policies that will appeal to these Remainers or Leavers, and we don’t know if middle class Labour voters are getting sick of the failure of Labour to deal with anti-semitism within the Party ranks. We don’t know any of this and it is hard to say when we will. Not, presumably, until Christmas when Boris Johnson has been Prime Minister for a while (itself an assumption).

But while there is great uncertainty, the Conservatives cannot just sit patiently on the sidelines and watch the action unfold before coming to a decision on their broad governing and campaigning strategy. They have to deliver Brexit  – but they also have to prepare and execute a programme that is going to be good for the country and, yes, let’s be realistic, for their own electoral prospects.

So what should they do? With the polls so messed up, all anyone can do at this point is to sketch out a governing and campaigning hypothesis on the basis of careful thought – and put it to the test.

For five years at least,  I have been advocating a strategy that focuses hard on working class and lower middle class voters in provincial England. I emphatically would not junk this approach; these voters will likely form the basis of the Conservatives broad base for the foreseeable future.

However, for positive and negative reasons, under Boris Johnson, this needs adapting. Positively speaking, these working class and lower middle class voters are, assuming that the Conservatives deliver Brexit (or are seen to die trying), temperamentally more positive towards Johnson than Theresa May.

And not just on Brexit; Johnson instinctively understands the importance of the NHS and schools, he understands public concerns about rising crime, he is unembarrassed about being English or about English history (something that has not been sufficiently explored) and he doesn’t obsess about political correctness. These voters aren’t “locked down” – far from it – but Johnson starts in a good place with them. More needs to be done to keep this voters onside, and I will be setting out some ideas on how in the coming weeks.

Negatively speaking, there’s no denying that Johnson starts in a terrible place with Remain voters full stop – and particularly those from urban, liberal-minded, middle class backgrounds. These are the people that associate – wrongly, but there we are – the Brexit cause with racism and intolerance. He is in a more difficult place than May with these voters, and it would be a disaster for the Party if vast numbers of them peeled away. Johnson needs a high-impact, high-visibility, immediate strategy for these voters – showing that he is the same person that ran London in an inclusive, centrist way.

Which brings us back to Clinton’s triangulating strategy of the mid-1990s. Back in those days, Clinton created a campaigning and governing strategy designed to appeal both to partisan Democrats and to floating voters that leaned Republican. Early Blair did the same, and this is what Johnson’s team should be considering. The Conservatives should deliver Brexit whatever happens, develop a longer-term strategy to turn the Midlands and the North blue, but also launch an assault for liberal-minded Remainers.

What might this entail? The Government is going to have to look again at increasing NHS spending – given the side of that bus, further NHS spending (with reform) is going to be hard to walk away from. It should look to develop a suite of environmental policies that incentivise good behaviour and that wrestle the issue away from the very hard left. The Government should also launch, along the lines of the GREAT campaign, a global PR campaign to encourage the best qualified workers to move to a modern, tolerant, post-Brexit Britain. And the Government should look at making it easier for new parents, at a time when they’re financially stretched, to secure loans for childcare. There will be many other alternatives, but you get the point.

The Conservatives must continue their transition towards becoming the provincial workers party, but the creative energy in the short-term should be directed South.

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