Mar. 17th, 2017

mtbc: maze A (black-white)
Apparently we are not meant to have patients stay overnight in mixed-sex wards in British hospitals. Probably due to a lack of vacant beds this rule turns out to have been fairly commonly violated.

I am not sure what the fuss is about. If private things have to be done then the curtain can be drawn around each bed. Men and women generally have a good idea what each other look like and, given diversity of both sexual orientation and gender identity, I doubt that being in a same-sex ward much protects against whatever it is that people are worried about.

The National Health Service's chronic underresourcing and the lack of social care in the community would seem to me to put this mixed-ward issue far down the list of things to which to consider paying any attention.
mtbc: maze N (blue-white)
In the US it seems common for political parties' manifestoes to be known only by the broadest of strokes and then not especially raising expectations because it can be a challenge for any party's mainstream to hold enough grip on the House, the Senate, and the White House to be able to follow through. This is one reason why the Affordable Care Act was so significant. It may seem as though the Republicans have a firm grip now but in trying to replace it the House want to pull it one way, the Senate the other, and the President was registered Democratic over much of the previous decade: they are hardly unified by ideology.

In contrast, in the UK there is often one political party with a majority in the House of Commons and that usually suffices to effect a party's goals. There are intra-party splits, such in the Conservatives over the European Union and in Labour over socialism, but their electoral mandate is strongly associated with their manifesto and their promises are violated only at considerable peril. If the majority party fails to deliver on specific proposals then there are rarely any credible alternative culprits at which for them to point. I would offer that the fiasco a few years ago over raising university tuition fees is part of what now so wounds the Liberal Democrats.

I was therefore pleased last week to see Her Majesty's Government so quickly and wholly fold over the Chancellor's proposed manifesto violation in raising Class 4 National Insurance contributions. (National Insurance deductions are rather like Social Security deductions in the US: indeed, the last I checked, they had some interchangeability in the US/UK tax treaty.) I have no strong opinion on if Class 4 contributions are wrongly relatively low but it is good to see that election manifestoes still mean something significant. Being elected into public office is not a mandate to then go ahead and do whatever one wishes.

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Mark T. B. Carroll

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