The Pin Factory Blog

For ideological reasons, political reform of the NHS behemoth often seems impossible. Politicians across the spectrum, fearful to disturb the foundations upon which the NHS rests, hide behind platitudes, while MRSA haunts the hospital wards. However, cracks are increasingly showing in the system that no amount of political veneration can cover. The seeds of change are showing through, encouraged not from Westminster, but forced through by those that the NHS is supposed to be looking after: the people.

Earlier this week The Times' Daniel Finkelstein, reported the disgraceful case of Colette Mills and Debbie Hirst, two cancer patients who have both been refused the use of the cancer drug Avastin alongside their NHS chemotherapy, even though they are willing to pay for it out of their own pocket. Avastin has been shown to help cancer sufferers, but has not been approved by NICE because it is not considered cost-effective enough to be available on the NHS.

So why have Colette Mills and Debbie Hirst not been permitted to use Avastin alongside their NHS treatment? It has nothing to do with the drug's efficacy… In fact, the reason has nothing to with the drug… Actually, it has nothing to with health. According the the health secretary, Alan Johnson, they were refused because: "That way lies the end of the founding principles of the NHS". But when 'principles' stop the sick from getting life-improving drugs, are they really principles worth defending?

It has been obvious for some time that Johnson’s 'principles' are outdated. Following last year’s report entitled Free at the point of delivery: reality or political mirage, it is was generally accepted that a secret top-up system already exists. Politicians have duly responded by sticking their collective heads in the sand, preferring this to facing up to modern realities. Colette Mills and Debbie Hirst, like others before them, are seeking justice through the courts. They are unlikely to be the last. It's time the NHS's unworkable 'principles' were replaced with a more flexible and customer focused system of health care, one truly fit for the 21st century.

Last night, my wife and I were sitting in the living room. I said to her, "I never want to live in a vegetative state, dependent upon some machine, and fluids from a bottle. If that ever happens, just pull the plug."
She got up, unplugged the TV, and, threw out my beer.

13, "We should create public sector jobs to boost employment."

There are no public resources, except those which government takes away from its citizens. If government is to spend money on projects, this means that private citizens are deprived of those funds.

Government can appear to create jobs by means of public spending. They can enter the market as purchaser for certain projects, and see new jobs apparently created in response. These new jobs owe their existence to that government demand, and many depend on it for their continuation, in that unless the spending continues at that level, the new jobs may disappear.

Government funds such projects by taking funds from the private sector, either by open taxation, by stealth taxes, by borrowing, or even through inflation. Either way, it takes away the funds which sustained jobs in the private sector. People have less to spend on the goods and services of private business; they have less available to invest in it. This means that temporary, government-created jobs are at the expense of real, lasting jobs in the private sector.

Furthermore, government commands goods and services inefficiently. It costs more for government to perform many deeds than it does for private business to do the same. This is because government bureaucracy is often more cumbersome and more costly. Lacking competition, there is no pressure to make it efficient.

Government-created jobs are often capital intensive, such as infrastructure jobs in road or bridge-building, and use a great deal of costly equipment for each person employed. By contrast, the luxuries foregone when the private sector is subjected to extra taxation tend to be in labour-intensive service areas such as dining out, hairdressing, etc.

The effect is to ensure that more jobs are destroyed than can be created. The problem is that political leaders are usually praised for the visible new jobs, without being blamed for those which quietly disappear from the private sector.

With my Christmas and New Year only just subsiding, I'm tempted to recommend this new title (published 28 January, but you can order it now on our online bookstore): Beat the Booze by Edmund Tirbutt and Helen Tirbutt (£6.49 + pp – normal price £9.99). But it's really about dealing with the problems of serious drinkers. Well... perhaps I'll recommend it anyway.

More to my taste, though, is Junk Medicine: Doctors, Lies and the Addiction Bureaucracy by iconoclastic doc Theodore Dalrymple (£9.74 + pp – normal price:£14.99). Almost everything you know about heroin addiction is wrong, he says. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and heroin addiction is more about mentality than biology.

Browse a wide range of other titles in the Adam Smith Institute's bookshop. 

Finally, someone with something sensible to say on the subject of MPs' pay. As 80% of their work is now done in Brussels their pay should be adjusted by 80%....

Interesting economic research in neuroeconomics . Yes, we are still rational but it can be different parts of the brain being rational at different times.

Understanding modern marriage: it is simply hedonic now? 

Understanding the current problems within the NHS. Unfortunately, it was actually designed to be this way.  

Given the quality and expertise of those who rule us, perhaps this isn't a very good idea. 

Millie Tant writes to a Third World farmer offering encouragement. 

And finally, the 1994 pilot of 24. Haven't we come a long way? 

A new report from Global Vision suggests that while Germany is in shape for economic recovery, Britain isn't – quite a turn-around from a decade ago. While Germany and most of Continental Europe have adopted at least a measure of economic common sense in the last ten years, Britain seems to be taxing and spending itself into oblivion.

OECD figures show that general government outlays accounted for 41.2 percent of the market-price measure of GDP in Britain in 1997 compared with 48.3 percent in Germany. Since then, the share of government outlays in UK GDP has risen by 3.4 percent to 44.6 percent, while Germany has cut it by 4.4 percent to 44.3 percent.

Economists David B Smith and Dr Eugen Mihaita of the University of Derby say that even the limited reforms of 2003, when Germany was facing crisis, have helped. But the real reason why Germany's prospects are rising and Britain's are falling is down to a decade of Gordon Brown. He inherited low taxes, low spending, a deregulated economy, and has spent the past decade letting them all slip away.

Who's part of 'Old Europe' now?

 While two families were queuing to go on the London Eye, their two five-year-old boys were getting acquainted.

"My name is Joshua. What's yours?" asked the first boy.

"Adam," replied the second.

"My daddy is a doctor. What does your daddy do for a living?" asked Joshua.

Adam proudly replied, "My daddy is a lawyer."

"Honest?" asked Joshua.

"No, just the regular kind," replied Adam.

12. "Brands are basically a con to make people pay higher prices for goods than they merit."

A famous brand usually commands a higher price than the unbranded competitor, but there's a reason for that. In the absence of personal knowledge of the seller, such as you might get in a local economy, the brand serves as the label of trust. Because people have had good quality and value from the brand, they can count on it. The producer values the reputation for excellence because it brings customers back for more, and brings in new ones.

The brand thus has commercial value. It is like a seal of quality, indicating to customers what they can expect and rely on. This is the basic reason why they are advertised and why, incidentally, they are counterfeited. A producer of dubious quality goods can try to palm them off by stealing the name and reputation of the famous brand.

There is more to brands. Their advertising often conveys images that people associate with the brand, so that consumers buy the association as well as the brand itself plus its reputation. In developing countries certain brands of Scotch whisky are regarded as 'aspirational,' advertised as linked with success. Consumers are buying more than the whisky; they are expressing an association with success and a determination to succeed themselves. These so-called 'intangibles' are not to be sneered at. They are among the most durable of consumer goods. The feeling of aspiration might be remembered long after the whisky, together with its attendant hangover, have been forgotten.

The teenager, trying to express an identity independent of parents, can choose brands associated with qualities that he or she feels illustrate the character that they are or want to be. Brands can thus serve to project an identity and to declare something about a person. People pay the premium because these things are worth paying for.

In these modern times we have access to designer clothes, stylish jewellery, make up and a host of other potions and lotions. We can even go under the knife to have bits of us either chopped off, sucked out or augmented. All of this is to make us feel better about ourselves, ultimately making us happier. The fact that we can do this shouldn't mean we all have to – we are all different, after all – and as we have so much to choose from we can select what we feel we need.

Whilst many are happy with what they have and the way that their bodies develop with the ravages of time, others seek to fight time and enlist the skilled help of others to stave off depressing feelings about themselves. Surgery which might once have had a purely medical purpose is now being used simply as a cosmetic enhancement to make people look (and in most cases feel) younger, prettier, or more feminine or masculine.

The fact that some women choose to undergo cosmetic surgery for themselves has of course riled the feminists (and others) who believe that it is an abuse and subjugation to a male dominated society. Far from it. It is nothing more than women choosing to empower themselves by altering their body into a shape that is more acceptable, not to wider society, but to themselves.

To those of a hardline feminist ideology women's bodies are not their own, they are all part of one global female collective, a rejection of the individual and a hatred of the truly empowered woman of the 21st century. That women have this power over their own bodies should be celebrated. This freedom shouldn't be criticized, it should be used as a weapon against those who oppress.

An excellent piece reminding us what the whole thing is really about:

They say “the Devil is in the details.” Sometimes, so is God.
Statists, Socialists, right-wing paternalists - all those who think of
humanity in terms of classes, races and masses - need constantly to be
confronted with such stories and images. They claim to love humanity;
everything they do is for “Society” or “the greater good.”  These are
the merest of abstractions. A good human loves and cares for other
humans around him; for actual, individual specimens with all their
faults and weaknesses, not classes or masses.

Next time you hear an appealing abstraction weighed against the
interests of an individual or a family, please picture a man making
barbed wire to imprison his uncle or my neat little secretary typing a
death list. They served abstractions too.

There are other reasons to support this liberal capitalism thing too. The more of it you have, the longer people live. 

Contrary to the rumours, the very fact that people can opt out of its rat race is one more reason to support it. 

Further, despite the experiments, looking at what people actually do shows that they do prefer the higher living standards, with the inequity. Migration does tend to be from poor countries to rich.

Iain Dale announces that he has Type II diabetes. Our wishes for his continued good health. Perhaps worth remembering that a century ago this diagnosis was close to a death sentence: now it's a chronic, manageable, disease. We continue to advance.

Well, we'll continue to advance if this attitude can be driven out of politics. They serve us, not the other way around. 

And finally, about as good a description of this year's Presidential election as you're going to get.