The battle for freedom and opportunity
is never finally won.

While consultants in the software industry have long had to worry about IR35 rules designed to promote employment and enforce higher tax rates, it seems the British Government previously chose to use just the arrangements it sought to stop. The Telegraph reports:

Jonathan Baume, general secretary of the First Division Association (FDA) which represents senior civil servants, said pay among the highest-ranking staff needed to be more “transparent”.

His comments come after it was disclosed that more than 25 senior Department of Health officials have had their salaries paid to limited companies, enabling them to reduce their tax bill.

However, Mr Baume said he believed such arrangements had allowed the Government to pay senior figures less and that cleaning up the system would mean salaries would have to rise.

And:

Speaking on BBC Radio 4′s Today programme, he said: “What we have found is that in certain cases, because the market rate was so much greater than the salary that would have been offered in the civil service, various deals were being done and some of these are now being exposed.

IR35 is intended to ensure that people and firms do not dodge income tax, NIC and employment law:

The legislation ensures that, if the relationship between the worker and the client would have been one of employment had it not been for an intermediary the worker pays broadly tax and NICs on a basis which is fair in relation to what an employee of the client would pay.

And yet here’s the NHS, in particular, apparently using just such intermediary arrangements to enable excessive public sector pay. The hypocrisy stinks, but why are people being paid so much out of taxation and in a market so dominated by the state that it can scarcely be called a market at all? If people want large rewards, they should take the higher risks inherent in private business. If they want the security of a taxpayer-backed income, then it is at least disingenuous to call on a distorted market in aid of high pay.

For the General Secretary of the FDA to call for higher pay to deal with this mess shows just how out of touch some high-paid taxpayer-funded officials have become. Given that my constituents are yet again facing unwelcome changes to health services, we should be asking whether this entire system of reward serves the public interest.

Today, I asked David Cameron about Wycombe Hospital during Prime Minister’s Questions in the Commons. The context is the Better Healthcare in Bucks consultation.

On a day when PMQs were dominated by health service reform, I said I had visited the offices of the Bucks Free Press on Monday to see readers’ reactions to the proposed changes affecting Wycombe Hospital. I told the Prime Minister that Labour had left a tragic legacy of distrust and despair about the NHS locally and I asked whether the right way to restore trust and accountability was clinical commissioning and Foundation Trust status.

The Prime Minister agreed and drew attention to how Labour had undermined community hospitals.

The changes proposed locally are out for public consultation until April. All of us who support Wycombe hospital must seize this chance to make our voices heard by attending a consultation meeting. The first meeting in Wycombe will be on Tuesday 28 February at the King’s Centre in Desborough Road from 10am until 1pm. I will be participating and I urge as many constituents as possible to join me there.

A survey is available here. I have submitted related written and oral questions to the Secretary of State for Health, which I will publish as they are answered.

Last Wednesday, I attended the re-launch of the Royal College of Midwives (RCM) Parliamentary Panel.

The meeting coincided with the publishing of a report by the RCM on the State of Maternity Services in the UK. This revealed that the number of births per year increased by 22% between 2001 and 2010, while the number of midwives had increased from just over 18,000 in 2001 to just under 21,000 in 2010.

These statistics suggest that there is a shortfall of 4,664 midwives nationwide. This is mainly due to the 71% increase in births to women aged 40+ since 2001.  The RCM noted that births to mothers in this age group are more likely to involve complications, such as an increasing risk of giving birth prematurely or a caesarean or an epidural injection. This inevitably means that midwives have less time to attend to other mums. Projections show that this mis-match between the supply and increasing demand for midwifery services is unlikely to diminish due to the continuing high birth rate and the complications that may arise.

I’m glad to be part of the re-established Parliamentary Panel which will highlight this fundamental issue.

My colleague Jesse Norman MP has done some fantastic work towards obtaining rebates on exorbitant private finance initiative (PFI) contracts. See for example his article It is time to derail the PFI gravy train. To that end, yesterday we held a lengthy debate in Westminster Hall which you can find here.

PFI really matters to Wycombe and Buckinghamshire, where long, expensive hospital contracts have become fixed points in the local health system. A sensible, negotiated rebate would help NHS staff deliver more.

My colleagues did a fine job in explaining the minutiae of PFI and its faults so I tried to widen the debate to encompass PFI’s place in our present social system:

I would like to develop one point: how PFI fits into the nature of our society. I am reminded of something that Churchill said, which I think speaks to the third way. He said:

“Some people regard private enterprise as a predatory tiger to be shot. Others look on it as a cow they can milk.”

I will come back to how he finished the quote at the end. It strikes me that the third way seems to have turned private enterprise into a vampire squid to be suckered on to the faces of people on normal and low incomes.

…

It is strange that so much money is being funnelled to firms whose commercial risks are being underwritten by the power to tax. Far from protecting the poor, the state now seems to be an institution for protecting the rich from the risks they take with their own investments. I am a capitalist, and I believe that capitalism requires entrepreneurs and investors to bear their own risks. Somehow, through all this mire and mess we find ourselves in, we need to recover the principles of a free society and a vision of a capitalism that works, and works for everybody.

The worst part of the present system of vampire squid state capitalism is of course the banking system, but PFI as recently executed is in there too. The Treasury has made a start but there is far to go before PFI satisfies the public’s incisive sense of fair play.

A doctor and Conservative candidate writes on health reform and it’s very much to the point of our local experience:

A renewal of the NHS must not be piecemeal or deal with the symptoms. It must tackle the fundamental flaws – in its management, its funding, and the maintenance of professional standards. And there is a belief that getting all those things right could actually save the Treasury a lot of money while at the same time give the public a superior service.

Read more.