Scoping the impact of Brexit for NHS procurement

Dr Albert Sanchez Graells, Senior Lecturer in Law, University of Bristol Law School

Dr Albert Sanchez Graells, Senior Lecturer in Law, University of Bristol Law School

NHS England spends over £20 billion every year on goods and services. A significant part of the remainder of NHS non-salary budget involves the commissioning of health care services. This expenditure and commissioning is controlled by NHS procurement rules, which in part derive from EU law. NHS procurement rules are regularly criticised for imposing excessive red tape and compliance costs, and calls for NHS procurement reform to free it from such strictures are common.

In this context, Brexit could be seen as an opportunity to overhaul NHS procurement and to move away from the perceived excesses of EU law. This post concentrates on two issues. First, does EU law prevent significant reforms of NHS procurement and, if so, can Brexit suppress such constraints? Second, is the way Brexit is unfolding conducive to an improvement of NHS procurement? Continue reading

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It’s in the EU’s interest to press ahead with Brexit negotiations

The extraordinary outcome of the UK general election and the uncertain domestic political climate has led to calls by Scottish first minister Nicola Sturgeon for a “short pause” in the Brexit process. Despite this, Brexit negotiations are now scheduled to begin on June 19.

Nieves Perez-Solorzano Borragan, Senior Lecturer in European Politics, University of Bristol

There are no advantages for the EU in delaying or pausing Brexit negotiations. It is ready and waiting to negotiate an orderly British withdrawal

Limiting the uncertainty caused by Brexit has been at the core of the EU’s narrative since the Brexit referendum. Delaying the negotiation process only prolongs uncertainty about the direction of Brexit. Meanwhile, the EU is eager to address other challenges such as the refugee crisis or an increasingly unpredictable international environment. A pause would also increase legal uncertainty: there is no agreement on whether it is legally possible to stop the Article 50 process, so the Court of Justice of the EU might have to intervene.

The UK Negotiating Position

The UK’s negotiating position outlined before the election appears under pressure as the prime minister, Theresa May, no longer has a parliamentary majority to sustain it. And as the negotiations start, the Government has not been forthcoming in making public its Brexit priorities after the general election, so the assumption is that they have not changed. Continue reading

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The importance of the advice sector in the context of legal aid cuts

Dr Sarah Moore, Lecturer in Sociology (Department of Social and Policy Sciences, University of Bath).

The PolicyBristol blog has the pleasure of welcoming this guest post by Dr Sarah Moore, who was one of the participants in the recent book launch of Advising in Austerity. Reflections on challenging times for advice agencies (Policy Press, 2017). Dr Moore is also the co-author of Legal aid in crisis. Assessing the impact of reform (Policy Press, 2017) and offers here her insightful views on the need to boost the activities and funding of the legal advice sector.

Anyone familiar with legal aid reform will know that the Legal Aid and Sentencing of Offenders Act 2012 (LASPO) has dramatically altered the meaning and nature of legal aid. It has meant, amongst other things, a significant reduction in funding, largely achieved by taking a large number of areas of civil law out of scope, including private family law cases, and almost all cases involving social welfare, housing, medical negligence, immigration, debt, and employment.

The most strenuous critics of LASPO have pointed out that the recent funding cuts restrict people’s access to justice. In answering to these problems, LASPO incorporated a set of exceptions. Those who could provide evidence that they had been victims of domestic violence, for example, were to be given access to legal aid to pursue family law cases. And an Exceptional Case Funding caveat was incorporated in the Act for those who could successfully make a case that their human rights would be breached without publicly-funded legal assistance. Both have been woefully inadequate.

Research led by Rights of Women indicates that, even after the government relaxed the rules on domestic violence evidence and legal aid eligibility, a significant proportion of female victims (38% in their 2014 survey) did not have the mandatory evidence to receive publically-funded support. And the Exceptional Case Funding (ECF) scheme has been a disaster by anyone’s standards. In the first year post-LASPO, the Legal Aid Agency received only 1,520 applications for ECF. According to the Public Accounts Committee, only 69 were granted funding. That is far, far fewer than the Ministry of Justice and Legal Aid Agency had predicted in the post-LASPO period. Applications have picked up in the last year, as has the acceptance rate, but the fact remains that this safety net is sorely under-used. Continue reading

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Why healthcare services have a problem with gambling

Image of electronic gambling machines.

“I have a problem with gambling. There’s not enough of it.”

Dr  Sean Cowlishaw, Research Fellow at the Centre for Academic Primary Care, University of Bristol

That was the admission from billionaire Steve Wynn, a major figure in the casino industry, speaking at a recent gambling research conference in (where else?) Las Vegas. And sure, it made for a good quote. But it’s also a rather glib dismissal of a serious issue that affects many thousands of people across the world.

The UK certainly has a problem with gambling. At least it has since 2007, when laws were changed to allow for huge growth in gambling opportunities and exposure. It has been hard to ignore the subsequent explosion in industry advertising, which increased by around 500% between 2007 and 2013. By contrast, you may have missed the increased numbers of high intensity electronic gambling machines, called Fixed-Odds Betting Terminals (FOBTs), which now occupy the high street (within betting shops) and allow punters to wager up to £100 every 20 seconds.

Yet Britain doesn’t have much insight into its problem with gambling. Compared to most other addictive behaviours, involving drugs or alcohol for example, gambling is largely ignored by health services and public health agencies. This is partly because gambling is a hidden concern. It does not manifest with physical warning signs. Indicators are usually visible in extreme cases only, and generally following major life crises such as extreme debt or relationship breakdown. Continue reading

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The 2017 General Election: first thoughts

Dr Hugh Pemberton
Reader in Contemporary British History, University of Bristol, Department of History

Writing on the morning after the election, the fog of war has lifted to reveal a battlefield on which all sides are claiming victory but nobody has actually won.

Others more prescient than me wondered before the election if it did not have a whiff of another ‘snap election’ – 1974.

It turns out they were right.

Then Ted Heath went to the country to secure a strong mandate to deal with an issue of national importance (in those days, union power) but found that he ended up with fewer not more MPs.

Ted held on in No.10 for a while but eventually Labour formed a minority government.

But the arithmetic and the politics this time are not those of 1974.

Screenshot of UK General Election 207 results, taken from BBC News website.

 

What might be the lessons of yesterday’s vote?

First, though the Conservatives are the largest party, their loss of seats (even as their vote rose as Britain returned to a two-party system) represents a major defeat for the programme on which the Prime Minister went to the country – in the expectation of a landslide victory.

Second, austerity economics no longer holds sufficient appeal to deliver victory.

The Conservatives ran on a programme of continuing austerity, Labour on ending austerity.

The relative fortunes of the two parties suggest that an alternative to apparently never-ending austerity holds significant electoral appeal.

Third, a hard-Brexit appears to have been rejected.

The Conservatives promised a hard-Brexit, Labour a soft-Brexit (along with the SNP and Plaid Cymru), and the Liberal Democrats no Brexit at all).

Both major parties managed during the campaign to close down debate on Brexit.

Nonetheless, the setback to the Conservatives suggests that a hard-Brexit resonated with too few voters. (We should remember that whilst 51.9% of voters embraced ‘Leave’ in 2016 they were far from agreed on what form that departure should take).

Fourth, the result represents a significant personal victory for Jeremy Corbyn.

Many, including me, were sceptical that he could go beyond energising young people and actually get them to vote.

We were wrong.

Delivering both a large increase in Labour’s vote and an increase in the number of its MPs is a major achievement.

Where might we go from here?

First, we will likely see a Conservative minority government, sustained in office by the DUP.

Though today’s politics are not those of the 1970s, the experience of that decade is that minority government is possible, and indeed if done well can provide sufficient leverage for the party in question to go to the country and increase its majority (as Labour did in October 1974).

But minority government is hard, tiring, and unstable.

The governing party must fight every vote in the Commons as if it could lose.

Concessions must be made.

A minority government finds itself in a constant bidding war as it seeks to bribe smaller parties to lend the government their votes.

Even then key votes will be lost.

MPs must practically live in their offices and in the tea rooms and bars, constantly on hand in case a division is called and their vote is required.

Exhaustion soon sets in and there is a risk of growing paralysis.

Second, we must, surely, see a major reality check on Brexit.

Moving to exit the EU represents the biggest governmental challenge in the UK since the dark days of 1940.

Having initiated Article 50, the sands are already rapidly running through the hourglass.

Yet we have yet to start negotiations.

Instead we are indulging in an orgy of national introspection – indeed the absence of discussion about Britain’s future place in the world was perhaps the most striking feature of the recent election campaign.

This cannot go on.

But the election leaves the (presumably) future Conservative government in an exquisitely difficult position.

It has embraced a series of negotiating positions that presume (indeed demand) the hardest of hard Brexits.

Yet the voters appear underwhelmed.

So, either the government must push on to deliver its promise, and face possibly cataclysmic rejection at a later date.

Or it must change course.

Third, whichever party forms the next government, and whoever is our prime minister, given the political difficulties and conflicting signals generated by the election result, it is difficult to see how we can possibly begin negotiation with the EU-27 on the present timetable.

Asking for a pause in the process looks almost inevitable.

Fourth, Labour has moved left, and its general election performance – even though it did not deliver victory – is impressive enough to ensure that this policy shift is going to be long-lasting.

It will be a surprise if opponents within its parliamentary party do not fall into line.

Finally, Mrs May has been significantly discredited, not least in the eyes of her MPs.

She is unlikely to be able to keep a lid on simmering discontents in her parliamentary party – not least those who oppose her hard-Brexit policy.

This will be a significant force for instability both in domestic and foreign policy

But whatever happens it’s all going to be fascinating.

This article was originally post on Hugh Pemberton’s personal blog here.

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The General Election 2017: national security, deradicalisation, and citizenship

As we head into the elections this Thursday, national security is a burning issue. The UK has been the target of three major terrorist attacks in the past few months. The latest attack in London comes within just two weeks of the bombing in Manchester last month. The involvement of British nationals in perpetrating these attacks has brought many questions about extremism, radicalisation and integration to the forefront.

Dr Devyani Prabhat, Lecturer in Law, Bristol School of Law

Party leaders are laying out their strategies for counter-terrorism. Theresa May has announced plans to set up a new counter-terrorism agency, monitor social media and web content for extremism, have stronger custodial sentences for terrorism, and work on integration of communities. Meanwhile Jeremy Corbyn has focused on the problems of British foreign policy, funding for terrorist activities, and the lack of policing resources. These plans are not reflected in their respective party manifestos and do not engage directly with the issue of alienated citizens. In fact, Prevent, a mainstay of counter-terrorism, is not even mentioned in the Conservative party manifesto, while the Labour manifesto merely mentions a review of Prevent. Both major parties are, however, likely to comprehensively rethink the current Prevent programme in light of the recent attacks. The Liberal Democrats and Green Party have already announced plans to replace Prevent. When such replacement or revision takes place, parties need to consider why minority citizens can become alienated and what British citizenship means to them as part of long term deradicalisation programmes. Continue reading

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Manifesto promises on pensions

Image with an old persons hand, the image is split with a zip and behind it is coins and money.

Dr Hugh Pemberton
Reader in Contemporary British History, University of Bristol and lead –  Thatcher’s Pension Reforms project.

The most dull and predictable general election in modern British history has its interesting aspects. First, it may mark a turning point in the major parties’ ideological stances. Second, it may mark a return to two-party politics (with polls indicating around 4 in 5 votes will go to one of the two main political ).

In the arena of pensions policy, Labour offers much more to voters than do the Conservatives.

Labour’s promises on pensions

Labour’s manifesto is its longest ever, packed with policy proposals and spending promises – not least on pensions – to be funded by higher taxes on the better off and on companies in a faster growing economy. Continue reading

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The many Brexits of Bristol

Bristol strongly supported Remain but not all of its component parts did. Ward-level data reveals who voted for what, why, and thus how we might move forward as a community.

Figure 1 How Bristol voted in the EU referendum, ward by ward, with a high Remain vote in red and a low Remain vote in yellow. The original interactive map can be found on Bristol247.com who kindly gave us permission to use this image.

At odds with much of England, the City of Bristol voted overwhelmingly for Remain in the EU referendum, with 62% as opposed to 38% for Leave. Hundreds marched through the centre of Bristol to show their dismay the day after the referendum result. At the same time, recently available ward level data indicates the outer areas of Bristol including Bishopsworth, Hartcliffe and Hengrove were majority Leave. Just as a picture of a deeply divided country emerged on 24 June 2016, can we understand Bristol as a microcosm of modern Britain? And what exactly does it mean to vote Leave in a city which was enthusiastically Remain?

On 4 April 2017, the University of Bristol hosted a workshop on local communities as part of the wider initiative ‘#BristolBrexit – A City Responds to Brexit’. Working closely with local residents, city officials, stakeholders, practitioners and charities in Bristol, the workshop sought to include a balance of participants between central Bristol and the outer estates. The workshop participants identified the challenges we face post-Brexit with a particular focus on Bristol, including the racism and prejudice faced by minority communities, ensuring the rights of EU citizens in the UK, and the general sense of insecurity and uncertainty brought on by the Referendum result. Built into the design of the workshop, the conversation then turned to ‘who is missing?’. Large segments of our local communities, including young people, abstainers, and Brexiteers are still missing from the Bristol-Brexit discussion. Continue reading

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What will Brexit mean for the future of European student mobility?

The UK government’s stance on immigration will likely cost British students their access to Erasmus+. How will UK universities keep their students thinking globally post-Brexit?
As Brexit negotiations gather momentum, the time has arrived when we must consider how we can successfully navigate the next two years. The UK must think about how we will fill the Brussels shaped void, the implications of which will soon start to become clear. It’s a void that will loom large in my professional life as my colleagues and I consider the future of European student mobility without the Erasmus+ programme.

If the results of the referendum caught us by surprise, I’m determined that we will be prepared for any outcome that the negotiations deliver. And, moreover, that along with other stakeholders, we take an active role in helping fill that void and shape it into something that can be a worthy successor to Erasmus. I was recently invited to take part in an excellent workshop “Projecting Bristol and Britain to a Post-Brexit World” organised by Dr Nieves Perez-Solorzano and Professor Michelle Cini from the University of Bristol. This was a good opportunity to start thinking about how we can proactively participate in Brexit discussions and this short piece considers some of those ideas with regards to international student mobility.
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Bristol, Brexit and the creative challenge

Bristol’s creative industries give the city a strong starting point for taking the city global post-Brexit. But it will need support to succeed.

Graffiti on wall of person with a flower

Street art in Southville Bristol. Heather Cowper/Flickr. (CC 2.0 by-nc)

Brexit is framed as both a threat and an opportunity – the loss of the EU market and the free flow of talent against the chance to work across the whole world. The creative industries already work globally – our music, films, TV, design and digital products and services are renowned. We also benefit from the free flow of talent – up to 50% EU citizens in sectors like visual effects – and investment from European cultural programmes. And, of course, Europe is a huge market and English remains the key language of the industry.

Combined with the devolution of powers within the UK, this has created a matrix of changes which all reinforce one thing – we’re heading for “the City and the World”. As a biologist with 30 years experience in factual TV, this resonates with basic ecology, which I believe provides the philosophy to deal with complexity and develop the right response to the coming change.

Creativity is a very human industry, in production and consumption. The energy within the ecosystem comes from individuals with talent, and there are skills shortages. We need to be able to draw on a wide range of talent, and ensure the Tier 2 visa arrangement aligns to needs – currently they are too restrictive in the definition of ability and salary level required. The industry exists predominantly as a collection of microbusinesses, and we do not have the capacity to sponsor individuals in visa applications.
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