The Paralympic Games start in just over two years’ time. However, many London Tube stations are still not accessible to wheelchair users. As any disabled person who has ever tried to get a lift installed anywhere knows, lifts cost money. A lot of money. So it is a shame, but not a surprise, to disabled people that six step free access schemes were deferred last year, saving £50 million.

London Underground says there are 61 step free, accessible stations in London but, as last night’s BBC News investigation showed, the lifts are too small for more than one person – especially since most wheelchair users would always need a carer with them on public transport.

As Steve Smith, the son of a long-term wheelchair user, told the BBC:

“The underground stations with ‘accessible lifts’ as you could see in the report are too small and not easily accessible for a disabled person and their luggage and any carers. God knows how they would feel if they suffered from claustrophobia!

“If they put proper lifts of a decent size in, they would be accessible to everyone who needs help accessing the underground – not just some of the disabled.”

A spokesperson for Transport for London told Left Foot Forward:

“We would like all stations to be step-free, but it costs a lot of money – a lot more than people think. There are 8,500 step-free buses, all black taxi drivers have ramps and drivers are trained to assist disabled people. All of the Docklands Light Railway stations have lifts.

“Disability is not only about people in wheelchairs – we now have announcements and hearing loops for those who are deaf and blind.”

Unfortunately for the Coalition Government, they are currently making massive spending cuts wherever possible – just when spending extra money on sport and access would have allowed the rest of the world to see London for the wonderful place it is.

Unfortunately for Paralympic athletes and their disabled fans, disabled people already feel that their services are at the top of the list of things to make cuts to. So while it is to be hoped that Tube stations will become more accessible in the next two years, disabled Tube users cannot be blamed for having their doubts.

It is to be hoped, however, that the Government will consider the fact that if and when Paralympic athletes and disabled fans are able to get around the city, they will spend just as much money as anyone else during London 2012 and will, in this way, contribute to our economy, just as Olympic athletes and their non disabled fans will.

As young people collect their A-level results today a double whammy of failed policies has left them in a precarious position. Top-up fees, that threaten to be raised yet again, leave many feeling unable to mortgage their future on the hope of higher earnings whilst cuts to funding and places mean that those that chose to take the risk may miss out a place regardless of their ability or aspiration.

More than 650,000 people have applied for a place on university course this year, more than ever before, and this is being used by apologists for top-up fees, such as the Russell Group of ‘elite’ universities, as a demonstration that they do not deter young people from going university.

Clearly these people haven’t spoken to any students recently. If they did they would hear story after story of young people at the beginning of their working lives saddled with £20,000 or more of debt and terrified about what the future brings.

The same people say that this means that a further doubling, or even tripling, of fees would bring in the money that universities desperately need and not affect the numbers of young people who apply for a university course.

Once again they are ignoring clear evidence that the doubling of fees demanded by vice chancellors would put a significant proportion of students off going to university and that the prospect of debt affects those from lower-income families significantly more than others.

Even if fees were no deterrent to those from poorer backgrounds going to university, further widening the gap between rich and poor, they would still be deeply regressive.

A sticker price placed on a degree that asks a teacher to pay the same for their degree as a corporate lawyer, both professions that require a university education, unfairly punishes those who gain least financially from their degrees. The system is broken and must be replaced with one that asks graduates to contribute based on their real earnings.

That graduate contribution should be paired with recognition from the government that a well educated work-force is beneficial to society in general, and that this requires better investment. Public investment in higher education in the UK is below the OECD average, 20% less than France, and 10% less than the US.

Other countries recognise that higher level skills are essential for both economic recovery and the future employment needs of the country and continue to increase the number of places at university. The UK has slipped from third to eleventh placed in the OECD in its graduation rates, slipping behind countries like Japan, Sweden, and even Slovakia.

Of the 650,000 people applying for university this year, up to 200,000 will miss out on a place because the government has placed an arbitrary cap on the number of people that can go to university. This is not based on the number of qualified candidates – 3,500 straight A students weren’t offered a university place last year – but rather a lack of willingness from successive governments to fund places for every student with the ability and ambition to go into higher education.

Instead, the current government have compounded cuts made by their predecessor meaning that those students who do get a place at university will be entering institutions struggling to provide adequately for them.

For Ministers to decry poverty of opportunity while presiding over this current crisis is cheap talk, but to stand by and do nothing as young people are left to sink or swim is a dereliction of duty. Abandoning this generation of young people would cause permanent scars to individuals and their families, society and the economy.

More widely, there are clearly serious issues with a funding system that is unable to support the hundreds of thousands of applicants who have made the grade, and leaves a quarter of applicants without a place. The discredited system of top-up fees exploits applicants’ limited options by heaping £25,000 debt on top of the significant pressures they already face. Ministers must introduce a fair, progressive and sustainable alternative that supports rather than penalises students.

An educated workforce is the driver of a modern economy and a Government desperate to get the UK back on sound financial footing should recognise the transformative power of universities and students, and fund their future accordingly.

Last night’s Newsnight focused on the row between George Osborne and Iain Duncan Smith over expensive changes to the welfare system. Cuts to universal benefits, such as the Winter Fuel Allowance, appear to be the compromise on the table. David Cameron famously referred to Labour literature during the election that warned of these cuts as “lies“. But Sunder Katwala has unearthed another unfortunate turn of phrase used by David Cameron to reassure voters.

Next Left today dig out David Cameron’s eve of election mimic of President George H. W. Bush. On May 4th, referring to pensioner provisions such as the Winter Fuel Allowance, David Cameron told an election rally:

“And let me say very clearly to pensioners if you have a Conservative Government your Winter Fuel Allowance, your bus pass, your Pension Credit, your free TV licence all these things are safe. You can read my lips, that is a promise from my heart. Don’t believe the lies you’re being told by the Labour Party just because they’ve got nothing positive to say.”

As the BBC’s Nick Robinson blogged at the time:

“It’s an unfortunate phrase given its history. George Bush Sr was the first to say “read my lips”. The rest of the sentence was “no new taxes”. It helped him win the presidency in 1988. He went on to raise taxes to reduce the deficit and “read my lips” became shorthand for broken political promises.”

Watch President Bush’s famous remarks:

Labour leadership contender David Miliband has launched a campaign calling for David Cameron to “come clean on Winter Fuel Payments”. You can join the campaign here.

In just a few days, more than 2,000 38 Degrees members have come together to share their stories of what they value about the NHS. They’re concerned about the Coalition’s plans for the health service, including privitisation of services and layoffs of huge numbers of NHS staff.

With media coverage of the NHS focusing on the negative, 38 Degrees members decided it was time to correct the balance with a view positive stories of their own. You can read the stories here – http://www.38degrees.org.uk/share-your-NHS-stories/

38 Degrees member Joanne explains:

“I was diagnosed with Rheumatoid Arthritis at age 29, my local NHS have been simply wonderful supporting me through it all. We can’t let a fantastic service like this be eroded by back door privatisation.”

Others value the security that the NHS gives over a lifetime, like 38 Degrees member Gordon:

“I am 55, and I know that whatever happens to me in my last few decades, I will always be well cared for, and with no worries whatsoever about what it will all cost. And this applies to every single person in our country, not just those of us who can afford it.“

All over the map, which has comments drawn from almost every part of the UK, 38 Degrees activists are also clear about their political worries for the NHS. Paul, from London, says:

“I am very concerned for the future of the services provided as part NHS. The prospect of this current coalition government forcing through drastic ideologically driven cuts under the mask of ‘essential spending reduction’ is a real worry.”

The Coalition is planning to move fast – legislation is expected before the end of the year. But those opposing the plans are moving quickly too. With thousands of people across the country opposing the reform of the NHS, forcing through these changes to the NHS may prove to be a step too far for the new Coalition.

• Stand up for the NHS by adding your voice here:-

http://www.38degrees.org.uk/share-your-NHS-stories/

Cancer – and particularly Breast Cancer – has become a political football with questions being asked over whether very large increases in investment by the last government have led to better results. This morning the BBC and other news sources are headlining a new report in the BMJ showing trends in Breast Cancer ‘mortality’ throughout 30 European countries.

The major findings for UK readers are that whilst mortality has declined in most countries, the UK starting from a high base has achieved one of the biggest improvements—with about a third less deaths.

This study starkly contrasts with the equally well-reported EUROCARE study that found relatively poor improvements in ‘cancer survival’ in the UK. Why the difference? Well, ‘mortality’ and ‘cancer survival’ are different indicators each with their own problems.

Mortality as the name suggests measures the rate of death from a disease within the whole population; e.g. 28.2 breast cancer deaths per 100,000 in the UK according to the BMJ study. Mortality figures were highlighted in the election when David Cameron questioned the value of the extra cancer investment.

He said:

“Now what Gordon Brown is not telling you about the situation with cancer, cancer drugs and cancer outcomes is after all of the things that he has talked about, all of the money that has gone in, our death rate from cancer is actually worse than Bulgaria’s so all that has happened has not actually improved the outcome which is what matters.”

Well – so what? Whilst I’m reluctant usually to rely on anecdotal evidence, I‘ve been in a Bulgarian hospital and I’m pretty confident that their low cancer mortality has nothing to do with standards of care.

At a guess I would say it might be their record keeping or the fact they die on average much earlier of other causes. Mortality is probably a useful metric for following cancer trends but it has problems comparing between countries.

Meanwhile survival is the percentage of people that are alive sometime after diagnosis – e.g. 49.6 per cent overall cancer survival after five years in the UK according to EUROCARE. However it is as malleable to changes in diagnosis as it is to changes in the success of treatment.

The authors of the BMJ report point out that the countries that have reported the greatest success in improving EUROCARE4 survival rates are also those that have reported the greatest increases in incidence.

In short they suggest these countries have instigated intensive screening programs and have identified many small relatively benign cancer – many of which may never have progressed or proved life threatening at all. So perversely intensive screening can greatly improve survival without improving mortality very much.

Furthermore, in an accompanying editorial (behind paywall), to the BMJ study it is claimed that UK survival statistics are also lowered due to an administrative gap between diagnosis of cancer and the often-later registration of diagnosis. D’oh!

On the whole I trust the BMJ study. The improvement reported is consistent with the experience of most cancer professionals. There is a larger message here however over just how slippery statistics can be, and particularly international comparisons. Evidence based policy is seldom simple.

Three months into government the coalition still appears no closer to a settled view on university funding – with the Tory Party in particular split between universities minister David Willetts’s insistence graduates should pay a “bigger contribution” to higher education, backbencher Douglas Carswell’s fears of “economic stupor”, and even a call by some in the party for a return to free university education.

The main academic and student bodies are also divided over the issue, with the University and College Union warning Vince Cable’s proposed changes risk escalating the cost of a degree for all students, while the National Union of Students, who support a graduate tax, cautioned against making “sensationalist and simplistic judgements”.

The most left-field suggestion comes from Marcus Booth and Dylan Thomas, who are both on the Conservatives’ approved list of candidates, who explain on Conservative Home:

“The UK spends a little over 1% of GDP on higher education, over 70% of which is government spending in the form of research grants, tuition fee subsidies, and student bursaries.

“Income from tuition fees, currently set at £3,300 per student, comes to only 0.15% of GDP or approximately £5 billion. This is small change for the government but an increasingly heavy burden for graduates.

“We believe that every pound spent by the state on education will have a far greater multiplier effect than the same pound spent on welfare payments to NEETs (not in employment, education or training). Therefore, tuition fees are not a necessary evil but in fact a result of a failure to prioritise government spending.”

While Carswell wrote:

“Taxing graduates more for being graduates is a great idea. If you want to induce economic stupor… Universities need more funding. And more young people want to study. Great. If Society is going to be Big, then let them work it out without imposing blanket solutions or expropriating anyone’s future earnings.”

The UCU, however, says key workers, including doctors, teachers and nurses, would face “massively increased study bills” and the cost of a university degree “would rocket”:

“Teachers, nurses, doctors and social workers would pay considerably more back than under the current system. Under a model where graduates pay a tax of 5% over 25 years, doctors would pay back over £100,000 (£105,564) and teachers close to £50,000 (£46,046).”

General secretary Sally Hunt added:

“Whatever scheme is proposed to replace fees, the government must ensure that studying for key professions remains attractive and that the prospect of prohibitive costs over a lifetime will not put off the next generation of innovators and public servants.

“We urge Vince Cable to look again at the idea of taxing big business for the substantial benefit it gains from a plentiful supply of graduates, rather than merely looking to penalise students further.”

Our guest writer is Richard Exell, Senior Policy Adviser, TUC

In his emergency Budget, George Osborne made two important choices: to bring down the deficit earlier and faster than Labour would have, and to use a higher proportion of cuts and a lower proportion of tax increases. In addition, he introduced some important spending increases (such as £3.7 billion to partly reverse the increase in employer NI Contributions and £3.9 billion to raise income tax personal allowances) that have to be paid for by bigger cuts than would otherwise be necessary.

Alistair Darling planned to cut spending by 2014-15 by £52 billion and to increase taxes by £21 billion; George Osborne’s budget added £32 billion to the cuts and £8 billion to the tax increases (net of cuts in NI, income, and corporation tax). As Tim Horton and Howard Reed have pointed out, the cuts have a disproportionate impact on low income families, even when offset by any gains from the increase in personal allowances.

The scale of the cuts made it obvious that anyone who wanted to make the case against them would have to keep up with a growing list of cuts announcements and that we would need a resource that kept a record of them. Try looking for the 1980s cuts on the Internet – there’s bits and pieces, but there isn’t a comprehensive list. That’s why the Trades Union Congress established Cuts Watch on our Touchstone blog – noting down the news of cuts as we learn about them.

There are three groups of cuts. First, there are the “savings” announced by the Treasury on 24 May, which cut this year’s spending by £6.2 billion. During the election the Conservatives promised that there would be “efficiency savings” this year rather than cuts. The measures on the list include real cuts, such as the abolition of the Future Jobs Fund, the Low Carbon Buildings Programme and the Child Trust Fund and the decision to abandon the loan for Forgemasters. On the same day, the new government began a review of spending commitments made by their predecessors, leading eventually to the cancellation of Building Schools for the Future. Since then there has been a steady trickle of these cuts, emerging from all Departments – most recently the cancellation of Domestic Violence Protection Orders that would have protected the families of violent men while they are going through the legal process necessary to get a longer-term Protection Order. Even people who see themselves as progressive supporters of the Coalition will have at least one item on that list that they believe should never have been touched.

The May “savings” also included £1.2 billion in funding for local authorities and ring fences being removed from another £1.7 billion. This has led to so many cuts around the country that we’ve only been able to report a fraction. One clear theme that is emerging is that the removal of ring-fencing is leaving youth services exposed and in the last week we have reported on cuts to Connexions and youth projects in Birmingham, Hampshire, Norfolk, Sheffield, Coventry, Northumberland and Slough. It seems likely that, by the end of the year, we will no longer have a careers service that covers the whole country

The second group of savings is made up of those cuts that were announced in the Budget. There was the two-year freeze in public sector pay and £11 billion in cuts to benefits and tax credits. Payments to families with babies were hit by cuts in Maternity Grants and Baby Tax Credits and the abolition of the Health in Pregnancy Grant and all children will lose out because of the 3-year freeze of Child Benefit. Cuts in tax credits worth £3.2 billion are dwarfed by what looks like a technical change: uprating benefits and public sector pensions in line with the Consumer Price Index instead of the Retail Price Index is expected to save the government £5.8 bn a year. The Budget announced that everyone who gets Disability Living Allowance is going to be re-assessed, with the expectation that the entitlement of one claimant in every five will be removed. Housing Benefit reforms will put a cap on the amount that can be claimed – regardless of what your rent may actually be – and will subject unemployed people to an arbitrary 10 per cent reduction in their HB once they have been unemployed for over a year.

Finally, there are the rumours of the cuts that are going to be announced in the Comprehensive Spending Review on 20 October. The Coalition’s supporters are working themselves into a lather about the possibility that Trident or the RAF’s Tornados may be scrapped or the army may lose three of its eight brigades – hence Simon Heffer’s proposal that the aid budget should be scrapped instead. Heffer is in a perpetual harrumph about the Cameron government, but the pre-emptive leaking of October cuts is bound to focus attention on the decision to exempt overseas aid from the cuts – the Tory right could mobilise around this issue. Other possibilities that may just be kite-flying but could be genuine leaks include means-testing Child Benefit and scrapping bus passes.

The totality of these cuts – which go far beyond anything envisaged by Alistair Darling – is to achieve a new British settlement with a smaller state and higher levels of inequality. The success of the Coalition will depend on whether they get away with claiming these were an inevitable consequence of the deficit or whether their is a backlash against the inevitable unfairness of this ideological approach.

The British Medical Association in Scotland has told finance secretary, John Swinney to stop being naive and admit that cuts will have to be made to the NHS north of the border. In its final report, published last week, Scotland’s Independent Budget Review made clear its view that the NHS should be subject to cuts as much as other public services, concluding there should be “no overriding presumption of protection for any of the major services”.

Whilst calling for a cross party discussion on how Scotland should address the tough spending choices ahead, Swinney rejected the call for the NHS to face cuts just as any other services will, commenting:

“…we will apply any Barnett consequentials arising out of the protection given to the health service by the UK Government to the health service in Scotland.”

Responding, the British Medical Association warned that whilst cuts to the NHS Scotland budget would be a “seismic shock”, the SNP had to properly plan and prepare for the cuts that are to come.

The BMA has admitted:

“If the scale of real-terms reduction in public spending in Scotland is anything like that envisaged by the review, it would be naïve to believe that the healthcare budget, one-third of the Scottish Government expenditure, could remain immune from its impact.”

Adding:

“It is vital that decisive action is taken now to start prioritising the core functions of the NHS to ensure they are protected as far as possible from the effects of the budget cuts and that quality of care and patient safety are maintained.”

The BMA’s stark calls for a more realistic debate over the future financing of the NHS in Scotland are echoed by concerns expressed by the body representing Scottish local government, the Convention of Scottish Local Authorities (COSLA), that ring-fencing the NHS would mean local government would be faced with having to make the brunt of the cuts to come, hitting some of the most vulnerable the hardest.

The debate across Scotland mirrors that being continued in Westminster, following shadow health secretary and Labour leadership candidate Andy Burnham’s call for the coalition government to drop its plans to ring-fence England’s NHS budget in order to provide greater protection to areas such as social care, under the control of local authorities.

The Coalition government’s plans to introduce a £2.5 billion pupil premium is likely to mean deep cuts in spending on early years, childcare, and youth services or further cuts in other departments.

Michael Gove and Sarah Teather’s join press release yesterday outlines that:

“The proposed pupil premium would provide additional per pupil funding on top of the existing funding provided to schools. Schools will be free to spend the additional funding as they choose to raise the achievement of disadvantage pupils.”

On her blog earlier this month, Lynne Featherstone – the Coalition’s equalities minister – said:

“Obviously – the new coalition government’s ‘pupil premium’ in the coalition agreement – where £2.5 billion will come on stream starting in the second year of government – and where the money follows the pupil with special needs or on free school meals (and which will benefit every single school in Haringey) will be a blessing. However, that will bring us in a lot of money – but equally it will bring money into those boroughs like Camden and Hackney too.”

But the Department for Education’s budget for 2010-11 set out that £46.5 billion of the department’s total spending of £68.7 billion would be on “schools including Sixth Form”. The remaining budget of £22.2 billion is made up of £10.3 billion on the Teachers’ Pensions Scheme and £11.9 billion on support for children, families and young people. Finding £2.5 billion for a new pupil premium from this latter budget would mean a reduction of 24.2 per cent in funding for programmes like Sure Start and Education Maintenance Allowances unless pensions were slashed. This would be above and beyond the cuts of up to 20 per cent being planned by the department. The DoE has already cut £670m from its budget this year. An alternative would be for further cuts in other departments.

Confounding the uncertainty around the cost, the efficacy of the scheme is uncertain. According to the IFS, “the level of funding targeted at deprivation has increased rapidly in recent years, particularly in terms of the funding provided by local authorities.” They go on to conclude that:

“any revenue-neutral or low-net-cost [pupil premium] option is likely to lead to significant numbers of schools experiencing large losses in per-pupil funding. Minimising such losses with additional public spending is likely to prove difficult given the level of fiscal restraint required over the course of the next parliament.”

This prompted the Financial Times to report ”doubts cast on ‘pupil premium’ proposals.” Even with the Conservative’s guarantee during the election that the pupil premium will “not be taken from other schools”, the IFS were only prepared to say that, “there is little more we can say about the Conservatives plans for a pupil premium.”

Last week Vince Cable announced that he had asked Lord Browne to consider a graduate tax as part of his review of higher education funding which is due to report in the autumn. Since then confusion about what skills secretary Vince Cable has proposed and how that relates to the National Union of Students’s proposals has been widespread.

Dr Cable said he was “interested in looking at the feasibility of changing the system of financing student tuition so that the repayment mechanism is variable graduate contributions tied to earnings”. This is the basis of a progressive graduate contribution that asks those graduates who gain the most financially from their education to contribute the most to the continuing of the system.

With this as our base line there are still many variables to decide upon – the threshold at which contribution begins, the level at which the contribution is set, etc – and I look forward to working with Dr Cable and Lord Browne to find the fairest way to set these.

However, over the last week it has become clear that many see Dr Cable’s exploration of a graduate tax as simply a rebranding exercise to mollify Liberal Democrat backbenchers, who fought the election on a promise of scrapping tuition fees, and students, who have campaigned for many years for a fairer higher education funding system.

The Russell Group of universities proposes keeping, and liberalising, the ‘sticker price’ market in higher education and whether you call the payback scheme a loan or a tax it will still be a ‘poll tax’ and not based on ability to pay. That graduate tax is not a graduate tax at all, but fees by another name.

Those sceptical of the idea of a graduate contribution, see only the rebranding exercise and argue that free higher education is the only progressive way to ensure that university education is available to all, and in an ideal world higher education would be paid for through existing taxation, but a graduate tax is a fair and progressive system. It adds a small amount of extra taxation onto those who gain financially from attending university.

The current system, and an expanded market in fees, ask a social worker, teacher or nurse to pay the same for their education as an investment banker, corporate lawyer or high-flying executive. No one could rightfully claim that the former group work less hard than those in the latter group, but they do earn less.

Over the coming months as Lord Browne continues his review, the debate will rage about the best way to fund universities and we must be clear about what we mean when we are discussing the various systems. A true graduate tax is a clear and progressive way of funding universities and removes any link to ‘sticker prices’ decided by institutions based on their self-aggrandising assessments of the future worth of their degrees.

Choosing a place and course of study is not like buying a car and we will ensure that any system that places students in a market place cannot call itself a progressive graduate tax.

Our guest writer is Trevor Cheeseman

Britain’s ageing population is a national success story. Life expectancy is the highest on record, the product of universal improvements in healthcare, social support and education.  A newborn baby boy could expect to live to 77 and baby girl to 81 if mortality rates remain the same as in 2006, though this masks significant regional inequality.

This has a political dimension though: who pays for pensions, but also who pays for care – supporting basic daily tasks like washing, dressing and preparing meals – when we need it, which the NHS does not provide. The UK needs more carers and more care homes, but lacks a sustainable way of funding it. Currently in England, only people with assets of less than £23,000 receive state funding, with many forced to sell their family homes. A percentage levy on estates after death would avoid older peoples’ anxiety about how to fund care costs.

Labour came to this issue fairly late on but it was pursued by Andy Burnham. As health secretary his white paper ‘Building a National Care Service’ proposed “people get their care free when they need it in return for a compulsory contribution… [whereby] society takes collective responsibility for sharing care costs, in a way that will give people peace of mind and will allow them to plan properly for later life”.

This raised the political profile but a key feature of debate was the spoiling tactics of Andrew Lansley when he refused to participate in cross party talks. Instead he attacked Burnham’s proposals as “a death tax”, backed by adverts with tombstone imagery (see right).

Lansley was accused on a BBC Politics Show three-way debate by Lib Dem Norman Lamb, now a Coalition transport minister, of “not being straight with people”. The Tory election campaign advocated an £8,000 voluntary insurance model to cover residential care costs.

Times have changed however, in that this week’s terms of reference for the Coalition’s Commission on Funding of Care Support, published by the Department of Health, do allow consideration of the compulsory option.

The move was highlighted as a major u-turn by Lansley in the Guardian and Daily Mirror., while the Telegraph quotes Lansley from earlier this year on Burnham’s proposal and the poster campaign:

“It was necessary to criticise him and right to criticise him, because frankly it is an extremely bad policy.”

Burnham has welcomed the commission and pledged opposition cooperation. He commented:

“If anything shows how Andrew Lansley played politics ahead of the election then this latest U-turn is it. As with the NHS White Paper, today’s announcement is yet another example of the Tories changing their tune only weeks after the election.”

Care funding is one of a growing number of issues where the divide between the home nations is widening. Scotland took advantage of its devolved powers to offer free personal care for the elderly, which Labour in England rejected as too expensive. However, the body representing Scotland’s 32 councils is the latest to call into question the future of free personal care for the elderly.

Lansley’s Funding Commission has 12 months to make its report. Yet with significant spending cuts for social care predicted by the Institute for Fiscal Studies, Lansley knows he will then have to address the issue of how to fund the care costs from growing old.

Our guest writer is Matthew Pitt, Parliamentary researcher and assistant to William Bain (Labour, Glasgow North East); he recently finished his MA in international law (peace and security) at King’s College London

In the pursuit of implementing policies that will benefit the society as a whole in the name of fairness and progression, Vince Cable announced last week his intent of abolishing the current system of subsidised loans by possibly replacing it with a university tax. Exact details have not yet emerged, but the business secretary has asked Lord Browne to include an assessment of the graduate tax in his Independent Review of Higher Education Funding, which will be announced later this year and is expected to recommend a rise in tuition fees that is currently capped at £3,225.

This, however, does not entail that we should not begin scrutinising his self-proclaimed intent of making the system of university tuition fees fairer. At first sight, a graduate tax would close the ever-widening gap between the rich and the poor by charging a higher tax on those students who move on to higher-earning jobs. But in the same breath he reaffirmed that students will ‘almost certainly’ have to pay more.

Yes, the current tuition fee system may be costly and desperately requires profound change. Yes, it is only fair that those with top jobs should pay more than lower-earning graduates. And yes, by merely lifting the cap on tuition fees the coalition government could in no way argue that its policies are progressive.

Nevertheless, our worry is that whatever job category you fit in, you may be burdened well into your fifties or sixties by a special tax, which you will have to start paying once you earn more than £15,000. Although the tax would go directly to Universities and not the Treasury, the state will inevitably dig deeper into graduate pockets, which necessitates either a high-level tax for a short-term or a slightly lower one for a lifetime.

Back in May, the Russell Group had already termed such a plan as ‘the wrong option’, since those ending up in the upper 20 per cent of earners may have to pay as much as £16,000 a year once they graduate.

As with every policy by the government, the university tax cloaks itself in a robe of savings that will benefit our society as a whole in the long-term. Yet, beneath this disguise lies a sinister truth, which most of us would probably call common sense. Announced non-stop on the news, the Coalition is trying to reduce the UK’s budget deficit and thereby calm any speculation in the markets in the hope of preserving its vitally important triple-A credit rating.

Nevertheless, even with the planned broad introduction of two-year courses, the government will have to cover the massive expenses that would have been paid via tuition fees by the students over the time of their studies.

In an era of unprecedented cuts, the Treasury would have to pay the missing fees directly to universities, causing a financial black hole that will only begin to close after at least two years at which point the benefits of the tax will come trickling in and only gradually replace government spending. Considering the modest earnings that most graduates experience at the beginning of their careers, the time period is likely to be much higher. In support, Neil Shepard of Oxford University estimates that the graduate tax could leave up to £5bn in the budget deficit due to costs involved in the implementation process.

How ironic it would be if this matter of common sense would turn into reality and require the government, which announced cuts in investment in higher education in the name of long-term interests, to cover the costs involved in the implementation of the graduate tax over two to three years (and beyond) in the current unstable economic climate.

It remains to be seen how well thought-through and well-researched the announced policy by Dr. Cable will be once Lord Browne has given his assessment of the graduate tax. As stated in an article on last week, written by the president of the National Union of Students – Vince Cable: Friend of students or con artist? – families and students will not be fooled nor conned by any covering of the graduate tax as fair if it does not fully consider the devil in the detail.

First of all, it needs to clearly set out the exact financial numbers that graduates will need to pay. Secondly, the fog over how long they will have to pay needs to be cleared up. Lastly, the costs of the government in introducing a graduate tax in the first few years need to independently calculated (preferably not the OBR) and announced before the Coalition government ends the discussion prematurely by implementing an idea in its infancy.

The Scottish Government has been told not to rule out the introduction of tuition fees for university students as part of the ongoing debate over how to fund higher education. It comes following Vince Cable’s recent call for a new graduate tax as a fairer, more sustainable model of funding.

In the latest salvo in the battle of ideas over how to fund higher education, Andrew Cubie, who played a central role in drawing up the plans that saw the scrapping of tuition fees north of the border, told the Herald:

“My view is that if you undertake a comprehensive review of any issue, it is not rigorous to eliminate any solution in whole or part before you commence, even if that solution may not at first sight seem attractive.”

Cubie’s comments are just the latest suggestions ahead of the publication of Lord Browne’s review of the subject which will provide food for thought for Holyrood; last week, the think tank Reform Scotland called for a new system of deferred fees, concluding:

“Higher education is something that has to be achieved academically, but it is not fair that those who go to university have their time there subsidised fully by tax payers, many of whom have not had that opportunity.”

The developments have increased pressure on the SNP Government to undertake a similar in depth review of how to fund Scotland’s universities, with Labour’s higher education spokeswoman Claire Baker describing calls for such a review as now being “unanswerable” and Conservative spokeswoman, Liz Smith, declaring:

“Down south there is at least a debate going about the future of higher education and how it is funded, whereas in Scotland the SNP Government is totally narrow-minded.”

In reiterating his party’s manifesto opposition to tuition fees, education secretary, Mike Russell, has pledged to come up with a “uniquely Scottish solution” to the problem, stating:

“When we know what the recommendations are south of the border, we will publish a green paper that looks at the proper solution in Scotland, which may include a variety of new proposals.

“There are things that all universities are thinking about, the way they can do things differently, and then we will move to a sustainable Scottish long-term solution.”

However, on Friday it was reported that the Holyrood administration would be considering the prospect of introducing a new graduate tax in line with Vince Cable’s suggestions.

Responding, Liam Burns, president of NUS Scotland, said:

“Although we should look first to the state and businesses to fulfil their responsibilities to higher education, a progressive graduate contribution, which only kicks in when you see a genuine financial benefit, and explicitly increases the amount students have in their pocket while they study, is certainly something we should consider in Scotland.”

On Thursday, the Association of Investment Companies reported that whilst Scottish students were less worried about debt than those elsewhere in the UK, they were more worried about their job prospects once they graduate.

Our guest writer is Tehmina Kazi, director of British Muslims for Secular Democracy

During the last fortnight, various newspapers have reported on a BBC London News investigation which showed that some Muslim pupils were being withdrawn from music lessons. This week, a Daily Mail headline screamed: “Council FORCES schools to re-arrange exams and cancels lessons to avoid offending Muslims during Ramadan” – relating to guidance received by headteachers at Stoke-on-Trent Council in Staffordshire.

The newspaper left it to Councillor Ruth Rosenau to clarify that no-one was being forced to implement anything; this was mere guidance on an issue which leaves many people stumped (some Muslims included).

Unlike sex education and R.E, music is a compulsory part of the National Curriculum. Most of the coverage on the music story quotes Eileen Ross, head of Herbert Morrison Primary School in Lambeth, where almost a third of children come from mainly Somali Muslim families:

“There’s been about 18 or 22 children withdrawn from certain sessions, out of music class, but at the moment I just have one child who is withdrawn continually from the music curriculum…

“It’s not part of their belief, they feel it detracts from their faith.”

It is important to assess why music is singled out in this way, particularly given the increasingly multi-faith and multi-cultural nature of our educational institutions.

The Muslim Council of Britain in turn stated that 10 per cent of Muslims, a small minority, would subscribe to the view that music is haraam (forbidden). While there is a plethora of scholarly opinions on this issue, it is extremely telling that Dr Diana Harris, author of the book Music Education and Muslims, told the BBC:

“Most of them really didn’t know why they were withdrawing their children. The majority of them were doing it because they had just learned that it wasn’t acceptable and one of the sources giving out that feeling was the Imams, particularly Imams who had come over from Pakistan, didn’t really speak English, and felt threatened. I think they were adhering to very strict lines about what was acceptable.”

These parents most probably thought they were doing ‘the right thing’ by removing their children from music lessons, not realising the wider implications for the education of minority communities in Britain.

Dr Harris has conducted research into the issue discussing the lack of Qu’ranic references to music. In a paper for the National Association of Music Educators, “Teaching Music to Muslim pupils: Issues and Considerations for Primary and Secondary Teachers/Trainees,” she states:

“Music itself is not referred to in the Qu’ran.  Some scholars believe that the phrase ‘idle talk’ refers to music but this can only be speculation.”

British Muslims for Secular Democracy, the organisation that I work for, released a guidance booklet in February 2010 for teachers, to help them address cultural and religious issues affecting Muslim pupils. We confirmed the above view that there is no specific Qu’ranic proscription of music, and assert that creativity is considered to be a divine blessing in Islam.

While conservative Muslim scholars prohibit the use of instruments (except basic percussion), there are others who state that as long as the songs in question do not promote obscenity or immorality, music is not outlawed in Islam. Robert Bunting has written a chapter in Maurice Irfan Coles’ 2008 publication, “Every Muslim Child Matters” where music is described as a gateway to creative and critical thinking, to communication, literacy, cultural understanding, global awareness and citizenship, plus a means for young people to communicate with a wider audience.

Let us also not forget the influence of individual cultures on these decisions.  At Dr Harris’ “Music Education for Muslims” Conference in 2002, the Switzerland-based scholar Tariq Ramadan said:

“We are saying, for example, as Muslims, that Islam is a universal message.  It means that when we speak about a universal message we are speaking about different cultures and when we deal with different cultures we have to know what is the context we live in, in order to link the universal message with the context of the specific environment.”

Dr Harris’ own interviews with Muslim parents show that Bangladeshi women in Tower Hamlets were not concerned about music from a religious point of view, but they were afraid of children losing their own culture if they only heard Western music in school.

Imam Zaki Badawi stated in the Society of Muslim Researchers’ 1993 “Proceedings of the Conference on Islam and Music: Much Ado About Music Education” that 90 per cent of people who objected to music in schools had never been inside a school, let alone inside a music class.

This highlights that it is not just educators who need to equip themselves with the skills to teach in a multi-faith environment. Muslim students and their parents also have a responsibility to learn how to adapt to them, and with British schools and teachers under increasing scrutiny, teachers may often be inclined to acquiesce to every cultural or religious demand from pupils’ families.

This however, is not a satisfactory solution, particularly when certain parents do not really know why they are making the demand in question. The Islamic Elementary School of Berlin has grappled with these issues, and director Christa Petersen is often able to ameliorate the concerns of parents – even a father who demanded the withdrawal of instruments from music lessons – without reference to the state.

While practices and beliefs which define groups and individuals are indeed precious, they cannot become the sole basis for educational policies.  This approach seems to be one that will increase resentment in the future. Cultures are continually evolving and schools need to reflect this by being flexible enough to treat all pupils equally. This, in fact, is the real test of commitment to tolerance and understanding.

It is crucial that our children are raised as well-informed individuals with open minds, and it is equally important that they make the effort to adapt to their society and their school environment. The true meaning of multi-culturalism is people living side by side under one shared identity, whilst proudly holding on to their own so that nobody feels resentment or a lack of belonging.

With this vision we can fight back against fringe groups that insist that Muslims and Islam are “incompatible” with Western democracy, and it starts with the education of children. By encouraging all students – including Muslim students – to view each other as equals, we can take steps to correct the disengagement that has been felt by many British Muslims for far too long.

More details from the NHS white paper are emerging on the extent of marketisation and the role of competition that the coalition is planning to introduce. Until now the internal market in the NHS has been governed by specific ‘principles and rules for cooperation and competition’.

But the white paper published this week proposes the introduction of competition law, thus treating the NHS like any other regulated industry.

While media coverage has focused on the abolition of Primary Care Trusts and the use of GP commissioning consortia to purchase care, the marketisation agenda has been largely overlooked.

Left Foot Forward reported in March on the implications of Tory proposals to use competition law to force services to be commissioned through open tender. As shadow health secretary, Andrew Lansley had criticised Andy Burnham’s limits on the involvement of voluntary and independent providers.

The white paper reveals that increased competition is to be introduced by converting Monitor, which currently regulates foundation trusts, into an economic regulator of all NHS care providers, from 2013. Monitor’s role will be to promote competition, to regulate pricing, and to support continuity of services in those areas that are not financially viable.

In its plans the government makes explicit comparisons between Monitor and regulators of utilities:

“Like other sectoral regulators, such as OFCOM and OFGEM, Monitor will have concurrent powers with the Office of Fair Trading to apply competition law to prevent anti-competitive behaviour.”

Monitor will:

“Help open the NHS social market up to competition, as well as… require monopoly providers to grant access to their facilities to third parties; or conduct market studies and refer potential structural problems to the Competition Commission for investigation.”

The white paper also refers to preventing anti-competitive purchasing behaviour. This means that GPs sitting down with hospital consultants to discuss care pathways could be outlawed as collusive. Other providers, such as private companies, would be able to take the GP Commissioner to court were they excluded from opportunities to bid to provide care.

Though not widely discussed thus far, it seems inevitable that the coalition government’s package of reforms envisage a marked increase in the role of private companies in healthcare provision. This is caused by the move away from the previous government’s stance that NHS organisations should be the preferred providers of care, combined with the emphasis on competitively open tenders which can be prohibitively costly for NHS bidders.

Business Secretary Vince Cable’s announcement this morning in support of a graduate tax today is an important milestone in the campaign for a fairer university funding system, but we will only celebrate when he has made good on his word and the unfair and regressive system of student fees has been consigned to history and replaced with a progressive alternative.

NUS has long supported, costed and advocated a progressive graduate contribution based on earnings after graduation as an alternative to the regressive market logic of tuition fees. Vince Cable is right to say that if the current system of top-up fees is a form of graduate tax, it is comparable to the poll tax.

Not only does it share key features of Thatcher’s disastrous levy, but it is also as deeply unpopular.

It is quite right for Dr Cable to ask why, under the current unpopular and regressive top-up fee system, a care worker or teacher is expected to pay for their education as much as a corporate lawyer or banker.

A fairer system would involve the abolition of sticker prices in prospectuses based on guesswork and their replacement with a contribution determined entirely by future earnings. This would end the very notion of tuition fee debt.

The fair solution is to abolish tuition fees and ensure that graduate contributions are based on actual earnings in the real world, rather than sticker prices in prospectuses, which are based on guesswork.

It is now crucial that the Business Secretary makes good on his stated priority of delivering a fairer funding system for students, and we will scrutinise and judge him, his department and the Government on that. It is quite clear that students and their families are not prepared to be treated as fools or conned by rebranding and marketing exercises.

A genuinely progressive graduate contribution has certain key features, and this will be the acid test of Dr Cable’s stated priority of ensuring students see the funding system as fair. We will hold him to it.

It is now incumbent on him as the Secretary of State in charge of universities to make good on his commitments, including that made in his manifesto to abolish fees, on the basis of which he was re-elected as an MP two months ago.

Where the Business Secretary is wrong is in suggesting that a fairer higher education funding system must come at the expense of cuts to university funding or student places, or both. At a time when we need more high level skills to speed the economic recovery, and when countries like France and the United States are investing in universities and students, it is both unfair and short-sighted to believe cuts will be in our long term interests.

Dr Cable is right that that greater flexibility is needed in higher education in combination with greater fairness, and this includes expanding the range of study options and modes. However, it would be wrong to force students to take two year degrees or to stay at home because they would not otherwise be able to afford the cost of university. The re-opening of a two tier system would not be in line with his stated aim of greater fairness for students.

The devil may very much be in the detail of what the Coalition Government eventually propose. What is clear is that Dr Cable was re-elected as an MP just two months ago having personally signed the NUS pledge to students and their families to vote against any rise in fees, and to work to introduce a fairer alternative, while the Liberal Democrats as a party have made much of their pledge to abolish tuition fees entirely.

Students and their families are not fools, and will not be conned by rebranding exercises or marketing drives, so we must now be clear – failure to meaningfully live up to these promises will simply not be tolerated and accordingly we will hold Dr Cable and the Coalition Government to account in the weeks and months ahead.

Yesterday’s announcement that all 302 152 Primary Care Trusts in England will be abolished by 2013 with more power given to GPs represents a complete about-turn from the Coalition Agreement of less than two months ago, which promised directly elected patient representatives on PCT boards and pledged that local PCTs “will act as a champion for patients”, commissioning services best undertaken at a wider level “rather than directly by GPs”.

The agreement, pages 24-25, clearly states:

• We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT).

The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board. This will ensure the right balance between locally accountable individuals and technical expertise.

• The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs.

It will also take responsibility for improving public health for people in their area, working closely with the local authority.

At no point does it mention their abolition, but quite the opposite, namely that PCTs would be stregthened and democartised. Now, they are in fact going to be split up between councils and GPs – yet even the supposed accountability to local councils isn’t fully democratic, as they will also be answerable to a national body.

Earlier today, Left Foot Forward looked in detail at the health secretary’s white paper, highlighting one of the most fundamental problems the plans will encounter – that most GPs do not want the hassle of strategic planning, negotiating multi-million pound budgets and making unpopular decisions about NHS service organisation and costs – and asking whether the white paper marks the beginning of the end of the NHS.

Our guest writer is Trevor Cheeseman

David Cameron has made no secret of his desire to roll back the state – but was careful in opposition to try and reassure voters that the NHS would be safe in his charge. The Coalition document even promised “no top down reorganisations” for the NHS. Instead, two months on Andrew Lansley’s new White Paper ‘Equity and Excellence: Liberating the NHS’ is being described as “the NHS turned upside down” by a leading health commentator.

The main proposal is to make GP “consortia” take over budgets for NHS services from local Primary Care Trusts (PCTs). £80 billion of public money is to be given to GPs from primary care trusts to commission NHS services from 2012 – by assessing local need, setting contracts for local health providers and monitoring those standards. This builds on the Tories’ GP fundholding of the early 1990s which had high transaction costs and led to differential service standards between GP practices.

There are some fundamental conflicts of interest in giving GPs the final say over real funding streams: GPs are independent contractors, running businesses seeking to maximize income; they will also now hold massive budgets which they may choose to spend much of on services they run themselves.

Yet there is a more fundamental problem: most GPs do not want the hassle of strategic planning, negotiating multi-million pound budgets and making unpopular decisions about NHS service organisation and costs. In fact, clinical commissioning as an idea is nothing new – for the last five years Labour ran Practice-Based Commissioning (PBC), a voluntary scheme that allowed GPs considerable influence on how services are commissioned, but with PCTs having the final say.

By any objective measure, progress has been challenging: the Department of Health’s recent survey results highlight a decline in interest in PBC and a consistent minority of GPs who actively oppose the principle of GPs getting involved, such that the DH’s  lead GP referred last autumn to PBC as “a corpse”.

Yet the White Paper is thin on detail, with key points unclear. Will GP consortia be allowed to retain budget underspends; and what will happen if they overspend their budget? Not insignificant questions given this proposal coincides with what even Nick Clegg admitted at the weekend was “an extraordinarily tight settlement for the NHS”. How will regulation be undertaken? Again, the detail is absent.

Could this White Paper mark the beginning of the end of the NHS, or is it hyperbole to suggest as much? Certainly the principle of a service based on needs, and free at the point of use remains. Standby, however, for rows during  this Parliament – on the “postcode lottery” of differential service standards now likely to develop, and on health top-ups, such as for expensive drugs or faster access to services.

And not forgetting the prospect of those private sector companies required to “support” GP commissioning consortia being allowed to refer to their own (or arms’ length) providers’ services who run private hospitals, primary and community services.