“Constructing a Humanist Politics”


Issue No 10 Friday 7 November 2008



This week


  • Allowing Top Up Payments For Medication Will Usher In Top Up Health Insurance. We Must Act Quickly To Regulate This

  • Brown Courts Trouble With Ill-Thought Out Proposals For A “Bill Of Rights And Responsibilities”



News Stories

Highlighting  news stories important to the Civic Republican view, particularly those that are overlooked or little covered in the main media.




National Health Service patients are to be allowed to pay privately for life-prolonging cancer drugs that the state does not supply. Alan Johnson, the health secretary, will end the practice of withdrawing care from patients who pay privately for better medicines in an announcement expected to be made to parliament this week.

The government has previously banned the practice of NHS patients buying extra drugs privately (known as “topping up”) as ministers claimed it would lead to a two-tier NHS. Ministers will try to avoid the embarrassing possibility of two patients on the same ward receiving a different quality of care for the same illness by asking those paying for supplementary drugs to have them administered at private clinics or in the private wings of NHS hospitals.

Up until now those who can afford it (and who have sufficient confidence in private health insurance companies to pay up) have been able to take out private medical insurance. Alternatively anyone can pay for their own treatment from their own pocket.

But the minute you pay for any part of your treatment you forfeit the right to any subsidy form the NHS for the treatment. You have to pay the whole lot.

Once the principle of “topping-up” is accepted the next natural step is for insurance companies to offer insurance for the costs incurred in the “topping-up” – instead of as now funding the whole treatment or nothing at all.

This would be like the French system were most people have top-up health insurance. Because it is only a top up payment by the insurance companies it is affordable for many. Fifty pounds a month would be a guide figure but many pay less.

If this is to be done in Britain, an absolutely essential feature of the French system that must be carried over is that the insurance companies must not be allowed to ask questions about the person’s health history. The so-called “mutuelles” that provide this insurance can only compete on price.

The result is that

•there are no cumbersome forms to fill in,

•there are no disputes about payment,

•there is no nerve-wracking discussion with a loss adjuster when you make a large claim,

•premiums cannot be put up following a claim (and no “no-claims bonus” can be awarded incidentally),

•the payment by “mutuelles” is integrated with the computerised system of state payment

•a widespread use is encouraged making the insurance viable for the “mutuelles”.

Anyone who has dealt with British private insurance knows what a stressful and often fruitless exercise it can be. The almost universal practice of not insuring for “existing conditions” makes the insurance virtually worthless in many cases. The inability of the French “mutuelles” to enquire about existing conditions is what creates all the above benefits.

The French system of top-up insurance deserves to be looked at urgently following the health secretary’s announcement. This must be done immediately before unregulated insurance policies are offered.

The British people’s appetite for unregulated financial arrangement has been fully satisfied!




Brown Courts Trouble With Ill-Thought Out Proposals For A “Bill Of Rights And Responsibilities”.


The prime minister’s high-profile plan to introduce a “bill of rights and responsibilities” is in disarray following a cabinet revolt. A cabinet source said: “The whole thing was panned. Nobody spoke up for it. It was total humiliation for Jack Straw, Minister of Justice.” Brown had hoped that by matching new rights with “responsibilities”, the government could avoid accusations of giving people more rights with no duties in return.


The Prime Minister’s proposals to link rights to responsibilities run counter to the Joint Parliamentary Committee’s report on human rights which said that rights should be absolute and not dependent on an individual’s performing some laid down responsibilities.


Some ministers fear that any political gain from laying down new responsibilities for citizens would be outweighed by a public backlash over the new rights proposed.


It appears that Brown is interested in going with the committee’s report in granting some economic rights but the government’s legal advisers have warned of “massive difficulties”, questioning how social and economic rights could ever be “justifiable” - enforced by the courts.


However, the Joint Committee’s report made it clear that “economic rights’ should never be subject to judgment by the courts as this would put them in the way of political decisions. The report proposed that a form of words should be found that would nevertheless define some kind of responsibility on government to protect the economic well-being of citizens


The Civic Republican Manifesto advocates that citizens should be guaranteed a degree of Economic Enfranchisement defined by:


  1. Right to education

  1. Right to work for fair pay and conditions

  1. Right to be taxed fairly

  1. Right to good inexpensive public services, such as healthcare and public transport

  1. Right to fair state awards/benefits


To a degree these already exist under legislation. The proposal in the Manifesto is that these should be given weight in the constitution.


The Joint Committee report sees the preamble to a Bill of Rights as the proper place to state such general objectives and advocates that they would provide an objective that policy should be directed towards.


As an example the New Labour government has betrayed the people in its management of the financial services. There is no question of the people seeking redress through the courts but a bill setting out a generalized right to economic enfranchisement by the government would mean the government could in some sense be held to account.



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…….Until next week