Feels like the old days?

Yesterday LinkedIn floated on the NYSE and in the first day of trading their shares screamed upwards, doubling in value. According to the BBC

"LinkedIn sold 7.84 million shares at $45 each. At $100 a share the company is worth about $10bn."

It's one company, one float, but it does feel a little like the old days when internet companies took off at a million miles an hour. The Financial Times has already started reporting that there are fears of a return to the bubble saying 

"...it also drew warnings that a new internet bubble might be in the making, with investors rushing to pay prices far higher than a level that was considered extravagant only days before."

If there is significant demand for new internet floats there may be something in this. But I'm left feeling that we're about to go round the merry go round again having learnt nothing from the last ten years. 


This is a real failure of vision, we have not replaced old models of growth either at the company or the country level with anything meaningful. Without that the old models will hold and we'll be open to repeating our mistakes that led to the credit crisis and the recession again. 


Not that anyone in LinkedIn should be worried. They've pulled off a great flotation. Here's hoping that there is a real, long term business under the hood.


Finbarr 

I don't want choice

So the reforms proposed for the NHS rumble on with a listening exercise and much debate on whether this is the end or the saving of the NHS.

One small point that has bothered me for some time now is the chimera of choice. Much has been made of patient control and choice, that patients want choice and that choice will drive improvements in the system. My knee jerk reaction to this is that patients don't want choice, they want good healthcare. They want to be well. They don't want to be spending valuable time trying to figure out which provider might be slightly better for them.

This may be simplistic but real choice is not possible. Can I choose any provider at any time for any treatment? No and that's ok. I want to have faith in my doctors and ensure that they are the best trained, best resourced and given the support they need to focus on my care and nothing else. Not budgets, not distribution or anything else. Just care.

There is an interesting piece by Angela Coulter from the BMJ last November which tries to pull apart choice. As I read Coulter's piece there is a world of difference between choosing a provider and choosing or helping to choose a treatment plan. Here's the key quote -

Although only a small minority of people want to switch providers, patient surveys show a
large unmet demand for greater involvement in treatment decisions

So in the debate on reform at least on the issue of choice let's use our language properly and support patient engagement with their care, but let's not mislead people into thinking that they have full choice.

F

Process stories, process stories

As the results of the local elections across the UK start to come in the next wave of frustrating reporting has started. It is true that the Lib Dems are getting beaten up quite badly currently down 336 councilors in England alone according to the BBC. However, the process stories of what went wrong and the continuing characterisation as this being highly personal to Nick Clegg are frustrating.

Without access to internal polling or YouGov numbers, what appears to be happening? The Conservative vote is the same. They should not be so smug, they have a solid voting group but that's not increasing. The Lid Dem vote has shattered, with those who came to them from Labour in the last election going back, those who feel betrayed by the coalition move going to other parties such as the Greens, some Lib Dem voters who are almost Tory going over the line and a core group of Lib Dem's staying with them.

Would this carry over to a Parliamentary election? Given the mood of the country probably. Are the Lib Dems now a spent force in national politics? It is difficult to see how they might come back. Unless ...

One scenario for the Lib Dems to stop the bleeding might be a leadership challenge from Chris Huhne followed by a no confidence vote in the Commons and return to the polls. Would there be enough votes to bring down the coalition? Assuming all Tories vote to remain in power (305) and all others beyond the Lib Dems vote for a new parliament, the Tories would need 21 of 57 Lib Dems to stay the course. How likely is that right now?

Although having said that are Labour too comfortable in opposition? Would they want to take over right now? Probably not.

It seems we might be stuck here for a while ...

Best

Finbarr

Voting rubbish

Over the past couple of months there has more rubbish written on the UK voting referendum than I thought possible. Both sides have been at it and in the end it has become personalised, around Nick Clegg.

This is a really sad statement on the level of debate in this country. No chance of a grown up, engaged debate.

For what it is worth this is the wrong referendum. AV is a tweak. And is not some massively complex thing that simple people cannot get their heads around. It feels like the public have willingly been treated as idiots.

Apparently David Cameron has said a no vote would be a 'disaster'according to the Telegraph. The Lib Dem's have been posturing with clashes in Cabinet, reported by the BBC.

This is all rubbish. AV is a small change and will lead to very little difference in the outcome of elections. Unfortunately it has obscured any debate on the need for real constitutional reform.