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Health seems to have become the theme of the day in the Lib Dem leadership debate, at least amongst bloggers (John Dixon's "A Radical Writes" here, and Tristan's "Liberty Alone" here as examples). The two candidates themselves have both now produced manifestos of sorts with Chris Huhne (page 9) promoting "the principle of universal access on the basis of need" and Nick Clegg earlier (despite John Dixon's interpretation otherwise) setting down the principle that "our universal public services must be free to use and accessible to all".

Both have admirable reasons for wanting to retain this universality and free access; that if we choose any other paradigm the poorest will miss out by not being able to afford to pay in a non-free system. But, as I've said about education, and more recently touched on in my piece about protectionism last week to me this seems, if you pardon the terrible health-related analogy, merely a sticking plaster. The ideal revolutionary liberal position surely would be to ensure that everyone had the financial wherewithal to participate properly in a market system and then to trust them to make their own choices.

On the day that the Marmot report into diet and cancer appeared, and whilst acknowledging that he said that his commission was still to deal with policy recommendations, one can be fairly certain that they are not going to recommend that the government, local or national, takes control of what dietary choices people are allowed to make. And yet our knowledge increases all the time that such choices are likely at least as important to our health outcomes as the treatment we may receive once we are ill. So why do we not do the same for illness care when all the evidence suggests that despite £110bn a year public expenditure, we are still the "sick man of Europe"?

Surgeons operating
Originally uploaded by el Reino

The NHS was, I believe, a fantastic idea at the time, in the context of the war on the five wants. In a near bankrupt nation post-war it was also clearly in the national interest to try to use economies of scale and national bargaining to ensure that you could provide a basic level of universal service to all. But let's face it, right now it is a gigantic protection racket, the mother of them all if you ask me. We also heard today that the average GP salary is now at £110,000 - a ten per cent rise in the second year of their new contracts - and yet the Department of Health today has said that 1200 British medical graduates are unlikely to get training places in the UK this year. So there's almost certainly an economic rent arising from the triple protectionism of the NHS, the GMC and the BMA.

Hopefully at least this and the national bargaining for other staff would end with localization so that those parts of the country where it is difficult (read near impossible) to live on a Grade D nurse's salary can offer decent packages, but I haven't even touched on the protectionism of NICE, NHS drugs contracts, the drugs patenting system as a whole and the stifling bureaucracy surrounding anything innovative by way of ways of treating and so on.

None of this is to say that the "private sector" is necessarily the best solution in all areas. I'm against monopoly and public protectionism, not public service per se - after all the nature of the hippocratic oath is dedication to a public service. And the worst of all worlds could be one in which there's a certain amount of public funding up for grabs by private operators who have no incentive to innovate and be really efficient - that's simply transferring the protectionism to shareholders.

No, the problem is really one of how to ensure that everyone would have the ability to pay for their choice of provider. And I return to the Citizen's Income and the systemic economic imbalances that concentrate unearned wealth, or more correctly the wealth created by the community as a whole rather than by an individual's or firm's own innovation, investment and labour. I'm not a good one to talk on health issues - the last psychiatrist I saw reckoned my attitude to my developing diabetes was one of the "slow suicide". But I'll bet if I was faced with a bigger insurance premium or buying more fruit and veg instead of eating crap, I'd probably plump for the healthier lifestyle to minimize my insurance. Redistribute the common wealth properly to everyone as is our birthright and we have these choices.

Just look at Nuffield Hospitals Group right now - it's buying up private gym firms like Cannons (effectively turning private companies into social enterprises of course). Why would it be doing that? Because BUPA really wants its members to live healthily, not to call on them when they're in a preventable medical condition. I'm also sure that insurance firms are likely to be better, with safeguards against abuse, at sifting out bad clinicians; it's in their interests to do so. Their actuaries will be poring over doctors' success and failure rates to ensure they're not granting accreditation to people whose patients inexplicably drop like flies, or who routinely over-diagnose or over-prescribe. Nor would they be likely to allow their members to spend a single night in a hospital where they're more likely to come out with a worse illness with attendant higher costs, if they come out at all.

One model I've looked at, for example, would see a GP as a "personal health adviser" who advises their clients through the maze of choosing lifestyles, treatments, clinicians and therapies that will be efficient and varied. I'd like to see surgical firms organized more like barristers' chambers with large national firms specializing in different clinical areas ready to hot-foot it to a treatment centre several hours away at the drop of a hat to do an op in their specialism rather than a patient wait on a list for the local, perhaps only semi-specialist to have a free spot in a tight general surgery list. You could have a choice of a large general hospital sized treatment centre thirty miles away in the local city, or a ten bed rural town cottage hospital with one theatre with the same surgeon prepared to visit either for the right fee but with different approaches to aftercare based on different needs of patients and families.

Sure, there's still a role for some kind of local democratic input - most especially in procuring facilities and staff for emergency medicine, but even their funding options could be varied - with some able to provide that by engaging local charitable resources, others perhaps by raising a local tax of some kind, perhaps even through planning obligations, who knows. But one thing is certain: these options and innovations are unlikely to appear when the system is riddled with protectionism and political game-play.

I know the Lib Dems are always on about how terrible it is that other parties plagiarise our own policies and take the credit, and I thoroughly approve of today's "Making it Happen" announcement and policy document at least as to direction. But might I humbly suggest that when our people are scrambling around in the bowels of government looking for these savings that seem to have been promised by every aspiring government since Nebuchadnezzar they could do a lot worse than to shamelessly borrow these fellow travellers' ideas on demolishing the QUANGOcracy.

There. £64bn savings. Done!

This year's election campaign takes me to my home ward of Headington Hill & Northway in Oxford. I have not previously had the opportunity to stand where I actually live, and have done for a dozen years now, but I have to say there is a certain amount of slightly smug satisfaction in saying so, as I find I am the only candidate in the ward who actually lives here. It will also of course be the first time I have been able to vote for myself. I hope I remember!

I can say with absolute honesty that "mine is the same bus service you have to put up with" or "your local Co-op is the one my Co-operative membership was registered at and is my twice weekly shopping place". My local chippy is in the ward. And where I buy my lottery tickets (yes, I know - fool and money and so on...) is also your corner shop. When I cross the main road to get to them I have to run the gauntlet of the same traffic, often speeding, or coming from five different directions at once, as you do.

It is a most unusual ward, with a very diverse population and distribution of households:

At the one end we have 1200+ students in halls of residence, where I am based. Most of these residents live here for just the two academic semesters of their first year at the university, so they change every year, they are usually new to the city, and often to the United Kingdom and many are away from home for the first time for any extended period of time.

Next there are multi-million pound houses in a series of private, almost country, lanes. Some of the most expensive property in the city is here. The older ones in particular each have interesting stories about who commissioned them (usually late 19th and early 20th century university and city grandees). And if you are careful, looking on a map you can still work out where the farm boundaries lay by the age of the pattern of each piece of subsequent in-fill development. And if you are not careful, and don't look at the map carefully enough, you could get lost in here, as I did the second night after moving into the hall all those years ago and ended up walking round and round the same circular street in the dark!

Then there are a couple of biggish chunks of private inter-war housing in the main - you know the ones - they make up a lot of Britain's cities - the hipped roof, bay windowed semi-detached homes, in relatively formally laid out estates, usually, as in these cases, with a theme to the street names - here it's mostly the lake names from the Lake District but also the musical theme of composers and players associated all, I think, with Oxford University.

And then beyond them, and inside the northern bypass nestles a middle sized estate of post-war originally local authority built housing rising up the side of the foot of the hill on which Headington stands and which made it such an ideal spot to be the home and lookout of Saxon kings. Quite a lot of this is of course now in private ownership but substantial parts are still council tenants. We also even have one of Oxford's five only tower blocks here - which must offer some residents a most fantastic view of the city's famous skyline.

Several major city employers more or less surround the ward on the east and the south - with my employers, Oxford Brookes University at the southern end, a couple of private schools in the middle and the JR Hospital complex at the northern end. All of these put pressure on the ward, particularly as regards traffic and housing, and whilst it's not the most popular area with students when living out, being on the wrong side of Headington Hill for the main student scene, there are plenty of houses in multiple occupancy housing both students and young workers having to share to make housing costs affordable in Oxford.

It is virtually all residential, with one pub only in the ward itself, together with a British Legion Club, three student union bars and a 1200 capacity club venue. There's one Anglican, one Catholic, one United Reformed and one Evangelical church in the ward and also a community of nuns. Two small rows of neighbourhood shops and, apart from the two private girls schools already mentioned, a Catholic state primary school and a non-denominational state primary school. What was formerly a middle school until a previous round of schools reorganization is now a community centre and social club, combined with offices of the city council and the home of the Oxford Womens' Training Scheme and the Oxford Lawn Tennis Association. Its former playing fields now create what is effectively a "village green" for the Northway estate, with football pitches and so on.

There is a small youth centre, one doctor's surgery and a dental practice - two if you include the one in the Students Union building at Brookes. And what was previously a girls' state secondary school is now home to Brookes's School of Health & Social Care. We have mainly one public service bus route to and from the city centre and one of the Brookes Bus services links the School of Health and Social Care with other Brookes facilities in east Oxford and eventually the City Centre. There is a much less useful cross town service which is a shame because the suburban centres of Headington and Summertown could do with the patronage.

We have three parks, one of which is a private nature reserve, all of which, from the vantage point of the side of Headington Hill itself, offer beautiful glimpses of the city centre, the Cherwell valley and the countryside beyond the ring road. The nearest main shopping area is probably Headington itself, but since radial traffic in Oxford seems to flow better than orbital traffic, the City Centre is often easier to get to, especially if you are reliant on public transport.

As is common where there have been no new laid out streets in the past fifty years, most of the roads and pavements are in varying states of disrepair, none were designed for as much traffic as now tries to cram down them and some, that were really never designed for much through traffic at all in the days when the main roads had plenty of spare capacity to keep traffic flowing have become regular, and quite dangerous in places, "rat-runs".

As is also common with areas of predominantly inter- and post-war housing, in places the community is now beginning to feel under siege a little and slightly out of control as original residents die and their houses are snapped up by small developers wanting to make a bit of money by creating a couple, or more, of flats, albeit it, dear knows they fill a great need in a city of house price hyperinflation. Victims of their own success and location in a way, many of the houses are just now out of the reach of family buyers these days in what would be, and probably once were, ideal surroundings for young families.

Sounds pretty average suburbia? Not a bit - every race, every walk of life, every level of the social and economic ladder is represented here. It is in microcosm a mirror of the whole city. Whilst on average not especially deprived, it has quite a large elderly population and so there are people who need more, and more local, services and facilities than they get and also quite a lot of people who have seen the area change a great deal and who are ever sensitive to more change in their neighbourhoods.

So what? Well, all of this is a most long winded way of me saying that this is a different kind of election for me than previous ones. It feels different. In a very real sense this is about way more than politics. This is about me offering myself as representative in the service of the place that I live, that I have lived in for nearly a third of my life. And that if in three and a half weeks' time I wake up on a Friday morning having won Headington Hill & Northway, I want everyone in the ward to know that they can call on me as a member of their community, whatever the issue, whoever they are, and I will do my best to help them.

If that happens to assist in the spread of Liberal Democrat support, influence and policy at the same time, that would be great!

You'd have thought that a city in which the Green Party regularly polls up to 20% of the vote, holds a quarter of the county council seats and a sixth of the city council seats (and the latter in a minority administration to boot where their vote in council can effectively make or break a policy) and where they have been in a joint administration even, would be one of the most sustainable cities in the country.

You'd be wrong:

OXFORD people are among the greediest in the country in consuming the Earth's resources, according to a new league table.

A report by the Worldwide Fund for Nature ranked the 60 cities in England, Scotland and Wales by their residents' average ecological footprints - and discovered each Oxford person consumes more than three times the resources the planet can sustain.

It used data from local authorities to calculate the area each city's residents needed for food, energy and resources and to absorb waste and pollution.

Oxford ranked joint 55th out of the 60 cities, with its residents having among the five largest footprints for housing, consumer items and private services.

I'm sure they would tell us it's all because we don't carry out enough of their policies. My hunch is that in fact voting Green is for most people a substitute for taking personal action. That voting Green is "doing my bit for the environment".

I suspect Oxford's bad showing is nothing to do with local politics, but partly that in the big picture we are a city with a global reach. That we probably have a greater proportion of residents who are visiting from overseas and travel back regularly - at university vacations and so on - certainly judging by the success of the multitude of Heathrow & Gatwick bus services. That we are a magnet for London commuters so have a higher proportion than other cities of people who commute 120 miles a day. And that the city ballooned in the rapid growth of the motor industry resulting in hundreds of acres of relatively inefficient inter-war housing making up the bulk of our built environment.

These are structural issues that are too big for what is seen often as a crusty, crypto-communist, community politics organisation to address purely locally. It needs real devolution of power that can only be granted by the Westminster players so we can have real control of our own development as a city, changes to the way we tax people for environmentally damaging habits and so on.

One thing the Greens could do locally, as some have in the past with the Oxfordshire Land Value Tax study, is to support my calls for Oxford to be allowed to trial LVT as a replacement for the Council Tax, city wide - see if we can't persuade a majority of the city council and city representative county councillors to support such a move. That's part of the bigger picture that we can try to address, and it's their party policy. Efficient use of land is key to reducing our footprint, to getting people able to commute less, to use more local suppliers where possible, to remodel the city with an efficient built environment and so on.

I caught this on the BBC:

It is this last part that really gets me riled:

What utter bollocks, to use the technical turn of phrase, when applied to a parent. In the public gaze, there will be a parent taking a taxi with their child, acting as parent and under their authority alone as parent. The whole purpose of the CRB type legislation is to reassure those with primary caring responsibilities for vulnerable people, usually parents and other guardians, that others, when put in positions of contact or responsibility for their wards, children and relatives, have been checked out.

Do parents living in council housing have to be "CRBed"? Does a parent waiting with their child in an NHS medical facility waiting room have to be "CRBed"? Or even a parent stepping onto school property to deliver their child right to the door? In what way are those different from this case?