The NHS (National Health Service) Thread

[Col city fan]

The funding for the NHS is not being cut back Col. It is not increasing in line with demand agreed, because the government want to force those provising services to do it more efficiently, and it is a proven tactic that limiting resources makes people decide what is important.

Also, show me a western country with no public health provision? If there is one thing you can be 100% sure on it is that the NHS is here to stay in one form or another.

The question here is what do you consider the NHS to be? For me it is the principle of healthcare free at the point of use, and open to everyone equally. This is not going anywhere. Whether the buildings are owned and managed by the NHS, or the cleaners employed by the NHS doesn't matter. Many large organisations outsource all kinds of activities which are not core to their purpose, and the NHS should be no different. The question around actual medical or surgical provision being privatised is more complex, however I wonder again what you are scared of? Many of the doctors are the same ones. Should we blame consultants for offering private practise alongside or in place of their NHW work? The bastards, privatising our NHS. This has always been there since the NHS began though no?

The whole Tories trying to private the NHS argument is basically a political weapon used to block any form of change that threatens the interests of a particular group or union.

Isn't 'not rising in line with demand' the same as 'cutting back'? By definition if demand exceeds supply and continues to do so, the service provision will suffer? That's basic economics no? I can't see any difference?

Your point of 'Free at the point of delivery' then becomes the issue. With increasing demand and expectation, with no more funding to meet it, 'delivery' is becoming almost impossible. Targets that drive the NHS are becoming increasingly hard to meet and rather than waiting for NHS appointments people are essentially forced to seek private care both for initial assessments and sometimes for treatment. Or put it this way, they often FEEL forced to because they don't want to have to wait for months to get an initial consultation. They might be in pain?

My feeling is that 'efficiency savings' is the smokescreen. How many 'savings' can be made before services cease to be? Some services over Leicestershire have all but disappeared.

If we want a strong and effective NHS it must continue to be well funded. Such that the money in equates to demand. Without this, people will be waiting longer, more wards will close and less staff will be employed.

[Bryn]

I don't have the numbers to hand but isn't it 30bn of efficiency savings with 10bn extra going in?

[Jon the Hat]

I don't have the numbers to hand but isn't it 30bn of efficiency savings with 10bn extra going in?

 

Which would mean £40Bn more to spend on services.

Isn't 'not rising in line with demand' the same as 'cutting back'? By definition if demand exceeds supply and continues to do so, the service provision will suffer? That's basic economics no? I can't see any difference?

Your point of 'Free at the point of delivery' then becomes the issue. With increasing demand and expectation, with no more funding to meet it, 'delivery' is becoming almost impossible. Targets that drive the NHS are becoming increasingly hard to meet and rather than waiting for NHS appointments people are essentially forced to seek private care both for initial assessments and sometimes for treatment. Or put it this way, they often FEEL forced to because they don't want to have to wait for months to get an initial consultation. They might be in pain?

My feeling is that 'efficiency savings' is the smokescreen. How many 'savings' can be made before services cease to be? Some services over Leicestershire have all but disappeared.

If we want a strong and effective NHS it must continue to be well funded. Such that the money in equates to demand. Without this, people will be waiting longer, more wards will close and less staff will be employed.

Efficiency savings doesn't mean cutting services, although I am sure there are more efficient ways of delivering a lot of services.

[Bryn]

Course it means there's an extra forty billion, that's why pretty much every single target is getting worse and worse.

[Manwell Pablo]

You do know that MRI scans are often done over the weekends? In fact, many routine tests are done on Saturdays and Sundays. This is to try to get through the backlog of people wanting tests done at a time when the demand on the NHS is ever rising whilst the funding for the NHS is ever being cut back.

It's a pretty impossible situation and I think people should support the NHS rather than looking to slate it. If you don't, it'll go private in its entirety. THEN we'll see people really moaning.

And for those people who say it's not being privatised and never will be..open your eyes.

It's happening very slowly to be fair but yeah, my last contract was with a private company commissioned by the nhs. The involvement of outside company's and providers having to tender for services is the start of it but the ball is certainly in rolling, and it will continue to do so as long as the Tories are in office.

It's rock and hard place really because I dread to think what Corbin would do to it, good as it would be for me professionally.

[Jon the Hat]

Course it means there's an extra forty billion, that's why pretty much every single target is getting worse and worse.

 

Personally I would put that down to lack of engagement from a workforce encouraged by their unions and the left wing media to believe they are failing when they aren't, and a desire to block anything the Tories propose or implement.  Happens all over the public sector sadly.

[Rincewind]

Personally I would say it was a lack of engagement when the Health minister is more interested in playing with his phone than listening to an opposition MP who is making an important speech about the sector the Health minister is responsible for.

The right wing media have also done their part in representing the governments position to sway public opinion against junior doctors.

It works both ways.

[Parafox]

All I want to say, by way of example is, my colleague and I waited with a patient (who was not critical but need to be seen in A&E), a staggering 5 and a half HOURS on the ambulance outside LRI ED before we could even get in the hospital doors, followed by a further 45 mins before we actually handed over formally to staff and called clear and we weren't the only ones. This never happened 3-4 years ago, never. The delays at ED are causing a worrying lack of available ambulance resources across any 24 hour period. We are at breaking point on our service and we are pared to the bone in finacial terms. Our trust can't get additional funding from the CCG to provide extra resources to manage the demand, so it is about money or rather the lack of it.

 

Rising demand with restricted income means that, the "40 Billion" that's meant to come from savings and a 10 bill injection will go nowhere because the NHS is so underfunded and has been throughout at least 3 governments. That money will not even bring it up to a fully sustainable level even if we got it tomorrow instead of it being drip-fed over two to three years.

 

The delay I mention also meant we were 2 and a half hours late finising our shift; 10pm instead of 7:30 which, because of the European Working Time Directive, meant we had to have 11 hours break before we could return to work which in turn meant 1and a half hours the following day without a crew for the vehicle. (And I missed a trip to see Bill Bailey's live show).

Edited 10 May 2016 by Parafox

[Jon the Hat]

I don't believe there is a way to quickly fix the funding of the NHS, if you do what Blair did and throw money at it, you still end up where we are now 20 years on.  The only way is to force the conversation on what services we really want, and take out the waste and duplication as you go.  Would be much easier if everyone saw that and pulled together to achieve it.

[Col city fan]

Personally I would put that down to lack of engagement from a workforce encouraged by their unions and the left wing media to believe they are failing when they aren't, and a desire to block anything the Tories propose or implement. Happens all over the public sector sadly.

You take a very political stance on this Jon. I try to look more objectively. I can see why austerity measures are important but don't agree with your complete defence of them and of efficiency savings. You sound like a true blue in every sense.

And one thing I would add is I can't see an awful lot of 'efficiency savings' in Mps who give themselves a pat on the back and a pay rise of what 11% above inflation? (along with all the expenses) when Nurses and Doctors got 1%

That don't smack of austerity.

Edited 10 May 2016 by Col city fan

[Bryn]

Personally I would put that down to lack of engagement from a workforce encouraged by their unions and the left wing media to believe they are failing when they aren't, and a desire to block anything the Tories propose or implement. Happens all over the public sector sadly.

I can't even be arsed.

[Jon the Hat]

I can't even be arsed.

 

You cant tell me that a fully engaged and supportive workforce wouldn't be able to deliver better for the money they already have.  You can argue about the reasons they are not engaged, and I recognise there are different viewpoints.  I get bored of the its all about money and the bad Tories boo bolllocks.  Labour threw money at the NHS and look where it got us.

[Jon the Hat]

You take a very political stance on this Jon. I try to look more objectively. I can see why austerity measures are important but don't agree with your complete defence of them and of efficiency savings. You sound like a true blue in every sense.

And one thing I would add is I can't see an awful lot of 'efficiency savings' in Mps who give themselves a pat on the back and a pay rise of what 11% above inflation? (along with all the expenses) when Nurses and Doctors got 1%

That don't smack of austerity.

 

The NHS budget is **** all to do with Austerity.  The government have decided they have to force the BHS into savings, because there is little evidence they will deliver otherwise.  If you make management choose between cutting front line services and streamlining admin they will usually, but not always, make the right call.

[DJ Barry Hammond]

The NHS budget is **** all to do with Austerity.  The government have decided they have to force the BHS into savings, because there is little evidence they will deliver otherwise.  If you make management choose between cutting front line services and streamlining admin they will usually, but not always, make the right call.

The NHS budget has been in the governments words protected, but there are a lot of local government services that impact the NHS that have had their budgets dramatically cut, which then has a knock on effect to the NHS and the money it spends.

Unfortunately efficiencies can only go so far and potentially some of the best efficiencies actually need money spending on them in the first place (i.e. Get joined up care in place).

But I think the biggest problem facing the NHS relates to the privatisation of the big pharmaceutical companies because a lot of its funds will go to providing these companies ever increasing profits - had governments thought about this, they would have kept drug development in house at Universities under a public programme as this would have helped keep essential costs down in the health service AND syndication of the drugs as an export would have helped fund universities several times over.

[Webbo]

The NHS budget has been in the governments words protected, but there are a lot of local government services that impact the NHS that have had their budgets dramatically cut, which then has a knock on effect to the NHS and the money it spends.

Unfortunately efficiencies can only go so far and potentially some of the best efficiencies actually need money spending on them in the first place (i.e. Get joined up care in place).

But I think the biggest problem facing the NHS relates to the privatisation of the big pharmaceutical companies because a lot of its funds will go to providing these companies ever increasing profits - had governments thought about this, they would have kept drug development in house at Universities under a public programme as this would have helped keep essential costs down in the health service AND syndication of the drugs as an export would have helped fund universities several times over.

Where would the universities get the money to develop these drugs?

[Bryn]

You cant tell me that a fully engaged and supportive workforce wouldn't be able to deliver better for the money they already have.  You can argue about the reasons they are not engaged, and I recognise there are different viewpoints.  I get bored of the its all about money and the bad Tories boo bolllocks.  Labour threw money at the NHS and look where it got us.

I reject any insinuation that the workforce can give any more than it does already, the only reason it functions as it does is because we're all grinding ourselves into the ground for it.

Not that I think throwing money without a strategy at it does any good either.

[DJ Barry Hammond]

Where would the universities get the money to develop these drugs?

This is thinking back to the day when governments fully funded universities.

[Guest MattP]

Governments never fully funded the universities, it was the future funding them through borrowing.

They just claimed they did, just like a lot of things now they claim to fund which is really done on the debt of future generations.

[Webbo]

This is thinking back to the day when governments fully funded universities.

What are you saying? The taxpayers should fund all this research and bare the losses when these drugs don't work?

[DJ Barry Hammond]

What are you saying? The taxpayers should fund all this research and bare the losses when these drugs don't work?

Some of our biggest Universities are ideally equipped to do this type of research and it enhances the quality of study in those places for its intake (I believe a few do this work for private companies)... Yes there's a bit of speculation involved, but ultimately the government would have been in control of how much it put in and there's many areas where it would stand to gain, even if "the drugs didn't work" as you say.

[Webbo]

The last thing any successful venture wants is civil servants  deciding what project gets funding.

[DJ Barry Hammond]

The last thing any successful venture wants is civil servants  deciding what project gets funding.

Well that's why you'd set up a trust to run the operation, away from civil servants - it wouldn't be there as a political structure, it would be there as a practical solution.

This sort of thing isn't unheard of by the way - look at the French government who has a stake in its major energy supplier who exports it's services. If a government can use its resources to obtain funding for its activities from outside its own populace as well, that's all the better for the people who live within.

[Alf Bentley]

Personally I would put that down to lack of engagement from a workforce encouraged by their unions and the left wing media to believe they are failing when they aren't, and a desire to block anything the Tories propose or implement.  Happens all over the public sector sadly.

 

 

Would you find it reasonable if someone made a post like that about you, accusing you and your colleagues of "a lack of engagement" and of (implicitly) acting unprofessionally under the influence of vested private interests and the right-wing media? Would you find it reasonable if that person essentially implied that the entire private sector was riddled with such a lack of professionalism? Particularly if that poster had a superficial, external knowledge of your sector? (I'm assuming you don't work for the public sector yourself - apologies if I've got that wrong; I think you said that you were a Finance Director in the private sector?).

 

[Disclaimer: I don't work in the public sector myself, though I did for a few years in the 1980s (most colleagues were hard-working and professional, a few were lazy or incompetent); I've been self-employed for 17 years and have had public and private-sector clients. Public sector clients have universally been highly professional, but sometimes a bit slow-moving and inflexible. Private sector clients have mainly been highly professional (1 or 2 rotten apples), a bit quicker-moving and more flexible, but many have bothered less about quality - so as not to lose business from end clients with unreasonable deadlines] 

[Jon the Hat]

Would you find it reasonable if someone made a post like that about you, accusing you and your colleagues of "a lack of engagement" and of (implicitly) acting unprofessionally under the influence of vested private interests and the right-wing media? Would you find it reasonable if that person essentially implied that the entire private sector was riddled with such a lack of professionalism? Particularly if that poster had a superficial, external knowledge of your sector? (I'm assuming you don't work for the public sector yourself - apologies if I've got that wrong; I think you said that you were a Finance Director in the private sector?).

 

[Disclaimer: I don't work in the public sector myself, though I did for a few years in the 1980s (most colleagues were hard-working and professional, a few were lazy or incompetent); I've been self-employed for 17 years and have had public and private-sector clients. Public sector clients have universally been highly professional, but sometimes a bit slow-moving and inflexible. Private sector clients have mainly been highly professional (1 or 2 rotten apples), a bit quicker-moving and more flexible, but many have bothered less about quality - so as not to lose business from end clients with unreasonable deadlines] 

 

I don't recall you getting upset when the media slams bankers, politicians and the like of all being self serving greedy scum

 

I don't think it is that unreasonable to say that the public sector has a problem with ridding itself of incompetent and lazy employees, in a way that the private sector doesn't.  I don't think it is unreasonable to say that the NHS workforce has an engagement problems in many places either, and as I said you could argue why till the cows come home, but certainly political interference from unions who want to block Tory plans is part of it.  I probably made my point a little bluntly there, as there is also no doubt the impact of more and more pressure on services, without additional resource to cover it, and I have no doubt at all that there is a majority of people in the NHS working their arses off to do their very best.  That is not the best environment for anyone though either is it?

I don't think it is unreasonable to hold the public sector to a higher standard than the public sector either, given they are spending public money, taken without choice from the people (same applies to private contractors to the public sector of course, which is also a problem). 

[Guest MattP]

I don't think it is unreasonable to hold the public sector to a higher standard than the public sector either, given they are spending public money, taken without choice from the people

 

That's pretty much the crux of it for me as well. If a private company/investor wants to blow it's own cash they are completely free to do so, but wasting or being profligate with taxpayers money is deplorable.

 

And before anyone mentions banking bailouts they should be held to the same standard as other public services after receiving our money as well.