Unpopular Opinions You Hold

[leicsmac]

6 minutes ago, foxile5 said:

Herein lies the problem.

 

Any reform of the NHS won't be with free at the point of service health care in mind. It'll be with 'how can we maximize profit' in mind and will effectively remove health care from those who most need it.

 

However, for some, it won't be enough to know this. It'll only be in reality when they're charged 45k for an unavoidable op that they realize it.

 

We're not a country that would do cheap health care. The class system here dictates that nothing good will come for free.

Precisely.

 

Which is why any reform must be viewed and carried out with the utmost caution, scepticism and oversight.

[leicsmac]

2 minutes ago, HighPeakFox said:

A euphemism for the ages, right there.

It does apply perfectly, I think.

 

I've also seen, directly, the damage it does in other nations with healthcare systems that reflect it more.

[HighPeakFox]

Just now, leicsmac said:

It does apply perfectly, I think.

 

I've also seen, directly, the damage it does in other nations with healthcare systems that reflect it more.

Oh I quite agree. I just think there's a more direct, blunt term that already exists for it, which bothers some people because it's a little too close to the truth than they care to admit.

[Wortho]

1 hour ago, The Year Of The Fox said:

I completely agree.

 

Unfortunately though, in the eyes of most, the NHS is sacrosanct, and (any) government the arch enemy

 

 

I can’t see any party promising a proper overhaul as part of their manifesto- it just won’t win them votes. The irony is, if the government went in deep on the NHS it would exonerate themselves from most of the public, the opposition and the striking NHS staff’s accusations

 

They won’t do that though as they know the can of worms is far too large. 

The tories did inherit the massive PFI liabilities from labour.

At my place of work some of buildings were replaced under PFI, probably £150m, which will be paid back over 25 years. It will be about £1billion in total. Would have been cheaper going to Wonga!!

This applies to the NHS as well.

[Trav Le Bleu]

@StanSP is a decent bloke who makes insightful contributions to FoxesTalk.

[HighPeakFox]

7 minutes ago, Trav Le Bleu said:

@StanSP is a decent bloke who makes insightful contributions to FoxesTalk.

Mods 

[reporterpenguin]

I’ve never worked for the NHS but I do work for a public sector organisation and I believe some of the issues with the funding model are shared between them. 
 

The one that always gets me is the need to spend budget during the year, but the parts of the budget being ring fenced for certain areas. I know we’ve put contracts out to tender for things just for the sake of it, and the most expensive quote chosen, just to use that bit of budget so it isn’t cut the following year. 
 

When it gets towards the end of the financial year there’s always a massive splurge on things that aren’t needed while other areas in desperate need of funding are left crumbling, all to make sure as much of the budget is used as possible.
 

It’s a system that literally incentivises waste while also keeping funding from areas that need it. 

[leicsmac]

15 minutes ago, reporterpenguin said:

I’ve never worked for the NHS but I do work for a public sector organisation and I believe some of the issues with the funding model are shared between them. 
 

The one that always gets me is the need to spend budget during the year, but the parts of the budget being ring fenced for certain areas. I know we’ve put contracts out to tender for things just for the sake of it, and the most expensive quote chosen, just to use that bit of budget so it isn’t cut the following year. 
 

When it gets towards the end of the financial year there’s always a massive splurge on things that aren’t needed while other areas in desperate need of funding are left crumbling, all to make sure as much of the budget is used as possible.
 

It’s a system that literally incentivises waste while also keeping funding from areas that need it. 

Yeah, the inefficiency is a matter of record.

 

However, again, in the absence of a perfect solution (which won't be found), much better this inefficiency than more efficiency and people not getting the care they need because they either can't afford it or the system itself cannot afford it. I'm not sure why some folks appear to overlook that and just look at the bottom line.

[reporterpenguin]

20 minutes ago, leicsmac said:

Yeah, the inefficiency is a matter of record.

 

However, again, in the absence of a perfect solution (which won't be found), much better this inefficiency than more efficiency and people not getting the care they need because they either can't afford it or the system itself cannot afford it. I'm not sure why some folks appear to overlook that and just look at the bottom line.

Oh I completely agree. 
 

But when there’s such low hanging fruit like organisations not spending money just for the sake of it it’s an easy stick to beat them with. 
 

I won’t pretend I have the answer, but trusting organisations to know where investment is needed and not having it dictated from above seems a good place to start. Along with not cutting budgets because an area of the previous budget wasn’t fully spent the previous year. 

[Guest BlueBrett]

15 minutes ago, reporterpenguin said:

I’ve never worked for the NHS but I do work for a public sector organisation and I believe some of the issues with the funding model are shared between them. 
 

The one that always gets me is the need to spend budget during the year, but the parts of the budget being ring fenced for certain areas. I know we’ve put contracts out to tender for things just for the sake of it, and the most expensive quote chosen, just to use that bit of budget so it isn’t cut the following year. 
 

When it gets towards the end of the financial year there’s always a massive splurge on things that aren’t needed while other areas in desperate need of funding are left crumbling, all to make sure as much of the budget is used as possible.
 

It’s a system that literally incentivises waste while also keeping funding from areas that need it. 

Absolutely this but even worse. We don't just incentivise waste we actually reward ineffectiveness. Across all domains of the public sector we operate a funding for failure system.

 

Imagine Department A has a budget of X to deal with a problem with a magnitude of Y.  The level of funding is ostensibly linked to the size of the problem. As a leader within department A would you like a smaller or larger budget next year?

 

Well I can tell you all of these bureaucrats consistently opt for a larger budget because that increases their power and prestige. The incentive therefore is not to remedy the problem, but to exacerbate it, as a magnitude of Y+1 will result in a departmental budget of X+1.

 

If the problem was actually addressed effectively or, heaven forbid, solved entirely, the departmental budget would be reduced, along with the prestige and 'clout' of the individuals working within it. Many of the worthless mid-tier project managers on 45-60k salaries 'working from home' 3 days a week and benefiting from public sector pensions, job security and other perks would be even more surplus to requirements than they already are. The same thing applies across the board with NGOs and every group that receives public money. The whole system is one big dependency complex, ineffective by design.

[leicsmac]

8 minutes ago, BlueBrett said:

Absolutely this but even worse. We don't just incentivise waste we actually reward ineffectiveness. Across all domains of the public sector we operate a funding for failure system.

 

Imagine Department A has a budget of X to deal with a problem with a magnitude of Y.  The level of funding is ostensibly linked to the size of the problem. As a leader within department A would you like a smaller or larger budget next year?

 

Well I can tell you all of these bureaucrats consistently opt for a larger budget because that increases their power and prestige. The incentive therefore is not to remedy the problem, but to exacerbate it, as a magnitude of Y+1 will result in a departmental budget of X+1.

 

If the problem was actually addressed effectively or, heaven forbid, solved entirely, the departmental budget would be reduced, along with the prestige and 'clout' of the individuals working within it. Many of the worthless mid-tier project managers on 45-60k salaries 'working from home' 3 days a week and benefiting from public sector pensions, job security and other perks would be even more surplus to requirements than they already are. The same thing applies across the board with NGOs and every group that receives public money. The whole system is one big dependency complex, ineffective by design.

 

33 minutes ago, leicsmac said:

Yeah, the inefficiency is a matter of record.

 

However, again, in the absence of a perfect solution (which won't be found), much better this inefficiency than more efficiency and people not getting the care they need because they either can't afford it or the system itself cannot afford it. I'm not sure why some folks appear to overlook that and just look at the bottom line.

This is an example, I think. Apologies for pointing it out directly.

 

If there is a proven way to make the system better and more efficient without causing risk to people's lives and health then I (and many other people, I suspect) would be all ears.

[Tommy G]

2 hours ago, leicsmac said:

As there should be when you're dealing with something (human life and suffering) that in principle and practice should be above material value.

 

What use is money to a sick or dead person?

Because if the money was used efficiently it would help the nhs perform 10 fold. 

[The Year Of The Fox]

Pleasing to see that most on here see beyond the ‘the NHS are unaswerable’ sort of mantra 

 

 

[Guest BlueBrett]

1 minute ago, leicsmac said:

 

This is an example, I think. Apologies for pointing it out directly.

 

If there is a proven way to make the system better and more efficient without causing risk to people's lives and health then I (and many other people, I suspect) would be all ears.

Well the answer is to look at the incentive structures and make sure they are aligned with the actual stated goals of the organisation as opposed to completely antithetical to them.

 

Rather than funding for failure it should be rewards for results. That sounds like I'm not saying much I know but it would actually be a seismic shift in the orientation of these services. It may well be that the easiest way to get there is through privatisation. 

 

I disagree that people are open to change. Why would they be? Millions of mediocre, fundamentally self-interested people enjoy relatively comfortable middle-class lifestyles off the back of the current system. Many of them are unionised and we've seen how they baulk and rage at even the suggestion of amendments to their working practices. 

 

A friend of mine is a programme leader for local government. He has dozens of PMs, coordinators, project officers etc under him. The department is so bloated but there is nothing he can do about it as they are all protected by their absurd contracts. Most of them are significantly overweight and mentally fragile. Very few of them do anything productive at all and they all make reasonably good money at the tax payer's expense. Most of them literally take the piss but don't even seem to recognise they are doing it. They will regularly disappear for an afternoon on the grounds that they had to take their dog for a haircut or something and seem to feel that this kind of thing is completely reasonable and within their entitlement as tax payer funded 'public servants'

 

 

[BKLFox]

9 minutes ago, The Year Of The Fox said:

Pleasing to see that most on here see beyond the ‘the NHS are unaswerable’ sort of mantra 

 

 

It really is and it’s the 1st time I’ve seen this subject debated without it falling into a 1 sided predictable blame game.

[leicsmac]

23 minutes ago, Tommy G said:

Because if the money was used efficiently it would help the nhs perform 10 fold. 

And as per above, if someone were to present a plan based on actual empirical evidence that would prove this, and make things more efficient while maintaining the fundamental reasoning behind the NHS - to preserve life and health - then I would welcome it.

 

12 minutes ago, BlueBrett said:

Well the answer is to look at the incentive structures and make sure they are aligned with the actual stated goals of the organisation as opposed to completely antithetical to them.

 

Rather than funding for failure it should be rewards for results. That sounds like I'm not saying much I know but it would actually be a seismic shift in the orientation of these services. It may well be that the easiest way to get there is through privatisation. 

 

I disagree that people are open to change. Why would they be? Millions of mediocre, fundamentally self-interested people enjoy relatively comfortable middle-class lifestyles off the back of the current system. Many of them are unionised and we've seen how they baulk and rage at even the suggestion of amendments to their working practices. 

 

A friend of mine is a programme leader for local government. He has dozens of PMs, coordinators, project officers etc under him. The department is so bloated but there is nothing he can do about it as they are all protected by their absurd contracts. Most of them are significantly overweight and mentally fragile. Very few of them do anything productive at all and they all make reasonably good money at the tax payer's expense. Most of them literally take the piss but don't even seem to recognise they are doing it. They will regularly disappear for an afternoon on the grounds that they had to take their dog for a haircut or something and seem to feel that this kind of thing is completely reasonable and within their entitlement as tax payer funded 'public servants'

 

 

I'm sorry, but again this is a lot of looking at the problem and not much applying a solution that could be shown to ensure that people don't get left behind.

 

3 minutes ago, BKLFox said:

It really is and it’s the 1st time I’ve seen this subject debated without it falling into a 1 sided predictable blame game.

As per above, I think a lot of folks are OK with making the system more efficient, they're just worried - rightly so IMO - with such reform ending in a system where the poor or the unfortunate end up suffering and dying as happens in so many places around the world.

[FoxyPV]

Public sector procurement.

 

It's a convoluted, protracted affair and is so inefficient.

 

Our procurement branch told everyone we couldn't buy off our IT framework in the middle of the biggest IT change in health in NI for 8months!!!

 

Had to go to the ****ing chief exec before they'd consider an extension.

 

Absolutely ****ing clueless 

[BKLFox]

5 hours ago, leicsmac said:

And as per above, if someone were to present a plan based on actual empirical evidence that would prove this, and make things more efficient while maintaining the fundamental reasoning behind the NHS - to preserve life and health - then I would welcome it.

 

I'm sorry, but again this is a lot of looking at the problem and not much applying a solution that could be shown to ensure that people don't get left behind.

 

As per above, I think a lot of folks are OK with making the system more efficient, they're just worried - rightly so IMO - with such reform ending in a system where the poor or the unfortunate end up suffering and dying as happens in so many places around the world.

I’m surprised in your replies Mac because, & I know you don’t mean it like this, but it’s like your saying it’s almost to hard to change so just leave as it is as otherwise it will affect people’s health.

 

As I say I know you don’t mean it to come across as such but given you are so passionate about climate change and a lot of your responses to objections to certain changes are geared around yes people don’t like it because it hits them in the pocket or they have to change the way the do something and that puts people out so therefore to selfish to accept the changes that will help their earth.

I think much in the same way people have to accept that for a time any changes might affect their NHS service but reality is day to day running isn’t great as it is with long waiting times, staffing etc etc so not sure we would see many change at the coalface that affect our lives.

 

We can’t just keep pumping money into it or think a change in government will suddenly see it bearing fruit, the issues run deep into its foundations with it’s processes, procurement, it’s contracts, fraud, it’s the belly of the beast that needs going after without hitting the bit we see.

 

 A scrupulous task force needs to be put together dedicated to solely looking into that belly to highlight issue, provide actions & most importantly see them through.

 

How radical would that be, we can’t create a blank canvass & start again we have to work with what we have & it’s not going to take someone with an IQ of 200 to come up with a smart fandango plan, it’s no different to what everyone of us do when trying to cut back when times are hard, we look to see where we’re pissing money up against the wall and cut cloth, amend & ditch contracts accordingly.

 

It will take years & be a struggle granted but like climate change it needs addressing sooner rather than later before it eats it’s self & really affects us.

 

 

[leicsmac]

10 minutes ago, BKLFox said:

I’m surprised in your replies Mac because, & I know you don’t mean it like this, but it’s like your saying it’s almost to hard to change so just leave as it is as otherwise it will affect people’s health.

 

As I say I know you don’t mean it to come across as such but given you are so passionate about climate change and a lot of your responses to objections to certain changes are geared around yes people don’t like it because it hits them in the pocket or they have to change the way the do something and that puts people out so therefore to selfish to accept the changes that will help their earth.

I think much in the same way people have to accept that for a time any changes might affect their NHS service but reality is day to day running isn’t great as it is with long waiting times, staffing etc etc so not sure we would see many change at the coalface that affect our lives.

 

We can’t just keep pumping money into it or think a change in government will suddenly see it bearing fruit, the issues run deep into its foundations with it’s processes, procurement, it’s contracts, fraud, it’s the belly of the beast that needs going after without hitting the bit we see.

 

 A scrupulous task force needs to be put together dedicated to solely looking into that belly to highlight issue, provide actions & most importantly see them through.

 

How radical would that be, we can’t create a blank canvass & start again we have to work with what we have & it’s not going to take someone with an IQ of 200 to come up with a smart fandango plan, it’s no different to what everyone of us do when trying to cut back when times are hard, we look to see where we’re pissing money up against the wall and cut cloth, amend & ditch contracts accordingly.

 

It will take years & be a struggle granted but like climate change it needs addressing sooner rather than later before it eats it’s self & really affects us.

 

 

I suppose I can see why it would appear that way, but allow me to be clear and restate what I have said a few times: I'm very welcome to the idea of restructure, or even root and branch reform if necessary, but it cannot come at the cost of affecting any services at all that would affect the poorest and most vulnerable, which is why such a change would have to be very carefully planned and executed.

 

Oddly enough, my feelings on this particular matter and on climate change as you mention align for pretty much the same reason: people (possibly) seeking to condemn a large amount of other people (and possiby themselves), either through ignorance or malice, for the sake of short term material gain and self interest. That's not only immoral for me, it's also horribly irrational.

[Parafox]

Wasn't the creation of NHS Trusts meant to stop reckless spending?

 

[Wymsey]

Some unions have too much power.

[FoxyPV]

1 minute ago, Wymsey said:

Some unions have too much power.

😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄😄

[Corky]

On 20/09/2023 at 08:29, Nalis said:

The desire to see Brendan Rodgers fail at other clubs feels a bit odd to me.

He was happy to see us fail. We have had some duffers in charge but only Taylor comes close to that disgrace last season.

 

Until he comes out and apologises to us and refunds us our money he can get stuffed.

[ealingfox]

Brendan Rodgers should be erased from our history. We should be telling our children and grandchildren that Wes Morgan was player-manager when we won the Cup.

[Sly]

Golf is a terrible sport.

 

This bloke summarises perfectly how I feel about the game.