[Misc] The NHS

[Half Time Pies]

And, the top person in that organisation will be a politician? Minister for Health? It is run by politicians.

You are completely missing the point, politicians have no input in the day to day running of the NHS currently, the main role is to set the budget and overall strategic policy. This wouldn't change under the sort of system you are advocating, the DofE would still set the budget for the company to operate within and tell that company what they would like it to deliver.

 

[Two Professors]

I think I need a Doctor, I agree with something you’ve posted

Private or NHS?

 

[Johnny RoastBeef]

It needs to be run by private companies, operating services on a tariff basis, funded centrally by the government. This would improve efficiency and remove the wasted money spent on arse covering middle and senior public sector management, the money saved then diverted back to frontline services. Couple this with a centrally operated purchasing system, giving the NHS as a whole far greater bargaining power, driving down the cost of consumable items.

This is pretty much the blue print for the future of the NHS anyway.

 

[lawros left foot]

Private or NHS?

NHS, I’m not rich enough for private, and I don’t mind a queue

 

[Sussex Nomad]

It needs to be run by private companies, operating services on a tariff basis, funded centrally by the government. This would improve efficiency and remove the wasted money spent on arse covering middle and senior public sector management, the money saved then diverted back to frontline services. Couple this with a centrally operated purchasing system, giving the NHS as a whole far greater bargaining power, driving down the cost of consumable items.

This is pretty much the blue print for the future of the NHS anyway.

You say it so much more eloquently than I ever could.

 

[Two Professors]

NHS, I’m not rich enough for private, and I don’t mind a queue

Think the forces were marvellous training for patience.Servicepeople today don't know what they have missed without pay parade.

 

[Sussex Nomad]

Where blueprints go and as far as I'm concerned, there needs to be a cross party/private business solution to the crisis that is the NHS. Let business take hold of this mess we have. Let them solve the problem, and if they make a buck and we're happy what does it matter? The way it is right now, it's a car crash, not waiting to happen, it has happened.

 

[drew]

The fact you said it is the 5th biggest employer in the world says everything about why it fails so badly. I would guess (yes guess) that one fifth of those are on the front line.

It would appear ignorance is behind your comments.

50.6 per cent of NHS employees are professionally qualified clinical staff. A further 26.0 per cent provide support to clinical staff in roles such as nursing assistant practitioners, nursing assistant/auxiliaries and healthcare assistants.

Taken from http://www.nhsemployers.org/news/2015/07/the-nhs-workforce-in-numbers

Ignorance is behind a lot of people's perceptions of the NHS. Moron on the LBC was banging on about his friend in the NHS and the fact that their trust has a number of Matrons and question why they need them. Well my wife is a matron for a department of 240 employees. Is anyone suggesting that that number of staff don't need any leadership?

As regards admin staff, take them away then what they do will have to be done by clinical staff taking them away from the front line.

 

[Hastings gull]

The whole thing needs a rethink and needs properly costing and then funding. This latter point will mean higher NI though. In fact Id actually have a separate health NI payment.

Herr T and I rarely agree on anything, but in this regard we have one thing in common - we both have experience of the German system, and quite frankly it is far superior. If the politics were to be taken out of it, that would be a great help, and I am really trying not to be partisan here, but it is the left wing that is rather more guilty in this respect. Herr T is right in that we brits do want things on the cheap - often on here, I read of folk saying that they are willing to "pay a bit extra" but would they be willing to pay a lot extra, because that is what is needed.

Coincidentally, when I got back from dog walking today, chatting at length with someone from the Ambulance Service, I recall his story that one hospital here in the South East (I won't name it) when someone needs to be transported home, phones two firms and the patient goes back in the first one to arrive . . Whatever your politics, it is fair to say that waste on a large scale is far more likely to be prevalent in a state-run organisation, when someone is spending someone else's money and ploughing more money into it just encourages even more. As I have written before, my GP and the local pharmacist speak regularly of NHS waste. I personally have no objection to the principle of an "NHS type" system, but whilst it is regarded as a bottomless pit (even if it isn't in practice) funded by taxation, as it always will be, this is what will happen.

 

[Sussex Nomad]

It would appear ignorance is behind your comments.

Why call me ignorant?

 

[sir albion]

Keep it the way it is and and make all staff fulltime instead of consultants and agency staff as well as increasing the nurse pay dramatically as they're ridiculously under paid for what they do.
Also stop being abused and ripped off by large pharmaceutical companies who really do make a fortune by over charging.

It just needs a overhaul as it's been abused and mismanaged for many years....

 

[Husty]

The fact you said it is the 5th biggest employer in the world says everything about why it fails so badly. I would guess (yes guess) that one fifth of those are on the front line.

Right and you think that proportion would improve under privatisation do you?

 

[Sussex Nomad]

Keep it the way it is and and make all staff fulltime instead of consultants and agency staff as well as increasing the nurse pay dramatically as they're ridiculously under paid for what they do.
Also stop being abused and ripped off by large pharmaceutical companies who really do make a fortune by over charging.

It just needs a overhaul as it's been abused and mismanaged for many years....

There are people working with my girlfriend, 'consultants'. earning 1k a day.

 

[Sussex Nomad]

Right and you think that proportion would improve under privatisation do you?

Well, yes, why wouldn't I? What would be the point of this thread?

 

[Hastings gull]

Because 30 years ago they were starved of investment in both rolling stock and infrastructure; and had been for decades. Much like what the Tory government is doing to the NHS. They came in in 2010 on a manifesto of no top down reorganisation of the NHS then that is exactly what they did. Removed the Primary Care Trusts and all that has happened is they are now replaced with commissioning agencies.

As for the 'no money is never enough' comment that get's trotted out. We are always behind. The tories will keep banging on about them spending more on the NHS than ever before but that is still considerably less most other civilised countries pay. Based on GDP we are seventeenth on the list. Excluded the top 4 (USA, Norway, Switzerland and Luxembourg as the first is off the scale and the other three don't have comparable economies/demographics). The fifth is Germany and they spend about 30% per head more then we do!

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

What you're now suggesting is that even less is spent on healthcare as we will all pay the same only a chunk of that will now go to shareholders.

Your political allegiance is known, but to be fair don't all parties make this boast when in power? The health system certainly needs more cash and folk might have to be prepared to pay a lot more; the issue is what future system would make best use of the resources.

 

[sir albion]

There are people working with my girlfriend, 'consultants'. earning 1k a day.

Stupid money and it's clear they charge ridiculous amounts

 

[dingodan]

Even if you had a private company running it all, they'd still get the money and requirements from the government, so it would still be political, but with a private company making a massive profit at our expense. And of course in the years where their gambling went wrong, the taxpayers would bail them out as it would be too big to fail.

There could be a way to distance the running of it from the government (like the BofE) while still keeping it in the public sector.

How about, instead of paying in money and having the government dish it out, people pay into a health savings account which can only be used for medical expenses, but can be directed by the person to a health care provider of their choosing?

The idea that businesses only cut corners and try to reduce costs in order to make a profit isn't really true. By that logic Apples best bet would be take the camera out of the iPhone, it would be cheaper to make saving them money. Nobody wants an iPhone without a camera though do they? The market forces business to provide the highest quality product at the lowest possible price, that's a good thing not a bad thing.

I challenge anyone here to give an example of any product or service, ever, which has been efficiently delivered by government.

Imagine if we had a department of mobile phones, and all our mobile phones were produced and issued by a government run provider, the quality would go down, the price would go up and the distribution would reduce, year on year. Instead, we have a free market in technology, the price goes down, the quality goes up and the distribution increases, year on year.

Governments were never supposed to provide products or services, they are not capable of doing it, only an open and free marketplace can.

If you don't believe me, just watch as the NHS provides a poorer service next year, and will need more money than it did this year to do it. It doesn't work, it will never work.

 

[Sussex Nomad]

Stupid money and it's clear they charge ridiculous amounts

Happens in all ministries, I've seen worse stories, but anyone picking up a grand a day on the back of health is scum.

 

[Half Time Pies]

It needs to be run by private companies, operating services on a tariff basis, funded centrally by the government. This would improve efficiency and remove the wasted money spent on arse covering middle and senior public sector management, the money saved then diverted back to frontline services. Couple this with a centrally operated purchasing system, giving the NHS as a whole far greater bargaining power, driving down the cost of consumable items.

This is pretty much the blue print for the future of the NHS anyway.

I am not aware of any evidence that contracting out to private companies saves money which can be then be diverted to frontline services. In my experience of working for a North London NHS trust for 6 years those services that were contracted out tended to cost the trust significantly more money in the long run.

 

[Triggaaar]

How about, instead of paying in money and having the government dish it out, people pay into a health savings account which can only be used for medical expenses, but can be directed by the person to a health care provider of their choosing?

So when we need health care, can we only use the amount of money we personally have put it, or can we use the overall pot everyone paid into. If the first, then poor people die, if the latter, how much can we use?

If you don't believe me, just watch as the NHS provides a poorer service next year, and will need more money than it did this year to do it. It doesn't work, it will never work.

So you're saying that the NHS provides a worse service than it did in the 40s, 50s, 60s? That's obviously nonsense. Lots of my family have had great service from the NHS, curing problems they couldn't have hoped to achieve decades ago. A lot of this of course is due to the advancement in medical treatment (which comes at a cost), but I'm not the one saying the service will be worse year on year.