How it Works3 mins ago
Lib Dems
I read earlier that the Lib Dems would put 1pm on income tax to pay extra for the NHS and care.
There was a time I would have agreed that I would pay a penny extra tax for the NHS but not any more. Not until they get their fingers out and become efficient and train more nurses and doctors instead of relying of bank or foreign workers to plug a whole left by not appreciating the workforce.
I would actually go back to nurses actually nursing and doctors do the Doctor stuff.
From what I have seen it is the under funding of training and the over training of nurses that have seen the biggest reasons for spiralling costs.
I know for some the NHS is sacrosanct and will not hear a word said against it but let a few knowledgable business people in to sort out the way it runs, make it efficient etc etc and use the savings for the benefit of treatment.
I am not talking about privatisation I am talking about making it business efficient from the ground up.
There was a time I would have agreed that I would pay a penny extra tax for the NHS but not any more. Not until they get their fingers out and become efficient and train more nurses and doctors instead of relying of bank or foreign workers to plug a whole left by not appreciating the workforce.
I would actually go back to nurses actually nursing and doctors do the Doctor stuff.
From what I have seen it is the under funding of training and the over training of nurses that have seen the biggest reasons for spiralling costs.
I know for some the NHS is sacrosanct and will not hear a word said against it but let a few knowledgable business people in to sort out the way it runs, make it efficient etc etc and use the savings for the benefit of treatment.
I am not talking about privatisation I am talking about making it business efficient from the ground up.
Answers
“1p on tax wont buy a weeks worth of the NHS.” 3Ts is nearly spot on. One penny on the basic rate of income tax raises under £4bn per annum (and probably less than that when “
14:08 Sat 06th May 2017
have they forgotten John Smith? Anyway the NHS is a bottomless pit, yes you are correct, it needs to be run more efficiently. It's a typical public sector mess of empire building managers and paper pushers who think the purpose of the NHS is to provide them with jobs. They need a decent private sector CEO to kick it's aris into shape and run it efficiently. BTW I am a huge fan of the NHS as a concept but it needs sorting. 1p on tax wont buy a weeks worth of the NHS.
“1p on tax wont buy a weeks worth of the NHS.”
3Ts is nearly spot on. One penny on the basic rate of income tax raises under £4bn per annum (and probably less than that when “behavioural changes” to raised taxes are factored in). The NHS annual spend is around £140bn, so the increase would pay for about ten days’ expenditure.
There is a strange anomaly with the NHS. It often manages to provide some superb treatment for those with serious and life-threatening conditions. But it cannot manage the bulk stuff – the diabetics, the worn out hips and knees, minor accidents, fractures. It is hopelessly inefficient in those areas. It has no properly thought through systems in place. Most of its systems are designed to make the employees’ lives agreeable and the patients come a very poor second. Huge sums are spent on so-called “primary care” (i.e. the GP service) and these sums were ridiculously increased under the Blair administration. For probably 50% or more of their time, GPs represent simply a clearing house: “Take these pills. If you’re not better (or dead) within a fortnight come back and see me and I’ll send you to somebody who knows what they’re talking about”. A system needs to be developed that does not depend on paying somebody £100k pa to run this process.
The NHS is often spoken of as “the envy of the world”. Well I’m afraid it’s not. I’ve received health treatment in other countries which run a State funded health service and they are streets ahead of the UK. Raising a couple of billion pounds will not improve the NHS one jot. Most of it will be lost in the noise and “executives” jockey to enhance their empires with further administration (more cash always requires more administration). It needs brave politicians to bite the bullet and tell the public the NHS can no longer be funded the way it is and that they will have to pay directly. Shrieks of horror would ensue from the usual suspects but they needn’t worry as we have no politicians with the courage to do what’s necessary. They’d sooner see the health service degenerate to third world standards along with many other aspects of life in the UK.
Politicians’ stock answer to any problem they encounter is “more money” (followed by “more taxes” to raise it). The NHS is not short of money. It is short of efficiency and proper organisation. I could give countless examples of waste that just I have witnessed. I won't bother to recount them because we all see it for ourselves. Mr Farron needs to see it for himself before glibly suggesting that everybody would be happy to pay more only to see that waste increase.
3Ts is nearly spot on. One penny on the basic rate of income tax raises under £4bn per annum (and probably less than that when “behavioural changes” to raised taxes are factored in). The NHS annual spend is around £140bn, so the increase would pay for about ten days’ expenditure.
There is a strange anomaly with the NHS. It often manages to provide some superb treatment for those with serious and life-threatening conditions. But it cannot manage the bulk stuff – the diabetics, the worn out hips and knees, minor accidents, fractures. It is hopelessly inefficient in those areas. It has no properly thought through systems in place. Most of its systems are designed to make the employees’ lives agreeable and the patients come a very poor second. Huge sums are spent on so-called “primary care” (i.e. the GP service) and these sums were ridiculously increased under the Blair administration. For probably 50% or more of their time, GPs represent simply a clearing house: “Take these pills. If you’re not better (or dead) within a fortnight come back and see me and I’ll send you to somebody who knows what they’re talking about”. A system needs to be developed that does not depend on paying somebody £100k pa to run this process.
The NHS is often spoken of as “the envy of the world”. Well I’m afraid it’s not. I’ve received health treatment in other countries which run a State funded health service and they are streets ahead of the UK. Raising a couple of billion pounds will not improve the NHS one jot. Most of it will be lost in the noise and “executives” jockey to enhance their empires with further administration (more cash always requires more administration). It needs brave politicians to bite the bullet and tell the public the NHS can no longer be funded the way it is and that they will have to pay directly. Shrieks of horror would ensue from the usual suspects but they needn’t worry as we have no politicians with the courage to do what’s necessary. They’d sooner see the health service degenerate to third world standards along with many other aspects of life in the UK.
Politicians’ stock answer to any problem they encounter is “more money” (followed by “more taxes” to raise it). The NHS is not short of money. It is short of efficiency and proper organisation. I could give countless examples of waste that just I have witnessed. I won't bother to recount them because we all see it for ourselves. Mr Farron needs to see it for himself before glibly suggesting that everybody would be happy to pay more only to see that waste increase.
NJ //The NHS is often spoken of as “the envy of the world”. Well I’m afraid it’s not.//
Yes you are right, it might be if you live in Nigeria but not anywhere closer to home.
Here in Germany the accent is on preventive medicine; on Monday I am to have a full three-yearly head to toe "m.o.t." as a matter of course and I didn't even have to ask for it.
If you try asking a NHS doctor for a full check up and he will inevitably ask what is your complaint? I was once told it is actually a "National ILL-health Service", that was some time ago, but I don't think it has changed.
It simply can't go on as it is.
Yes you are right, it might be if you live in Nigeria but not anywhere closer to home.
Here in Germany the accent is on preventive medicine; on Monday I am to have a full three-yearly head to toe "m.o.t." as a matter of course and I didn't even have to ask for it.
If you try asking a NHS doctor for a full check up and he will inevitably ask what is your complaint? I was once told it is actually a "National ILL-health Service", that was some time ago, but I don't think it has changed.
It simply can't go on as it is.
No, I wouldn't pay more - I've paid enough. You are all quite right, there is huge inefficiency. After living in France for so long I can see very clearly where waste areas are - admin. is the main culprit. To employ someone in France if hugely expensive - so the systems are efficient. A whole 2 hours at Poitiers hospital to fix my hip replacement - that's what it took - and a couple of weeks prior to diagnose and confirm. Granted you do a lot of the work yourself - e.g. ring consultant's secretary and make appointment.......but it works!
And your experience demonstrates perfectly my point about the "Primary Care" service, jourdain.
In the UK your journey would have begun at your GP.You cannot have direct access to your consultant. You must be "cleared" by your GP first. So, a week or two to get a GP appointment (which you don't need) another week or two for him to refer you to the consultant. Five or six weeks after that and you get an appointment through the post (which may not be convenient, and if it's not, another two or three weeks' delay). A person on £100k is making the arrangements you could easily make yourself.
I have a similar situation. I have a condition which is stable after treatment but not cured. When it needs further treatment I have to go to my GP. I know what's needed, my GP knows what's needed, but I cannot simply ring my consultant to make the arrangements.
It's jobs for the boys and girls, delay and inconvenience for the patients.
In the UK your journey would have begun at your GP.You cannot have direct access to your consultant. You must be "cleared" by your GP first. So, a week or two to get a GP appointment (which you don't need) another week or two for him to refer you to the consultant. Five or six weeks after that and you get an appointment through the post (which may not be convenient, and if it's not, another two or three weeks' delay). A person on £100k is making the arrangements you could easily make yourself.
I have a similar situation. I have a condition which is stable after treatment but not cured. When it needs further treatment I have to go to my GP. I know what's needed, my GP knows what's needed, but I cannot simply ring my consultant to make the arrangements.
It's jobs for the boys and girls, delay and inconvenience for the patients.
One thing that would help, and which could be brought in immediately, is to charge the large number of people who do not turn up for GP appointments. And then find a way to deter people from seeing their GP for ridiculous ailments like colds etc which they could and should treat themselves.
Oh, and make GPs stop routinely prescribing antibiotics: something that is going to have huge repercussions for all of us in years to come.
And I take your point, NJ, that a lot of the time GPs just seem to work as a referral service - anything they're unsure about, they just pass it on for someone else to deal with. We're always told how hard they work, but they no longer usually work in the evening, at weekends and are not on call overnight, as they used to be.
Oh, and make GPs stop routinely prescribing antibiotics: something that is going to have huge repercussions for all of us in years to come.
And I take your point, NJ, that a lot of the time GPs just seem to work as a referral service - anything they're unsure about, they just pass it on for someone else to deal with. We're always told how hard they work, but they no longer usually work in the evening, at weekends and are not on call overnight, as they used to be.
I don't think anyone would claim the NHS is a paragon of efficiency but you simply cannot discuss the problems in the NHS without mentioning PFI. These have introduced the concept of structural debt into the health service and is the main reason why trusts are closing. The value of PFI debts vastly, vastly, vastly exceeds the cost of wages in the NHS. The total budget of the NHS is about £120bn - NHS trusts owe about £80bn in PFI repayments.
I submit that is probably the reason NHS is in crisis. It is not because it hires too many people (though it does do that), it's not because too many sick people use it (inevitable consequence of an aging population), it's because governments of both parties have awarded lucrative contracts to their sponsors and allowed them to make enormous profits from the public sector. The current state of the NHS is intentional.
I submit that is probably the reason NHS is in crisis. It is not because it hires too many people (though it does do that), it's not because too many sick people use it (inevitable consequence of an aging population), it's because governments of both parties have awarded lucrative contracts to their sponsors and allowed them to make enormous profits from the public sector. The current state of the NHS is intentional.
PFI debt is a factor but isn't the biggest problem with the running of the NHS.
Empire building by managers making the system so unwieldy and inefficient that no mater how much it could be improved it never will.
People complain they already pay for the NHS through taxes but if they want all the care possible then not enough is being generated by tax.
At one point the government couldn't afford building work for the NHS so it went to this PFI. TBH that was always going to be the more expensive way to do it but when you have no money in your pocket wonga is the only option left.
The NHS needs reform from top to bottom and no one in any of the parties has the guts to say so or do anything about it.
I think that before we get blown to smithereens by Trump and Kim ung whatsit or overrun by Islam we will see the collapse of the NHS.
Empire building by managers making the system so unwieldy and inefficient that no mater how much it could be improved it never will.
People complain they already pay for the NHS through taxes but if they want all the care possible then not enough is being generated by tax.
At one point the government couldn't afford building work for the NHS so it went to this PFI. TBH that was always going to be the more expensive way to do it but when you have no money in your pocket wonga is the only option left.
The NHS needs reform from top to bottom and no one in any of the parties has the guts to say so or do anything about it.
I think that before we get blown to smithereens by Trump and Kim ung whatsit or overrun by Islam we will see the collapse of the NHS.
I've yet to see any actual figures for what this supposed "empire building" costs the NHS though, whereas the costs of PFI are staring us right in the face.
"At one point the government couldn't afford building work for the NHS so it went to this PFI. TBH that was always going to be the more expensive way to do it but when you have no money in your pocket wonga is the only option left. "
Well yeah, because they'd been slashing govt incomes so recklessly. It was disastrous short-term thinking by both parties.
"At one point the government couldn't afford building work for the NHS so it went to this PFI. TBH that was always going to be the more expensive way to do it but when you have no money in your pocket wonga is the only option left. "
Well yeah, because they'd been slashing govt incomes so recklessly. It was disastrous short-term thinking by both parties.
a friend's wife is an administrator at a thames valley hospital which has PFI contracts in place. a department needed a new noticeboard; this could not be actioned themselves because any "damage" to the infrastructure (like drilling holes in walls) is subject to massive fines. no, they had to go to the sole contractor assigned to do this type of work, who charge 300% (on average, according to my source) above the going local rate for the type of work. needless to say the department didn't get their noticeboard.
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This graphic from The Health Foundation shows the "net deficit" (which in the case of the NHS amounts to debt) in NHS Trusts since 2012.
It is not "part of the problem", it is the problem. Everything else is distraction.
This graphic from The Health Foundation shows the "net deficit" (which in the case of the NHS amounts to debt) in NHS Trusts since 2012.
It is not "part of the problem", it is the problem. Everything else is distraction.
There are ways to put up notice boards without the need for drilling holes.
PFI is part of the problem not THE problem.
Take away PFI, which you can't so no point trying, and there is still waste and inefficiency.
Take off PFI and the NHS would still not be able to cope with demand for ever more expensive and sometimes dubious treatment.
PFI is part of the problem not THE problem.
Take away PFI, which you can't so no point trying, and there is still waste and inefficiency.
Take off PFI and the NHS would still not be able to cope with demand for ever more expensive and sometimes dubious treatment.
Goodgoalie makes an important point. In every waiting-room and surgery in France there is a stern notice warning that a missed appointment will be charged at 15 euros and that a second offence will result in the patient having to find another doctor.
Contrast the UK. OH gas regular appointments with a practice nurse to have a wound dressed. We got in early (for once!) because a woman had failed to arrive with her 3 children for their immunisation vaccinations -------this was for the 3rd time! 1st 2 times the nurse had kicked her heels waiting for them. We told the nurse to sign them off.
Contrast the UK. OH gas regular appointments with a practice nurse to have a wound dressed. We got in early (for once!) because a woman had failed to arrive with her 3 children for their immunisation vaccinations -------this was for the 3rd time! 1st 2 times the nurse had kicked her heels waiting for them. We told the nurse to sign them off.
I went to the GP Friday for the fifth of six timed injections.
I duel arrived on time but half an hour later still no sign of my turn so I went to reception to complain.
Various excuses and no more appointments for two weeks were met with from me, I don't care. These are timed and the appointment set by you. I cannot sit here till you decide you have time because I have things to do. Sort it out. They found someone to give the injection within two minutes.
Now I know that doesn't prove anything about the discussion but it does show that GP surgeries are not all sweetness and light.
Oh and to really *** me off the other week the receptionist took so long to make my next appointments I got a parking ticket. £50 just for their incompetence.
I duel arrived on time but half an hour later still no sign of my turn so I went to reception to complain.
Various excuses and no more appointments for two weeks were met with from me, I don't care. These are timed and the appointment set by you. I cannot sit here till you decide you have time because I have things to do. Sort it out. They found someone to give the injection within two minutes.
Now I know that doesn't prove anything about the discussion but it does show that GP surgeries are not all sweetness and light.
Oh and to really *** me off the other week the receptionist took so long to make my next appointments I got a parking ticket. £50 just for their incompetence.
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