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"if we want a state that can actually do anything then one way or another we all must be willing to pay for it"
But not all of us do want that.
With a very few exceptions, the very last people I would turn to to run anything is "the state" or "the government". You only have to look at services which are run by them to see why that is.
Such things are far better run by people who know what they are doing and who are not encumbered by political dogma and point scoring. That means there will be a profit motive. Some may precede that with "unfortunately", though others, including me, would say "thankfully".
state ownership can be done well or done badly. there are some parts of our economy where i don't think the profit motive should have any place and is in fact doing harm to this country... e.g. in the NHS where huge sums of money are doled out to private health companies for very dubious gains and in our water companies which have been an absolute disaster
"e.g. in the NHS where huge sums of money are doled out to private health companies for very dubious gains..."
Both Mrs NJ and I have unfortunately had extensive dealings with the NHS over the last six to nine months. Both our experiences have been absolutely disastrous on so many levels - far too involved to detail here. We have both had to resort to private healthcare to get our problems fixed (for which we have had to pay) and it was worth every penny. Where the NHS utilises private healthcare capacity things get done and they get done quicker and more efficiently.
"... and in our water companies which have been an absolute disaster"
I have on record on here that I believe water supply - in particular domestic water supply - should be funded from general taxation. Whether this would mean the industry should be state run I'm not sure, but you are right in saying privatisation has been disastrous. Much of this stems from the deficiencies in the regulatory regime that was put in place. There is no real "competition" in the water supply market and it is unlikely ever to benefit from private involvement.
untitled: ""if we want a state that can actually do anything then one way or another we all must be willing to pay for it" - We need reform more than more money. Politicians throw buckets of cash at things so they can say they have, neither side ever considers a reboot, especially of the NHS and the WSS budget. We need reform to effeiciency. I know a few people who work in the NHS for example and they have all the horror stories. When Noo Labour was throwing dosh at the NHS they just went out and hired new teams of managers to expand their empires. The NHS budget is already bigger than the GDP of most of the countries of the world and it will never be enough, it needs reform not dosh. Ditto for many other departments.
"....reform can't be achieved without investment"
Of course it can.
One very simple example involving tthe NHS:
Most NHS hospitals and clinics steadfastly refuse to notify patients of appointments by any means other than letter. This is despite the patients having provided contact details (phone, e-mail) every time they complete one of the many forms the health service requires of them.
There are three consequences of this:
Firstly these appointments are made unilaterally without reference to the patient. Incredible as it seems to NHS staff, their patients often have other things going on in their lives and they are not just standing behind the letterbox waiting for their appointment to arrive. So many of these appointments (for which the patient may have been waiting some time) have to be cancelled or amended.
Secondly the appointment letters are often lost or delayed in the post meaning many appointments are missed. This wouldn't be quite so disastrous if it was easy for the patient to re-book, but it isn't. They either have extreme difficulty contacting the required clinic or, in the worst case, a "missed appoinment" means they have to be referred again by their GP.
Lastly, the cost of this must be enormous. Letters are sent First Class and even with a discount the NHS probably gets for bulk use, I doubt Royal Mail will handle them for less than about 80p. Add to that the cost of the stationery and you're almost certainly looking a a pound a pop or even more (bearing in mind the NHS probably pays well over the odds for its stationery supplies).
It would cost very little to modify the systems which staff must use to book these appointments to produce an e-mail or an SMS message (or both) rather than produce a letter. The cost of informing the patient would then be next to nothing.
The NHS makes around 120 million outpatient appointments every year. So to make this small "reform" would need very little investment but would save them £120m a year. But not only that, it would make the system of informing patients of their appointments far more reliable. If they reaally wanted to step into the 21st century they could even provide a response facility so that patients could confirm that they have received the appointment and that it is acceptable.
The only "reforms" the NHS ever seems to undergo is the shuffling of management structures. But the people left to do the heavy lifting (doctors, nurses, ancilliary staff) still do much the same thing in much the same way as they have done for years; they simply report to a "modernised" managemeht structure. This is just noise. The reforms that are needed are those which make patient outcomes better and rearranging various boards, trusts, commissioning groups and so on do nothing to that end.
I appreciate that not all reforms are as simple as the one I have outlined, but if the NHS will not even embrace that, what chance is there that they will change anything more complex?
//If they reaally wanted to step into the 21st century they could even provide a response facility so that patients could confirm that they have received the appointment and that it is acceptable.//
The hospitals I have used recently do this via text messages (as a follow up to the initial appointment letter).
The Conservatives do not have a good record to defend. The voters know we have had a cost of living crisis, endless austerity, rapant inflation and an economy that has stagnated for years. Add to that Truss' and Kwarteng's lunacy and we have the mess that we have today. I pity them trying to defend all that going into an election.
Sometimes I feel bombarded with texts from the NHS. Appointment asking for confirmation, then reminders 14, 7 and 1 day before all with the option to reschedule or cancel.
Texts telling me I'm still on a waiting list - confirm I still need an appointment.
Texts reminding of bank holidays and the alternative arrangements whilst my GP is closed.
It's a good system particularly because it makes cancelling/rescheduling so much easier
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