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NHS turmoil is just the start of Tory ideology run wild

Discussion in 'off topic' started by internet radio, Feb 22, 2011.

  1. internet radio

    internet radio pfm Member

  2. simeon

    simeon No fixed engagements

    This is not a surprise, but it is only stage one of the project. Stage two (for which we are already being prepared) will be the throwing up of hands at the cost of services and a reduction in the 'offer' to the public as the new inefficiencies combine with reductions in funding to force local commissioners of services to slash and burn while the government denies all responsibility. Then we will truly have begun to approach the US model.
     
  3. Peter Stockwell

    Peter Stockwell Fried Man in Paris

    I'm not gloating, but the UK political climate is truly dreadful, and I wouldn't have believed it could happen, naive that I am.

    My condolences.
     
  4. demersal

    demersal Banned

    In the newspaper = must be completely true?
     
  5. Mescalito

    Mescalito pfm Member

    Peter,

    Don't judge UK politics by the ravings of us sad wan%ers on the off-topic section of a hi fi forum. In the real world, people are just keeping their heads down & quietly getting on with their lives.

    Chris
     
  6. Joe Hutch

    Joe Hutch Mate of the bloke

     
  7. Still

    Still he said his naim was ralph

  8. Mick P

    Mick P Retired and content

    Chaps

    The NHS has over 200 procurement departments and very few contracts take advantage of procurement clout.

    There is nothing wrong with going out to tender in order to drive prices down. The services provided internally are not that good and not that cheap, so outsourcing will mean better patient care. It is a total fallacy to think that public service workers do a better job than private workers.

    Swindon council is just about to outsource a social care programme. It was voted in last week.

    The private cost is £15ph compared to £46ph for council workers. This is on an absolute like for like basis.

    The private care range of hours is longer and includes sundays

    The public workers had a shorter hour range and did not want to work sundays. This means the current six day cover will be extended to seven days.

    Because of the savings, more workers are going to be recuited to provide better care and there will still be savings made to throw into the pot.

    So yes, the NHS is in urgent need of outsourcing and it will be done.

    This should have been done years ago.

    Regards

    Mick

    PS I will not answer any questions if they are of an abusive or aggressive nature as I have no wish to argue with aggressive people as it is tedious and gets Tony L stroppy with me.
     
  9. Still

    Still he said his naim was ralph

    A hint of desperation as Mick attempts to make the thread subject him :)
     
  10. demersal

    demersal Banned

  11. prowla

    prowla pfm Member

  12. Still

    Still he said his naim was ralph

    I heartily agree.
     
  13. TheDecameron

    TheDecameron Unicorns fart glitter.

    I couldn't agree more
     
  14. Tim Jones

    Tim Jones pfm Member

    I have a lot of sympathy for the idea that the only way to drive improvement in the service is by making the money follow the patient, get them to exercise choice based on good information, etc, and with the idea that as long as the founding principles of the NHS are firmly in place then the private, public or other status of the provider should not matter.

    However, it really is quite tricky to find solid evidence that market testing for clinical services, at least in the NHS, saves much money, and quite a lot of evidence that it is a thoroughgoing PITA to manage. When we bring the private sector in (as we did a few years ago to run Independent Sector Treatment Centres), they have a tendency to run off with the high volume, low risk surgical work that makes the most money for NHS Trusts, leaving us with all the loss-making, tricky stuff. Also worth pointing out that, as distinct from other areas, the staff are actually from the same pool (most consultants do a mix of non-NHS and NHS clinics) so actually expect the same or better T&Cs in their private work.

    About 20 years ago I wrote a report on whether market testing saved money in council refuse collection (it was called 'Cheap Rubbish?' Geddit?). It did. Quite a lot IIRC. If you can specify something clearly in a contract, quantify it, etc, things tend to go well. But I'm not sure how easy it is to do that for patient care.
     
  15. simeon

    simeon No fixed engagements

    Indeed. Speccing cold surgery on uncomplicated patients is relatively easy. But experience with the ISTCs, as you point out, showed that the deal (forced on us from the centre) meant they only did the simple stuff. Anything complicated was left to the NHS. And any complications had to be picked up by the NHS.

    Speccing complex packages of care for, say, the elderly with multiple co-morbidities is a bit harder unless you chop the patient pathway up into manageable segments. But then you risk losing continuity of care, introduce a load of hand-offs and all the complications and expense that goes with that. The private sector will cherry-pick. They know it, we know it, the politicians know it. If we just leave the hard stuff to the NHS, that also means that to keep costs down there will need to be higher levels of aggregation of service and a consequent loss of local provision.

    But hey, maybe that's the way to go. I mean we all drive to the supermarket. Why expect local services you can walk to? Oh, yeah, not everyone has a car or is well enough to drive. Cue the big society. **** off and get a neighbour to take you. Waddya expect? It's not the job of the state to look after you. Help yourselves. Losers.
     
  16. Darmok

    Darmok "A Priori Teleology."

  17. sean99

    sean99 pfm Member

    :) Very droll, but sadly quite an accurate take on the Tory mindset.
     
  18. simeon

    simeon No fixed engagements

    If you think tummy-ache medicine is bad, google avastin and lucentis and see what the muthas have done with blind people.
     
  19. Mullardman

    Mullardman Moderately extreme...

    We now have it in writing that you are even more deluded than Nick and Dave.
    :D

    Mull
     
  20. Mullardman

    Mullardman Moderately extreme...

    What you mean is that a massive cost reduction is being achieved by paying staff poverty wages, and a profit is being taken by the contractor out of tax payers contributions.

    You need to explain how that can possibly lead to improvements in care. Be careful here, I am not talking about leading to reductions in cost, but improvements in care. Do try to remember that the primary purpose here is Care. Not cost cutting, and certainly not profit.

    I could reduce Care costs to Zero tomorrow. Not difficult, so long as you don't Care.
     

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