The Political Thread

[TordelBack]

If you were to ask outsiders what was the best thing about the British state, it'd be a toss up between the BBC and the NHS - and anyone who had actually experienced both would plump for the NHS.  I know several folk from Norn Iron who now live and work down here in Saor Stat Merkel, and traipse back home every time they need a doctor or a dentist.  It baffles me that something that so defines what's good about the UK could be about to be turned into a second-rate copy of systems whose users can only dream of what you currently have. 

[Robin Low]

If you were to ask outsiders what was the best thing about the British state, it'd be a toss up between the BBC and the NHS - and anyone who had actually experienced both would plump for the NHS.  I know several folk from Norn Iron who now live and work down here in Saor Stat Merkel, and traipse back home every time they need a doctor or a dentist.  It baffles me that something that so defines what's good about the UK could be about to be turned into a second-rate copy of systems whose users can only dream of what you currently have. 

It's certainly scaring the crap out of me. There are a number of private companies who are straining at the leash to get in there and rip-off chunks of the NHS, from pathology to continence services. Now, some of these companies might be extremely smart and efficient when it comes to business, but since their bottom line is profit and not people I wouldn't trust them in the slightest.

The real problem is that there is no active support from the general public, who through no real fault of its own has no knowledge or understanding of the complexity and cost of running the NHS - hell, I find that even people within the service are staggeringly ignorant of issues outside their immediate area of work. I think because of that ignorance, there's similarly no understanding of what's going to happen when the private sector gets even more involved.

Regards

Robin

[Old Tankie]

Just 'cos someone does a nifty little rap, doesn't make something true.  The NHS definitely needs reforming, my missus worked in it for years and always said the waste was appalling.  Just because something's done for a profit, doesn't make it bad or inefficient.  In fact, I would argue that it would improve services, as a private company would not want to lose its cash cow to a rival company through bad service.

The NHS just doesn't do efficiency.  Anybody who works in the NHS and says they've never seen bad practice is telling porkies.

The PCTs waste a fortune, why not see if the Docs can do a better job!

[TordelBack]

It's not really my place to comment, as a non-Brit, but to me the issue isn't "Reform: Good or Bad?" - obviously the NHS, and most state organisations everywhere, could benefit from reform.  Public Sectors are always rife with inefficiencies that would be weeded out by financial pressure in the Private Sector.  However the scale of reform proposed, the resources required to make such a change actually workable, and the general philosophical direction it takes (from an inefficient system where the casualties tend to be costs, to an allegedly efficient system where the casualties are more likely to be, well, casualties) are all deeply suspect.  It's not like this model hasn't been explored elsewhere, in countries with infinitely crapper health care services.

I work in a sector which supplies (far less important) private services to the State - I can assure you that what many of my colleagues see when they see a public contract hove into view is 'ker-ching!".  State bureaucracies are seldom equipped to deal efficiently and promptly with the deficencies of the faster, cleverer and more determined contractors they end up getting.

[Old Tankie]

I take your point about some private companies lapping it up when they get public sector contracts, TB, there would obviously have to be strict controls.  But I have to disagree with you when you say that in "an inefficient system the casualties tend to be costs"; a milion pounds wasted through inefficiencies is a scanner or some life-saving drugs or some doctors and nurses.  That's why I think there needs to be reforms.

[vzzbux]

I see the marches went peaceful then with no wanton destruction.




V

[Zarjazzer]

Ah yes the private sector the people that brought you Enron and the current financial catastrophe. They would have taken all our money/savings, your wages would have stopped and every ATM would be empty in order to pay for their own folly.

The world was just a few hours from that happening until guess what? The boring old state/taxpayer had to save their sorry over paid pompous arses. Free  markets are bullshit. And dangerous bullshit too.

Strange how the government never rushed to help say the British ship building industry or mining yet bankers are protected.
Free markets for the poor, socialism for the rich no wonder people are rioting.

[Richmond Clements]

I see the marches went peaceful then with no wanton destruction.




V

Yes, the march did- the twats who went on a wrecking spree were clearly nothing to do with the TUC organised demonstration.

[vzzbux]

It just seems odd that no one has mentioned the events of yesterday. Normally an event like this would have its own thread. I know a few of the boarders were on that march and I hope they are all right.
Having had a torrid day at work yesterday and finishing late the only footage of the events I have viewed is whats on the news at the moment. They are mainly concentrating on the violence and disruption. Yet again the media showing you what they want you to see.





V

[Richmond Clements]

It just seems odd that no one has mentioned the events of yesterday. Normally an event like this would have its own thread. I know a few of the boarders were on that march and I hope they are all right.
Having had a torrid day at work yesterday and finishing late the only footage of the events I have viewed is whats on the news at the moment. They are mainly concentrating on the violence and disruption. Yet again the media showing you what they want you to see.





V

I had the bbc news channel on in the background yesterday (in a hope of spotting Bou in the crowd) and they had some pretty fair coverage most of the day. They did, however, cut to and minor skirmish at any given opportunity. But on the whole, I'd have to say I thought the (live) coverage from the BBC on the day was good.
I didn't see anything last night, or haven't had the news on this morning to comment on what they're reporting right now however.

[Professor Bear]

Strange how the government never rushed to help say the British ship building industry or mining yet bankers are protected.

Be fair - most MPs don't go on to highly-paid consultancy jobs in the ship building or mining industries once they do their stint in office.

Didn't I also read somewhere that Britain farms out MPs as consultants on privitising nationalised industry?  MPs make a huge amount of money telling the world how privatisation works so they actually have to advertise that it's a real thing by selling off whatever's not nailed down while they're in office in order to reap the rewards when they leave that office.

No conflict of interest there, then...

[The Legendary Shark]

Save the NHS campaign:  http://38degrees.org.uk/

I too heard some of the BBC's coverage yesterday. Several times I heard reporters, upon interviewing members of the crowd, say stuff like "but, there is no alternative to cuts, is there?"

Yes, BBC, there is an alternative. A huge great stonking alternative that would solve not only public service cuts but reinvigorate every area of the world. It's an alternative that isn't new and has been proven to work. The alternative that allowed Caesar to build a world-spanning empire. The alternative that allowed Abraham Lincoln to fight the War of Independence.

It's simple: Take away from the banks the power to create and control the money supply and return that power to the people via their governments. The only people who will lose out under this system are a handful of bankers and hedge fund managers - and I think they're already rich enough to cope with being forced to exist on a couple of pounds less caviare a month. It's not as if using public money instead of private money will throw anyone into poverty, for Christ's sake - just the opposite.

http://www.positivemoney.org.uk/

Blood pressure returning to normal. Soap box sagging. Frustration easing...

[The Legendary Shark]

"According to the Guardian and others, minister Ed Vaizey is still considering web blocking as a serious option to tackle copyright infringement..."

http://action.openrightsgroup.org/ea-campaign/clientcampaign.do?ea.client.id=1422&ea.campaign.id=9984

[Robin Low]

Just 'cos someone does a nifty little rap, doesn't make something true.  The NHS definitely needs reforming, my missus worked in it for years and always said the waste was appalling.

I also work in the NHS and my mother worked in it for 43 years over five decades (she also has experience of the private sector). Neither of us are going to proclaim perfection, but both of us are seeing a service intended to care for human beings being turned into a sausage factory where numbers are the primary consideration. That's the sort of reform that's happening, not improvement to actual healthcare.

Just because something's done for a profit, doesn't make it bad or inefficient.  In fact, I would argue that it would improve services, as a private company would not want to lose its cash cow to a rival company through bad service.

It seems a logical argument, but then it's private companies who are providing the cleaning services that are so routinely condemned, but since they employ minimum wage staff, often from overseas, and treat them just as resources not people, what can you expect? It's a question of an organisation's priority, and for the private sector that's just profit. Any organisation who sees any part of the NHS as a cash cow should not be allowed anywhere near it.

The NHS just doesn't do efficiency.  Anybody who works in the NHS and says they've never seen bad practice is telling porkies.

The NHS does do efficiency and cost effectiveness. Hell, our pathology services does the local private hospital's work because they couldn't do it cheaply or efficiently enough. Sure, you can find bad practice in the NHS, but anyone who works in the private sector who says they've never seen bad practice is also a liar. And at least some of the alleged bad practice the NHS is accused of is actually based on opinion, selfishness and plain lack of understanding of systems, technical requirements and legal obligations, both within and without the service.

The PCTs waste a fortune, why not see if the Docs can do a better job!

They won't, for they simple reason that doctors and consultants live in their own little microcosm of the NHS have no or limited understanding of how anything else works. Even when you explain something to them with short words, diagrams and physical examples they fail to understand. Even when you think you've got through to them, you find that they've completely forgotten within a couple of months. Or they just do something their way, because they want to, and stuff anyone else. These are often people who can't even fill out basic patient details properly or legibly on standard forms they use everyday. There's also a shocking degree of selfishness and lack of consideration of others. A gross generalisation, of course, but the culture is there.

All this extra responsibility placed on GPs eats into their already limited time. The only way they'll be able to manage things efficiently will be to hire administrative staff to do it for them.

One of the other things we're talking about is point-of-care testing - some (though no all) diagnostic tests being done at the GPs rather than sent to laboratories. This seems easier for patients, and some GPs think it's going to be cheaper for them. However, GPs and practice nurses frequently do not understand the science and practicalities of performing tests properly, interpteting the validity of results, or even the equipment (I've already heard some horror stories) - and there's no reason why they should, it's not their area of expertise.

So, we're looking at massive and costly training and external auditing systems that will need to be put in place or expanded to make sure everything is done properly. Also, you'll end up with lots of little groups each with their own kit and equipment, rather than more centralised, hospital-based labs working on a larger scale - there is no way on earth this will be more cost-effective or efficient.

What so few people seem able to grasp - even many of the people working in it - is the enormous complexity of the NHS, the incredible diversity and range of services and departments even within subsections of it, the legal requirements, health and safety rules that cannot be ignored, the theoretical and practical science and equipment that underpins diagnosis, cleaning and laundry services, finances and purchases of anything from paper towels to ink cartidges to diagnostic antibodies, hazardous waste mangement which ranges from bloody swabs and body parts to sharps to thousands of litres of toxic chemicals, mandatory and specialist training, internal and external auditing, volunteer transport service, physical and staffed security system, and more.

And if you you're going to say that other companies have to do that, well, I'll remind you that the NHS is the world's third largest employer and one of the most publically scrutinised, and I doubt the scale of our services are matched by any other.


Regards

Robin

[The Legendary Shark]

The NHS has saved my life at least twice.

Never once was I presented with a bill. Never once was it even considered too expensive to save my worthless hide.

Efficient or not, what more could I ask?