I am publishing tomorrow’s blog now, as the Health Secretary has just spoken to Conference and this provides some of the relevant detailed background for those writing about it.
In response to those of us who have asked how the new Secretary of State will ensure the extra money directed to the NHS will be used to raise the quality of care, improve access and get the waiting lists down, Mr Javid has announced a review of NHS and CareĀ leadership.
He has appointed General Sir Gordon Messenger and Dame Linda Pollard to conduct a review into how efficiency and innovation can be improved in the NHS and how regional inequalities can be reduced. As Health now has a massive Ā£230 bn budget, absorbing all of our Income tax, CGT, Inheritance tax and Stamp Duty it is indeed to time to review how it can be better spent and to ask what another Ā£12 bn canĀ bring that Ā£230 bn cannot achieve. I wish to explore this in a few pieces and pass on my thoughts to the Secretary of State. I would have preferred the terms of the review to have been more narrowly focussed on quality and cost of care.
Let us begin by asking what can we expect of the two lead characters appointed?Ā I wish them both well and acknowledge they have had successful careers in public service. May they be wise and insightful in this task, stepping outside the frequent public sector wish to claim all is well and turn most arguments into one about how much extra money is required .Often the need isĀ to remedy defects in the way the baseĀ budgets are spent.
General Sir Gordon can draw on the talents, bravery and discipline our soldiers show, and their ability to improvise and respond quickly when on active service. He was decorated for his personal bravery in leading troops in action. I hope he has also learned from some of the failings of MOD and senior army management. There is a long history of big budget overruns and delays when buying equipment. The use of the rank of Lieutenant Colonel paying around Ā£80,000 a year for 1510Ā senior officers in a service of 82,000 armed personnelĀ does not look like slim management. There are 590 moreĀ officers of ranks above Lieutenant ColonelĀ to fill the main national management roles.
Dame Linda Pollard can draw on the example of the bravery, hard work and versatility shown by the front line NHS workers handling serious covid cases over the last year and a half. The Leeds Teaching Hospital she chairsĀ was last rated asĀ Good by the Care Quality Commission. It did, however, receive criticism for safety which needed improvement. It failed to meet performance standards for referrals to treatment – i.e. too many people waited too long. Its emergency readmission rates were above the national average meaning more remedial treatments were needed. Its staff cost per unit of work were lower than average but its non staff costs higher. I would be more reassured about her advice were Leeds to have an outstanding rating for safety and quality of care, and were it not to have issues in getting waiting lists down.
The media did not seem to report any of this, saying the review was an attack on waste and wokery. It is not quite what the announcement says. I do think the Secretary of State needs to sit down urgently with the leading CEOs running the NHS in England to get them to identify what they need to do to get waiting lists down, the prime current objective. Of course this also entails performance criteria for quality of treatment and cost. His own performance monitoring system which is very detailed by CQC should help him decide which of the senior CEOs areĀ good, which need to be mentored to improveĀ and which if any need to be removed for continuing poor results.
October 5, 2021
Good morning. Sort of ?
Damned by faint praise, methinks.
Ā£230 Billion a year. What on ? I never use the NHS. Haven’t for years. So who is costing us so much ?
October 5, 2021
You are fortunate Mark, medical advances mean many more people, particularly the elderly and those born with severe disabilities, are kept alive for decades longer than they would have survived when the NHS was instituted, and require the expensive and frequent treatments that are now available. That is an ethical question that the whole country needs to discuss, but they won’t.
I would certainly have been happier with an NHS Review headed by a businessman/woman with a proven record of managing very large companies.
October 5, 2021
@SM; “That is an ethical question that the whole country needs to discuss, but they wonāt.”
Not at all, it is a political question. Doctors already make difficult, ethical, decisions about outcomes, what treatments to offer, when to stop treatments and offer palliative care instead, but at least they do so on medical grounds not due to economic considerations -or shouldn’t have to.
I agree with your last sentence, the ingrained MOD mindset is totally wrong, no disrespect to General Messenger, I say that as someone who has worked for a couple of MOD suppliers/contractors and have distant relations who have retired from the active forces within the last 10 years, having each gained reasonably high rank.
Do we actually need yet another NHS review, soon there’ll have been more reviews in the last half century than the country has teaching hospitals. Just put Matron back in charge!… š®
October 6, 2021
Hopefully we’ll find out if the decision to discharge elderly people with COVID from hospital into nursing homes was made by politicians, administrators or health care professionals. The inquiry can also explain the associated increase in midazolam for ‘palliative care.’
October 6, 2021
Exactly!
Stockpiled even.
October 6, 2021
@SM Not trying to second guess ‘Mark B’ and as Sir John said “As Health now has a massive Ā£230 bn budget, absorbing all of our Income tax, CGT, Inheritance tax and Stamp Duty it is indeed to time to review how it can be better spent and to ask what another Ā£12 bn can bring that Ā£230 bn cannot achieve.”
As the spend on the NHS is now all of the tax take and revenue for the whole country, meaning no money for infrastructure, schools i.e. everything else. There is clearly something amiss and like most you can see it is not going to the customer facing front end or its direct support.
October 6, 2021
Tale from today.
My daughter wears braces (paid for by the taxpayer, thank you although if I only paid for everything we use and no tax then I would be better off) her treatment has been going on for 2.5 years (should have been 2). We have been delayed in finishing the treatment as one of her baby teeth is stuck and not coming down so they can’t know where to finally position the teeth.
We need to see a dental consultant at an NHS hospital. All the orthodontic work to date has been carried out by the private sector paid for by the taxpayer but now we need the public sector. We have been waiting for a referral for more than a year after the June ’20 date was cancelled (that took six months to get).
Today I phoned the hospital to which we had been referred to ask how long it might take. They told me to phone the access centre who had the records. The access centre said yes, she was on the waiting list but the hospital had the waiting lists so they could not let me know how long the appointment might take to come. No the hospital could not tell me as they didn’t have the records.
If they had needed my custom in order to get paid, this would not have happened. As they all get paid regardless, we have an issue.
October 6, 2021
Absolutely not . Health Care is vastly different than any other industry .Co morbidities, poly pharmacy, changing hourly requirements, new problems from afar, sweeps of patients to the manageable change many times in the day. Many have tried to box need and time and money manage most things.in the NHS.They make a Fool of themselves.A patient is an individual and not only does need change hourly but predictions also morph frequently.Did we predict covid?
October 5, 2021
I am afraid I donāt have much faith in General Gordon and Vicky Pollard.
It is easy enough to find ātwo lead charactersā, as you call them, from the usual list of quangocrats and insiders. Far more difficult to see them actually achieving anything.
Stripping out layers of bureaucracy would be a start. Getting rid of overpaid non medical consultants from the big accountancy firms would be another. I donāt expect that to happen though.
More private firms will just find lucrative but unvented NHS contracts via their pals in parliament. See Matt Hancock for details.
October 5, 2021
Un vetted not unvented.
October 6, 2021
I’m afraid Peter I agree with you. None of the layers of management will go. If they do all that will happen is they will be given another pointless post elsewhere. A bit like local government. ….now don’t get me started on that little fiasco.
October 6, 2021
What are they thinking of? A retired General, just look at the defence budget! Do the military have any idea about efficient use of funds? And a Dame who is involved in some capacity running a Hospital Trust which does not have a very good record. Both will not have any idea about efficiency and the economical running of a business operation, for that is what the NHS is on a very large scale.
October 6, 2021
Mark B, I had a pituitary tumour 22 years ago, successfully operated on but since then I have had to take hormones in pill form, supplied free by the NHS. So I am one of your culprits, kept alive by the NHS.
October 6, 2021
My mother is similar John.
Do you think that you and she could contribute for each prescription? I have to @ Ā£9.35 per item, could this reflect the cost of the treatment better (50p for aspirin, Ā£50 for some others)?
October 7, 2021
The point is, John, that the NHS was not designed to take into account needs such as yours, and that there needs to be a complete rethink of how such matters can be coped with, both economically and ethically.
October 5, 2021
As with no amount of money, no amount of talk, no amount of public reviews will improve things, no new highly paid advisors will improve any thing. They will need their staff, their offices, in turn extra support staff but the system will block them.
It is a top down industry, diversity officers, diversity secretaries and many more pumping up their own esteem and draining the taxpayer that now embedded wont permit change.
Its a mirror image of what is wrong with Government 11years of talk about doing this that and the other and still reform, pairing back, or improvements to anything promised going back a decade or more
October 6, 2021
Nota#
Well said, bang on the money.
October 5, 2021
Yes.
But he says so many things.
Look at the passport contradictions.
October 6, 2021
There’s scope to sack 50% of administrative staff. Too many equality and non job positions
If course it won’t happen. Been trying to book a blood test at my GP.
An audience with the Queen would be easier.
October 6, 2021
This is where this is going: ‘A team of scientists from Rutger’s University has created a robot that can take blood samples from patients. The robot can perform as well or even better than people in drawing blood. The new machine will help many people and save time in clinics and hospitals.9 Feb 2020’
October 6, 2021
Nightmare!
October 6, 2021
But can it complete the required diversity and black history courses during induction?
October 6, 2021
Who straps your arm to the chair arm? In order to stab your arm accurately it will need to be very still – imagine a cough or sneeze at the wrong moment just as HAL moves in and plunges a long needle through your bicep or wrist.
October 6, 2021
+1
Iām not sure what qualifies a person ( certain benefits or area of the country maybe?) but some I know are getting the full works. GP face to face, hospital and full dentistry.
Here they tell you not to phone and certainly not turn up in person.
October 6, 2021
@Ian Wragg; “Thereās scope to sack 50% of administrative staff.”
That’s the face and shape of the rights wings love affair with ‘market forces’ & the private health care providers and non medical facilitators. Thus the NHS back office today (all the Trusts, GPs, Dentists, Contractors etc. counted as one) is more bureaucratic now than ever.
But I agree, for examples local GP practises could do more, letters from my GP practice are signed off by the “Business manager” -for goodness sake, let’s find the political will to get rid of such people, positions, within these practices, even if that means integrating GPs more fully within the wider NHS, then recruit an additional GP or at least practice nurse.
“Been trying to book a blood test at my GP. An audience with the Queen would be easier.”
You appear to blame your GP for the lack of an available (non elective?) blood test, but do you know that the problem is not an inability for your GP to send blood samples off for testing, the logjam not being the NHS or GP but at the (private?) test lab. No point your GP taking a blood sample for it to then sit in a refrigerator for the next how ever long.
October 6, 2021
They texted me to book for a blood test, it’s just that you can’t get through 9n the phone. Today I walked to the practice and the receptionist wouldn’t give me a slot becthey only do them by phone now.
An elderly gentleman was trying to change his appointment because of some transport issue but he too was sent packing.
October 6, 2021
@Ian Wragg; You do realise that most GP practices are merely contracted to the NHS, with quite a lot of contractual freedoms written into the contract compared to the rest of the NHS that is in effect owned by the State, stop blaming the NHS for the faults of the semi-private sector! Hence why I made a case for bringing GP practises (finally, after only 74 years…) fully into the NHS, and in the process getting rid of the current infestation of “Business Managers” who decide how their own practice should best operate.
October 6, 2021
In your first paragraph you describe market forces as pursued by a bureaucracy Jerry, not a reflection of “right wing” or the market but by centralisation.
October 6, 2021
@NS; I was comparing the NHS of the last 40 years with the NHS of the 33 years before that, both eras suffered from the same sources of the bureaucracy you mention, be it GP’s and surgeons who never really wanted to be a part of the NHS, the Trade Unions who though they should run the service, the civil service who thought they could run it!
October 7, 2021
If you look at the type of administration staff in this era Jerry they do not reflect a market – accountants, appointment administrators and their expanding overseers do are not needed to find competitive services. A red herring methinks.
October 7, 2021
@NS; “A red herring methinks.”
Indeed your argument is! Every private NHS supplier is operating in a competitive market, when I worked for a NHS supplier we had to compete with I think three other completive tenders to win the multimillion GBP NHS contract. You seem to think the “NHS” is just the services run directly by the DHSS, when much of the “NHS” is actually private companies providing medical and non medical ‘services’ to devolved Trusts (everything from the building to the coffee machines, even car parking), Trusts themselves a contractor in effect to the DHSS.
October 6, 2021
Ian Wragg.
Scope to sack 50%
Definitely. One hospital I was in had a senior sister on a Saturday morning sitting on a computer with piles of paper entering stats onto a document for administration. Asked the why question? Was told its to ensure the data is correct. Who supplied the data? A nurse. Why can’t the nurse put it straight on the computer? She might entrer it incorrectly. Really can you be sure that she has filled in the form correctly. If looks could kill!!! Easy bit of overtime.
October 6, 2021
@turboterrier; A ward nurse is not a trained computer input operator, nor are they likely to have the time to do such work (in addition to their nursing duties), a senior sister not usually engaged in routine patient centric work more than likely is both trained and has the time. Often being ready to stop such tasks when additional help in needed on the ward, such as in a ‘crash’ situation..
The real “Why” question you fail to ask is why do senior administrators, stratification, people within the DHSC etc. need all this data, to make themselves look busy, to give themselves and their mates jobs perhaps?
October 7, 2021
If a ward nurse has the time to write obligatory data about a patient’s progress on a piece of paper, s/he has the time to enter it on a tablet (tech, not pharma!), which could then be transferred quickly and easily to a bigger system. And if the nurse is incapable of doing a task like that, how is s/he capable of adjusting drips, putting the correct amount of medication in a hypodermic or observing changes in a monitor the patient may be hooked up to?
October 7, 2021
@SM; I suggested the ward nurse doesn’t have time, not that they do not have the skills to use IT!
You seem to expect the ward nurse to enter the data twice, once on the written patients ‘bed notes’ and again into the IT system. Have you ever thought why bed notes are still written by hand on paper charts, might it be so they remain in clear view to all, who wants to be trying to log into a IT system when the patient has ‘crashed’… All admitted patients also have a hand written, or at least printed, wrist/ankle tag that is in plain sight, I wonder why have they not been changed to those far more efficient bar codes?
October 6, 2021
@Everhopeful +1 Yes what ever the MsM tells him you want to hear and as tomorrow is another day and another ‘virtue signal’ who cares. Kicking the can down the road
October 6, 2021
+1
October 5, 2021
Why bother with yet another central government inquiry; even next door’s dog knows THE PROBLEM IS central government! Just go and copy the French system. The WHO has ranked it first on several occasions recently. Civitas Report: Investigating what the UK can learn from the French model of healthcare funding November 2018 (Google it) saying:-
“Tax-funded models, and particularly the UK due to its large governmental involvement in administration, are affected by ‘an inefficient, centralistic setup’ with a bureaucracy that attempts to regulate and manage the system of healthcare. Notwithstanding recent efforts to devolve some duties to medical professionals, the structure of healthcare administration in the UK still suffers from the inefficiencies of excessive governmental oversight. This will continue to be the case while the state is in charge of managing funding and spending. The inefficiencies may initially be caused by the bureaucratic burden that results from attempting to manage complex decisions from central government, without the necessary division of responsibilities. But this affects the entirety of the system, as the use of resources in hospitals and surgeries is affected by decisions made at the stage of central government.”
I have said before on this site; the UK is the most centrally controlled economy in Europe. Therein lies the fundamental problem; some systems are just too large for even big brains to run. Unfortunately, you prefer to keep voting to keep the system that is failing you personally.
October 5, 2021
Everything in the UK is subject to the false dichotomy.
We can either carry on doing what we do, or adopt whatever the Americans do.
We cannot ever, ever, learn anything from, say, the French.
Because they speak French.
October 5, 2021
You making things up again NLH?
Who actually says what you are claiming?
October 6, 2021
Peter2 beginning to think NLH is just MiC holiday replacement troll.
October 6, 2021
@a-tracy +1
October 6, 2021
Yes I think it’s MIC. Same style or lack of.
October 6, 2021
@Peter2; The truth appears to stings…
Although @NLH is wrong on one count, rather than France, we could learn a lot from how Germany run their health services.
October 6, 2021
Nah, they speak German, mate.
October 6, 2021
I agree Jerry.
Sadly when anyone criticises the current NHS system they face people saying,..So you want the same system as in America.
No.
We should copy best world practice.
October 6, 2021
@Peter2; “We should copy best world practice.”
Copy what the UK had back in 1950 in other words then. š
October 7, 2021
I realise you feel things were better long ago Jerry, but I was hoping we might copy current health systems around the world and copy them.
October 6, 2021
But not very well. They hardly understand me at all.
October 6, 2021
(:
October 6, 2021
Putain!, absurditƩ.!
October 6, 2021
NLH
Are you āAndyā posting under a different moniker?
Do you only support Democracy when your side wins?
I question the need for yet another Remoaner posting that āeverything is the fault of Brexitā the battle youāre fighting is lost but, of course, itās nothing to do with me!
October 6, 2021
No, he isnāt me. And Brexit is very far from done. We have the public inquiry to go yet and many Brexitists to prosecute.
October 6, 2021
Martin,
The French have it right… You want to get on in France you speak French, not like English public services that feels that it should speak every different language on the planet and supplies free translation to those that don’t speak the national language i.e. English. Or the Welsh that waste a fortune on having everything in two languages…
October 6, 2021
Acorn 10000%+ spot on. And do not forget the documents which are printed in 30+ different languages.
I have lived and worked in Africa and Central America. You speak THEIR language or nothing happens. You want a translator or an assistant to help you, then YOU PAY.
The UK is a soft touch that is why thousands try to get here. Once you have a foot on the soil the “system” bends over backwards to assist.
October 6, 2021
@Know-Dice; There are at least three official languages in France, Standard French, French Catalan, French Basque…
October 6, 2021
So are French official documents always in three versions of French?
October 6, 2021
@Know-Dice; I can’t speak for France but in Spain, were they have at least four official languages, yes.
Also, dose not the USA produce at least some official documents in both English and Spanish; Canada, French and English; whilst in Australia English has no official legal status.
October 6, 2021
@acorn it’s interesting the French system is highly rated and having seen it works very efficiently and financially personally I agree their professional advisors would do a better job of how to utilise Ā£ 230Bn or nearly Euros 300 Bn if the truth be told.
Sadly like asking the Police to investigate themselves we get nowhere and nonsense, kicking the can down the road.
The political slogan “Free at the point of use or delivery” is incorrect and acts as a major stumbling block to us all. The serious debate is avoided by all short term politicians sadly as it is bigger than any UK government so far.
October 6, 2021
The NHS is highly unionised and therefore, highly politicised. Labour, the unions and the media will make damned well sure that no reforms, no matter how small or well intentioned, are ever going to succeed. Hence why I advocate making company financed health insurance tax free. We need to wean the people of State / Politicised Healthcare.
October 5, 2021
The General will need to show the utmost bravery if he criticizes the religion of NHS.
October 6, 2021
I surmise that unfavourable comparisons between NHS outcomes and those in say, France and Germany will be used as a reason to replace it with – not theirs, but as ever … … … … the American system. Where outcomes are similar, but cost four times as much per person as does the NHS.
October 6, 2021
That’s nonsense again NLH
Critics of the NHS often point to better systems as in Europe and elsewhere.
It is those like you who refuse to accept there are much better systems for providing health care that keep going on with this odd conspiracy theory about replacing the NHS with an American model.
October 6, 2021
OK, P2, you seem so cocksure. What is the future of the NHS? How will it evolve? Will there be more private solutions? What further levels of privatisation if any will be introduced? Will patients have to pay something, to the GP, for analyses, for medicine, for long-term treatment, for potential home or residential care? Will it go to the insurance model? Will it be going more to an American, German, French or Zanzibarian model? Will the ārevisedā NHS favour prevention? ā¦
You are able to say that NLH talks nonsense, fine. Now tell us something that brings some meat to the debate, makes sense and gives us some actual ideas of what you are thinking of this important question of āproviding healthā to the UK people.
October 6, 2021
Oh another quiz.
Is that you again heffy?
I grew up with the NHS and it has saved my life.
But it needs to change and improve.
My view is it should copy the best systems on the world.
Is that sufficient to stop you becoming a troll?
October 6, 2021
Why do you ‘surmise’ that? Has any politician of any stripe ever advocated adopting ‘the American system’ that you can actually quote?
The French health service has been assessed as the best in the world, and it certainly has more nurses and hospital beds per capita than the UK. However, as here, the considerable increase in life-expectancy is causing France financial problems. (Sorry, I’m beginning to sound like a well-known contributor to this site, but it’s a fact that cannot be ignored!).
October 6, 2021
Indeed āle trou de la Securite Socialeā (the ever-increasing hole in the financing of the health and care services from 1948 to the ā90s) has haunted French politicians for decades. Many temporary/āpermanentā solutions by successive governments (of right or left flavours) were bandied around, tried and mostly failed over the years to deal with it.
The CSG (contribution sociale generalisee) and CRDS (contribution au remboursement de la dette sociale) were introduced in 1990 with rates of 9.2 % (CSG) and 0.5% (CRDS) added to the usual taxes. It was rather successful, the huge deficit having decreased to āonlyā ā¬34bn in 2019, and words had circulated that it could be decreased possibly suppressed in 2024.
Unfortunately Covid-19 has added ā¬50+bn to it, and the French Government has now put off such measures (decrease or cancellation of these two taxes) till 2030+.
But having seen these last ten years how some old (and sick) members of my extended family had been cared for in their old age, I would think that even if somewhat expensive to the community, the French medical and residential care systems are so much better than what I have witnessed the (South East) UK system(s) to be.
October 6, 2021
It’s like the French pension fund, SNCF etc, they are bankrupt .
They keep borrowing today for them.
October 7, 2021
There is no such thing as āthe French pension fundā, Ian. Right now, there are still 42 ācaisses de retraiteā, some in pretty bad financial conditions, some doing pretty well. That was one of Macronās promises when he got elected in 2017, to simplify the system. A French person after 40 years working in different jobs might have to claim between two (the basic state + complementary pension likely subscribed jointly with the employer) and 10+ different bits of pension money from as many āpension fundsā.
The only positive thing that happened about ten years ago is that āSĆ©curitĆ© Socialeā has on its site some good tools helping people to keep track of their career (at any stage of it), which then provide relevant information on how to claim.
Now most secondary school children in France are even given a short tutorial on how to deal with the site. Imagine if such a thing were to happen with UK children dealing with the DWP site. That would make a difference.
As for your comment about SNCF, it does not appear to be consistent with the 2020 Annual Financial Report (available in English at medias.sncf.com āSNCF Group Annual Financial Reportā). Funnily enough ThamesLink, Southern, SouthEastern, GreatNorthern and GatwickExpress are UK railway franchises run by the railway company Govia, itself owned by Keolis whose major shareholder is ā¦ SNCF.
Sorry to rain on your parade ā¦
October 5, 2021
ā the Secretary of State needs to sit down urgently with the leading CEOs running the NHS in England to get them to identify what they need to do to get waiting lists down,ā
No, theyāre causing it. Large CEOs pass on responsibility to Senior Managers who will in turn speak to middle managers and on.. The SoS needs to speak to the front line and the patients, visit the best three hospital CEOs with the lowest waiting lists then visit with the three most failing hospitals and meet their CEOs and staff to get a feel for the difference. It is a postcode lottery in the NHS. Compare the CEO in Oxfordās biggest hospital with the CEO in Leighton/Crewe, do they treat the same number of people with the same levels of poverty. The hospital with the waiting list two years behind start there. See what the best hospital does and why – is it just more affluent area, hence a higher ratio of the local population with private treatments, better diets giving more resources for the poorer residents. Our successive governments segregate people on social class (with the majority of social housing in the same towns – check out those with more than 20% social houses) and governments put people in ghetto areas to protect rich posh postcodes and then wonder why different schools and hospitals can cope and others canāt. It is not rocket science. You need some business people in the mix not just public sector types. Dragonās Den type volunteers one for each hospital, ask them to volunteer their time to give their views on how to fix their local hospital.
October 6, 2021
@A-Tracy
Your suggestions are full of common sense. Only about half the people employed by the NHS are actually clinically or professionally qualified. The rest are middle and senior management, a large proportion of whom are providing government with data monitoring how the vast sums are spent.
It seems that the more the NHS spends on management, the fewer beds are available to treat the patients. If we are not carefull, the NHS will become an enormous organisation dedicated to providing jobs and careers for women who wish to return to work after having children – rather than looking after the sick.
October 6, 2021
SG agree – I’ve always thought we need to attract more male nurses into the profession (perhaps a change of the job title away from ‘nurse’). If I was SoS I would review bank nursing and the way we staff departments, how many nurses do 3 days per week then the other 2 days on bank to double their money or do night shifts where they are allowed to sleep half the shift each hospital Manager should work several nursing shifts on different wards to see how the ‘failing hospitals’ are doing things day and night, then work a couple of weeks at the best hospitals. The way we enable exhausting long shifts to facilitate this is terrible. No nurse can repeatedly day after day do a 12-hour shift effectively, a driver is restricted to 9 hours driving and 1-hour working! 10 hours in a smaller van (and most of that is stuck in traffic jams not constantly on their feet caring for people and medicating people).
October 6, 2021
Sakara Gold
If we are not careful……….
Slap my thigh I thought it was already in place.
October 6, 2021
There is a programme on Channel 4 called Undercover Boss where the boss poses as an apprentice to see the challenges encountered by their employees at various outlets in their businesses.
A similar televised exercise by the Secretary of State would enlighten the populace, the Secretary of State and the opposition and may increase appetite for proper reform.
Majority funding for health care should come through taxation with top ups from each patient so that value for money is considered. But as Acorn writes above the delivery should not be managed by the State.
October 6, 2021
What is needed is a senior executive from the private sector is has experience of being an ‘axe man or woman’. He or she must be prepared to cut through the burgeoning ranks of middle and junior management. It can be done humanely with voluntary redundancy and early retirement.
The remaining staff must be able to cope with a comprehensive computer system so that whenever a patient is seen by (yet another) different member of the medical staff who is suitably qualified, the patient’s accurate medical history is available on screen or smart phone at the touch of a button. It’s not rocket science. There are plenty of Personnel Record systems out there already. We don’t need billions spent on a tailor made system costing billions that has to be abandoned because it doesn’t work, as has happened before.
October 5, 2021
If someone has been appointed to the senior position of CEO and has a need for mentoring to improve their performance, don’t you think there’s something seriously wrong with the selection process? You don’t offer mentoring at CEO level, they should be mentoring others! If they’re incompetent at that level, they should go.
October 6, 2021
BJC it is very difficult to dismiss underperformers and the public sector is rife with it. Overpromoted people who aren’t really capable are rarely dismissed or even demoted. However, even CEO’s do training courses, see best practice elsewhere and copy it, once someone has a job like this it doesn’t mean there isn’t room to train and grow. We can easily identify failing units and put those CEO’s and Senior Managers up near successful hospitals and put them on ward observation, admin observation etc. for a couple of weeks different shifts.
October 6, 2021
BJC
Absolutely Correct !
October 6, 2021
Off topic, of course, but I see that the famous “fuel crisis” seems to be ebbing away. The inevitable spokesman said today that outside London only 8% of forecourts were without petrol, and things “seemed better”.
Of course things seem better. This was not a petrol shortage but a distribution lock-up caused by panic buying. Point out to people that they are *causing* the crisis and they will stop behaving like idiots and it will ease off.
But this hasn’t prevented the Press from continuing to talk as if there was something really basic going on last week. As if somehow refineries were not working, or there was no oil, or no tankers.
And what about the famous “hundred thousand” missing drivers? Where did they go? Last week the Press were howling for them and this week they may as well never have existed. If we were missing a hundred thousand drivers, or even ten thousand, how can the crisis be well on the way to resolving itself without them? Were they never missing to begin with?
This was a combination of a panic and a hoax that began the panic. Funny how it all took place the week of the Labour Conference.
October 6, 2021
a-tracy
Brilliant comments.
Have you the time to be seconded to the General’s task force? With views and thoughts like that you could well be very handy.
Reply Yes I could help but will not be asked
October 6, 2021
As I always say, JR should be PM but the trouble is, he and his wisely chosen cabinet would make things work!
Whoever is really pulling the strings, they obviously donāt want that!
I donāt know how he bears all the utter rubbish.
October 6, 2021
Everhopeful – The UK Establishment pulls the strings regardless. Remember we are all subjects and therefore will comply.
October 6, 2021
turbo – I’m already on a patient panel. I have a problem attending in-person meetings because of work commitments but at certain times a year, I could spare a week to do a review. There are many, many retired top class business people that could and would do this, and as John has indicated backbench MPs willing to do this in their local hospital if they have the requisite operational management skills. When retired who wouldn’t love an opportunity to audit and help out.
You know what though the public sector don’t like it. I volunteered once to be on a standards committee the interview was like facing a firing squad,, needless to say, I didn’t get the voluntary job.
October 6, 2021
Reply to reply
Yes. You like me, but people like us are and never would be considered.
Bit like being an MP. Good enough by miles to lead the country. Completely ignored.
October 6, 2021
During the referendum campaign David Cameron gave a speech in which he pointed out that the origins of the EU were essentially as a peace project. He, correctly, identified that peace in Europe is very far from a given.
He was derided by the Brexitists with silly headlines about World War 3 and the like. None of which he actually said.
It is ironic that those same Brexitists – the ones who have shamed our country and left us short of food and fuel – are now talking about gunboats in the Channel and threatening France. Angry, screaming headlines in the Daily Mail – a paper which backed the wrong side in the run up to World War 2 – demonstrate just how low the Brexitists have sunk.
They embarrass our country. It really is beyond pathetic.
October 6, 2021
I can only assume that yours is a parody account, since it does not seem conceivable that a piece of self-administered therapy would appear in a discussion on the NHS, under the guise of a an irrelevant and ill-argued diatribe veering from Brexit to WWII and the Daily Mail unless this was your aim.
Good luck at the Fringe.
October 6, 2021
Actually it is kind of linked. Old people voted for Brexit. It is a policy by and for pensioners that young people donāt want. It is being imposed on the young against their will – by the old who are also rigging the electoral system to keep themselves in power.
Young people pay vast sums in tax so the old can live on handouts. Vast sums go on their pensions, fuel payments, bus passes and social care. Add in the massive drain pensioners are on the NHS and it is clear the system is unsustainable.
You didnāt pay nearly enough into the system during your working lives, you live too long in retirement taking money out of the system. You are unaffordable.
The answer is simple. Charge pensioners to use the NHS. Make them pay for their own social care. If they canāt afford it – tough. I am sick of paying for grannyās latest hip replacement just so she can spend the next five years sat in a chair whinging. Pay for your own hip dear.
October 6, 2021
I know there’s no kudos in fact-checking our Andy, but maybe someone has to.
In the referendum, all age groups from 45 upwards showed a clear majority for Leave. It wasn’t just pensioners. The situation was still the same two years later:
‘The UK is divided into the under-45s who, on balance, favour staying in the EU, and the over-45s, who want to leave.’ Survation poll of polls Summer 2018, reported by the BBC.
I wondered how many young people were actually taking advantage before Brexit of working in the EU, which it was claimed they wouldn’t be able to any more, after Brexit. The ONS publishes figures on British citizens working in the EU in recent years. The number of young people on short-term work trips in France nose-dived from 23,000 in 2009 to 4,000 in 2014. With Spain, it’s a similar story: the number of young Brits in Spain for short-term work collapsed from 19,000 to 8,000 over the same period. So well before Brexit came along, it seems freedom to work in the EU was losing its attraction for young people. I wonder why.
October 6, 2021
Andy – Your Jobeeker’s allowance won’t cover the cost of anyone’s hip replacement so don’t worry about it.
October 6, 2021
Young people cost older people a fortune.
October 8, 2021
24/06/2021: āUK deaths outnumber births for first time in 40 yearsā. ons.gov.uk.
I guess P2 will be pleased, less youngsters to be supported by older people.
Or is it the other way around? Anyway the future is getting brighter, by the day.
October 6, 2021
From the opposite direction comes a similarly effective solution.
There is now a wealth of information about how to age as healthily as possible. This includes a clean diet and moderate exercise, particularly balance and resistance training.
Also euthanasia for the terminally ill who want it, with the correct precautions. I do not want to go the way my poor father did.
Both will save the NHS huge amounts and enable the elderly to continue to be productive to society, whether voluntarily or in actual work. (I see many driving buses and manning tills as it happens.)
The NHS has been successful in delivering an ageing population, alas not a healthier or happier one and loneliness in old age is a terrible thing to witness.
October 6, 2021
I got to the last para and read ‘The answer is simple.’
for a moment I thought ‘OMG. He is going to recommend that at a certain birthday we are forced to swallow a ‘goodbye’ pill.
October 6, 2021
The biggest failure of Brexit is that you are still here!
October 6, 2021
No Andy, the Brexitists haven’t left us short of fuel. The company running the tankers left a few stations short of fuel which when reported in the alarmist way it was got spread around social media and got out of hand. Why did this German company not train adequate British tanker drivers, the top of the profession that usually has a waiting list to get into?
The Daily Mail doesn’t represent leave?
October 6, 2021
Perhaps the General and the Lady should wear kilts. It seems to focus the mind. Incessantly.
October 6, 2021
The threats have come from the French. They have indeed sunk very low.
October 6, 2021
Essentially the EU was designed to stop Germany invading France (yet again.)
Great Britain was never envisioned to be part of it – nor the countries behind the Iron Curtain.
October 6, 2021
The strength of the unions in the NHS has led to some very dodgy practices. When I worked there a senior person got his girlfriend a Ā£75,000 per annum job she was totally unfit for. This led to their break up and she was constantly in tears at work. The NHS answer? Move her back to a secretarial job in another Trust. But the kicker was that she kept her Ā£75,00 per annum for three years! The new Trust paying the secretarial wage and the old Trust the difference.
October 6, 2021
Peter, yes I would say that unless you commit a serious crime it’s virtally impossible to lose your job or income.
October 6, 2021
Unless, it seems now, you refuse to be coerced into taking a medical procedure you don’t wish to. Is that the ”serious crime” you speak of?
October 6, 2021
How do you eat an apple? A bite at a time. One of the classic openers when training staff at all level in identifying and implementing continuous quality improvement within the said company or organisation.
The task in hand is not a sprint it can’t be as you have 74 years of deep seated culture to change with all the passions and emotions that exist within.
Start with one hospital not a trust, that meets all if not some of the criteria mentioned in a- Tracy,s excellent comment. All the internal and external forces that impact on its operational existance identified and dissected to find all the different inputs that construct their processes and procedures. Best of the best.
Then comes the difficult part, getting the rest of the organisation to accept, own and implement it.
It has been said on this site many times that the whole NHS structure top down organisations belongs well into the last century. Invert the triangle and have the vision and direction coming from the bottom upto the masses on the front line. The vision comes from the Chairman or CEO who is out there walking the talk on and with the front line staff working at the public coal face. They are the people with the visions, emotions hope and beliefs that see and live with the waste and want change but everybody is too busy locked down in their damage limitation control departments trying to keep going. The front line staff be they nurses, porters or ambulance crews they are the golden key to real change. Always a but!!! The existing management structure is going to like it..Not a lot.
October 6, 2021
And in other news nothing to do with him Boris is forcing up prices through both increasing the minimum wage and ignoring supply chain problems caused by him failing to understand and plan for post Brexit people shortages.
He truly is a snake oil salesman.
October 6, 2021
Nig 1
Snake oil salesman.
And some.
October 6, 2021
“failing to understand and plan for post Brexit people shortages”
Companies hire their own staff. They had five year’s notice of the end of free movement and did nothing. Instead, we have companies in high unemployment areas of the UK complaining that they can’t hire enough Poles and Romanians, while they ignore British people on their doorstep.
And you are going to blame Boris for this>\?
October 6, 2021
There will be no meaningful improvement without first starting with a well planned comparative review of good practice in other countries, including financing and health outcomes. That would take some time, though not necessarily massively so, to plan with robust terms of reference and a tender of non partisan consultancies to carry out the work. I think we all know this latest review is but an effort to buy a bit of time by Mr Javid and which will result in a report which merely recommends tinkering with the status quo and advocating even more funding.
October 6, 2021
Did we hear when this brave review will actually complete it’s work?
If it is going to take 18months or more then it will be far too late – Just what is to stop it being completed in weeks?
Isn’t this supposed to be urgent?
As suggested a banging together of heads by the minister would probably be more effective!
Let’s have no more fudge.
October 6, 2021
Bryan, it needn’t take more than four weeks.
October 6, 2021
Bryan – -” urgent” in govt terms neans VERY expensive – – and VERY long term. When spending other people’s cash, time and cost is NO problem. Govts are there to look after themselves and their pockets – NOT THE COUNTRY.
October 6, 2021
Every management consultant I have ever seen in action or known, always finds the answers with the front line workers, they are the ones at the sharp end who produce the results, and can tell the true story of inefficient management, work planning, working practices, knackered equipment, shortage of key equipment or materials, and very often know how to cure the poor design of failing products and services..
The fault of any failing business is usually with its management or directors.
Anyone who has used the NHS will tell you its the administration and management which is the problem.
Absolutely a waste of time and money trying to solve the faults with the NHS with non commercial minded people.
Good as the armed forces are at their task, their serving members are of a different mindset to the general population, because serving members are under the complete control of their officers/management 24 hours a day.
October 6, 2021
Alan, I agree with you, but … I have encountered front-line NHS staff over the years, particularly nurses, who quite deliberately have done things ‘their’ way not because it benefitted the patients but because it suited the staff, such as denying food choices to those who had specified Halal or Kosher dietary requirements or chiropody services to the bed-ridden, as only two amongst many instances.
October 6, 2021
Gerry Robinson did a quick management review on a Hospital in about 2007 with a follow up in 2013, originally broadcast on BBC, but can be still viewed on Utube I believe.
In just one week he made many departments and the operating theatres more efficient, by getting all the various factions/departments within the hospital together under his guidance, to talk about a way forward which improved working efficiently and suited everyone.
It produced an immediate change for the good, with greater patient flow, at no cost.
The result showed that change can happen for everyones good, if the right person is put in charge.
October 6, 2021
What that programme also showed was the importance of good management. But good management costs money. And Brexitists, Faragists and Tory pensioners spend their lives whinging about how many people earn more than they Prime Minister. Other than immigrants and the BBC it is one of their main topics of interest.
A FTSE 100 company boss can expect to earn many millions of pounds a year – plus bonuses. The NHS is infinitely more complex and the people who run it are paid a few hundred grand. About the same as a lawyer with a few years experience at a big firm.
Good managers cost big money. It is frankly outrageous that the NHS chief exec is earning less than Ā£5m. Leaders of individual hospitals should earn Ā£1m or more each. You get better candidates when you have proper salaries. We could afford to pay people properly if we werenāt wasting Ā£110bn per year on state pensions.
October 6, 2021
Alan Jutson
+1 Well said Alan. I posted on very similar lines but got moderated.
October 6, 2021
The two people leading the review don’t look particularly well qualified but who is ? You might have hoped for some private sector CEO on the review but of course the government are too scared to let any private sector person near the NHS. There’s nothing else like the NHS in either the public or private sector anywhere in the world so literally no-one can bring any experience to the review. That’s the problem. Better would be to send these two to first review health services that have better clinical outcomes than the UK – they wouldn’t be spoiled for choice – say France and Germany – and only then having informed themselves should they look at the NHS. But they won’t of course, there will be the usual UK attempt to re-invent the wheel, a complete lack of interest in similar EU countries, and a review which takes a long time to come to conclusions which don’t address the problem.
October 6, 2021
The French health system – well if its a shown in Spiral Im all for it.
October 6, 2021
+1
A very lefty relative was shocked beyond shocked to see a credit/debit card machine in a french drs surgery!
Yes, wellā¦the NHS is only āfreeā for those who donāt pay!
October 6, 2021
Everh – – free – – as in arrive at Dover in a dinghy? free food, bed, heat, water NHS etc etc ?? –
October 6, 2021
+1
October 6, 2021
Can we have a simple breakdown of the Ā£230bn.
How much goes to front line services.
How much goes to paying for administration right up to the top civil servant in the Ministry of Health.
We might then know where we can save money without it affecting medical outcomes. In fact redirecting expenditure might lead to better medical outcomes.
I would like to see a serious drive to eliminate waste, which evidentially I suspect is prodigious.
October 6, 2021
Take a pause and a deep breath before consulting- (2021 -2022).
NHS Long Term Plan Settlement Ā£144,365m
Capital budget Ā£301m
October 6, 2021
delete as incomplete
October 6, 2021
An organisation that employs 1,500,000 people is not manageable. Many people in the NHS are employed basically to provide reports to their bosses so that their bosses can make a stab at managing things. Given our recently increased longevity and the constant development of expensive technology and treatments, the NHS is difficult to manage effectively and is a bottomless pit. The only hope is for the NHS to become a health service rather than an illness service. You should have an annual health check with a doctor who, if you are fat and unfit through your own self indulgence and laziness, should tell you in no uncertain terms that āyou cannot expect the NHS to fix you when you become ill through your own faultā. Shape up!
October 6, 2021
‘Many people in the NHS are employed basically to provide reports to their bosses so that their bosses can make a stab at managing things’.
I would imagine that is exactly what is going on, dig up data for this, that and t’other. Present in all manner of ways, and then repeat but with plausible explanations when output doesn’t stand up to scrutiny.
Perhaps arse-protecting organisation would be a reasonable description.
October 6, 2021
I was under the impression that there was an NHS āResetā in May 2020 where apparently lessons learned during covid were used to bring about changes.
A tad premature since apparently the plague is still with us even now?
The reset involved some idea involving genomes and predicting the likelihood of a particular disease in a particular person. This would allegedly be cheaper than merely diagnosing, treating an ill person and waiting for the outcome.
Really the NHS bigwigs should get advice on all this from those doctors and nurses who danced away the pandemic on Tik Tokā¦they seemed to have all the answers!
October 6, 2021
I am very cynical about the NHS – whenever one goes into a hospital, there are always far, far too many staff walking the long corridors carrying files and papers. Why is this ? It never happens in businesses these days.
However, We live in East Dorset and I am pleased to say our healthcare is excellent. We have a very good surgery with very attentive and caring GPs and either a telephone or face-to-face appointment is a phone call away and normally takes place the same day, sometimes after a call back from the duty Doctor on Triage duty.
Diabetic reviews and preventative investigations are being done as usual, although the former are sometimes taking place by telephone, after a visit to the surgery for a blood test. This is actually an improvement. Repeat prescriptions are handled with a simple call to the Pharmacy and can be collected or delivered within two or three days.
The question is, if the NHS in Dorset can do so well, why can’t the rest of the Country ?
October 6, 2021
population density
October 6, 2021
A review of the NHS is superfluous. If a Tory government tried to change it in the way it desperately needs, the other parties would have a field day. Our local social media thinks the NHS is wonderful just the way it is and it’s FREE! The ridiculous seal clapping exercise during COVID didn’t help and awarding an organisation a medal for failing to equip its staff properly was truly bizzare. Like awarding the Ghurkas a VC for attacking Russian tanks with teaspoons!
October 6, 2021
The matters are not just the NHS.
As a friend wrote:
Levelling up? Red wall voters need to wise up:
Need to sell your house to pay for care? Thereās an Ā£85,000 cap to paying.
So, a Hartlepool house, valued at Ā£150,000, then the cap is at a massive 57% tax of your wealth. 85% if it’s a Ā£100,000 house.
For a Surrey house thatās worth Ā£1,000,000, then the cap is just 8.5% tax of your wealth.
Tories are good at protecting their wealth.
It amounts to a Poll Tax on old age and infirmity.
October 6, 2021
Assuming the Surrey millionaire won’t just pay cash for his or her care NLH
October 6, 2021
NLH, you’ve misunderstood the cap. It only covers medical costs as the “hotel” costs are uncapped.
October 7, 2021
Thanks – yes, I was keeping it simple to show the dissonance with any “levelling up” claim.
October 6, 2021
Oh Look! – Another review to show the Government in action and knows how to spend taxpayer money.
‘Lets create another review, another fully staffed department, get the taxpayer to fund more of our pals to keep them of the streets’
This gives us a ‘virtue signal’ to show we mean action, more correctly to kick the can down the road and delay all previous promises. Small State read bloated State of superferulous hangers on. Reform the HoL read increase size exponentially. Control illegal’s read open the tap and flood the place. Take back control read yes Sir we will do as you order. A generation of promises by the Political establishment and they have just become more self serving, considerable richer, larger egos and frankly taking the p…s out of the electorate, the taxpayer.
Do all these extra taxpayer funded staff , answer the over busy phone lines? Do the provide staff to increase through put through medical departments? More likely just as with the taxpayer funding Diversity and Woke Departments they just distract suck in more tax payer money but add nothing to customer service.
October 6, 2021
In Social Services and NHS there are too many talking heads and not enough people doing things.
Too many meetings with no end product.
Too many non-jobs (facilitator/advisor etc)
Not enough deadlines set; little policing and few sanctions for failure.
There is a whole lot of hot air and rubbish and not enough action.
Inefficiency is baked in
October 6, 2021
Why is an administrator in the NHS appointed to examine the failings of NHS administration? Perhaps the NHS needs fewer people calling themselves doctor with no medical degree running it? Why are there so many organisations involved in the administration of the NHS at different levels? The NHS is grotesquely top heavy like many parts of the public sector. This latter is a direct consequence of continual meddling by politicians with no medical knowledge or experience reorganising it for the nth time. This country is a paradise for rank amateurs with sharp elbows to foist their way into positions where they can do real harm.
October 6, 2021
That sounds about right, just because every organization, including every company, has a tendency to get top-heavy, over-managed and filled with people with paper qualification who turned out to be ineffective and were given nominal roles instead of being fired.
October 6, 2021
Health Security Agency/ONS figures for England for July through to September show over 7,000 non-Covid deaths above the five-year average. I hope the review will look into why this is happening. It is unusual at this time of year. This is at a time when Covid hospital admissions and ventilator bed occupancy have been declining in recent weeks, according to the same sources. We appear to be heading into a health crisis that is not caused by a virus infection. The focus now needs to be on the whole range of health conditions, and not just on Covid. If those new appointments could bring some new pairs of eyes to the problem, that would be all to the good.
October 6, 2021
Most people will have heard that if serious cancers and the like go undetected or not acted upon in reasonable time, the previous possible life-saving chemotherapy will be deemed too late due to the victim being in too poor a condition to withstand the effects.
October 6, 2021
John – – the govt is REALLY losing it – everyday different ministers say completely different things – and now out comes the old regulars – – TAX CUTS AND LOWER IMMIGRATION – – – REALLY ????? – Spending through the rooooooooooof – – and the world turning up, then complaining about their taxpayer funded lives ??? Turn up with NINE kids – OF COURSE WE’LL BUILD YOU A NEW HOUSE !!!!!!!!
How many Afghans are coming? – 20k – – or 20 million?
October 6, 2021
Government 20k figure is confusing. Is this 20k total or 20k of those with visas plus dependants?
October 6, 2021
Has anyone seen Dr Roy Spendlove and Dame Lucy Doolittle recently?
October 6, 2021
Indeed, for they are almost like old friends now, in a way! I suspect they are both so busy at present and enjoying such success that they have neither the time nor the need to leak.
October 6, 2021
āLeveling Up!ā, āBuild back Betterā,āThe Great Resetā,āGet Brexit Doneā all hollow soundbites, all with no defined meaning other than in the Governments mind. All come election time cannot be quantified.
All strange bizarre phrases from the Government that has ignored the referendum, increased the tax take to the highest it has been in 70 years and removed more of peoples liberties than any other in the modern era. Talking about the greening of the World knowing full well neither this PM, his Government or the UK at just 1% of the problem can effect. At the same time to prove a point sets out to maliciously penalizing the people of the UK, exporting their jobs then re-importing products from the nastiest place in the World. Forcing the UK back to the Stone Age. A UK Government fighting its people for the sake of ego.
No amount of āvirtue signalingā should be permitted to drown at the perpetual failure of this Government.
How about setting the people free. Returning freedoms and control to the people, Returning democracy to the people. The people will build a better Country than any controlling Government.
How dare Boris stand in front of his Party and spout such falsehoods.
October 6, 2021
Boris said heāll get ālevelling upā done, the same way heād got ābrexitā doneā¦.so nothingās going to change
What we need is another ābig societyā campaign; you could call it ābuild back betterā
October 7, 2021
@glen Cullen – nearly there, you missed the bit of him handing his mates taxpayer money to not fulfil the objective. Waste, waste, waste
October 6, 2021
The speech is a speech of a government in opposition
Lots of āweāll do this, weāll do thatā¦levelling upāā
Its wasnāt a speech of a PM in government, when he shouldāve been describing the governments plan and its successes he was attacking the labour conference
What has this party become, a party of sound bites and platitude
Churchill he is not, everything he said that was wrong with the UK today, was and has always been within his gift to put right with an 80 seat majority
October 6, 2021
Levelling up is the sign of a Government in opposition? Levelling up is a sign of a PM who recognizes the inequality is Labour’s best weapon and who intends to take it away from them, bit by bit.
October 6, 2021
Listened to parts of the PMās speech ā is he serious. He criticizes others while overseeing and creating worse. He announces initiatives while at the same time, ignoring his previous failed pledges. He spends taxpayer money like its going out of fashion while trashing the UK economy to ensure there is no future. He then tries to invoke āThatchersā spirit while trashing it, the hole in the tax take is all self inflicted ā he has neglected the economy. Thatcher balanced spend to income.
October 6, 2021
I canāt understand why labour arenāt attacking Boris on his broken tax pledge, but then again I canāt understand why the tory members, tory MPs and the media arenāt criticising himā¦..it will be on every labour poster at the next election
October 6, 2021
Making progress has nothing to do with recognizing failed pledges. That’s just puritanism, like going to confession.
He’s doing more or less the right thing, committing a certain amount of taxpayer money to creating incentives for industry to react to.
And no, the Thatcher spirit is not always to avoid spending money. If you say that you are just buying into the Labour slander on Thatcherism.
October 6, 2021
I follow what you’re saying, however I believe this government could’ve achieved much more just by doing nothing
October 6, 2021
Including funding no vaccines?
October 7, 2021
Vaccines yes, track n’ trace no
October 6, 2021
Off topic – sorry
In the Prime Minister’s speech he extolled the private sector for it’s ability to move swiftly for things that are needed like the vaccines.
Why then do we need a nanny state for climate and zero carbon why not leave it to business to solve the problem? government will just waste money.
October 6, 2021
You are playing games with the meaning of the word “need”. We need the private sector to respond to incentives by producing new technologies and products, and we need Government to realise that climate change is important to set the incentives to begin with.
October 6, 2021
The Secretary of State might be interested in improving efficiency and innovation but of course the NHS is likely not. Medics do not wear themselves out getting qualified to save lives to then have to worry about costs and productivity.
Circa fifteen years ago an NHS consultant surgeon somewhere in East Anglia explained how, in contrast to most colleagues in his specialism, he had no waiting list. This was achieved through always running contemporaneously two operating theatres, thereby allowing junior colleagues to undertake as normal but without his immediate presence the preparation and post-operation routines whilst he busied himself only with the surgeon’s specialist tasks. The time he saved avoiding being an onlooker to the routine meant he could keep two theatres busy with his specialist work whilst always being on-hand lest junior colleagues needed assistance. I recall he left the NHS soon after, perhaps to retire. No-one was interested in emulating his example.
October 6, 2021
The NHS legal advice would have warned against the risks and penalties for such behaviour, should a mistake be taken to court.
October 6, 2021
What ”leadership” would THAT be, then? Oh, you mean the sort of ”leadership” that doles out unscrutinised and undebated diktats. I think there’s another word that’s more appropriate…..
October 6, 2021
Boris Speech.
Pure Henry V if not better. Would like it if he had laid it out to the french, and the EU over fishing, immigration and the NI protocolāāā. They have to be put back in their box. Am sure the party will take strength from it.
October 6, 2021
Were you taken in by it too ?
It was complete tosh.
October 6, 2021
Canāt wait for all this ālevelling upā to kick in, my neighbour has a new Porscheā¦Iām hoping that this government will deliver mine soon
October 6, 2021
Your neighbour has a new Porsche? That’s nice. Wait till he starts complaining about the trade deficit, created by people like him.
October 7, 2021
My message, if you care to read it again, was about ‘levelling-up’ – My apologies if I didnāt make that obvious
October 6, 2021
Or the private sector finding Mickey mouse problems to try and further their own career.
October 6, 2021
Rather an interesting post I think the implication is this may be a cosmetic exercise. What I don`t understand is why the NHS is unable to get the sort of vast savings every private Company has gobbled up from the use of IT . You should at least be able to automate a lot of functions and do more with less.
Nothing of the sort seems to be possible ?
October 6, 2021
There are no “vast savings” from IT when it is applied to automating the sort of administrative functions you have to do anyway. They become more accurate and predictable, not vastly cheaper.
You make real revenue from computers when they design new products, drugs and technologies, and that’s not what the NHS is. It’s the quintesential service industry. It uses the technologies other poeple develop.
October 7, 2021
Well ‘back in the day’ – more than a couple of decades ago, I was hired to choose the computer, install it, retrain staffing, select a software house and subsequently support and develop the administrative requirements. Basically producing new modified timesheets which were used to do weekly payroll, admin, P45, P60, utilise legal deductions, then again using the data produce several thousand invoices per week.
Then these were used to enable a ‘profit and loss’ sort of statement of business in 80 locations.
This exercise allowed a reduction of staff to 28 from 80 within 2 years, and the Board accepted my proposal to drop cheque wages payment production and despatch – adopting BACS quite early on. That little lot saved a fortune. So it was quite possible to introduce Computer systems that were more efficient and saved a lot of money and staff problems.
October 6, 2021
Before Boris became PM, I was one those that thought this could be the man for the job, especially after the likes of Blair, Brown, Cameron/Clegg & May
Then again we keep getting reminded of his sound bites followed by lack of real actions. That then reminds as the Mayor of London he backed an amnesty for half a million migrants who do not have proof of their right to stay in the UK. What did he suggest today?
After todays fiasco of a pitch at the Conservative Party conference, there is a feeling the man is just a chancer and gets always with a lot because he was preceded by similar egotistical triumphs. No wonder the HoC is all for being ruled by the EU, as it saves them being responsible for how the Country is run. He has arrived at nothing that suggests and ability that would allow him to organise as much Childs birthday party let alone a country.
As a party the Conservative Party should hang their heads in shame, even more so if the left Manchester uplifted.
October 6, 2021
“…he backed an amnesty for half a million migrants who do not have proof of their right to stay in the UK…”
Yes? And what happened? Did the sky fall?
October 7, 2021
@jon Livesey – as you well know he did nothing, there was no intention of following through, he was just appealing to his electorate
October 6, 2021
Nota#, would you buy a secondhand car from him?
October 7, 2021
no! and not his push-bike either !
October 6, 2021
It’s been an exhausting day on UK energy markets. Gas has hiked to 10 p/kWh; tracking Dutch TTF Hub market. Electric hit 27.2 p/kWh for tomorrow at the UK end of the interconnectors. It was 10.6 p/kWh at the Norwegian end of the wires.
That’s what happens when you leave the EU Internal Energy Market. Compare those prices with what your current supplier is charging you. Then surmise how long your current supplier will survive. None of them have hedged against these prices being sustained for weeks. The big boys who are doing the government a big favour mopping-up its privatisation failures, will be expecting a Christmas present from the Treasury, which will be well camouflaged from inspection. Expect some renationalisation of sectors of the gas and electricity industry; on similar lines to the bail-out of the privatised Railway franchises.
October 6, 2021
Are you telling us the EU energy market will refuse to accept world prices acorn?
Gosh that’s clever.
October 6, 2021
What are you talking about, it can’t be a problem, it didn’t get a mention on Boris speech
October 6, 2021
“Thatās what happens when you leave the EU Internal Energy Market”
You must be living under a stone. EU energy pries are currently going through the roof. This week EU natural gas prices rose by 60% in two days. In two *days*!
October 6, 2021
The tragedy is that we are sitting on untold cubic yards of gas and refuse to use it.
October 6, 2021
In case anyone is interested, the Coronavirus regulations sit under Section 45D of the Public Health (Control of Disease) Act 1984. With regard to Section 45 D of the Public Health (Control of Disease) Act 1984, Sec 45 E explicitly prohibits any regulations made under the provisions of Sec 45 D to compel any medical treatment, which includes vaccination and other prophylactic treatment.
October 7, 2021
Thanks Barbara.
No one in any main political party has proposed or suggested compulsory vaccination as far as I know.
Companies have always been free to ask it of their employees, on the other hand. My last employer required it for work travel to certain countries for instance.
October 6, 2021
Off topic, but the famous “fuel crisis” is gradually fixing itself. In fact, the BBC has changed from reporting numbers to reporting “frustration”. That’s when you know the media can’t let go of a bit of bad news that has run out of facts, so they turn it into something personal and subjective.
And I still don’t see the hundred thousand missing drivers. Apparently about a hundred heroic EU drivers came galloping to the rescue and applied for visas, but they won’t arrive for weeks. By then we will be shrieking about too many chicks or too few Big Issue sellers.
We allow ourselves be hoaxed over and over. Fake crises sell newspapers and newspaper adverts, and they feed the public’s addiction to melodrama and its insistence on living in times of fear and trembling. We’re like Kavaffi’s city fathers waiting for the barbarians and wondering why they don’t show up.
October 6, 2021
Yup.
For all the lack of lorry drivers I still manage to find the usual moving road blocks everywhere. (One overtaking the other for miles on end.)
October 7, 2021
Back into the argument for all lorries to use the inside lane only on dual carriageways, and must be able to overtake another by using the middle lane of a motorway within half a mile, and nevr on an upward slope.
October 6, 2021
Sorry couldn’t resist – “Father of the House Sir Peter Bottomley has claimed it is āreally grimā to live on Ā£82,000 a year, as he argued MPs should be paid the same as GPs.”
Yet a pensioner that has paid into their state fund for a minimum of 30 years has to live on Ā£137 per week approx. Ā£7,500 a year. They still have to eat, need heat and light etc These MP’s like all State workers will get incremental increases to cover the programed rising inflation directly created by this Government – the Pensioner won’t. That is the Boris version of ‘leveling up’ ‘building back better’ and we are all in this together.
October 7, 2021
For the first time, patients with secondary breast cancer in England and Wales are going to be counted in a special audit funded by the NHS. Secondary breast cancer is when the cancer has already spread to other parts of the body. The condition reached the headlines in September after the death of the singer Sarah Harding. Campaigners have fought for a decade for this information, which they say will improve patient treatment and support. 11,000 people die each year from breast cancer.
There must be other stage 4 discoveries where detection has been missed due to lack of GP consultation, referrals and hospital action. What an appalling state of affairs. NHS ought to be termed a ‘failed organisation’ by Government.