In conducting the review of Health spending the new Secretary of state needs to pursue some of these questions.
- How much will the planned reorganisation cost?Ā What is the purpose of the abolition of Clinical Commissioning Groups and their replacement by Integrated Care Boards and Integrated Care Partnerships ? Will someĀ of the CEOs of the CCGs be appointed to be CEOs of theĀ new bodies?Ā Will they still be paid some redundancy payments or is there a clause which says if they maintain employment with the NHS there shouldĀ be no such payment? If the NHS decides to appoint former CEO employees in the reorganisation does it save headhunting and recruitment fees on those people? Are there planned savings from the reorganisation, and if so how much and when?
- Test and Trace. Test and Trace understandably was expensive in its first year when there were a lot of set up costs and provision of a large capacity in the face of an unabated pandemic. Current year spending of Ā£15bn on T and T seems high. Surely next year there canĀ be a sharp reduction in T and T spending, with much of the cost now sunk, and with less need for capacity to man the system which can beĀ largely automated anyway.
- What are the forecast costs of theĀ vaccine programme against CV 19 going forward? Again surely there willĀ be substantial savings next year as most people who want to be vaccinated will have had two jabs and many will have had a winter booster as well?
- How much will be saved by not hiring in capacity from the private sector in the way the NHS did during the peak of the pandemic? How many treatments and operations will the private sector carry out for people willing to pay, relieving pressure on the NHS as private capacity is returned to that sector?
- What productivity savings are brought by the use of digital consultations and remote medicine?
October 7, 2021
What has been the cost of “management” as compared with the cost of front line medical staff.
How will this cost relationship change in future ?
October 7, 2021
The front line medical staff are not used efficiently either much waste here too not just the admin and Ā£80k diversity officers. Only about 50% of expensively train doctors stay with the NHS such a poor employer is it. Many go abroad for this reason.
Allister Heath today.
Three mega-risks that could doom Borisās high-wage gamble to disaster
His speech was brilliant, but the PM faces some potentially calamitous threats to his ambitions
Not brilliant though, mildly amusing perhaps but very, very wrong headed and totally detached from reality. Tax, borrow piss down the drain, expensive and over regulate policies will just not work mate. Raising minimum wages would be idiotic – a law making it illegal for many to work or to learn how to work.
October 7, 2021
It was a speech of a jokey dodger – it produced the laughs but avoided the key issues that concern people today. Not good enough.
October 7, 2021
Right on OT.
October 7, 2021
A one off Ā£3000 bonus for “good” math and science teachers who go to deprived areas. Sure this is unlikely to work when decent Maths science people can earn more than double a teacher’s salary! You really need to pay maths and science teacher much more than some other teachers it is called supply and demand.
It would of course add to the gender pay gap though, as only about 20% of undergrads in STEM are female currently. Most women are not interested it seems.
October 7, 2021
They’re all good…a teacher has never been sacked
October 7, 2021
Indeed must all be good then. Though many maths and science teacher at many schools do not even have a decent Maths/Physics/Chemistry A level (let alone further maths).
Probably the case for most MPs too or they would not constantly confuse cause and effect like Boris and his Blackpool/Riddle Valley – no reason for the different life expectancy drivel.
October 7, 2021
Amazon delivers perfectly made custom manufactured stuff in a couple of days but the health care system sends letters confirming appointments to discuss a possible treatment way into the future. A massive jump is needed, and the NHS just won’t do it.
October 7, 2021
The NHS is a system designed to ration, delay and deter patients. They are not customers (as they have paid already) so put them off whenever possible and keep the cash.
October 7, 2021
Agree the NHS is a poor employer, to frontline staff anyway. Doctors, especially Junior Doctors are leaving but not necessarily for better prospects but to leave the profession altogether. Junior Doctors are treated as nothing more than glorified administrators and expected to work 12/13 hour days, 5 days a week without a break. Overtime pay doesnāt exist. The stress levels are unsustainable. To add to their low morale this idiot out of touch Government for some reason have singled them out to not receive the 3% pay rise the rest of the NHS can expect. No wonder they are leaving the profession.
Johnsonās speech was entertaining but had absolutely no substance at all. As many have said before and we now know, he makes a good cheerleader but he is certainly not PM material.
October 7, 2021
Indeed medical students leave after 5 or 6 year training, with perhaps Ā£120K of student debt (going up at Ā£7K PA in interest) and they get a salary of perhaps just Ā£28K (below Ā£15K net after tax, NI, interest, travel to and from work and student loan interest) and are often treated with complete contempt and not given proper support either. Failing them and their patients too.
Meanwhile (top newly graduated would be) lawyers can start on over Ā£100K.
October 7, 2021
āIf you’re a doctor starting your specialist training in 2021 your basic salary will be Ā£39,467 to Ā£53,077. Specialty doctors. If you’re working as a specialty doctor you’ll earn a basic salary of Ā£45,124 to Ā£77,519. Consultants. As a consultant from 1 April 2021, you’ll earn a basic salary of Ā£84,559 to Ā£114,003 per year, depending on the length of your serviceā source health careers.
Ā£28,000 doesnāt end up as 15k net. Plan 2 student loans are a graduate tax of 9% rather than a repayment scheme, it was set up in such a way that it is much harder to repay than plan 1. Plan 2 graduate taxes donāt start until someone is earning Ā£27,295.
October 7, 2021
You are absolutely right LL. After six years at Cambridge and a debt of around Ā£100,000 I cannot believe the hours my son is expected to work and all for a salary of just over Ā£30,000 working in a London hospital. After his taxes, N.I. And student debt have been deducted and he has paid his Ā£850 a month rent, he isnāt left with much and if that isnāt bad enough, Junior Do tors are not appreciated and seem to get dumped on from all directions. Meanwhile my neighbourās son has no degree, works in NHS Admin, and is on a six figure salary and gets to work from home. And now this clueless Government want to recruit even more Managers on Ā£270,000 whilst telling Junior Doctors they donāt even deserve the 3% pay rise promised to other NHS workers.
Tells us all we need to know about Johnsonās Government.
October 8, 2021
Jools B that is my experience and what I hear from many.
October 8, 2021
a-tracy
I mean the first NHS job after university. You say Ā£28,000 doesnāt end up as 15k net – it actually ends up as rather less than than this in general after after tax, NI, student loan interest and travel to and from work is covered.
October 8, 2021
LL – How many years into their degree does their first job start? Is it a full time job for the same wage as a nurse? Ā£28,000 that doesnāt seem right if a nurse gets that after a 3 year degree and a doctor takes what 7 years to train? That seems appalling if it is after 5 years of training.
The PAYE may be incorrectly worked out by your doctors employer.
Tax 12570 personal allowance – 15430 x 20% tax = Ā£3086
NI 9570 personal allowance – 18430 x 12% (it may be < 12% in the NHS) = Ā£2211.60
SL 27295 per.allowance – 705 x 9% = Ā£63.45
Total employment taxes deducted 5361.05 from 28,000 = Ā£22,638.95
It is a shame new doctors are housed as they used to be. However, travelling to work isnāt a compulsory tax deduction it applies to every job and there are people earning much less paying for transport to work.
October 7, 2021
My experience is that NHS medical consultants also work in the private sector. They cannot be in two places at once. So they waiting lists will not be reduced soon.
October 7, 2021
Clearly not in their interests to reduce NHS waiting lists is it? As they often pick up the private business fees.
October 7, 2021
So true LL. Had an experience some years ago where the appointment with the consultant was around 3 months hence, but arranged it privately within 3 days and any treatment was undertaken by the NHS.
October 7, 2021
Begs the question where is the NHS tax money going?
October 7, 2021
@LL; Indeed, and what the hard left, those logicically opposed to private medicine, have been pointing out for years!
October 7, 2021
But those on the left who want state monopoly medicine are the cause of the problem. State monopoly rationed, communist health care is a disaster. Without a private escape valve it would be even worse still.
October 7, 2021
@LL; Nonsense on stilts, just you usual anti NHS ignorance. The NHS was set up out of cross-party consensus formed in 1944 for a post-war Britain [1], a universal free at the point of need NHS would have been created post war had Churchill won in 1945, but heck if you really believe Churchill was “communist”…
“Without a private escape valve it would be even worse still.”
Many problems within the NHS, such as waiting lists, seem to caused by NHS trained practitioners ‘moonlighting’ (not that I’m suggesting ant tax irregularities) in the private sector. I knew someone who, not being able to get a consultants appointment on the NHS, chose to investigate having private treatment using his private health cover, one of the apparently readily available consultants offered was the very same person who was unavailable to his prime employer and their customers.
[1] come to think of it, I knew I had heard Boris’s “Build back Better” slogan before!
October 8, 2021
Jerry a free at the point of use, state virtual monopoly healthcare system is very clearly communist in essence. That is why it performs so poorly. So little incentive for it to do otherwise. When both main parties agree on something the climate change act, net zero, the Afghan war, the war on a lie, HS2, Millennium dome, the ERM, the EUā¦ it is nearly always a total disaster.
October 8, 2021
@LL; Yours are always just opinions, sans many facts.
How about we look at an alternative health service as comparison, how it is actually is funded, and no I won’t use the USA – doing so always upset the hard right, wonder why.
Germany for example might well make use of private hospitals but the majority of their patients come via the state imposed compulsory health insurance system, were the state requires the most adult citizens to purchase said health insurance from a provider, the state telling the provider what they can charge – that is how the German universal health care system is funded, and it works very well.
The difference between that and the UK’s universal health care system (as originally envisaged), the UK took the middle men out, meaning the state simply takes the the cost of compulsory health insurance at source, via both Income and NI tax, doing so saved money as the middle men no longer take a percentage cut to make their own living. Yes the NHS took direct ownership of hospital buildings etc, but that is surely a moot point, given more recently the NHS has had many problems with its enforced reliance on privately owned and operated buildings.
October 7, 2021
The Government which agreed to the new doctors’ contract should have insisted full-time for NHS – NO moonlighting privately.
October 7, 2021
According to one Max Pemberton (Trust Me, I’m a Junior Doctor) those ‘private’ consultants use NHS paid staff to do their private paperwork too.
October 7, 2021
”They cannot be in two places at once”
Oh yes they can, at the same hospital but NHS patient in the morning and Private patient in the afternoon
October 7, 2021
Many NHS hospitals used to have private wings, and the profit made there subsidised the NHS facilities. Certainly in our area of London, the Unions put a stop to the practice more than 20yrs ago.
October 7, 2021
most Consultants have a 9/10ths contract with the NHS giving them 1 half day in the working week for private work. They then may choose to do private work in the evenings and at weekends
If people who can afford to go privately do not do so the waiting lists will take much longer to reduce
October 7, 2021
6. From where will you source experienced and dedicated ‘double-vaccinated’ care-home carers to replace those who do not want to accept the ‘vaccine’ and who, according to you Sajid Javid ‘cannot be bothered to go and get vaccinated’ so should ‘get out and go and get another job’? Many carers do not want to risk their future health or perhaps the health of unborn offspring by accepting the ‘vaccine’, the long-term effects of which are not yet known. Have you weighed up the possibly terrible impact of your edict on ‘the most vulnerable people in our country’?
October 7, 2021
+1
The most vulnerable did not do very well the last time the Tories started weighing up possibilities.
It more resembled the aftermath of battle than of any caring medical decision.
I would like someone to show me a long term risk assessment for the jab thoughā¦oh that might be a bit difficult! I bet theyāve only got crystal ball and goat entrails predictions!!
October 7, 2021
No medical justification either, as ‘vaccinated’ people can catch, carry and transmit the virus, and a recent study found that ‘vaccinated’ people carry a higher viral load. The only measures that make sense are regular testing for all and vigilance to remove any visibly symptomatic workers. Hopefully there will be Parliamentary opposition to attempts to extend the mandate to other groups.
Sajid Javid said at the recent conference that the sole purpose of ‘vaccine passports’ was to ‘encourage’ (i.e. coerce) jab uptake, and given the alleged high uptake in this country there is no need for them. Setting aside the legality and morality of taking away people’s liberties in order to push them into participating in a medical experiment, it is to be hoped that this lack of necessity will result in rejection of the expected push for passports later in the year.
October 7, 2021
Mary M
How about the feelings of those already in a care home who want to be protected, and who are paying a very high price over Ā£1,000 per week to be looked after safely, do they not count, should they not expect their careers to care for themselves as well, so as not to put patients/residents at risk.
October 7, 2021
They have no right to know the private medical status of another individual.
October 7, 2021
I think they do. So you’d let someone with an infectious disease loose on your elderly relative?
October 7, 2021
Donna you are absolutely correct, but I am afraid If I was a patient/resident I would ask the question in any case, a refusal to answer would lead me to refuse to be cared for by that member of staff.
If they cannot be bothered to care and protect themselves, then I would not have any confidence they would bother to look after me, and keep me safe.
Simples..
October 7, 2021
He/she who pays the piper ?
October 7, 2021
This is how the vaccine moral blackmail works: unjabbed, think about what you might do to the vulnerable elderly folk in care homes, who believe that vaccination is needed to stop transmission. (Or, more likely, their relatives and the care home managers believe it, after being fed this nonsense through the media.)
All the various vaccines I took provided me with immunity against a disease. Stopping me from transmitting it never entered the picture. If these pharmaceutical products are different, I wonder if they can be called vaccines.
October 7, 2021
The last I heard the elderly had been vaccinated, ergo, the risk is mitigated.
October 7, 2021
Mary – – Why get another job? go to Dover, give a name – move into tax payer funded hotel, get taxpayer funded whole life !!!!!!!!! NO worries about power price rises !!!! NO worries about ANYTHING.
Mow we are back to hearing of less immigration and lower taxes – – exactly what has beeb said to us for years – – amd ALL turned out to be LIES LIES AND MORE LIES. – –
October 7, 2021
Well said. These are disgusting actions by the government.
October 7, 2021
Indeed Mary; forced vaccinations, by whatever means, are surely illegal? This is only a small step away from us all being forced to have all sorts of jabs including chip implants just like a dog.
We simply have to resist; not only for our own future and safety but for our descendants, living or yet to be born. Freedom is so easily lost but hard to regain.
October 7, 2021
David
āIt is an established principle in English Law that an individual with the capacity to consent cannot and should not be compelled to have any medical treatment against their wishes.
The Public Health (Control of Disease) Act 1984 (section 45E) provides that Regulations made under certain sections of that Act āmay NOT include provision requiring a person to undergo medical treatmentā¦ āMedical treatmentā includes vaccinations and other prophylactic treatmentā.
We would argue that this principle, enshrined in our domestic law, would make it inequitable and potentially unlawful for anyone ā employer, service provider or other organisation ā to seek to mandate the vaccine.ā
(Lawyers for Liberty, UK)
October 8, 2021
Barbara, Have you ever considered how the very nice words in your first sentence actually register with doctors dealing with people (terminally ill, mentally competent adults) at the end of their life?
October 7, 2021
Freedom and choice and fair competition between state sector and the dire, largely second rate, virtual state monopoly please. Already more knee and hip operations are being done in the private sector than the NHS as the rationed and delayed NHS fails the tax payers as usual. It is failing many millions a killing hundreds of thousands.
Extend fair competition to education, the BBC, housing, energy ā¦ too please.
So Boris thinks there is āno reasonā for people from the Ribble Valley dying older than those from Blackpool does he? Of course there is a good reason you idiot. Rather different types of people live there. An idiotic confusion of cause and effect. Rather like like saying women earn 15% less so it must be discrimination when it nothing of the sort. More over weight, smoking drug user per head in Blackpool I am sure than Ribble Valey. Get real Boris.
Still even more moronic is to think Net Zero and his green crap lunacy is lucrative or sensible. Not for voters that is for sure, perhaps for state subsidy farmers, crooks and some Tory donors he meant? The tax to death anti-growth, rip off energy Tories.
October 7, 2021
āThatcher would approve,ā says PM as he defends the vast tax rises.
I suspect she would not actually approve she certainly would be totally wrong to do so. But then she did close many Grammar schools, failed to sort out the dire state monopoly NHS and even appointed the damn fool John Major as Chancellor & let him push her into the disastrous ERM.
Reply As her Economic Adviser I would have advised her to query the absurd Treasury over statements of the deficit, and to ask Health to find money out of Test and trace and admin to get waiting lists down. The tax rise is wrong.
October 7, 2021
R2R
People know Johnson is talking codswallop. The point is Thatcher wouldn’t have started from here. The thought of her borrowing Ā£400bn to offset what she would have known as a statistically aware scientist was a touch of eccentric flu bringing forward deaths mainly of the old and infirm is just fanciful. My guess is she’d have kept the young in work, schools open, against the grist of the rest of the world, and protected the vulnerable. So it is just warped language to say she’d approve of tax rises now.
October 7, 2021
@SLS; Your comment says far more about you than it does those you criticise, Mrs Thatcher would likely have taken the same approach as Boris, just sooner, harder, after all she was a scientist…
October 7, 2021
I tend to agree as that is what a rational and numerate person would have done. Though Thartcher did let the idiotic John Major and the rest of the dopes force her into the idiotic ERM and she made many other rather obvious mistakes.
October 7, 2021
@LL; There were plenty of tax rises, often targeting the poorest, during Thatcher’s ‘s term as PM (the hike in the standard rate of VAT and the deregulation of the milk price, both in 1979, both historical facts), hers was not a low tax Govt, HMT just shifted from were collection was made! When taxes were lowered such cuts were being funded by selling off the family silver…
October 7, 2021
Mrs T would be apoplectic at the deficit! She would not recognize many in the parliamentary party as Tories. When some idiot told her the climate was changing she retorted āso you want to blame me for the weather too?ā
She would be devastated at the state of our country. Thank God she is dead and did not live to see this day.
October 7, 2021
She would have called out the rows and rows of her benches as ‘wets’. And Bernard Ingham has said ‘He condemns the government’s handling of coronavirus, describing it as “a confused mess and incoherent”, and claims ministers are “occasionally all over the show”.
October 7, 2021
“The tax rise is wrong” – indeed but was it only about four who voted against it? Rather like the climate change act.
reply 9 others joined me in voting No
October 7, 2021
Again, warped language from Johnson. It’s obvious that the lifestyle choices in Blackpool are at odds with those in the Ribble Valley and equally obvious that those impact on age of death. Those are the reasons, but it’s easier for him to say that than that there is no reason why people in Blackpool can’t take responsibility for their lifestyle if they want to and thereby die older. Perhaps better to give them a hand in this than just knock them?
October 7, 2021
Quite. Some children have never seen the sea nor the Tower, but others probably holiday abroad in the sun. Guess which is which?
October 7, 2021
@SJS; Anyone can eat for a healthy lifestyle, just so long as you can afford to…
October 7, 2021
Jerry, I had a very healthy diet as a child and my mother managed on a tiny budget. Tiny. She did it by buying lots of vegetables from the market, making her own soups, doing her own cooking instead of frozen meals and ready meals, we had the correct size portions, no waste, limited puddings usually fruit and jelly as a treat, my Nan was even more economic making her own pies, growing her own vegetables and fruit, we used every scrap from a chicken that made several meals, I could go on but you get the point. Healthy lifestyles arenāt about money – we walk every day that costs nothing. We exercise at home free videos online.
Yesterday I read about a supposed single mother with one child who had defrauded benefits (universal credit) by Ā£60,000 over 3 years, that is Ā£20,000 per year over what she was eligible for because she didnāt declare her partner that was living with her. To get Ā£20,000 a man would need to earn around Ā£28,000 donāt tell me this woman couldnāt afford to feed her child. She only worked 9 hours per week so had plenty of time to cook, prepare vegetables and shop wisely unlike most full time working adults I know!
October 7, 2021
+1
October 8, 2021
@a-tracy; What ever…and some accuse me of wanting to go back and live in the past (1950s-’70s)….
Other than the once a week Farmers Markets I can’t remember when I last saw a real old style market, one selling the shorts of products you mention, now you need to travel to the on farm shop, not much help for those who do not drive. Even traditional greengrocers and butchers can be far and few between, not helped by the Blair era centralisation of slaughter after F&M in 2000. Yes the supermarkets sell ‘fresh veg’, and now mostly pre packed raw meats, but then the poor need to cook such food, with energy prices as they are it is often cheaper to buy a ready meal and heat it through in the microwave oven, not up to an hour on the stove perhaps (that those low cost, wholesome, stews take) – as I said the other day, some families really are having to make the choice, so we have a hot meal tonight or do we use the meter money to have a bath, perhaps heat the kids bedroom or buy them a new pair of shoes etc. It’s not just about buying the food!
Give yourself a test, calculate what you would earn doing a MNW job, or better, what you would receive in UC payments, what ever happens no not allow you or your household to access any other money, then live on those calculations for a month, better 6, also stopping all your standing and direct debits, or at least remove said payments from your available living allowance. See how you get on…. A few MPs, not many, have tried this, most came away from it with very different views to those they went in with.
“We exercise at home free videos online.”
That says says it all. š š„
October 9, 2021
Jerry, no need to be techy. I have no desire to go back to those times, I wasnāt born until the end of that period and although I had a lovely childhood I love and accept all new technological advancements, earning gains, progress in education, progress in workplace training my family have taken full advantage off and entrepreneurial advances from the 1980s onwards when markets were opened up inside the UK.
I grew up without heating upstairs, I slept in the winter in a jumper please donāt make assumptions about people. It depends where you live perhaps some of these who canāt find work in the big Cities should move out into cheaper areas.
My parents live on much less NMW Jerry each year, so do many of my family. I know full well how to live on a minimum wage job the fact you presume I have no idea says a lot about you. Where I live in an area of social deprivation there is a market with fresh vegetables every week, same where my parents live they donāt have to go out to a farm shop. My children live in London and they can buy fresh vegetables a walk away? Mum uses a crock pot if that tip helps you out with cooking at low cost. She also cooks several meals and freezes things. I can give you other hints and tips if you havenāt ever needed to worry about it. I donāt have Sky boxes, my outgoings are very low. Never smoked, donāt drink from choice. So be careful with your assumptions again.
We were told this week that a single parent mother with one child overclaimed Ā£20,000 per year in universal credit she worked 9 hours per week and lived in Droylesden an area I know well so rent isnāt that high especially social rental. That figure is net. She was actually living with her fella and got caught out. If that was the extra she got then there were other benefits on top and we need to actually be told what these families are getting in total all the housing benefit, council tax reductions, all the help they get to buy cookers and fridges donāt tell me they donāt I know people who do. I have family and friends on universal credit they all manage to feed their children well so we actually need to investigate the people donāt because they need help not just more money throwing at them.
Exercising makes you happy Jerry, it releases feel good chemicals, yoga and Pilates online are excellent I can recommend it to you.
October 9, 2021
One more point my heating goes off around 9pm and doesnāt come back on until 6am whilst I get ready for work I canāt sleep in too warm a room I donāt consider this a hardship. Growing up without much money isnāt fun I agree with that, but my parents both worked my mother until she was 70 and we eventually improved our lot through hard work, saving, investing and growing our intelligence base. You can get out of poverty but people are never going to get out of a comfy nest when housing is paid for and all the other benefits if you only do 16 hours. My concern comes for two parents who stay together on minimum wage jobs who just tip over the benefits limit and canāt get help while their neighbour is popping out kids in four year gaps to keep her benefit train going without any father being declared to help support those children.
October 7, 2021
+1
October 7, 2021
But Lifelogic, during the Covid crisis not that many patients were given treatment for Covid in private hospitals, according to a new report out from the Centre for Health and the Public Interest, ‘For Whose Benefit?’. I thought the private hospitals had made a strong contribution, but apparently not. Maybe the NHS wasn’t being all that overwhelmed after all.
October 7, 2021
Regarding your last point, I was dealt with ‘remotely’ on Monday. Pre-pandemic, if I needed to see my GP, I would ring the surgery and ask for an appointment. Now? I spent fifteen minutes going through the eConsult process. (Did my form then go through some smart AI? Probably not.) Then, a GP, with commendable speed, rang to see if I needed to see a …………….. GP. After ten minutes of her valuable time, she decided that I did. So I now have an appointment for next week – to treat a problem made worse, in the first place, by NHS 111 delaying my seeing a GP, when it ordered me to isolate and take a PCR test, which was, of course, negative. Still with me? Javid needs to look closely at one metric: the number of people being seen by a GP, in person. And he needs to demand that the figures rise, week-on-week.
As for eConsult, there’s some merit in the system, but only if it is bright enough to put the form through AI and for the computer to be able to bump people up to the head of the line.
October 7, 2021
SW
111 is as useful as a Chocolate fire guard, prior to having a Stent procedure in July 2020 (thank you NHS) I was given a list of medication to take prior to the procedure, 4 x 75 Mg aspirin to be taken a week before the operation, I couldnāt see the point as the beneficial effects would have worn off by the following week so as it was Saturday I phoned 111 and carefully explained the situation, someone phoned back later that morning to confirm the reason for my call ā¦ at 5pm a doctor with an impenetrable foreign accent phoned back to say that he wasnāt qualified to answer my question and that I should contact the cardiac unit which was closed because it was Saturday, the prescription should have stated āand one a day thereafterā
My daughter had a similar experience because she was concerned about my grandsonās asthma
October 7, 2021
Well you can at least eat a chocolate fire guard! So perhaps rather worse.
October 7, 2021
s_w , hope you get sorted soon and wish you well, but it’s a moot point that funding for GPs, as with the BBC and probably the NHS in general, is rooted in the 1940s and surprise, surprise things have changed and nowadays we generally pay for what we actually use.
It seems GPs are paid a basic of around Ā£160 per annum per patient, plus any extras, irrespective of the use of the patients of the service. A fairer system would perhaps be for GPs to be paid on the consultations howsoever they are undertaken. There is no reason why GPs should lose any income and indeed their income would probably rise but productivity would definitely benefit,
October 7, 2021
@miami.mode; “nowadays we generally pay for what we actually use.”
I’ll just check my diary for this time next year…oh yes, the entry for 7th Oct 2022 “Will have Stroke at 10pm”, so I’ll need to make sure to take that health insurance policy out… If only life was that predicable.
“A fairer system would perhaps be for GPs to be paid on the consultations howsoever they are undertaken….//….productivity would definitely benefit”
Perhaps, but would it be the correct type of productivity.
I doubt there would be any improvement in services on what we have now, quite possible the opposite. Many a GP would likely take to examining plenty of otherwise fit and healthy people, almost certainly needlessly [1], just to get consultation numbers up, leaving little capacity for those who need to book on-the day appointments due to current actual illnesses. Would anyone seriously suggest we pay police officers based on how many arrests they make, pay fire fighters based on how many fires they put out?!
[1] where health education to teach regular self-examination would be cheaper, and better
October 8, 2021
jerry. you’ve misunderstood the first bit. I pay for the NHS constantly through my taxes, it’s the government that pays for the use and why would healthy people ask for an appointment?
October 7, 2021
+1
The governmentās long term aim must be to force people to go private?
Thus freeing up a newly reformed, shiny, kind, compassionate health service for their new, preferred citizens.
Kind of like the difference between sleeping on the streets and staying for free in four star accommodation. No charge, even for breakages!
October 7, 2021
At my surgery its phone at 8:00 am ha! You spend an hour in the queue only to be told all the appointments have gone and try again tomorrow! When I asked for an advance appointment, all I was offered was a telephone appointment on 26 October!
October 7, 2021
Thats now the norm
October 7, 2021
How much are your health problems costing me? I have private healthcare including GP services. I canāt remember when I personally last used the NHS. I just pay a lot for it for you lot to use it and whinge about it at the same time.
October 7, 2021
If you, allegedly, never use the NHS you will not comprehend what its problems are. However, should you or a family member ever be involved in a major traffic accident or a terrorist attack, for example, you will be – one hopes – attended to by NHS ambulance staff and perhaps taken to the nearest appropriate NHS Emergency unit. You might then be glad that some of us at least have attempted in our different ways to improve the service.
October 7, 2021
I donāt object to paying for the NHS. I pay far more for it than any of you. I object to all of you whinging about it when, frankly, you pay next to nothing towards it.
October 7, 2021
Most private consultants/GPs ARE NHS working in their own time. You’re queue jumping.
October 7, 2021
What a young aristocrat you are andy.
Popping down to Harley Street to see your Doctor.
In your Ā£80,000 car.
Whilst lecturing us all on the wonders of socialism.
Hilarious.
October 7, 2021
I literally want to axe your pensions and make you pay for your own healthcare and you think Iām a socialist. It really is rather odd.
Iāve also never been to Harley Street – at least not to any medical facility on it – and the most expensive car Iāve ever bought was Ā£38k. But thanks for guessing.
If we werenāt spending Ā£100k per year of our income taxes funding your pensions and old age perks then I could afford a more expensive car.
October 7, 2021
You do always sound rather dictatorial young Andy.
I dont think Ā£137 a week is generous after 30 years of paying weekly contributions.
Contributions which were said to promise a pension at the end.
If you stopped paying this income to old oeoplecwhat would thet survive on?
But do please stand for Parliament.
Join a political party.
See if your radical views are popular.
Be my guest.
October 7, 2021
When I used E consult, having failed to get past a permanently engaged signal on the telephone for five days, I received a snotty call to say that the doctor had no intention of answering my E consult form, as it was nothing more than an attempt to queue jump.
The NHS is broken. No-one seems to know or care other than the patients
October 7, 2021
In other words drop the receptionist triage, and develop a good computer Q&A to get to suggest likely problems relating to the symptoms. Then it determines next step – immediate GP, Pharmacy advice, A&E, SPECIALIST.
October 7, 2021
Test and trace should be wound up.
LFT tests are so inaccurate they are a joke.
Reorganisation will be moving deckchairs and be an expensive waste.
A cull of non clinical staff is required and GPS contracts renegotiated to force them into face to face consultation.
There’s billions to be saved with a bit of knife wielding.
October 7, 2021
+1
Yes.
If the unjabbed, merely by exercising their right to choose, can be sacked, why not a doctor who chooses not to work?
But anywayā¦I reckon theyāve all been āāavin a giraffeā as someone I know says when faced with apparent lunacy.
And all at our expense ..literally!
October 7, 2021
@Ian Wragg; T&T is, or could be, a useful tool to encourage people to act sensibly, not just carry on in utter selfish ignorance, T&T works well in both Australia and NZ. As for LFT, you say they are “so inaccurate they are a joke” but fail to qualify the comment, if you are talking about false negatives then you have a point (people will need to go back to taking PCR tests), on the other hand if they return false-positives that is no reason to throw a baby out with their bathwater.
“Thereās billions to be saved with a bit of knife wielding.”
An unfortunate turn of phrase when talking about the NHS! š But Mr Wragg is totally correct, although perhaps not in the way he intended, we need to spend money (more wisely…) to save money overall, if the NHS as a whole can provide a more timely service there will be far less sick-days lost to industry for example. Perhaps we also need to relearn the lessons that have been forgotten since the 1950s, putting NHS staff into the workplace, on-site, walk-in medical centres with at least one trained nurse. Are (older, semi retired?) experienced NHS paediatric nurses still attached to schools, if so do they offer both pro-active health care and a walk-in clinic for parents and/or child.
October 9, 2021
āLFTs are so inaccurate, they are a jokeā: As I had to travel in August and September I had to use both PCRs and LFTs (out of and in the UK, in and out of EU countries) and at least for showing I was Covid-19 negative both types of tests were āgood enoughā to agreeing the four times I had to use them. Obviously four instances of agreement do not make a statistically significant sample.
So Mr Wragg, what āproofā do you have that LFTs are a joke? How many such pairs of concurrent LFTs/PCRs have you had that allow you to say such a thing?
Or are you as statistically insignificant as I am?
October 7, 2021
more importantly what are we doing to improve life expectancy, survival times for cancer sufferers, early diagnosis, actually doing something useful if diagnosis is made. all of which is done far better abroad, and is mostly cheap as chips compared to a lot of what the NHS wastes its money on.
relatively cheap interventions which can give decades of quality life, versus likely early death, such as heart stents should be carried out far more often in this country. the sad reality is that if you are a good candidate for these but are taken to the wrong major hospital the chances are you will be left to wither and die. although some NHS hospitals do provide reasonable numbers of stents, some do hardly any at all. I know of A & E docs telling incoming patients “off the record” to go get in a taxi to the hospital in the other nearby big town as “you need a heart stent and you wont get one if you are admitted here”. admirable “duty of candor” from those docs, but risking their jobs saying this as their employers frown upon saying this.
a friend has his prostate removed at 40 in Australia, regular PSA tests, actually doing proper further testing if the levels are high, and actual proper treatment (that isnt just hormones and pain relief when its too late anyways) are what is needed. in the UK he would be dead, no doubt about it, certainly lots of the modern treatments are not available in anything but theory in the NHS.
anyone who has spent any time on large MOD sites will regard the idea that a ex senior military officer can bring efficiency with some hilarity. even the best brains in the centre cannot fix things. it needs a wholesale handing of real day to day power over to individual patients, so they can go to any of multiple providers of care, choose their own consultant, bypass the GP rationing function which is a waste of time in clear cut cases, allow failing healthcare delivery units to fail, and if the money follows the patients then the more successful delivery units should be able to expand.
stop obvious NHS waste, stop homeopathy on the NHS it is clear nonsense, stop gender reassignment for children its simple child abuse, stop the fake equality nonsense that in reality is mostly just lefty woke nonsense which actively promotes discrimination against white working class males, ie not equality. stop work visa and student visa entrants to this country coming in with medical conditions which will need expensive operations and the like within months of getting here, and their families. the nhs taking the much higher risk of new entrants to the country with expensive pre existing conditions is an undue burden.
oh and start giving medals to docs and other medical professionals prepared to work in the sink estates etc, at the moment its a tough gig with little recognition.
personally all I have had from the nhs is crap service, obviously sub standard, before and after covid, friends they have left to die, basic life saving care that nhs failed to provide I had to pay for (having already paid for it through taxes)…
stop treating it like a religion, the real people dont believe the hype
October 7, 2021
What productivity savings are brought by the use of digital consultations and remote medicine?
Yes this is what I have been wondering for years .Everyone else shed costs with IT and endured what was a painful restructuring for those whose jobs went . The NHS increased costs ?
The NHS compares adequately in a cost / result analysis with comparable systems in the developed world or so I read but I do have doubts about how meaningful such a comparison can be . Need to look at who is gathering the data
Another question to add to your list is a review and complete overhaul of purchasing Pharmaceuticals . The theory is that the buying power of the NHS will ensure low prices but , for example , why do the NHS pay astonishing amounts for low run drugs required for historical dependencies .
Surely the providers could be squeezed into providing this at cost price or as part of the deal , the amounts involved are quite incredible.
October 7, 2021
@Newmania; “Everyone else shed costs with IT and endured what was a painful restructuring for those whose jobs went”
There are more people employed in offices since the IT revolution than before, sure the typing pools has gone, replaced ten fold by other office grades.
October 7, 2021
Jerry, this isnāt necessarily the case in all private businesses. We have managed to reduce office staff significantly as technology develops. Smaller businesses see admin tasks as a necessity it is not a means to an end, our producers are 3 to 1. Iād like to add that one person is required just to deal with government documentation, regulation following, form filling, paye.
October 7, 2021
It is just all part of the agenda.
See what they were up to in āNHS Resetā May 2020ā¦predictive medicine! ( something like we have suffered recently?).
They believe that AI will reduce waiting times etc.
They picture January 2030 when all is running smoothlyā¦no more patient queues, no more overburdened health system. All done by genome prediction and AI.
Yeahā¦and we have had NO healthcare for nigh on two years.
What would Bevan have said? Well, maybe he DID say something!
@Chesham and Amersham.
October 7, 2021
@EH; “They picture January 2030 when all is running smoothly”
I doubt politicos see anything in their crystal balls, it’s called kicking the can ever further down the road, not solving the problems, any real (social or market) solution will hurt electoral chances.
October 7, 2021
How’s the government getting on with deploying ‘COVID sniffer’ technology, Sir John? Perhaps you could ask at a forthcoming Health Questions.
October 7, 2021
Indeed and good luck with getting anything meaningful as a reply.
And in other news the smell of BS coming from Boris was overwhelming. I see he pledges not to build houses on green fields. I expect the first ones to start tomorrow.
October 7, 2021
Btw off topic , I read Johnson` speech and have never read a Conservative Leader `s speech that so completely failed to make an argument. The rivers Alpheus and Peneus have more work to do ….chortle chortle smug look .. simper simper …
What a ——-
October 7, 2021
Can capacity be increased by removing the tax (IPT and PAYE) on private medical insurance so that more people take up private insurance.
October 7, 2021
And adjacent to the NHS having an ex military man put in to sort it out, I note an Air Commodore has been bought into the failing Business ministry responsible for our petrol shortages, to improve performance.
Yet again evidence, as if we needed it, that performance management across government is not fit for purpose.
Rumours abound that Liz Truss is finding her new Mandarins a bit Yes Ministerish. What a surprise.
Instead of asking these forensic questions Sir JR, we need a generic one across all Departments.
āIn view of multiples failures of delivery across Government, when will it take the necessary steps to remove under performing people and replace them with far more competentā?
October 7, 2021
We need top Logistics people, which the Forces do have !! Not the Chiefs – borrow the (staff Ed)
October 7, 2021
Well meaning, but it just scratches the surface.
The whole health and social care system needs to be put uprooted. By all means pay redundancy to those administrators left behind and not rehired (maybe two-thirds), but set the whole thing up to be run on an insurance basis as in France, with competition between providers and really efficient online communications.
Get the clever people at F/book and Google involved. Greater use of Apps instead of GPs. Call their bluff by doing most things online from anywhere in the Anglosphere world at far lower cost and only pay them by insurance per minute of face to face. Save on translators by employing GPs online in native speaking countries. The days of waiting weeks for a letter from your GP etc. have to be put behind us. Everybody will benefit from a wholesale rout of the NHS and social care systems.
October 7, 2021
Probable answers to our host, from both NHS administrators and front line staff;
1/. Indeed the change is like re arranging the chairs on the Titanic, jobs for the boys you know.
2/. Of course the taxpayer is paying far more for T&T than they need, what do you expect, its the old privatisation gravy boat with a fresh coat of paint. Other countries have had far better T&T systems, far better results, but then in those countries T&T wasn’t outsourced via a commercial style contract, assuming it was outsourced at all.
3/. Do MPs ask the same about the seasonal flu vaccine. But yes of course the cost, the booster doses, could probably be scaled back if there are no new variants, no risk of new variants, but surely you’re not suggesting the govt restrict peoples wish to travel to foreign parts again, either on B2B meeting or holidays?
4/. Surely if the NHS is buying capacity off the private sector is that not rather like more people buying their own private health care plan? Oh hang on, perhaps I miss understood, you did not mean those private patients who need clinical treatments but those patients who want treatment and NOW, even for minor aliments that many others will likely accept having to live with for now, given the circumstances the country finds ourself in.
5/. If you mean digital consultations etc. as used since lockdown #1, they were never about cost savings, they likely cost money to implement, their roll was to keep both patients and health care staff safe. If you mean post pandemic going forward, surely the need is to get back to in-person consultations etc, no?
I can only assume our host, with today’s article, was being both Devils Advocate and Matador….
October 7, 2021
Deviating slightly- Am I the only person disgusted by the thousands of masks tossed carelessly about the countryside, towns and villages? Its a good job they only stop bacteria and not the more infective corona virus! We would never be able to get rid of the infections. It also seems to me that councils make no effort to safely dispose of this contaminated waste. Nothing is ever done correctly by local or Westminster government.
They should be leading by example! Where are the contaminated medical waste bins!!!! Or home collections.
October 7, 2021
Morning all,
Hope you are well. I thought the conference went well.
Thatcherism on steroids Brexit will not work. Why ?
You will lose Scotland and the North of England as it was rejected 3 times and New Labour swept into power leaving the Conservatives in the wilderness. When new Labour copied Thatcherite policies they also lost Scotland and the North.
It seems the ideologues on the right suffer from the same problem as the ideologues on the left.
What will work is telling the truth how government spends. That is the true middle ground on the Political spectrum. Why ?
Because if the starting point is the truth instead of lying about it. Using sound money techniques from the gold stabdard, fixed exchange rate era that no longer applies to our monetary system you are always either going to come up with the wrong solutions or ideology is ultimately hijacked by vested interests. On both the left and right.
90% who post here in good faith on this blog still have no idea how our monetary system operates. They still believe it is tax and spend or borrow. As if we use the Euro. Which with the Ā£ is never the case.
It has to stop millions now know how it to really works. It is no longer a secret to be used for political purposes.
Once the truth is used the start of debate begins. Instead of trying to shoe horn left wing and right wing ideologies into the whole of government accounts. Using the truth makes it easier for things to get done in Brexit Britain. The truth is the true middle ground.
From the truth you can attach right wing policies to the monetary system. Instead of lying about it and never getting the tax cuts we deserve. Is just one glaring example.
For example: Healthcare
Once you understand taxes do not fund government spending as the government accounts clearly show the debate changes. The truth is the starting point what happens next is a political choice.
Once you understand government borrowing is merely a reserve drain so the BOE can hit it’s overnight interest rate and is monetary policy not fiscal policy the debate changes. The truth is the starting point what happens next is a political choice.
Once you understand the only constraint on government spending and tax cuts are the skills and real resources we have available and not the size of the deficit and debt, as Japan has shown for 30 years the debate changes. The truth is the starting point what happens next is a political choice.
Lying about it and starting off from the wrong place will be reflected at the ballot box. Because what was promised is never delivered. We are still living with the fall out of some of these policies because they started from a lie.
Please stop and think for Brexit Britain. 30% voted for Thatcherism on steroids the other 70% didn’t. They wanted a different kind of change and one of those changes was telling the truth from the start.
Just please imagine the debate we could all have about healthcare once people realise their taxes do not fund it. The only constraint is an inflation constraint what skills and real resources we have at our disposal. We start the debate as a sovereign currency issuing nation that uses floating exchange rates.
We rejected the Euro for economic reasons. Why is it we always act as if we are using it ?
October 7, 2021
Off topic, I now find the man so repugnant that I couldn’t even bear to listen to him myself, but it has been noticed across the island of Ireland that Boris Johnson gave a 45 minute keynote conference speech without once mentioning the Irish protocol, and no doubt conclusions will be drawn from that:
https://www.thejournal.ie/johnson-to-announce-he-has-guts-to-fix-uks-problems-as-benefits-cut-bites-5566512-Oct2021/
October 7, 2021
And from this:
https://www.rte.ie/news/brexit/2021/1007/1252276-protocol-sefcovic/
“‘No renegotiation of the NI Protocol’ – EU Brexit chief”
“The EU’s Brexit negotiator has told a seminar in Dublin that there will be no renegotiation of the Northern Ireland Protocol and that the EU will not accept any solution that will cut the region off from the benefits of the single market.”
Compare with this:
https://www.brexit-watch.org/nows-the-time-for-unionist-to-mean-something-in-boriss-brand
“Now’s the time for ‘Unionist’ to mean something in Boris’s brand”
“But the bottom line for me and the pro-Union community is that our place in the United Kingdom has been weakened and there has been no consent by the people of Northern Ireland that we should be left under EU rules and its court. So the only satisfactory solution is to replace the Protocol by arrangements which fully restores Northern Irelandās position as an integral part of the United Kingdom.”
October 7, 2021
A review of prescription policy would save Ā£millions. I have a friend (overweight, borderline diabetic) who is prescribed 100 Paracetamol tablets every month and has done for several years. She seldom uses them all and hands them out to family and friends. Paracetamol costs around 25p for a box of 16 at Boots; in 2018 it was reported that “The NHS in England has spent almost Ā£400m prescribing paracetamol in the past five years at a cost of Ā£3.23 per item,”
Prescriptions should not apply to drugs which can be bought (far more cheaply) over the counter.
PS. Johnson’s speech yesterday was very entertaining. But that’s all: no detail (natch) and told us nothing about what he actually intends to do (since he knows it has been and will continue to alienate genuine conservative voters).
October 7, 2021
Can’t agree there Donna as I know somebody who takes 8 Paracetamol a day and it would be impractical for them to visit a chemist every other day as I believe over-the-counter sales may be restricted to 16 tablets. Surely your friend should limit the amount of tablets she orders.
October 7, 2021
Sounds like kidney and/or liver failure on the way…
October 7, 2021
@miami.mode; “over-the-counter sales may be restricted to 16 tablets.”
32 actually, two packs of 16, but there is another issue, many people due to age, low income or acute condition do not pay, not even prescription charge – quite rightly.
October 7, 2021
Why doesn’t your friend inform her GP that the prescription could be reduced, or speak to her local pharmacist who is enabled to review prescribed medications ? Is she so incapable of initiative, or is she just irresponsible?
October 7, 2021
According to FOI requests across the country for the number of burial and cremations between 2015-2020, it would appear last years deaths were within the 5 year average and in most areas, only 2019 had less deaths than 2020.
So why not just disband T&T and save shedloads of taxpayers money?
October 7, 2021
The NHS is patently not averse to using private contractors, since that is what GPs, High St dentists and opticians are.
Many pieces of large diagnostic equipment in hospitals, such as scanners, are leased from private enterprises, who also carry out maintenance and repairs.
I do not begin to understand why patients requiring straightforward elective surgery or other regular treatment should not be sent to private hospitals wherever possible – if the terms were negotiated properly, this would benefit the patient, the NHS hospital and the private sector. It would then leave the NHS with more capacity to deal with genuine accidents, emergencies, epidemics, pandemics and severe and unusual cases.
October 7, 2021
With all cause mortality having been normal since March, the time is fast approaching where all covid focused procedures, including test and trace, should be wound down.
How about offering patients who opt for a private treatment 50% of what that treatment would have cost the NHS? That should encourage more people to avoid burdening the NHS, whilst simultaneously leaving the NHS with more resources to treat everyone else.
October 7, 2021
We really need an assessment of how many people have died and got ill owing to the lock down of so much of the NHS.
In my own experience I know of no-one who has died of Covid and six (soon to be 8) who died of illnesses that were not being properly monitored during lockdown. Only three of these people were over 60 and only one over 80. I also had to wait six months before I saw a specialist for a nasty hyperextension of my knee, having only seen a triage nurse at the beginning – as if to confirm my suspicions. I am forever altered but adapting well owing to private physio and my own determination and love of activity.
Let’s do some maths.
Average age of Covid death 82. 137k killed by Covid (according to Worldometer) There must have been an awful lot of popular 82-year-olds for everyone to have known a Covid victim, most of whom are at a time in life of ever decreasing circles.
My experience is likely to have been a truer one of the general population. A list of friends and relatives dying of other illnesses but none of Covid. Lockdown doubtless killed and hurt a lot of people but no-one is interested in quantifying it in order to set future policy.
Some may say that there would have been a lot more deaths without lockdown but they never mention lockdown deaths and whatever we did we did NOT save the NHS – an organisation which is rife with abuse and corruption and which has finally brought us to national bankruptcy.
There will be more viruses and we need to consider focused shielding as being the better option as it clearly was during this crisis.
——
Masks. If there is any doubt about their uselessness in closed spaces please look at the videos on YouTube ‘Vaping Through a Mask’, particularly the one where the vape is taken in unmasked, a more realistic way of breathing. This is before we even consider that most masks do not stop viruses at all, only vapour. And the general policy of ‘face covering’ means that many people wear pointless cycling buffs which fail to filter out anything at all – yet this makes a person *good* and one who wears nothing *bad*.
Face it. If you’re sitting in a train carriage anywhere near a person with a surgical mask on, who happens to have Covid, then you’re going to catch Covid. The only ones that work in these videos are properly fitted N95s.
October 8, 2021
It all needing saying – well done. A breath of fresh air – without a mask.
October 7, 2021
The cost of Test & Trace was, literally, unbelievably high. When I first read it I thought that some idiot had written ‘billion’ by mistake, instead of ‘million’. There needs to be an independent inquiry as to where this money went and criminal prosecutions must follow. It is simply not possible to spend that amount of money legitimately on this.
October 7, 2021
I agree absolutely.
October 7, 2021
Sir John – surely this is more huff and puff, to play to the media and create taxpayer employment for chums.
Logic suggests if the Customer/taxpayer facing side of the NHS or any State run department is not getting the service they are paying for, then the management is simply at fault and needs replacing. The taxpayer doesn’t need to be funding another review, it is just wasted money being sucked from the system as with all the reviews, Quango’s etc. We have created a society in which no one is accountable and taxpayer funding is an entitlement to those chums of chums. You could argue from that what is the point of an MP* or the HoC or even Government when they are hands off ‘Not me Guv’ every time a commitment and action is required.
An outside review entered into by tender, that is only proportional rewarded by the defined result of improved customer experience and costs saved – would be more ‘Honest’. But where is the honesty nowadays?
Or better still, lets find a proper Conservative Party the one that understands money, the economy and the simple fact you have to create the earnings to support expenditure. Something the average House Holder does daily
* Like most I more than accept our host is one of the small minority that still understands the meaning of ‘duty’ and ‘serving’. That is also the problem the HoC is majority full of what looks like freeloaders without an once of integrity.
October 7, 2021
There has and always been waste. loads of it in the NHS. It will always remain as long as you have a culture that…..
The NHS is not a business and cannot be run as such.
It’s not our money.
Eventually the government(taxpayers) will bail us out when we are over budget.
There is no accountability for failure.
There is a 74 year culture within the NHS including The Health Department and until you change or get rid of it nothing is going to happen. Just another department operating it’s Situation Normal model.
October 7, 2021
+10
October 7, 2021
Clearly health spending is getting out of control for the current NHS model we have, yes I know that view is not going to be popular, but it’s a fact.
Until that fact is accepted, it is almost pointless tinkering around at the edges, Medical science is now so fast evolving that we can keep people alive who would have previously passed on, but at what cost, and what quality of life.
We need to have a proper grown up discussion about the way forward, and the possible choices/options that could be made.
Perhaps topics for discussion could include: should we continuously treat those who deliberately self harm with drugs and drink numerous times, should those who undertake dangerous sports insure themselves against injury, should grossly overweight people just be put on a simple diet, should cosmetic surgery be available to those other than for medical reconstruction after operations.
If you want a proper discussion, then nothing should be off limits, unpalatable though that may seem.
Likewise should we encourage those who can pay for private treatment, to go for private treatment and reduce the waiting list for others, etc, etc.
Not suggesting any of the above is right or wrong, just suggesting an all inclusive debate is really the only way forward, if we are going to be serious about a review.
October 7, 2021
Hi Alan,
Hope you are well
Well once you realise your taxes don’t pay for the NHS.
That the only constraint on government spending are the skills and real resources available.
The question then becomes why is the private sector allowed to steal both skills and real resources needed for the NHS. Just so rich people can jump the Q ?
October 7, 2021
Derek
Interesting comment.
Who pays for the NHS then ?
The Government has no money other than that it takes from the people in the form of taxes, or which it borrows in their name.
Who provides and developed the drugs and medicines used by the NHS ?
Private companies usually ?
The private sector does not steal from anyone, customers go to them by choice, if they want to prioritise their own spending in that manner, likewise people have choice of who to work for, if they paid for their own training, what’s the problem with that.
If training was provided free of cost to them, at the taxpayers expense, then I would expect them to work for the NHS under contract for a fixed period at least.
Clearly it would seem you have never been let down badly by the NHS !
October 8, 2021
Morning Alan,
“The Government has no money other than that it takes from the people in the form of taxes, or which it borrows in their name.”
That is not true Alan when you think about it. Where did the people get the Ā£’s from that government takes from them ?
Where did the people get the Ā£’s from that allowed them to buy the government bond?
It is written in the front of every bank note. HM Treasury. Unless it is of course counterfeit.
HM Treasury gives you the Ā£’s you then use to Pay your taxes and buy government bonds.
Stamford bridge issues the tickets and collects them on March days. They don’t collect the tickets then issue them.
You have the sequence the wrong way round. It is spend then tax not tax then spend.
The Romans had to issue the coins first before Gaul, Germania, Britannia could get their hands on them to pay their taxes.
Tally sticks were the same.
October 7, 2021
Keep on printing.
As Mugabe once said.
October 8, 2021
Morning Peter,
Mugabe has a supply side collapse. When he handed his henchmen the white farms and they didn’t know how to farm.
You know a supply side collapse like this virus.
Most of not all inflation episodes in history were supply side shocks apart from when they were caused by excessive bank lending.
If you carry Ā£100 around with you and then suddenly the price of everything doubles. You now need Ā£200 to buy the things you wanted to buy before.
The supply side shocks causes the money printing.
October 8, 2021
“Causes the money printing”…Only if the Government decides to print lots more money.
If you keep on printing eventually the markets react against it and the value of your currency collapses.
October 7, 2021
Do your family members own cars John? – – I assume they do – – do they let anyone in the world arrive and use them? WHY NOT? Its what the NHS does – – WE PAY – and anyone can turn up and use it – even demand translators – – and SUE us for a payout if they are not happy with the outcome – – of their FREE treatment !!!!!
October 7, 2021
Stealing from Alister Heath
“At some point, delivery matters:”
https://www.telegraph.co.uk/politics/2021/10/06/three-mega-risks-could-doom-boriss-high-wage-gamble-disaster/
October 7, 2021
Our governments āgreenā policy this past decade WILL affect the health of the nation
Grain Power Station Closed December 2012
Kingsnorth Power Station Closed December 2012
Cockenzie Power Station Closed March 2013
Didcot A Power Station Closed March 2013
Fawley Power Station Closed March 2013
Tilbury B Power Station Closed August 2013
Uskmouth B Power Station Closed Pending Biomass Conversion April 2014
Littlebrook D Power Station Closed March 2015
Ironbridge B Power Station Closed November 2015
Ferrybridge C Power Station Closed March 2016
Longannet Power Station Closed March 2016
Rugeley B Power Station Closed June 2016
Lynemouth Power Station Closed Pending Conversion to Biomass January 2017
Eggborough Power Station Closed March 2018
Cottam Power Station Closed September 2019
Aberthaw B Power Station Closed March 2020
Fiddlers Ferry Power Station Closed March 2020
Coal units at Drax Power Station taken offline March 2021
This has been a planned & managed decline of our power stations, no wonder we have to import energy and the costs are risingā¦..just wait till the bills arrive…..all due to the actions of this government
October 7, 2021
And “leading experts”are today predicting that demand for oil will continue to grow even after 2050.The smart money has suspected this for some time-see Trafigura’s purchase of a 10% “long term”stake in Russia’s vast new Vostok Arctic oil project last Christmas.
October 7, 2021
+1
Well said.
October 7, 2021
And fracking of abundant shale supplies discounted by the Tories.
October 7, 2021
Update
BBC reporting āā Business Secretary Kwasi Kwarteng has said that by decarbonising the UK’s power supply, the country will protect customers from volatile fossil fuel pricesāā
ā¦ā¦is he having a laugh, the closing down of coal fired power stations has dramatically increased the demand and price for gas and imported electricity
October 7, 2021
And most of them blown up I suppose with the occasional one dismantled and sold overseas.
October 7, 2021
‘Higher Pay’ is not something that can be dictated it has to be earnt through productivity. But extra earning more means paying proportionally more in ‘tax’. So is it worth the effort? NHS Doctors have recently stated that putting extra hours is not going to be worth it because they are being asked to accept the same pension tax breaks as the majority of the Country rather than a preferential rate.
This is a tax and spend Government with no idea about productivity earnings and reward.
Work for the State get cocooned and awarded immunity from the true cost of living – if your tax goes up you get awarded with more pay. As a State employee there is quite a sensible, guaranteed taxpayer funded pension for most, even ‘gold plated’ – that is not seen a part of the income paid as the amounts quoted for pay are net. Work for the private sector your pay is gross, you then get to fund your pension. The sometimes disparity in pay is the opposite to the picture painted.
The tax system is broken it is not from this age, it has been tinkered, distorted and corrupted from successive Governments that think having the ability to award perks is more favourable rather than a fair equitable and proportionate system.
If every person and activity was on the same level playing field for tax it would be palatable to everyone, if everyone paid tax proportionally in the domains they wish to profit/earn from it would be palatable to everyone. As it is the rich People/Companies get to manipulate, while the trapped poor get to pay proportionally more to make up the shortfall elsewhere.
October 7, 2021
It is important to minimize costs, but it is more important to ensure that patients get the right care and promptly.
October 7, 2021
Well if you believe the DT the PM has pledged that there will be no homes on green fields. I assume that he and the Carrie have started a lawn turf business. In truth anything he says is Henry V minus a plan and the bows and arrows locked safely away.
October 7, 2021
Sir John please ask the Health Secretary whether he is aware that no nation sick enough to need to spend Ā£240 billion on health care can possibly afford to earn enough to pay. How is he going to slash the price and increase the number of beds?
October 7, 2021
To quote from “thelocal.fr” (well worth the membership for expats). The French system is a reimbursement one – you pay upfront for a medical appointment, procedure or prescription and then swipe your carte vitale. A percentage of the money is then reimbursed straight into your bank account. Most procedures are reimbursed at around 80-90 percent, while some such as cancer treatments are reimbursed at 100 percent. You can either pay the remaining costs yourself, or take out a mutuelle – a top-up insurance policy – to cover the rest. These are cheaper than standard private health insurance policies and if you are working, your employer is obliged to pay at least half of the cost of this.
Remember, free at the point of use leads to abuse. The French system properly separates the private sector providers from the public sector purchaser. The UK has ended up with many public sector purchasers and many public sector providers; an internal market where all the players are using the same government Bank account!
October 7, 2021
Why oh why are we paying middle managers cicaĀ£70k pa but only Ā£30k to a qualified nurse?Sack the managers and increase the nurses,clinicians,doctors etc pay.The NHS is so top heavy with managers and they are non qualified medical people.Matrons would be much better.
October 7, 2021
How many pupils do Eton and Harrow turn out each year?
The system has to find sinecures for them somehow, and the NHS will be made to do its bit too, I’d expect.
Not many nurses went there either, you see.
October 7, 2021
You got any data to prove that assertion NLH?
How many Eton and Harrow people are in the NHS
Come on eh as MiC used to say.
October 7, 2021
Goodness you lefties are chippy
October 7, 2021
A suggestion prior to the UK government laying an electricity supply cable from the UK to the Channel Islands that would end french bullying threats. Park one our attack submarines in St Peter Port harbour and use its generating capacity to supply our territorial islands until such time as the new cable is operational.
October 7, 2021
All self funded medical treatments should be tax deductible.
October 7, 2021
Neither the government nor the Conservative party can be taken seriously as long as the oaf stays in charge.
He won you the election. Now do the right thing and find a replacement. He may well not win the next one, once the bills arrive.
October 7, 2021
When I want medical help from my doctor I have to complete an on-line form. The form is not perfect, you have to lie a bit or you get told to ring 111 or go to A&E.
What do people do who do not use the internet?
That said, when I get the form submitted I am called by a doctor, at the latest, the next day. Itās a bit of a drag but not a big deal.
I had to pay for a private hernia repair earlier this year having been referred by my NHS doctor. I could choose a local NHS Hospital – wait 33 weeks – or a local private hospital – wait (according to the letter I received) 17 weeks. I chose the private hospital and saw a consultant. He said āAs an NHS patient I have no idea when I will be able to do this procedureā. I asked āand if I am a private patient?ā āTwo weeksā was the reply.
As a hernia can be life threatening I opted for the two week, private option. I canāt understand why when the NHS refer me there – so the NHS is going to pay – the wait is indefinite. When I am going to pay, the wait is two weeks. Did I pay more than the NHS would have paid?
Either way I feel cheated and would like the NHS to refund the 3 grand I paid. I paid tax and national insurance for 48 years. When it was my turn to need treatment the NHS wasnāt there. I want my money back.
October 7, 2021
So you didn’t ask ‘Are you at all embarrassed at being paid outside of your main employment, fitting me in very quickly when you could have been reducing the wait for people who cannot pay so rely on an NHS queue?’ Or ‘ If I do not choose to pay you, will you be idle for that period of time otherwise spent on me?’
October 8, 2021
It is and always has been legal for an NHS doctor to have a part-time contract, so that they can spend part of their time in private practice.
Private hospitals are run as businesses and therefore are generally far better managed than public enterprises, with one proviso: they do not have to take emergency procedures (in the case of accidents or major incidents) into account, as do public hospitals. This is why it would surely make far more sense for the NHS to contract out straightforward procedures to the private sector wherever possible.
October 8, 2021
Well SpaMedica, who have been opening new buildings, are doing lots of cataract ops on contract from NHS, reducing typical wait time to just a few weeks. I have a sister hopefully about to benefit from this.
October 7, 2021
I voted for Boris ,but what I’m hearing from the Conservative party sends shivers down my spine. Will I vote for Boris next time? No.
October 8, 2021
What, you live in Uxbridge?