NHS budgets and management

The relatively new Secretary of State for Health has a major job to do.He has to  ensure the NHS sustains high quality care and a good level of response and service. He needs to supervise how the substantial extra money will be spent and check on how the base budget is used.

Doing good and doing no harm to patients must be the common starting point.  Tackling the unacceptably high waiting lists is a clear priority.

This agenda should include

1 Further improvements in infection control. Controlling viral transmission requires better air extraction and UV filters in air systems. Other hospital infections require high levels of disinfecting and cleaning.

2. Expansion of capacity. Hospitals are short of beds and of some medical staff to man them. This should be a priority in new spend.

3. Reduction of administrative overhead where there are too many layers and bodies over the heads of medical teams

4 Intelligent digitalisation of records with good access for all screened medical staff who need access to a patients condition and diagnoses.

5. Development of more specialist units that become very good and efficient at the more routine operations like joint surgery and cataract removal.

6. Provision of more social care back up to allow discharge of frail and elderly from hospital after treatment.

190 Comments

  1. Oldtimer
    December 10, 2021

    A sensible list but with one glaring omission – a deep cleaning operation at No 10 Downing Street and the removal and retirement of its principal bed blocker to spend more time with his growing family.

    1. lifelogic
      December 10, 2021

      Replaces by whom? The main problems Boris has seem to be caused by Carrie. What is needed is the old small government, climate realist, libertarian Boris. Not the current tax to death, woke, lockdown enthusiast, net zero idiot that Carrie and Covid seems to have converted him too.

      Javid seems very unimpressive to me, though clearly not quite as bad as that other son of a bus driver in London. We shall shortly see if he is remotely up to the job. So far he just orders people to respect the (very second rate) NHS and locks people down. If he wants people to respect the UK healthcare system it needs to earn that respect. Currently it is clear from the NHS stats that far more are dying and/or will die from NHS ineptitude, lack of provision, delays and negligence than from Covid. He needs to sort this dire state of affairs out.

      1. lifelogic
        December 10, 2021

        Javid read politics at Exeter, Hunt and Handcock PPE, Amanda Pritchard modern history. Might healthcare not perhaps be better run by people who actually understood medicine, were numerate and understood how run organisations efficiently. Just a suggestion. We already no Amanda Prichard does not understand the NHS figures from her own mouth.

        Perhaps even extend this principle to having some people who understood business & energy engineering as ministers for business and energy, transport, transport engineering and economics etc. !

        1. lifelogic
          December 10, 2021

          know not no!

      2. Everhopeful
        December 10, 2021

        +many
        Agree 100%

      3. Oldtimer
        December 10, 2021

        Nothing will change until BJ is removed by MPs and Conservative party members elect a replacement. Who that will be and how effective they will be in the role are unknowns. Trust worthiness and competence are two characteristics that are essential plus sticking to the programme that got you elected is another.

        1. X-Tory
          December 10, 2021

          Of course Boris the Traitor has got to go – that’s obvious. It’s got nothing to do with parties, or the flat redecoration, neither of which I give a monkey’s about, but his failure in terms of policies: Northern Ireland, fishing, taxation, illegal immigrants, energy, covid, etc.

          The question is ‘who should take over?’ There is not a single cabinet minister I trust, given the fact that they are all both totally incompetent in terms of their ministerial jobs and complicit in all the failures of government we have seen. But can an outsider win the leadership? And if so, who should it be? Would our very own Sir John throw his hat in the ring? I have to say I have almost zero confidence that the Tory Party will pick someone acceptable who will convince me to return to the fold.

          1. Fedupsoutherner
            December 10, 2021

            X TORY. Agree totally. It has to be someone with true Tory convictions and integrity. Our host fits the bill perfectly.

        2. CH
          December 10, 2021

          you mean Truss-worthiness?

          https://en.wikipedia.org/wiki/Liz_Truss

          “those that fall behind get left behind…”

        3. No Longer Anonymous
          December 11, 2021

          Yes. Boris has blown it.

          It doesn’t much matter who takes over. They can’t be any worse than this Marxist appeaser.

          I am with Tim Montgomerie of Conservative Home. I will actively engage in civil disobedience if another lockdown is introduced.

          Enough is enough.

      4. Everhopeful
        December 10, 2021

        He is charismatic and has been a vote winner.
        But like all chaotic egotists he needs to be controlled.
        And that control is coming from the wrong place.
        But then, successive govts have allowed any notion of respect for elders to fly out of the window.
        So no chance of a wonderful Lord T figure giving him a talking to!

        1. No Longer Anonymous
          December 11, 2021

          Everhopeful,

          He’s just not funny anymore. He’s out Laboured Labour.

          So what’s his USP now then ?

          Not knowing how many kids you’ve had is not a good quality in a leader – much less one lecturing me on cutting carbon.

        2. Micky Taking
          December 11, 2021

          He could have a role as a warm-up artist prior to the main event. Instead of rolling in the aisles, they are dying in rows. Trouble is who will be the main event?

      5. Ed M
        December 10, 2021

        Libertarianism finds its origins in The French Revolution.
        The GREAT Edmund Burke hated the French Revolution and everything associated with it.
        I think we need to coin the phrase Burkian Conservatism. This is a Conservatism that is deeply rooted in our Judaeo-Christian / the best of our Greco-Roman heritage / history / culture – that gave us Parliament, Monarchy, Judiciary, Oxford, Cambridge, Salisbury Cathedral, Grammar Schools, Eton, Winchester, Guilds, Work Ethic, Family Values, Patriotism, ‘with privilege comes responsibility’ and so on ..
        When I think of Edmund Burke, I think of other people like him / who would have shared his world view (not forgetting that Conservatism should never be overly intellectual either): Jane Austen, Samuel Johnson, wonderful, sane, inspiring people like that.

      6. Ian Wragg
        December 10, 2021

        The farce of Net Zero.
        Send recycling to Romania and declare we are recycling more year on year.
        Cutting trees down and shipping them 3,000 miles to generate electricity and declare that the extra CO2 is good CO2.
        Run open cycle gas turbines to stabilise the grid because of the intermittent contribution of wind and solar.
        Import coal from Russia and ship it 2000iles when we sit on vast quantities of the stuff
        Import LNG from around the world when we have vast quantities here in Britain
        The whole sorry mess is down to an idiotic arts led parliament with not a single engineer amongst them.
        Never have we been so sorely betrayed by our dictatorial ruling class.

        1. Mitchel
          December 10, 2021

          From Business New Europe this morning:-

          “Gas storage in Europe continues to fall at alarming rates.Currently tanks are 64% full,same level as Jan 13 in 2020.On 8/12/20 they were 84% full,ie 20 percentage points more than currently.”

          And winter has barely begun!(As an aside,Russia experienced an extraordinary 85 degree C(153 degree F) temperature variation across it’s vastness yesterday,from -61c in NE Siberia to +24C at Shatoi in the Caucasus.

          A further observation from BNE re the new German government and Fraulein Baerbrock,its Foreign Minister:-

          “It’s weakness is Baerbrock who has no foreign policy experience.Lavrov(Russian FM) is going to eat her alive.”

        2. glen cullen
          December 10, 2021

          Agree – its all beyond a joke

        3. SM
          December 10, 2021

          +1

        4. alan jutson
          December 10, 2021

          +1

        5. acorn
          December 10, 2021

          UK spot gas price is up today at 9 pence / kWh, a couple of percent above the Dutch Hub price. On the basis that you need two kWh of gas to get one kWh of electric out of your CCGT you will be looking to bid that Grid price above £180/MWh (18 pence/kWh), just to pay for the fuel. (And pray the UK is becalmed, wind wise, for the rest of the winter.)

          On the electric side, the average wholesale price at the UK end of the interconnector wires is 21.6 pence/kWh. At the Norway end it is 11.9 pence/kWh.

          1. Mark
            December 10, 2021

            …leaving a profit of about £1.6m a day on present restricted volumes to be split between Stattnet and National Grid.

        6. Lifelogic
          December 10, 2021

          +1

        7. Fedupsoutherner
          December 10, 2021

          Well said Ian.

        8. No Longer Anonymous
          December 11, 2021

          A friend in Bristol now tells me he has to pay a £9 per day emissions charge because his car was made before – wait for it – 2015 !!!

          So that means people will be scrapping 6-year-old cars and buying new ones.

          How the hell is that green ?

          How on earth have we reached such Clown World with an 80 seat majority Tory government ?

      7. Paul Cuthbertson
        December 10, 2021

        LL- Javid seems very unimpressive…….?? He IS unimpressive but so are all cabinet members. If you look at the make up of the cabinet, Sajiv David, Rishi Sunak, Kwasi Kwarteng, Alok |Sharma there is a pattern here, the slow creep which goes unnoticeable by the public. have you seen it before somewhere????
        Dominic Raab would appear to be the only one to replace puppet Boris but then again he will also be controlled by the Globalist UK Establishment who have controlled us for centuries. We are all subjects without a voice unlike the the US Constitution which commences, WE THE PEOPLE…..

      8. Iain Gill
        December 10, 2021

        bring Portillo back

        1. SM
          December 11, 2021

          A wildly-overrated ex-politician with next to no economic ability.

    2. Mark B
      December 10, 2021

      Nice one 😉

    3. Juno
      December 11, 2021

      Quoting a great contribution yesterday:

      I am now happy for the Government to issue its pretend rules and so I’ll pretend to obey them.

      I’m resigned to the pubs and restaurants being wiped out but I and my friends will otherwise behave as we used to.

      What’s Tory Boy going to do about it ? Declare Marshall Law ???

      By the next election Britain will be a miserable and bleak place with nothing but Green gruel for the future. Has no-one in this government factored in the hardships of the last two years and how that has reduced our consumption ? Will no-one in this Government cut us some slack ?

      1. Donna
        December 11, 2021

        My local Stand in the Park Group have already organised home socialising for when the tyrants of SAGE and the Fuhrer attempt the next destruction phase of pubs and restaurants.

        Civil Disobedience is the only way this tyranny will be ended.

  2. Mark B
    December 10, 2021

    Good morning.

    I do not agree that Secretary of Health (English NHS ONLY !!) needs to do all those things. What he needs to tackle is the endless layers of bureaucracy / non-jobs. This would free up substantial amounts of funds.

    COVID 19 Does not discriminate, much like other ailments. So why do we need Diversity Officers ?

    1. lifelogic
      December 10, 2021

      Well Covid 19 does indeed discriminate heavily against the old, against men, esp. bald men, people with blood group A, people in certain types of jobs, the overweight, the elderly, certain genetic backgrounds and medical conditions … but “diversity” officers are hardly going to change this.

      What is needed is far more power and real choice to patients. A level playing field and fair competition between private medical care and state medical care. Not a state communist, take it or leave it, free at the point of use monopoly of unfair competition. Thus getting more money, innovation and efficiency into healthcare. But Javid is another daft Socialist it would seems, so it will not happen. Just no political will for sensible health policies (nor energy, economic, business, tax or other policies it seems).

      Anyone on a waiting list should be offered ~ 50% of the money to go privately. Saves 50% of the cost of the op and shortens the waiting list for others – another win, win like cuts in red tape. Then tax breaks for people taking medical cover or going privately & encourage company schemes – but perhaps make the policies pay for NHS care too if it is used. Scrap the 12% IPT tax on medical cover too. Pay GPs only when they perform and do their jobs.

      1. Ed M
        December 10, 2021

        ‘What is needed is far more power and real choice to patients’

        – I think you’re over-analysing things which won’t come to much either.
        What we need is a change in cultural attitudes / values. Where people take responsibility for themselves. Have more sense of public duty and patriotism. Stop eating junk food, smoking too much, drinking too much. Becoming more productive. Happier with their lives. More family-minded. NHS bills would tumble. Bills, in general (not just NHS), to tax payers would tumble as well.

        We need politics to achieve that. But politics alone cannot NEARLY achieve that. We also need: 1) Media 2) Arts) 3) Education 4) Church of England and other churches.

        We need to try and inspire a Burkian form of Conservatism in al these institutions. So that we can then go on to create a vibrant CULTURE / CIVILISATION contributing to a strong / stable / interesting economy instead of just mainly focusing on the economy (put too much focus on economic policy).

      2. BOF
        December 10, 2021

        LL. Very good suggestions.

        1. Ed M
          December 11, 2021

          The fundamental prob in the UK (and The West in general) isn’t politics or economic policy anymore (makes a bit of a difference but no longer a fundamental one – unlike say the 1970’s / 1980’s and before) is DECADENCE.
          1) Turning to state aid (instead of self-reliance / relying on family in hard times)
          2) Wanting to make a quick buck (instead of focusing on one’s long-term career / professional skills and enjoying one’s work not just earning quick money)
          3) Addictions (sugary foods / binge drinking / social media fanaticism / porn / dope etc).
          Everything now is about a quick fix. Quick buzz. Even in the arts. In days gone by, composers and artists and writers had to work hard to hone their skills, took a lot of time and work and energy to create the great masterpieces of the past. Same for architecture. Same for building up family life and neighbourhoods. Same for business. Same for everything.

      3. Christine
        December 10, 2021

        He’s of the Build Back Better tribe aka a Globalist stooge.

    2. Andy
      December 10, 2021

      I’m afraid your comment is absolute nonsense. Big, complex organisations – like the NHS – need a lot of back room people to make them function.

      You do not want highly trained nurses or doctors doing staff rotas. You do not want them carrying out building maintenance. You do not want them managing payroll or invoicing. You do not want them booking appointments or doing logistics.

      Tesco – another huge organisation – is a success because of the people behind the scenes. It it the purchases, the stock controllers, the warehouse staff, the drivers, the marketers, the finance people who make it a success.

      The NHS needs this sort of structure too – and, arguably, it is the Tories self-defeating campaign against people who make organisations work which makes our services fail. Of course things go wrong when you remove all the people who are paid to make them go right.

      1. Nottingham Lad Himself
        December 10, 2021

        It is the doctrinaire obsession with outsourcing, which prevents the NHS from becoming the efficient, well-oiled, co-ordinated machine that you describe, Andy.

        We know which sector of which party are obsessed with that, don’t we?

        1. Peter2
          December 10, 2021

          You really think the NHS should manufacture everything it needs NHL?
          Not use expert companies to build the buildings or make the CT scanners or assemble the ambulances or produce all the medicines it needs.
          You are obsessed too but with nationalisation and nothing but the state in control.

          1. Ian Wragg
            December 10, 2021

            NHL is an arts graduate pretty much like the useless bunch that rule us.

      2. lifelogic
        December 10, 2021

        “need a lot of back room people to make them function” well some staff yes but in the NHS we have far too many & most of these back room people do more harm than good. Often inconveniencing and wasting the time of the front line medical staff with endless paperwork, incompetence and inconveniences. The medical people need more control over the back room staff not the other way round as now.

      3. Roy Grainger
        December 10, 2021

        Agree. NHS should be a private-sector organisation like Tescos, it can never succeed as a state-run bureaucracy.

        1. James1
          December 10, 2021

          Entirely agree. The same applies in the case of schools. We should have the medical and educational equivalents of Tesco, Sainsburys, Marks & Spencer etc. running the provision of medical and educational facilities, and competing to provide the best services. Who in their right mind would countenance supermarkets being run by public sector bureaucrats.

      4. JPM
        December 10, 2021

        By your logic the NHS should be a beacon of efficiency and value in its administration. Anyone who has had dealings with the NHS know this to be far from the truth. Drop the ideology and accept the evidence that is plain to see.

      5. IanT
        December 10, 2021

        Clearly you’ve never had any contact with senior NHS managers Andy but I have. I’ve never had any commercial dealings with Tesco (just as a customer) but I doubt they would be the UK’s largest food retailer if they were run by anything like the NHS management I’ve met.

        1. SM
          December 10, 2021

          +10

        2. alan jutson
          December 10, 2021

          +1

        3. Andy
          December 10, 2021

          Tesco’s CEO is paid £6.5m plus bonuses and shared.

          The NHS CEO earns £250k – less than a below average City lawyer.

          Tesco understands that some costs – however high – are worth it. And you’re a Tory.

          Reply A private sector CEO has to please customers to earn the revenue, and will lose their job if they do not. the so called CEO of the NHS is sent ever larger sums taken from taxpayers.

        4. Micky Taking
          December 10, 2021

          Tescos would have to use Store managers to refill veg racks, while asking checkout staff to order food.
          Perhaps the shambles of CEO at NHS is only worth £250k? What are the key objectives compared to those of Tesco?

      6. SM
        December 10, 2021

        Of course medical staff should not be doing administration and management. The problem is that the NHS management system does NOT work, and hasn’t worked for decades, no matter which political Party is in power.

        The comparison to any successful commercial company such as Tesco is invalid, because when senior management in such a business make really bad decisions or neglect growing problems they can lose their jobs and/or their bonus – that is, it affects their own pocket, which is something that simply does not happen in the NHS. “Lessons are learned”, “we will try to do better”, “we were under great pressure”…. and so the lame excuses continue to flow.

      7. agricola
        December 10, 2021

        A recipe for atrophy.

      8. a-tracy
        December 10, 2021

        Andy, but highly trained nurses do work in admin doing rotas I know a high-grade nurse that does this and no longer provides nursing care. She books appointments sends correspondence and can work from home.

        They need to get the people that run the supermarkets like Aldi that force the more slovenly Tesco to up their game.

        1. Andy
          December 10, 2021

          The highly trained nurses do the rotas BECAUSE people like you have spent decades whinging about bureaucrats.

          I think a highly trained nurse should be nursing. And you think they should be doing rotas because you vote for w party which doesn’t understand how things work.

          1. a-tracy
            December 10, 2021

            No Andy she chooses to do it because its a day job with shorter hours, home working opportunities and the pay is excellent. Nothing to do with me. I don’t think she should be doing rotas at all, it is a waste of her skills and training sadly.

          2. Nottingham Lad Himself
            December 11, 2021

            The Tories do not care whether things work, only that any given undertaking can be used as a pretext to channel money to Their People.

          3. Peter2
            December 12, 2021

            Odd how they get huge 80 seat majorities then NHL

      9. Original Richard
        December 10, 2021

        Andy : “You do not want highly trained nurses or doctors doing staff rotas.”

        I expect this happens because the pay and working conditions will be better for the admin posts. At least they will get parking spaces.

        I see the Government’s new Christmas Covid rules are designed for the civil service, the quangos and the NHS admin staff – work from home or even the pub if you prefer and don’t travel to the office unless it’s to attend a party.

    3. Hope
      December 10, 2021

      Javid does not have the wherewithal, like Johnson no plan, strategy or direction. He will do what he is told by the civil service.

      Geisha Stuart now commissioner for civil service. Another Labour politician appointed by a fake Tory govt. Obviously the govt recognises there is no conservative peer able to do the job! Perhaps she could Javid a socialist direction to help out the unions! Unbelievable.

      JR, remind us what Francis Maud was appointed for? Was this not a role Cummings had agreed for himself with Johnson?

    4. Paul Cuthbertson
      December 10, 2021

      Mark B – jobs for the boys.
      Why do we need a Deputy PM, a position CREATED by Blair to facilitate buffoon Prescott.

    5. Nottingham Lad Himself
      December 12, 2021

      Why do people buy poinsettias? asks colour-blind man

  3. DOM
    December 10, 2021

    The fact that an MP is begging the NHS to install more beds to care for the sick and to cut its waiting lists is evidence that the NHS is now unfit for purpose. One would assume that the NHS would already be doing what John is now asking for without being told and yet it seems they are not. Why is the NHS not performing its core task? Because it doesn’t have to. There’s no accountability.

    The NHS NOW CONTROLS THE SOS FOR HEALTH not the other way round. This is the power of Client State politics. Democratically elected reps no longer can assert control over politically minded managers of public services who know they can do what the hell they like and never be held to account

    The Tory party and its MPs are petrified of being seen to be critical of the NHS. This crazy situation in which healthcare for the sick is somehow sacrificed to protect the political fortunes of the two main parties is utterly barbaric

    1. Sharon
      December 10, 2021

      An NHS with a country attached, is a description I’ve heard used!

      1. lifelogic
        December 10, 2021

        A dire, communist, take it or leave it (when & if offered) top down state monopoly that kills most competition, innovation and alternatives. Get the power back to the patients.

    2. a-tracy
      December 10, 2021

      They reduced beds during covid to leave a bigger gap between patients.

    3. Sir Joe Soap
      December 10, 2021

      Ergo, close down the NHS altogether and start again. Sell off the assets and let Amazon/Tesco/Google type companies get the thing properly orgainised. Let govt. guaranteed insurance do the paying. Take the physical side away from government altogether. If the food supply industry were run by government, we’d be starving.

      1. SM
        December 10, 2021

        +1

  4. turboterrier
    December 10, 2021

    As in all corporate, national, international organisations the person at the very top is totally dependent on his various heads out in the regions and branches. His direct reports especially those within the organisation of financial control are critical in the road to success. Therein lies the biggest problem for years even decades the NHS has never tackled head on the waste that is there every day. Millions spent on IT systems that don’t deliver and departments working totally oblivious to how the internal market actually works. Until the NHS gets how it performs internally across the organisation the end result will be situation normal. It needs to be broken up into smaller fast reaction units totally at one with the demands made by its particular patient base which is different in every location across the organisation. Too many of the top and middle levels of the organisation I suspect are still operating as they have always done concerned only with their departments. Right hands not knowing what left hand is doing comes to mind.

  5. Mick
    December 10, 2021

    1 Further improvements in infection control.
    My wife works as a infection control lead nurse and believe me she is worked to death , her job isn’t 9-5 it’s around 7.30 till late at night 6 or 7 days a week with not much gratitude from above, so don’t even think about increasing her workload or she will walk

    1. formula57
      December 10, 2021

      @ Mick – so one improvement should be to provide for a less exhausting workload then perhaps.

    2. Mike Wilson
      December 10, 2021

      Strange. I know two nurses. They have been working 4 days on/4 days off, 12 hour shifts for many years. I’ve always thought the 12 hour shifts were a stupid idea but they are happy because they very much enjoy the 4 days off element.

      If you take a 56 day period, they work 28 days x 12 hours = 336 hours.

      Someone on a 5 days on/ 2 days off, 8 hour shift pattern will work 320 hours over the same period.

      Those extra 16 hours worked every 8 week period are compensated for by receiving an additional 15 days holiday a year. With extra days built up because of length of service the two nurses I know have about 50 days leave a year. Incidentally, they seem to be allowed large chunks of leave at once. One of them, she and her husband are keen caravanners, has been taking 4 week holidays in France for years.

      The advantage, for the hospital, of these shift patterns is only two shifts a day to manage instead of three. The advantage for the nurses is lots of really useable leisure time.

      1. Micky Taking
        December 10, 2021

        it is more common for a pattern of 3 x 12 hours followed by 4 days off.

    3. a-tracy
      December 10, 2021

      These working conditions are dangerous to your wife and to patients Mick, I certainly think these 6 sometimes 7 day weeks 12 hours per day she regularly does are not a good idea.

      John, you should find out how many trusts are working nurses like this it is not good at all.

  6. Sea_Warrior
    December 10, 2021

    Add: a reconfiguring of the vaccination effort so that it is performed at minimum cost. GPs, I believe, are milking the system.

    1. lifelogic
      December 10, 2021

      It is idiotic of the NHS to waste GPs on giving vaccine injections when almost anyone could do the job after 30 mins training. But that is the hugely inefficient NHS for you. This when people cannot even get to see a GP when needed and many are or will die as a direct result of these delays and late diagnosis.

    2. JPM
      December 10, 2021

      You’re quite right – in many ways their behaviour is akin to profiteering in wartime.

  7. Peter
    December 10, 2021

    Good luck with number 3 and 4.

    An expensive and unaccountable bureaucracy has been firmly entrenched for years and recently the big accountancy firms have got their foot in the door and charge huge daily rates for their people.

    I have witnessed the failure to move from paper records to computerised systems.

    1. turboterrier
      December 10, 2021

      Peter
      Accountancy firms
      Well said Peter
      Spot on the money. MASSIVE WASTE.

  8. Donna
    December 10, 2021

    The relatively new Sec of State for Health said, only a few weeks ago, that he would not introduce a “vaccine” passport medical apartheid scheme because “we shouldn’t be doing things for the sake of it.”

    Now – with no evidence whatsoever that they will achieve anything, except destroy even more hospitality and entertainment businesses – that’s exactly what he is doing. I do hope he doesn’t intend attempting to become PM in the near future, because we’ve had two useless, untrustworthy PMs in a row and we really don’t need a third.

    Neither this, nor anything else, will “save the NHS” because the NHS cannot be saved. It is not fit for purpose; it appears to be there to provide well-paid jobs for left-wing public health bureaucrats. It needs fundamental reform, but they will resist it and this CONsocialist Government will never dare do it.

    1. Bryan Harris
      December 10, 2021

      +1

    2. beresford
      December 10, 2021

      It is being trailed that they are hoping to bring in ‘Plan C’ soon, with papers for pints and the return of the nonsensical table service. Can that ultimate deterrent to the virus, the Scotch egg, be far behind? If we have to make pointless gestures can’t we do something which is less economically and socially damaging, like wearing a yellow plastic duck on our heads? Also there are these worrying efforts to stigmatise the ‘unvaccinated’ by claiming that they are responsible for the arbitrary restrictions, resulting in calls from the dimmer members of society to punish them.

      1. Jim Whitehead
        December 10, 2021

        Beresford, +1, and might I suggest a Peppa Pig mask as a fitting gesture.

    3. BOF
      December 10, 2021

      Donna, make that three in a row.

      1. Hugh
        December 10, 2021

        Nah, four in a row – and counting.

  9. Denis Cooper
    December 10, 2021

    Off topic, for their own different reasons Theresa May and Boris Johnson allowed sundry opponents of Brexit to create unnecessary problems over the carriage of goods across the land border between Northern Ireland and the Irish Republic, please could the Tory MPs step in and stop Boris Johnson from doing the same thing over the passage of people across the border?

    https://www.independent.ie/opinion/editorial/uk-borders-bill-suggests-that-a-dangerous-blind-spot-exists-41136204.html

    “UK Borders Bill suggests that a dangerous blind spot exists”

    https://www.irishnews.com/news/northernirelandnews/2021/12/10/news/poland-s-honorary-consul-warns-of-border-check-disruption-2532031/

    “Poland’s honorary consul warns of border check disruption”

    1. Andy
      December 10, 2021

      I thought you wanted control of our borders to keep people out? And now you want an open border.

      Weird. Make up your mind.

      1. Denis Cooper
        December 10, 2021

        You thought wrong, as usual.

    2. Denis Cooper
      December 10, 2021

      And there is also this:

      https://euobserver.com/migration/153780

      “EU Commission’s search-and-rescue proposal hits opposition”

      “Resistance is emerging among some EU states to proposals on distributing people saved in search-and-rescue operations.

      A leaked internal EU document, dated 2 December, reveals opposition from Austria, Estonia, Ireland, Malta, the Netherlands, Poland, and Slovakia.”

      And there was me thinking that perhaps warm hearted high minded Ireland would like to give a safe and prosperous home to all those who manage to get themselves across the Channel to England.

      1. Blazes
        December 10, 2021

        You won’t let up Denis – but I’d like to remind you that it was not the Irish who started the Empire – seems to me this time that most of the people trying to get across the channel are trying to reach the promised land – but it’s not my promised land and it’s not a place I’d like to live in- I much prefer West of Ireland

        1. Fedupsoutherner
          December 10, 2021

          West of Ireland? You can keep it all. Very unfriendly and expensive. Only went once and swore I’d never go back.

        2. Denis Cooper
          December 11, 2021

          What’s that got to do with anything?

  10. Andy
    December 10, 2021

    He won’t be Health Secretary for long. This corrupt and incompetent government is imploding – and the useless blonde oaf is on his way out. His miserable administration is crashing and burning before our eyes.

    Whilst it is exceptionally funny watching the Tory Party fall to pieces it is very sad that it has happened while they are in government – and at a time when we need a steady hand. Our country really does deserve better than this useless shower of charlatans and incompetents that most of you voted for – and most of the rest of us voted against.

    1. beresford
      December 10, 2021

      And the alternative is the other half of the Uniparty, another shower of incompetents whose policies over coronafascism, wokery, and mass immigration are virtually identical. We can only envy America where there is actual political debate and the Opposition is actually opposing the President on these issues, both in the courts and in the Senate.

    2. Lester_Cynic
      December 10, 2021

      Andy

      I never thought that the day would dawn when I agreed with your post, the blonde oaf!

      The only thing that I disagree with is your view that Labour would have been an improvement, on what grounds?

    3. Donna
      December 10, 2021

      Unfortunately, the alternative shower of charlatans and incompetents in the Labour Party are even worse. And under FPTP and the Establishment Party System, that’s the only alternative.

      The best we can aim for is to destroy one or the other of them to allow a new, decent Party to emerge. It would be good if it could be the appalling Labour Party, but if necessary it will have to be the CONs ….. since they refuse to behave like a Conservative Party.

      1. Jim Whitehead
        December 10, 2021

        Beresford, +1, and might I suggest a Peppa Pig mask as a fitting gesture.

      2. Jim Whitehead
        December 10, 2021

        Donna, +1, It is a difficult position to evaluate. In the absence of a perfect solution I have concluded that it’s best to simply defeat one tyranny at a time. Perhaps the drastic upheaval in voter allegiances might awaken the public and the politicians that what has happened in Scotland to the main parties could also change the face of party politics in England. I would not vote with that musing in mind, I will simply cast my vote to soonest eliminate the current most damaging and treacherous element, viz. the Conservative Party.

    4. No Longer Anonymous
      December 11, 2021

      +1

      I never liked Boris. I only voted for him because my chosen party was stood down to face off Labour and I was presented with “Vote Tory or get Labour” and so I did to my shame.

      Now that the Tories are out Labouring Labour…

      No party is going to stand down to help the Tories out now. Tories cannot be trusted.

      The Tories are likely to lose the next general election.

      It wasn’t just the Red Wall that lent Boris their votes – it was Brexit Party voters too. And neither group wanted green zealotry and both wanted Woke and uncontrolled immigration to be taken on.

  11. Nig l
    December 10, 2021

    I have no doubt that privately he agrees and wishes he has a magic wand to achieve it. The problem is politically, although momentum for change is on his side, the government lack the balls to grasp it and take on the entrenched bureaucracy.

    The recent appointment of a life time NHS manager to run it, eschewing the opportunity for new/different ideas would seem to support that.

    This government is deep in trouble. An ‘easy’ win would be to start announcing initiatives with targets and progress updates plus personnel changes if performance less than satisfactory to show us we are getting value and you are capable of managing something effectively.

    I fear the fact that every time the NHS shouts ‘boo’ you jump, gives the game away.

  12. Brian Tomkinson
    December 10, 2021

    The first thing he must do is give us back a National Health Service rather than the National Covid Service we have endured for over 18 months. His puppet masters won’t allow that before the vaccine passports have been imposed as the vector to the imposition of an authoritarian state control system of every aspect of people’s lives. We currently live under an elective dictatorship. Are MPs going to act to protect or leberty, freedom and democracy or must there be civil disobedience?

    1. Everhopeful
      December 10, 2021

      +1

    2. Bryan Harris
      December 10, 2021

      +1

  13. Nig l
    December 10, 2021

    Can any one tell me how an ex public school boy from an entitled background, can at the age of 23 have enough experience of anything to be a special adviser to the PM.

    No wonder we are in the ordure.

    1. Donna
      December 10, 2021

      Ah, but he’s a very special and talented 23 yr old who thoroughly deserves a high-paid taxpayer, funded role in Downing St.

      The fact that his father is a significant CON Party donor had no bearing on his appointment whatsoever. Oh dearie me no.

    2. Micky Taking
      December 10, 2021

      possibly brilliant at arranging parties, oops business meetings.

  14. Iain Gill
    December 10, 2021

    A lot of the “vaccination centre’s” are holding Christmas parties for their staff, this for me highlights the nonsense of the new rules. These people are going to mix, drink, any pretence at social distancing and masks will break down after a few beers/wine, and the inevitable will happen. Among the very people supposedly leading the fight against the virus.

    The country is being led by clowns.

  15. Everhopeful
    December 10, 2021

    Get a health service that works?
    Not likely when we have one which has subsumed all branches of medicine and is (and has been for decades) WOKE beyond comprehension.
    For a health service to work you need a country where people are not afraid.
    And that time has long gone.

  16. BOF
    December 10, 2021

    To reduce the NHS budget, stop the Corona virus vaccination program now that the ominant Omicron variant has been shown to be very mild and does not result in many hospitalisations. Oh, sorry, what will that do to the profit margins of the pharmaceutical companies?

    1. BOF
      December 10, 2021

      Sorry, leave out the ‘ominant’!

  17. H Thomas
    December 10, 2021

    UK Warning. The Light and Freedom is going out in Europe
    We must not be bullied.
    We must not be bullied by The Far Left
    We must not be bullied by The Woke
    We must not be bullied by SSAGE
    We must not be bullied by The BBC
    We must not be bullied
    We must have Freedom, Democracy, and Liberty.
    A parliament that has been corrupted into a Dictatorship is UNACCEPTABLE
    Unelected Dictatorship. Be gone.
    The Great Silent Majority must take it on themselves to become educated and informed and then must stand up to the Bullies.

    1. Nottingham Lad Himself
      December 11, 2021

      The “Great Silent Majority” being a few hundred endlessly-moaning, right-wing obsessives, who spend every waking hour crawling over comment threads on the internet, then.

      Oh, aye.

      1. Peter2
        December 12, 2021

        That great silent minority being a few hundred endlessly moaning left wing obsessives who spend every waking hour crawling over comment threads on the internet.

        Come on Eh?

        Oh Aye

  18. alan jutson
    December 10, 2021

    The first thing to do is admit that the NHS is in a mess, it has been in a mess for years, with only the front line staff, many who are over worked, really holding it together.
    From my, and many others I know experience, the management and administration is absolutely dire, and until people admit the above, you are wasting your time with little tweaks here, and little tweaks there.

    You mention Social services should take up the slack in aftercare, but they cannot even run effectively now with what they have on thier plate at the moment, the system is in meltdown.
    The best aftercare that we ever had was decades ago, but government closed all of the convalescent homes and cottage hospitals to save money at the time, saying they were too small to be efficient !

  19. Everhopeful
    December 10, 2021

    Too many people.
    Keep building the estates.
    Not enough surgeries. Too many closed down.
    Not enough FULL TIME doctors..too afraid to admit why.
    Small hospitals closed down and built over.
    So MORE and MORE patients.
    More and more complaints catered for, encouraged by pharma. A tablet for this and that and the other. Thresholds lowered to create more illness.
    The NHS was imposed by socialists and should have been removed by conservatives.
    But they were too frit!

    1. No Longer Anonymous
      December 11, 2021

      Yes. It simply beggars belief that our town has got significantly bigger and they’ve closed down the hospital, police station and fire station and centralised them all elsewhere.

      Yet they tell us we must ditch cars.

  20. Sakara Gold
    December 10, 2021

    Sir John’s proposals as listed above are far too sensible to be adopted by the new NHS management. What really matters are the number of hospital beds and clinical staff.

    Sir John has previously suggested designating “Quarantine Hospitals” to care for Chinese plague virus victims, keeping them separated from DG hospitals. This would enable the rapid return of elective surgery and the cutting of waiting lists.

    1. Old Salt
      December 10, 2021

      SG
      I thought the nightingales were closed as there not the staff to man them so why were they acquired?

      Just why couldn’t the staff working on covid in the generals move to them thus avoiding much cross infection.

      We are very fortunate indeed in that the latest variant would appear to be less dangerous so far. Next time we might not be so lucky.

  21. Roy Grainger
    December 10, 2021

    “He has to ensure the NHS sustains high quality care and a good level of response and service.”

    When you say “sustain” you imply you actually think the NHS are doing these things at the moment ? It is a failed organisation, and oddly all the pro-EU Remainer fanatics like Andy are Little Englanders unable to see that public/private systems like the Netherlands and Germany are far better not least in terms of patient outcomes.

  22. Everhopeful
    December 10, 2021

    Oh lol! 😂
    Just noticed JR’s tweet re electric cars and dishwasher advice!
    Perfick!!

    1. forthurst
      December 10, 2021

      Is JR a member of the great unrinsed? I think he should come clean.

      1. Everhopeful
        December 10, 2021

        +1
        😂

  23. Bryan Harris
    December 10, 2021

    Yes, that all makes sense…

    So why has the NHS instructed GPs and hospitals to concentrate on vaccinating people over their normal day job? The queues are only going to get worse!

    Israel, for example, where most of the population have been given 4 jabs, has surely proven that no matter how many vaccinations are given to people, they are still not safe from passing on the virus nor contracting it – never mind the deadly side effects of the vaccines.

    When is this insanity going to end?

    1. BOF
      December 10, 2021

      BH. +1

  24. agricola
    December 10, 2021

    1. That hospitals should be striving to achieve maximum sterility is a given.
    2. The key is having sufficient trained staff. I think it wrong to poach them from other countries who have trained them and need them. We need to train our own and accept that it is a slow process.
    3. I can understand each trust needing its own administration. Equally I can accept that the Ministry oh Health needs to administer the budget and other strategic aspects. Additionally I think the NHS needs a professional purchasing and value analysis organisation. However I see no need for quangoes, regional boards , or any other costly construct between the MOH/NHS and the coalface at hospital level.
    4. Why not give every UK citizen a dongle containing their complete medical history, updated every time they use the system, but only accessable to medically trained staff. If you live in Wandsworth and have a road accident in Truro the paramedic has all your details.
    5. Specialist units to increase throughput are an excellent way to go.
    6. Aftercare at home or in specialist units need to be an integrated part of the NHS. A natural flow destination if necessary from any hospital treatment.
    7. Mental health and drug rehabilitation should cease being the poor relations of the health service.

  25. Lynn Atkinson
    December 10, 2021

    Thank you for supporting the people’s freedom to make their own decisions about how they conduct themselves in the light of the CV19 virus and it’s variants. I would NEVER ask you to legislate to stop anyone from locking themselves down if that is the best course of action for them to take. Similarly it cannot be right that the law does not shut the cafes and restaurants (making compensation a necessity) but simply takes away their custom by enforcing everyone to ‘work from home’.
    Time for politicians to accept that all the attendees at the ‘illegal’ Nr 10 parties at the height of the ‘crisis’, unvaxxed at the time, are hale and hearty!
    Let’s move and and build the economy!

    1. Nottingham Lad Himself
      December 11, 2021

      Lynn, if it were foreigners here, rather than a virus, which had killed 160,000 British people, then do you think that the Government would also have no right to impose whatever restrictions and orders were necessary to abate the problem?

      I’m thinking of say, a call to arms, curfews, searches of property and the like, all of which would deprive you of rights and freedoms.

      1. Peter2
        December 11, 2021

        Isn’t that what you and young andy are calling for now?
        A New Zealand style total lockdown of the UK

        1. Micky Taking
          December 11, 2021

          have we got enough sheep to keep us all happy?

        2. Nottingham Lad Himself
          December 12, 2021

          New Zealand were brilliant, precisely because thanks to their timely actions – unlike this country – they did NOT require general lockdowns, and their people were free to socialise and to go about their business.

          1. Peter2
            December 12, 2021

            One day New Zealand will reopen to the rest of the world.

          2. Nottingham Lad Himself
            December 12, 2021

            But now we have vaccines and therapeutics, so they will not suffer the hecatomb that did the UK.

          3. Peter2
            December 12, 2021

            I hope soo too.
            The effect on their economy of closing down their nation must be ruinous.

          4. hefner
            December 13, 2021

            According to stats.govt.nz the NZ GDP after plunging in Q3-2020 recovered rather better than, just an example taken randomly (obviously), the UK’s.
            Another ‘brilliant’ post by P2 who had not taken the time to run a 30-second check before writing some ‘great’ comment.

          5. Peter2
            December 13, 2021

            Any actual figures of recovery?
            Percentages or cash values?
            GDP per capita?
            Employment?
            Tax receipts?
            In money terms versus the UK?
            You seem a bit lacking in statistics heffy

          6. Peter2
            December 13, 2021

            Interesting article in the Financial Times Hef
            Saying what damage the NZ economy is facing

            https://www.ft.com/content/2a127489-1e43-4c31-817c-b607985fc0ea

  26. Nota#
    December 10, 2021

    To me that is not even a question or a discussion. In recent years the UK Government has been focused on shuffling the pack, moving the chairs, announcing enquiries and so on. All with a focus of creating a look-at-me headline, ‘I’m in charge’. The PR machine in all its glory. Instead of a UK Government with focus its like a kid at Christmas with a new toy.

    As far as I can see not a single thing has been achieved in releasing the potential of the UK in the last decade or more. Get ‘Brexit’ done – we are still waiting, the bonfire of the Quangos’ – expanded to keep ‘mates on board, the Civil Service, still expanding. meddling and ruling the roost, the NHS still consuming masses of money – while expanding its administration( but customer service declining), control of illegal immigration – not happened and is exploited by taxpayer funding to so-called charities aiding and abetting the process, reducing the taxpayer burden by greater efficiency – met with an unpayable debt higher taxes as the spending goes on. The list of past promises not fulfilled is beyond comprehension.

    All I would guess people want is a UK Government, that is there to serve, take responsibility for the authority lent it and release the people from this endless tyranny and just do something. It possible to suggest in retrospect let people live their lives take responsibility for their own action remove top down control and things will take off – the very thing the power crazy center cant accept. This ‘kids’ playing with a new toy is wearing a bit thin.

    1. hefner
      December 17, 2021

      P2, according to the FT article you quote, the annual NZ 2020 GDP is 0.9% lower than the annual NZ 2019 GDP.
      For comparison, the annual UK 2020 GDP is £1.96 tn, the annual UK 2019 GDP was £2.17 tn, a 9.6% drop year on year, ie ten times larger than the NZ one.
      It is one thing to be able to give a FT reference, another one to understand what it means in the context of another country.

      In conclusion a very interesting article in the FT once put in context.

  27. Original Richard
    December 10, 2021

    The message is clear from the fifth columnists who now control the NHS for their benefit.

    It is “save the NHS” by working, staying and dying at home.

    The “Yes, Minister” clip from the episode “Get Some Patients” is still available on YouTube and well worth watching.

    1. glen cullen
      December 10, 2021

      Concurrent activity – we, as a nation, need to start the campaign of ‘clapping’ again….it lifted everyone’s mood and made us immune to the incompetence of the government
      Maybe we could clap for the special advisers

      1. Micky Taking
        December 10, 2021

        I’d clap for every resignation from the Government.

  28. Alan Holmes
    December 10, 2021

    Here’s three other jobs.
    Investigate the grossly inflated death figures for covid.
    Investigate why so many elderly people were euthanised with sedatives and then labelled covid deaths.
    Publish the real figures for vaccine injuries and deaths.
    I can guarantee none of these will be done.

    1. Diane
      December 10, 2021

      Talking of jobs : 8 positions being advertised for Emergency Call Handlers, through a well known jobs agency to run from January 2022, long term temporary shift work, days and nights. Part of the job description as follows:

      “Due to the amount of small boats trying to make the crossing each day our client is facing an ever-growing challenge of small boats in danger. The duties of the role are answering calls of small boats who are in trouble and directing the Marine coastal agency to the boat by obtaining information from the person on the other end of the call as to their location ”
      Likely to continue to at least July 2022 is inferred.
      Good to see forward planning isn’t it.

    2. BOF
      December 10, 2021

      A H.
      Returning from ICU for the second time I could not help a feeling of triumph that I had not contributed to the Government’s 28 day fraud!

      1. glen cullen
        December 10, 2021

        Well said, hope your recovery is going well

    3. glen cullen
      December 10, 2021

      I still don’t get the 28 days thing

      1. Micky Taking
        December 10, 2021

        As has been said before, a minor Covid event -full recovery followed by all sorts of other events – accidents, undiagnosed problems leading to sad passing of patient within 28 days of recorded Covid.
        Nonsense stats.

        1. glen cullen
          December 10, 2021

          Same with the infection statistics, your number isn’t just included ‘once’ on your first day of infection, your number is included every day you continue to be infected and take a daily test…could be 10, 20 or 30 days – very misleading

  29. Original Richard
    December 10, 2021

    “3. Reduction of administrative overhead where there are too many layers and bodies over the heads of medical teams”

    Agreed.

    I would like the Government to ask each NHS Trust to publish a completed spreadsheet with the headings Job Title/Number of Personnel/Medical Qualification/Salary and to include management consultancy and any other employment tricks these Trusts may be using.

    1. Hugh
      December 10, 2021

      But who will act on the dogs dinner exposed? I recently had a minor
      run in with an ‘administrative assistant’ who asked (on a Thursday) if I would like to put my complaint to her manager. When I said ‘yes, put me through’ I was told that the manager was expected in the office the next Tuesday – not before as she was only part time. A two day a week manager, in fact. No wonder no-one takes any responsibility for anything in the NHS.

      Also, in my outpatient visits to five hospitals in the past 12 months I have encountered part-time nurses, physiotherapists, health care assistants, clerical staff not to mention the seven (of eleven) part-time doctors at my local GP surgery. I wonder, of the several hundred thousand employees the NHS claims, just how many are committed full-time workers?

  30. Ed M
    December 10, 2021

    In Ang Lee’s great film adaption of Jane Austen’s Sense and Sensibility you get a great snippet of life and love in England in the early 20th century. How people in our great country of ours today have significantly lost a vision of what it is to be civilised English. We have money, yes. But we don’t know what to do with it. When the goal should be to build up culture and from this flows a strong and healthy economy and money etc .. With the economy / money being about serving us not we serving the economy / money. That the economy / money is about paying for a civilisation. For our our Home life. Leisure. Culture. Etc.
    It’s not just here where people are getting it back to front but all over the Western World.
    We need to get back to basics, re-focusing on our Judaeo-Christian / best of our Greco-Roman world.

  31. acorn
    December 10, 2021

    Someone said, “if you are not confused by the situation then you don’t understand the system.” This site is always to the opposite. The less you know about a system, the more you think you can cure its ills. “Empty vessels make the most noise”, is certainly true on this diary.

    “The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20, while the number of patients treated has increased significantly.
    Most other advanced health care systems have also reduced bed numbers in recent years. However, the UK has fewer acute beds relative to its population than many comparable health systems.” A decade of misplaced neoliberal austerity has been exposed by the pandemic. The just-in-time supply chain has turned into just-haven’t got a back-up inventory.

    Good read at the Kings Fund: https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers#key-messages . Particularly, Figure 6 The UK has fewer hospital beds than most comparable countries Total hospital beds per 1,000 inhabitants.

    1. Peter2
      December 10, 2021

      It’s not “neo liberal austerity” acorn
      It is the advance of modern medical procedures that has led to less beds.
      Funding for the NHS has increased every year since it started.
      But it will never be enough for you will it?

      1. hefner
        December 10, 2021

        If what you say is to make any sense, could you please explain why the number of available beds per thousand inhabitants in 2020 is 8.00 in Germany, 7.37 in Austria, 7.02 in Hungary, …, 5.98 in France, …, and 2.54 in the UK. Do you think that health provision in other European countries is so backward that it is the reason why these countries have more beds than the UK?
        Average over the EU27 is 5.00 beds/1000. Is the UK health provision ‘twice as good’ as the average in other European countries? If you think it is the case, why is the UK not at the very top of good health statistics in Europe, but appears systematically within the second half of results (not considering Covid-19) for cancer, heart and cerebrovascular diseases, respiratory diseases, … (OECD Health Statistics 2020).
        And that with the UK usually a leading country in all types of medical research.
        Please explain.

        1. Peter2
          December 10, 2021

          More questions heffy
          You love a nice simple statistic.
          But what about relative obesity, alcohol abuse, drug abuse, the effects of tough industrial jobs, propensity of smoking and average ages.
          Your numbers of beds is a very partial statistic.
          PS
          Are you someone who wants radical change in the NHS to copy better European systems?
          If so tell us

          1. Peter2
            December 11, 2021

            And as you keep telling us you are an expert heffy….tell us how many bed days these apparently superior health services take to discharge a patient after similar treatments.
            Come on eh, as your pal NHL keeps saying

          2. hefner
            December 11, 2021

            P2, what are you inventing again. Did I ever say I was an expert? You make up things as soon as you are shown to have weak arguments. Hilarious.

            What you point out namely obesity, alcohol abuse, drug abuse, effects of tough industrial jobs, propensity of smoking and average ages, do you really think those apply only to the UK? When Covid is over, you might want to travel a bit within continental Europe and might realise that alcohol, smoking, etc are as if not more prevalent there than here.
            Then have you considered how these various ‘ailments’ are linked to economical policies? Are you with the Member for North East Somerset who finds ‘uplifting’ the increased use of food banks?

            When will you consider that health policies as implemented by successive UK governments have been rather poor (making economical priorities the one and foremost criterion in most decisions) and that since the ‘70s?

            As for the usual stand-up comic on this blog always pushing for the extension of private GPs and hospitals, he might be pleased to know that Circle Health Holdings Ltd., Spire Healthcare plc and Ramsay Health Care UK Operations Ltd. received respectively £468.1m, £430m and £385m from the NHS (i.e. UK taxpayers) over the first 13 months of the pandemic to support the NHS by ‘ensuring capacity’ (whatever that means). Which also means that over this period when these three private healthcare companies were having much less ‘customers etc Ed
            The private health companies (the three above and a few others) are now to benefit from a ‘four-year framework’ deal of NHS-funded work, thought to be worth £10bn to them.
            When are the MPs starting to question the past and present Health Secretaries about these contracts? (Private Eye, 1561, 26/11-09/12/2021, p.9).

            And rose, as you don’t appear to know, PE has very rarely been shown to be wrong in its news.

          3. Peter2
            December 11, 2021

            Hi hef
            So here you are again hanging on my every word.
            Yes, I think you do place yourself on here as an expert.
            But you never provide responses when asked.
            Which I find odd.
            Preferring to sink to cheap abuse.

            I realise how you Google search then cut and paste your responses but it still always fails to actually respond to any questions I post.
            But do carry on if it keeps you busy.

        2. Nottingham Lad Himself
          December 11, 2021

          Hefner, I’m sure that you know the first part of the axiom, which ends “…drag you down to their level where they may win on experience”

          1. hefner
            December 11, 2021

            Indeed, I know it, but that’s part of the fun on this blog …

          2. Peter2
            December 11, 2021

            No I just read your endless ridiculous lefty posts NHL and I reply to show you how wrong you are.
            Like your recent nonsense about stopping outsourcing the NHS and locking down New Zealand style.

          3. Nottingham Lad Himself
            December 12, 2021

            Like, mostly not locking down, as NZ didn’t, you mean?

          4. Peter2
            December 12, 2021

            No that isn’t what I meant
            You want us to have a New Zealand style lockdown yet delight in tens of thousands of dingy people arriving without any ID nor secure isolation.

            Hilarious.

    2. SM
      December 10, 2021

      Medical innovation has reduced the length of stay required in hospitals – but of course it has also led to being able to treat more and more severe illnesses, which combined with the growth in population means we are virtually back at square one. And as a lay member of more than one medical committee some years ago, I can vouch for the fact that it was senior NHS consultants who were assuring us that fewer beds were needed.

    3. Micky Taking
      December 10, 2021

      ‘the number of patients treated has increased significantly.’
      Perhaps one way of looking at events.
      However, many patients and families and care homes will say ‘ but the patient was turfed out too early from rushed ‘day clinics’ etc.

  32. SM
    December 10, 2021

    Item 6: shortage of beds due to lack of social care – there should be halfway-houses, otherwise known as convalescent homes, utterly separate from the main hospitals but within their grounds where feasible, where patients could be given therapies as necessary and be assisted to learn how to deal with their health problems once home. They should NOT be within the hospital because the wards will be taken over by active cases when accommodation runs short – I have witnessed this.

    At the same time, rather than having social workers running around departments trying to find patients and relevant staff (I’ve witnessed this too), those in need of their attention would be under one roof, hopefully with hospital records easily available.

  33. Bill B.
    December 10, 2021

    NHS reform and re-prioritising ordinary healthcare cannot proceed as long as the Prime Minister continues on this ridiculous Covid Plan B course. After Partygate, the government’s moral authority to impose restrictions has gone. Charlie Sansom in Basildon gets it. Who’s next? There should be plenty more. We cannot tolerate a government taking away our freedoms, to try and distract from bad headlines every time it’s hit by a scandal.

  34. a-tracy
    December 10, 2021

    Can you open up the number of nursing training placements, even if this means training on the ward over 5 years with day release? We keep being told we are funding university training for thousands and thousands of degrees that never pay back, nursing degrees do. Reading Mick above about the excessive burden his wife is carrying just isn’t on and makes me angry no one should be working 12 hour days seven days per week, no-one!

    This short staffing is frankly very worrying and paying bank nursing rates on a regular daily basis isn’t an effective use of funding.

    Get into schools and do a big recruitment drive encouraging boys to train.

  35. turboterrier
    December 10, 2021

    O/T
    According to the news media, the sharks are beginning to circle to be in the right position upon the PM’s removal be it resignation or driven out by the party.
    I just hope that the main players whose names are being bandied about do something that doesn’t seem to be practiced lately in parliament. That is to stop and think. and make decisions that are the best for the country, not the individuals concerned.
    Parliament especially the government is losing respect and credibility at an alarming rate. When companies and football clubs change management after a period of disruption they invariably bring in an old hand very experienced to steady the ship cast out the deadwood and commence the rebuilding process. We have had enough of the Wizz kids and career politicians blindly leading to paths to who knows where, We need a conservative leader with a capital C, experienced, streetwise, someone who carries the respect for what he is, and achieved not only by his peers and the electorate but world leaders. Maybe people will balk at the thought of an elder politician taking the helm in these troubled times, but with age comes experience vast quantities of it, and such people are natural team players and will select the doers not the talkers to ensure the right course is maintained. I hope our host will consider throwing his hat into the ring as and when it is required which may be quicker than we think.
    We need a very safe pair of hands to steady the ship and set the right course.

    1. Fedupsoutherner
      December 10, 2021

      Great post Turbo.

    2. No Longer Anonymous
      December 11, 2021

      +1

      If he’s up to it.

      A job that is injurious to health and to peaceful mind, clearly.

  36. Mark J
    December 10, 2021

    Less than 20 years after the Royal Berkshire Hospital had a major rebuild, there is now talk once again of either rebuilding it – or as should have happened in 2002/03 – a new Hospital on a new site.

    I’m all in favour of a new Hospital in the Green Park area of Reading that would be more accessible to not only residents if Reading, but those in Wokingham, Bracknell and Newbury too.

    Once again redeveloping the existing RBH site will be a waste of time and money. The site is no longer suitable for modern day medical requirements. Many departments are in separate buildings along the Craven Road, parking is absolutely atrocious and the site is generally too small for modern day needs.

    A fresh start elsewhere is required.

    1. alan jutson
      December 10, 2021

      Mark J

      It was not exactly a rebuild 20 years ago, it was simply more development on the same rabbit warren site, whilst leaving much of the existing still in place on site.
      The front is a Grade one listed structure, as are some of the original Wards with their historic tiling.
      Many of the low level outbuildings were not replaced or upgraded either.
      It was only completed due to the closure of Battle Hospital, and the selling off of the land to TESCO that had made enlarging Royal Berks necessary in the first place
      At that time Reading, Wokingham and surrounding areas were still rapidly expanding with a growing population, but the number of beds at Royal Berks and Battle hospitals combined, remained exactly the same but now on the cramped original RBH site.
      I attended a presentation at the time given by the then Chief Executive of R H, and to my question about why the number of beds had not increased line with the local population, he said it was not necessary.
      When I asked about car parking, he said patients could arrive by bus !!
      Enough said really, lack of planning, lack thought for the future, lack of common-sense.
      I agree a new larger hospital on a new much larger site, with plenty of parking, whilst still able to be serviced by public transport would make sense.

      1. Micky Taking
        December 11, 2021

        Why am I not surprised?

    2. dixie
      December 10, 2021

      Betcha they use it as a smokescreen to redistribute specialties – they’ve been trying to move the cardio specialists away from Reading to Oxford and/or Southampton for years – a 45-60 minute ambulance trip if you are lucky after an MI instead of the 5-10 minutes now. That’ll save some beds.

  37. X-Tory
    December 10, 2021

    An excellent list of recommendations, Sir John, but we both know that NONE of these things will be done, as neither Javid nor any other minister (such as Kwarteng or Sunak or Boris himself) cares what any of their backbenchers think or say – not even you. In any case, they are not even in control – their c ivil servants are. In best ‘Yes, Minister’ style they have all been captured by their departments and are now just ventriloquists’ dummies, parroting the departmental line and defending erring officials instead of sacking them. The government is in office, but not in power – as we have discussed before.

    Take just two, completely unrelated, stories today. Firstly we learn that Geronimo the alpaca did NOT have TB after all – just as his owner had said all along, and therefore his destruction was completely wrong. Will any official be sacked? Of course not. And secondly it turns out that the Liverpool suicide bomber was wrongly given an NI number by the DWP, enabling him to settle here despite the fact that he had no right to do so. Again, will the culpable civil servant be named and sacked? Dream on. Civil servant box-tickers are in control, and they have no intention of making any effort to do things right; they just want to go through the motions, do the least possible work and make NO changes to procedures whatsoever.

    Ministers are just weak, stupid, cowardly and pathetic, but they get away with it because you backbenchers let them. No wonder the polls are now showing that the country is sick of this government of traitors.

    1. glen cullen
      December 10, 2021

      Your last sentence Spot On
      The mood in the country is turning against Boris

      1. glen cullen
        December 10, 2021

        Bet Boris is happy he didn’t repeal the Fixed-term Parliaments Act

      2. Micky Taking
        December 10, 2021

        ….with every week that goes by.

  38. Jiminyjim
    December 10, 2021

    Sir John, I fear that you know only too well that the problem with the NHS is that the Tory party is scared of being accused of privatising it, which they’ve identified as a certain election-losing policy.
    The Tory approach to the NHS for the last 20 years has been to leave it completely unreformed, and throw more and more money at it.
    The entire edifice is now a total disaster, and your party needs to be made aware of the fact that the LACK of reform of this incompetent and disastrous organisation will be a certain election-loser.
    We have people now being hospitalised directly as a result of their GP’s refusal to see them. If you get out and about, you hear multiple horror stories.
    The fallout from this will destroy your government and party far more effectively than any number of ill-judged Christmas parties.
    It is becoming impossible to find anyone who has a good word for the NHS. You need to wake up before it’s too late

  39. LJONES
    December 10, 2021

    Number 6: ”Provision of more social care back up….”
    Isn’t that going to prove more and more difficult as more and more carers are sacked for refusing to ”toe the vax line”?

    1. Micky Taking
      December 10, 2021

      Carers are hired to care for the residents, often at enormous costs to their estate or family, but rely on the carer not killing them by introducing Covid. End of.

      1. LJONES
        December 11, 2021

        And isn’t the ‘vaccine’ supposed to protect the person who is immunised? Or what’s a ‘vaccine’ for?

        1. Micky Taking
          December 11, 2021

          Covid vaccines are aimed at preventing serious health problems relating to that virus. Perhaps later versions developed will indeed protect us totally rather than just significantly. People in care homes typically have all manner of problems, often age related where naturally they have become vulnerable. Passing this virus on to them with perhaps a large viral load has proven to be a step too far… but then you doubt it ….good luck with it when and if you should succumb – but asking for protection at that stage will be too late.

  40. Paul Cuthbertson
    December 10, 2021

    NOTHING will happen. Empty talk as always. Unfortunately our system of government does not allow, ACTION.

  41. forthurst
    December 10, 2021

    There should be no senior roles in the NHS for those who are not medically qualified. There are too many unqualified people in this country in charge of large budgets which they do not have the skills to spend wisely. There is a concept that because people have not obtained a useful skill through education and training that they should be put in charge of those that have. This is at the root of the maladministration
    of our country as politicians and civil servants work to misplaced priorities and misplaced beliefs.

  42. Norman
    December 10, 2021

    X-T: Your remarks re Geronimo, whilst understandable, are quite incorrect. He will have been culled as reacting positively to the TB test, and been NVL (no visible lesions) post mortem. This does not mean he was negative, or uninfected – just that confirmation was not possible in this case. The control programme is based on reaction to the test, not presence of disease.
    The really sad thing is that Tb has been allowed to become endemic in a particularly susceptible wildlife species – the badger. Tb was almost eradicated from them in the 1970s-1980s, but popular sentiment (again, understandably) caused successive governments to row back on targeted badger culling, so that now most of the country is plagued by overspill into our cattle herds.
    I have witnessed first-hand the suffering and angst this has caused our dedicated cattle farmers over many years, and with this latest climate-associated nonsense over ruminants and methane, they are becoming a persecuted minority. Hence I am speaking up on their behalf.
    Sadly, we have seen in recent days the utter stupidity, childishness and hypocrisy of the media, to the extent that the country is devouring itself into oblivion.

  43. Iain Gill
    December 10, 2021

    Re ” Further improvements in infection control. ” this needs more patients getting individual rooms, as is routine in the rest of the developed world and private hospitals.

    The NHS building new hospitals with large communal wards is completely unacceptable.

    And the rooms need air con that controls the air pressure per room, to allow precise control of air flow and reduce cross contamination.

    All of this, like much else, would happen naturally if more power was handed over to individual patients and away from top down rationing and control. Make the providers of care have to face competitive pressure from the patients, its the only dynamic which can force improvements and constant optimisation.

  44. Freeborn John
    December 11, 2021

    Why is the U.K. surrendering to the EU on the role of the ECJ in Northern Ireland. I am sick and tired of the weakness of Boris Johnson and David Frost when dealing with the EU. They need to say No and mean it.

    1. Nottingham Lad Himself
      December 11, 2021

      Fact-Free Born John,

      The UK is not” surrendering”.

      It is being dragged, kicking and screaming – by global opinion – simply to do what it contracted to do in a solemn, binding, international Treaty, ratified by our supreme Parliament, and not to wreck what it had also agreed to do in earlier ones.

      1. Peter2
        December 11, 2021

        It’s about the interpretation of that agreement.
        Like EU demand that supermarket lorries coming from Britain and destined for their own supermarkets in Northern Ireland are stopped and searched and checked.
        Got any examples of goods going from mainland UK into NI which have then been smuggled into the South?

  45. Lindsay McDougall
    December 11, 2021

    There’s a couple of things that you need to address:

    Should not isolating COVID-19 patients in Nightingale hospitals be on the Agenda? That would make it easier to manage the process of catching up on the treatment of other diseases. We should increase the number of nurses ASAP and allocate some experienced nurses plus auxiliary nurses to the Nightingale hospitals.

    The policy of centres of excellence is to some extent a cynical cost saving device. It’s fine for the middle classes and the rich who can drive to these usually out of town locations but the poor want treatment to be at smaller hospitals located close to railway stations and bus termini. It’s no use having treament that is free at the point of consumption if it costs a fortune to access it.

    I suppose that I’m flogging a dead horse in advocating modest charges for NHS treatments – say £20 per GP visit, £30 per non-emergency use of A&E and £150 pa for any use of the hospital system. It would provide a modest amount of extra revenue and get people to look after themselves better. Provision for the poor would be needed but it should be possible for GP surgeries and hospitals to set up charities with ring fenced donations for this purpose.

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