Managing the NHS

The NHS has thousands of managers. They tell me they do not know how many highly paid Chief Executives they employ, presumable because it is so many. Every quango from NHS England down, every hospital Trust has a CEO.

Suddenly we are allowed to see a couple of the top executives on tv. They are always given respectful interviews. They are never asked why they cannot get their staff on board, why they cannot get the waiting lists down , why we are always short of hospital beds. They are never asked what they did with last £10 or £20 bn of extra money.

Here are some questions that should be put to the managers

1 Ministers want waiting lists down. How could you do that?

2 The public want the nurses and doctors to be well remunerated and motivated. Can you use pay scales, increments and promotions to raise morale?

3 Why have you kept the service short of beds? Why hasn’t extra cash expanded medical capacity more?

4 Why do you expand the administrative and executive hierarchy so much? How much has the latest management reorganisation cost?

5  Why do you depend so much on agency staff? Isn’t this an expensive way of employing people who then cost much more than directly employed staff.

156 Comments

  1. David Peddy
    December 18, 2022

    You should be asking why Trust Boards need:

    1: A CEO and a COO ? What are they both doing ?
    2: Why do they need Deputies for both?
    3: Why do they need Directors of Strategy ? That is the CEO’s job
    4: Directors of Transformation & Change?
    4: Directors of Corporate Affairs
    5: Directors of Communication
    6 : ….and more jobsworth

    1. Lifelogic
      December 18, 2022

      +1 why do they choose people with no medical qualifications or medical experience?

      1. rose
        December 18, 2022

        One unqualified person gets in and then makes sure the people under her are inferior to her – a well known syndrome in all walks of employment.

        1. Mark B
          December 18, 2022

          And here is another:

          I once worked with someone who use to work in the Public Sector. His little trick was to ask for a meeting in which he contrived to get everyone to agree on an outcome. An outcome I might ass that he prefered. And when it went wrong, as it usually di, he could claim that we all agreed and we were ALL to blame and not him for coming up with these silly ideas.

          That is why they need so many people as it is harder to pin the blame and even harder to sack the culprit(s).

          1. Lifelogic
            December 18, 2022

            I knew someone taken on by the Civil Service and on her first day she was told all about how many holiday she was allowed each year and then how many sick days they could take each year (before any would be questioned) to augment their holidays as if these were an additional perk of the job. I assume this was HR pushing this message.

          2. Hope
            December 18, 2022

            I seem to recall JR previously told us Johnson gave the NHS billions, about £34 billion, then asked what they were going to do it!!

            NHS previously lost £34 billion on a failed computer system under Hunt. Who was censored or sacked? No one.

            We read in national papers NHS wanted to make their own app at outset of covid for test and trace. They wasted £11 million. The qualification the person and his appointment for leading this was based on that the fact he was Osbornes mate!

        2. Hope
          December 18, 2022

          Asylum seeker wins case in High Court on Friday that HS has not increased their weekly pocket money payments by inflation!!!

          O’ Mahoney reported in papers France opposite number stopped speaking to him for three months. Your party and govt then gives them tens of millions more!!

          JR, come on.

      2. Ian Wragg
        December 18, 2022

        Like all state run services, they are run for the benefit of the employees. Without patients the NHS would still be under resourced and struggling.
        Without a plethora od inclusion and diversity staff it couldn’t possibly operate.
        Even liebour acknowledge the NHS is broken but it’s too near your end of term to do anything.
        Same with the channel gimmigrants.
        Most MPs can’t wait to flee the sinking ship after almost 13 years wasted.

        1. graham1946
          December 18, 2022

          Well, apparently not for the benefit of the nurses. How do you account for the shortage of 85,000 and the loss of thousands each year after years of training and work if it is such a shangri-la? Such statements without a scintilla of fact does you no credit, just a built in bias. It is run badly, but that is the fault of the Tories who re-organised it in 2012. The other day the stupid BBC even had the arch culprit of this, Lord Andrew Lansley on asking how to fix it! Not once did they ask why he had made such a monumental cock-up in the first place. You couldn’t make it up

        2. Hope
          December 18, 2022

          As Ben Habib makes clear in his article:

          “The Trade and Cooperation Agreement binds us into so many commitments in terms of state aid law, competition law, employment law and even Net Zero. The UK is still joined at the hip by the EU, so clearly we still don’t have Brexit.”

          This effects the management of all public sector services. Until the UK leaves the EU properly the muppets in Govt. Just like the disgraceful building of warships in Spain, fitted out in N.Ireland. All under EU laws, regs and rules. All for the benefit of the EU and certainly Not in the national interest to forge our own way in the world!!

          The Tories betrayed the nation and voting public.

          1. Hope
            December 18, 2022

            ….Govt. Just follow EU guidance and lead nothing.

          2. Shirley M
            December 18, 2022

            Very well said, Hope. They care more for the EU (and any other country) than the UK and its people, whom they are supposed to serve. They PROVE it every single day!

          3. Lifelogic
            December 18, 2022

            +1

        3. Peter
          December 18, 2022

          Ian Wragg,.
          “Like all state run services, they are run for the benefit of …….”

          “For the benefit of a few favoured cronies.”

          Fixed it for you

          Nurses and ambulance drivers are not particularly well looked after.

      3. Hope
        December 18, 2022

        1. Your party and govt chose to put Sir Simon Stevens a Blaire advisor in charge of NHS until recently. What did you expect?
        1a. Stop mass immigration. Service delivery cannot match mass immigration- last year 1.2 million visas issued!! Who in cabinet thought services could cope!!
        2. Your party and govt has now chose to hire Patricia Hewitt a former Blaire minister to NHS. What do you expect?
        2. Sack all of SAGE, they all failed the nation to prepare, plan and implement a cogent pandemic plan- including Hint who failed for six years in NHS to make any proper changes. His record shows he is useless. Choose a balanced SAGE team instead of left wing control freaks. Investigate (named people ed).
        4. Put a conservative in charge of NHS and have whole scale radical change in leadership and management.
        5. Radically reduce all tiers of management, non jobs, bean counters, equality, diversity shit shat transferring all savings to front line delivery. No more translators or translation for multiple languages. No more world health tourism.
        6. Have one source of procurement to radically cut purchasing costs.
        7. No need to covid vaccinate to anyone under 50 unless serious medical condition renders risk better than expected harm.
        8. Javid sacked 40,000 care home staff for not being jabbed, who would have thought that might cause a back log at hospitals!! Idiot.

        The blame rests squarely with socialist Tory party.

        1. Lifelogic
          December 18, 2022

          Exactly & gross incompetence by Whitty and the other “experts” too.

    2. Mark B
      December 18, 2022

      A former MP and Home Secretary is on one of these Trust Boards. Ex-MP’s need somewhere to go when their political careers end in failure.

      1. graham1946
        December 18, 2022

        Politics and politicians should be no part of it. They generally know nothing and just have pet theories they want to try out before getting ‘elevated’ to the Lords. Lansley is the prime example. Not good enough to run the NHS, h re-organises it then gets booted across the corridor.

    3. Garincha
      December 18, 2022

      12 years. Twelve years. The only people who should be asked questions about the state of the NHS are the Conservative politicians who have been running this country for TWELVE years

      1. Peter2
        December 18, 2022

        Was it perfect under three terms of Labour under Blair n Brown?

    4. Peter
      December 18, 2022

      NHS grand panjandrum, like Council chiefs, have complete job security.

      When they fail they are given a huge pay off but promptly begin work in a similar role at another authority.

      Jobs are awarded through patronage. It’s another example of cronyism.

    5. Berkshire Alan
      December 18, 2022

      Further to my comment (still awaiting moderation) about the Management and administration being absolutely useless.
      Family member was due for an operation (day Patient) tomorrow, All booked in and confirmed in writing, attendance required for 7.00am tomorrow morning with Pre med’s done a couple of weeks ago.
      Daughter rings up yesterday just to confirm, and to make sure which is sensible in this day and age, took her 5 calls to find the right contact, as phone number on her letter was incorrect.
      No it turns out they are not on the list for surgery on Monday, but they will let them know in due course new arrangements !
      Everything our family member had arranged for Monday, including a driver to take her in (they would not be able to drive after operation) has now had to be cancelled, but the worst part, she was not even informed of any cancellation, so would have got up at 4.00am to get to the hospital, and wasted a day of their and their drivers time.
      What an absolutely shocking state of affairs, and this is multiplied by hundreds, if not thousands of patients a day.

      1. Mickey Taking
        December 18, 2022

        as Tom Jones sang ‘Its not unusual’.

        1. Berkshire Alan
          December 19, 2022

          MT
          You are certainly right, cancellations not unusual, but not getting any notification when they have landline, mobile, e mail, text contact details is a first for our family, I guess being generous they must have sent a letter if anything at all, at Christmas, and when postal workers on strike, so if notification was made that way, no surprise it has not been received.
          This just shows the added hidden cost to the patient of NHS Failure given they are self employed and had cancelled all work for a number of days (hand operation, no driving would have been possible)

  2. David Peddy
    December 18, 2022

    And we can add why does every Trust Board need a:
    1: CEO and a COO ? What do they do ?
    2: Deputies for both?
    3: Directors of Strategy ? That’s the CEO’s job
    4: Directors of Transformation & Change?
    5 :Directors of Communication?
    6: Directors of Corporate Affairs ?
    &: Director of Service & Improvement?
    8: Director of Integrated Governance ?
    9: Director of Integrated Care, Partnership & Resilience?
    These are Jobsworth ‘roles’ at considerable expense – high salary , NIC, Expenses and Pension- to the tax paye serving no useful role and under the tutelage of career Public Sector apparatchiks who have never run anything that is supposed to deliver a service

    1. Lifelogic
      December 18, 2022

      Plus all the net zero religion employees. “Chief Sustainability Officer of the NHS, responsible for its commitment to deliver a world-class net zero emission health service”. Plus all his over paid pointless minions.

    2. Mickey Taking
      December 18, 2022

      They have lots of friends on the jobs for the boys circuit!

      1. Peter
        December 18, 2022

        MT,

        Very true.

        For news I now go to Jonathan Pie. He seems fairly reliable on ‘strikes’.

    3. Gary Megson
      December 18, 2022

      I don’t know why each Board needs these, but I do know which political party has been running this country since 2010. Don’t let John Redwood distract you into thinking the problem here is the NHS’s managers. The problem here is the Conservative Party

  3. Lifelogic
    December 18, 2022

    Indeed. They also like to claim they cannot cope because they have lots of bed blockers that cannot be discharged due to lack of social care. So why on earth do they not provide a ward that provided just social care as a holding area for these patient to free the beds. They buildt the Nightingales after all. It could surely be cheaper to provide social care in one ward than proving it at many location in the community anyway. Then they say they ambulances cannot cope and have huge discharge waits. Sort that waste of resources out too with a proper and working discharge system the problem is appalling management the money need to follow the patient. Free at the point of use means the patients can only be deterred by with delays poor treatment and gross incompetence. So that is what they so often get.

    The current & last to CEO of the NHS have been dire one read modern history the other PPE both spent all or nearly all their careers at the NHS. As have all the recent health ministers. Hunt was good at saying sorry for their serial incompetence and gross negligence but not at anything else like sorting the negligence out.

    1. Cuibono
      December 18, 2022

      +many
      Marxism and its unpleasant offspring, the NHS, turned life into an illness.
      They provided things they had no business providing..made people dependent and now they abandon us, giving it all to others.

      1. Lifelogic
        December 18, 2022

        +1

      2. Hope
        December 18, 2022

        LL,

        The govt. could have used Nightingale hospitals as an interim measure for those awaiting care homes staffed by welfare claimants. The elderly people would only need basic care that some of us provide to our parents and grandparents!! If lodged there the unnecessary u lawful deaths caused by govt transferring them to care homes could have been avoided, really not hard to plan. The govt. had hundreds of thousands of volunteers do not forget!! The govt chose not to use volunteers they asked for!!

    2. Nottingham Lad Himself
      December 18, 2022

      The appalling quasi-US corporate approach which has been taken in the NHS is exactly the product of the so-called Think Tanks influence on Sir John’s party and on their disciples the ERG within it in particular.

      This, coupled with the paramount requirement that no sinecure created for Tory ex-public schoolboys must ever carry the remotest risk of culpability for any perceived offence or failure explains the present apparent paralysis.

      No one, but no one wants to be personally responsible for anything – very much like Tory government.

      1. Peter
        December 18, 2022

        NLH,
        “This, coupled with the paramount requirement that no sinecure created for Tory ex-public schoolboys must ever carry the remotest risk of culpability for any perceived offence or failure explains the present apparent paralysis.”

        Labour cronyism is as big an issue as Tory cronyism in the NHS and other public institutions. However, there is absolutely no culpability for either set of cronies.

        1. Nottingham Lad Himself
          December 18, 2022

          Er, by all metrics the NHS did rather well under Labour.

          After 12 years of the Tories it’s on its knees on the other hand.

    3. Mickey Taking
      December 18, 2022

      ‘the holding ward’ as you describe it is exactly what my better half has gone on about for years. The people moved into it could then be the focus of efforts to move out to other accommodation. Currently hospitals have a very highly paid senior manager doing it.

      1. Mickey Taking
        December 18, 2022

        oh and by the way from actual experience – most people ready to be discharged sit around for up to a day waiting on ‘the doctor has to agree to you being discharged’.

    4. SM
      December 18, 2022

      What you are talking about, LL, is convalescent wards within hospitals, and convalescent homes elsewhere.

      As bed numbers began to be reduced (with the full approval of the Medical Colleges), the convalescent wards were taken over by patients needing attention – I saw it happen.

      Convalescent homes, on the other hand, just vanished into the ether years ago, and not ONE individual in either medicine or politics has ever answered my questions as to why – whether in print or in person.

    5. graham1946
      December 18, 2022

      What you are describing is ‘covalescence care’ which is what we used to have years ago. Who would run this now – underpaid care workers – where are they? Even care homes can’t get them back after the disastrous ‘get vaccinated or get out’ order, again from the Tories. Osborne closed thousands of bed in his useless austerity drive which ruined services and doubled the national debt and is going to cost much more than he ‘saved’ putting it all rights, if they ever do.

      1. Lifelogic
        December 18, 2022

        Javid’s incompetence.

  4. Lifelogic
    December 18, 2022

    “Governments have learnt that fear works – and that is truly terrifying
    We have returned to the world of Galileo vs the Vatican. Scientific dissidents are again silenced and ostracised for their opinions”
    Janet Daley in the Sunday Telegraph today.

    Correct on this occasion Janet, so please can we fire the (vat on private school fees) socialist dope Michael Gove (English Oxon) and Brien O’Neal (PPE) for these appalling actions, do these dopes even have any science beyond GSSE/O level? Yet they rubbished the sensible and polite Barrington Declaration scientists like the delightful Sunetra Gupta and others who got it almost exactly right.

    Government are still pushing these ineffective, unnecessary and dangerous/ net harm vaccines even to children. Still not explaining or investigating properly the 200+ excess daily death either.

    1. Sir Joe Soap
      December 18, 2022

      The point is that PPE teaches them to be very good at expressing BS about things they know very little about or understand. The qualification also entitles them to a life away from real people.

      1. Mickey Taking
        December 18, 2022

        sounds like a degree for young wannabe politicians.

      2. Lifelogic
        December 18, 2022

        Indeed just like car salesmen and women. Professional liars and bullsh*****s in the main.

      3. Hope
        December 18, 2022

        LL,
        Musk still unravelling those scientists who were shadow banned and smeared. The US and UK govt’s wanted to shut them down and smear them!!

        Include Gove and Handcock to be investigated without hiding from ministerial protection.

        1. Lifelogic
          December 18, 2022

          and Neil O’Brian

    2. Diane
      December 18, 2022

      LL: Interesting article on The Daily Sceptic today 18/12 “So What Came of the Parliamentary Vaccine Debate ? ”
      Extract – A number of MPs thanked us for successfully getting the petition debated, as it was the first time Parliament debated the important issue of COVID-19 vaccine safety. Although the Government has said that it will not set up what was asked for, a public inquiry into COVID-19 vaccine safety, this could be another issue where the Government is forced to do a U-turn.

      1. Lifelogic
        December 18, 2022

        +1

  5. Cheshire Girl
    December 18, 2022

    Just an idea.
    Get rid of all the Diversity’ rubbish, and save a ton of money for patient care. Do it for all Public Sector jobs.

    1. BOF
      December 18, 2022

      CG. And good riddence it will be. In fact, illiminate all woke jobs and rules from the public sector.

    2. Lifelogic
      December 18, 2022

      Plus the NHS’s Directors of Lived Experience – what other experience is there?

      So Dominic Rabb (ex Minister of State at the Ministry of Justice) want to force killers to face victims’ families at sentencing. Well perhaps, but even better might be if all the people in the police, courts and criminal justice system and even (ex minister of State at the Ministry of Justice) that should ensure that so many serial and violent offenders are not left on the street to commit crime after crime after crime should attend and explain.

      Often crimes committed just a few days after they are released form prison. The criminals so often are clearly mentally ill and just need to be stopped for the good of the public and the criminals.

      So the police are not, it seems, seriously investigating the King Charles’s honours for cash case. What a surprise that is?

      I see the Sunday Times has whole ten page section of propaganda on Climate Action I would what that cost and who paid. Clearly the alarmist must be getting worried as the public realise the extent of the con trick and the vast cost. Let us hope not too many freeze to death this winter due to May’s moronic net zero insanity.

      1. Bill B.
        December 18, 2022

        LL, I wonder why you apparently paid for the Sunday Times.

        1. Lifelogic
          December 18, 2022

          My wife subscribes so I have access on line and Rod Liddle amuses me on Sundays.

      2. Mickey Taking
        December 18, 2022

        ‘NHS’ Directors of Lived Experience’ well they don’t want to talk about ‘Death experience’ in hospitals !

      3. a-tracy
        December 18, 2022

        The ‘Director of Lived Experiences first job should be to live the experience of working at the front end of the NHS. Three months on ward rotation, shift rotation, weekend rotas. They should all do the jobs of the lowest ranks to see how they are treated by the higher grades and patients. They must all live it to want to improve it. Like those programs of bosses that go incognito to work on their own bottom rungs.

      4. Chris S
        December 18, 2022

        The Climate Action section of our Sunday Times went straight on our wood-burning stove !

    3. Ian B
      December 18, 2022

      @Cheshire Girl + 1 ‘Diversity’ is not about the best person for the job but is posative discrimination. people need to start being honest about their motives
      .

      1. Shirley M
        December 18, 2022

        + many, Cheshire girl, and we all know ‘positive discrimination’ is a PC way of saying discrimination against whites. Minorities have every protection under the sun including quotas and anything else you can think of (except maybe meritocracy). Where is the protection and the quotas for the white majority?

  6. Anselm
    December 18, 2022

    Up to now, the NHS has been like the Monarchy, the Church of England, or the BBC – the third rail. If you touch it, you are dead.
    At long last people are beginning to see it for what it really is – an abomination.
    I can forgive it for letting me down during covid and for my wife’s operation that went wrong.
    But I think that instead of hiring diversity managers, a compulsory course in Parkinson’s Law might be a better alternative. (OK so you have to be old to get that.)

    1. Cuibono
      December 18, 2022

      +many

      1. Hope
        December 18, 2022

        To do this govt needs to scrap equality legislation babble introduced by Harman that includes race for equality schemes in every public sector.

  7. Sea_Warrior
    December 18, 2022

    O/T but I see that the British company Harbour Energy – the biggest operator in the North Sea – has declined to bid in the latest licensing round, because of Hunt’s ‘windfall tax’. What does this mean for our energy security, for the tax-take and for our balance of payments? That increasing corporate taxation would lead to a reduction in business investment is wholly predictable.

    1. Cuibono
      December 18, 2022

      Like travel energy is probably NOT meant to happen.
      God alone know what that will do to us all.
      For EVs read heat pumps.
      The powers that be are already working on destroying food supplies and then it will be water.
      Meanwhile à la Cloward-Piven they are flooding the country with dependents.
      Yet in all things they abandon their voters.
      They have caused all this but they have no interest in saving us!

      1. agricola
        December 18, 2022

        They will be replaced in 2024, and if the electorate is sufficiently perceptive it will not be with any of the other all time losers in the current HOC.

        1. IanT
          December 18, 2022

          “and if the electorate is sufficiently perceptive” – That’s a big ask…

    2. Mark B
      December 18, 2022

      I heard elsewhere that all the easy pickings have been hovered up by the large Multinationals and that what is left can only be extracted by small more nimble competitors who may now find it no longer profitable.

      Maybe that was the REAL plan 😉

      1. Cuibono
        December 18, 2022

        +many
        Yup!
        Nutshell.
        Nail on head.
        Corporatism ( Fascism, Communism)
        Gathering in all resources I imagine.
        For us it will be very much like the “Tommy Shop” model of 19th C.
        Digital currency too.

    3. agricola
      December 18, 2022

      Hunt is a socialist globalist whose interests are not that of the UK. 18 months and he is gone.

    4. Timaction
      December 18, 2022

      Indeed. Only our dire non elected dictatorship could think it’s a good idea to raise corporate taxes, windfall taxes, personal taxes at a time of recession and expect investment and innovation expecting the state to confiscate those earnings. The lunatics have taken charge of the asylum. Bit like free hotels, food, health, education, pocket money for illegal immigrants with no chance of deportation. I wonder what the pull factors are? Except every English taxpayer in the land who won’t be voting for the Tory Consocialists at the next election. Actions not words this day.

  8. Mick
    December 18, 2022

    Far to many chiefs and not enough(workers Ed)

    1. Narrow Shoulders
      December 18, 2022

      Are we no longer permitted to use that saying Sir John?

      Should we use native Americans or did Mick use another word?

      I do hope you gave not fallen under the influence of a diversity director SirJohn.

      1. agricola
        December 18, 2022

        He is firmly under the influence of tbe PC brigade. Two submissions pointing this out, including George Orwells 1984 Ministry of Information activities scored a removal from your seceptible views. Shame on you SJR.6

    2. agricola
      December 18, 2022

      I would add to the danger of your editing by citing George Orwell 1984. The hero’s work within the totaliterian government was the removal of words they considered unhelpful to their narrative. This is exactly what wokery and political correctness do so I find it surprising that an avowed Conservative should indulge in the practice.

    3. Mickey Taking
      December 18, 2022

      fast becoming an inverted pyramid.

  9. Shirley M
    December 18, 2022

    The NHS is like the current government. They are building their own little empire, and have totally forgotten their reason for existence, ie. to serve the people of the UK.

  10. turboterrier
    December 18, 2022

    The corporate culture within the NHS is rotten to the core in that it has been allowed to expand and create its own offshoots which in turn multiply with no fear of accountability and a arrogance never to admit the whole organisation financially is a bottomless pit.
    It needs a seismic corporate change programme which will empower those on the front line and in the trenches to manage their work stations.
    National should be removed from it title and the trusts should be broken down to smaller operational units. They are too big and in truth totally unmanageable because of all the back room managers and their little empires. Politicians have got to callout all these ares of waste and start being accountable for their decisions just as much as those they purport to control.

    1. a-tracy
      December 18, 2022

      I agree about the National turbo. It is out of control. The job vacancies, how many are there per region, which grades, what qualifications are needed to take those positions and how many are in training right now to fill them. The NHS has been left to sort this out for decades, they have failed, they decided how to train nurses, they decided how to organise work rotas, all have failed, the whole network has been brought down by degree only nursing.

  11. R.Grange
    December 18, 2022

    Yesterday’s topic, I realise, but relevant to knowing more about who runs important national institutions. And also, to knowing what exactly they are responsible for. Among the BoE’s many executive directors is Sasha Mills, Executive Director of Financial Market Infrastructure. Her page on the BoE web site says she ‘advances our work to protect the UK economy by keeping the backbone of the financial system secure and reliable’. Surely a vital and full-time responsibility, I as a lay person would have thought? But in fact it’s not full-time. Her web page also says ‘Sasha takes a leading role in equity, diversity and inclusion issues’. So on the finance side she advances the work, and on equity diversity and inclusion she plays a leading role. Do we see where the priorities lie?

  12. Cuibono
    December 18, 2022

    Milk on the NHS as advertised on milk bottle labels?
    Heating on the NHS as reported by the press?
    What you don’t get after paying in £ squillions…(yes! WE paid!) is a Dr’s appt. Or a home visit come to that.

  13. Barrie Emmett
    December 18, 2022

    Until I retired I was chair of a Patient Group at a local surgery, with five doctors and 8.5K patients.
    As such I attended various meetings within the NHS. Nothing was ever decided, serious issues adjourned until the next meeting. Most attendees were more concerned with the expenses claimable.
    Indecision, petty squabbles, I could go on. Nothing progressed over my seven years. Total narcissism amongst the attending hierarchy.

    1. Sir Joe Soap
      December 18, 2022

      Soviets.

      1. IanT
        December 18, 2022

        A very shrewd observation I think – yes, we are at Soviet levels of (in)competance. A vast machine that is collapsing under it’s own weight….

        1. glen cullen
          December 18, 2022

          Too big to fail and too big to work, especially with 4 competing organisations ie ambulance, nurses, doctors and administrators …its all need to be uniformed, one pay stream, one management struct and one union ..a bit like the army

          1. IanT
            December 18, 2022

            A senior Army officer on TV this morning (referring to the Army assisting the NHS):
            “We can bring Command and Control” (…to the situation). I think he was referring to what in civilian life we used to call “Management”.

    2. Cuibono
      December 18, 2022

      +many
      First hand experience!

      1. SM
        December 18, 2022

        I was on just such a committee some years ago, and was quite astonished at the disdain GPs show when questioned. GPs in general refuse to believe that the general public (ie their patients) have the right to criticise the service they are supposed and contracted to deliver.

        1. Cuibono
          December 18, 2022

          +1
          I can well believe it!

    3. Mark B
      December 18, 2022

      +1

    4. AncientMariner
      December 18, 2022

      Typical of ‘committee management’, it never works, at least for the good of the public. In recent years witness the Cameron/Clegg fiasco?

    5. Mickey Taking
      December 18, 2022

      why are we not surprised?. Like most meetings and true of the Civil Serpents, everybody avoids an action point on individuals and at the next meeting request on progress kept low key.
      I have to ask – how did you manage to stick it out for 7 years?

  14. Cuibono
    December 18, 2022

    The sheer, utter cruelty of the NHS shutting its doors ( maybe not to all?) during the Plague, having terrified the ( gullible) public with lies, was astounding.
    Why did the govt. do that? To pretend the staff was busy with “victims”?
    Scarcely logical. Would they abandon the country in a nuclear attack?
    However, we now know what Johnson was saying about not many dying.
    These entities are incomprehensible. What is their problem?
    Overweening/overarching ambition?

  15. AncientMariner
    December 18, 2022

    Exactly, in a nutshell well done that man.
    Why has the health minister not done this already, why have the last few health ministers asked these questions. I think Mr Hunt should explain why he did not ask in his long six years in the job?

    1. graham1946
      December 18, 2022

      Because they dare not own up to the Lansley re-organisation of 2012 which caused most of the problems and cost we have today, so they simply lob more and more money at it with no idea of how it is spent. It needs a different government to tackle it – the Tories never will, they never wanted the NHS in the first place, they voted against it many times.

      1. SM
        December 18, 2022

        I participated in many local formal discussions about NHS re-organisation, under both Labour and Conservative governments, from the mid-90s. Everyone has different ideas about what is needed, some need to be trialled first where possible, but I came across no-one who wanted the NHS abolished.

        The Lansley reforms made things unnecessarily complicated, undoubtedly, but the problem lies not in the concept of an NHS, but in its structure and financial foundations. Nye Bevan overrode questions from Labour Ministerial colleagues about potential economic problems, and no-one appears to have foreseen a time when medical science would mean a huge increase in the number of patients staying alive and needing long and expensive treatment into old age.

        Forget the fantasies about an NHS which ‘used to be’ amazing – its foundations have been cracking since it was first built.

        1. graham1946
          December 19, 2022

          Never said they want to abolish it, but they definitely did not want it. Going back to Nye Bevan, the Tories voted against forming it 22 times. The Lansley debacle did more than complicate it – it involved duplicating everything 219 times, a huge amount of wasted money in the attempt to introduce an ‘internal market’, a wet dream of Tories for donkey’s years. Now they see it doesn’t work, but cannot admit it. There is nothing wrong with the concept of free at point of use, paid for by taxes, it is the implementation and as I said the other day 38 re-organisations in its lifetime by interfering politicians. – no organisation can cope with that. What do you suggest about people living longer – putting them down at say 70 or simply become more efficient, cut the paperwork and put in the right amount of money per capita (not just numbers of billions or percentage of GDP a rubbish notion anyway)spouted by politicians trying to mislead)?

  16. Sea_Warrior
    December 18, 2022

    (5) is a particularly good question. Agency workers seem to be adept at looting the NHS’s resources. I wonder if the rates are capped by central government. If not, perhaps they should be – at no more than 125% of what a salaried worker would be getting.

    1. turboterrier
      December 18, 2022

      Sea Warrior
      Now with all the panic about heating within hospital areas my colleague has been installing small high tech heaters into dedicated areas. The control of the units are by wifi. He has an app on his phone and explained that he can control the units from home and the staff would have to contact him to come and rectify the problem. For the unscrupulous it could become a nice little earner.
      I wonder what manager thought that one up.

    2. formula57
      December 18, 2022

      @ Sea_Warrior “…125% of what a salaried worker would be getting” – not unreasonable given agency staff rewards do not include pension and perhaps other employee entitlements. Yet from my direct knowledge of I.T. agency staff, the agency itself may be taking a fee equal to the pay of each staffer it provides, thereby doubling the cost to the customer business. Outrageous though that seems, the agency may be warranting the quality of work done by the staffers it provides and so is at risk for similar sums although that fact alone is not likely enough justification.

  17. Sir Joe Soap
    December 18, 2022

    Remember it’s closer to being a religion than a business. Surrounded by words like revered, “our”, “our wonderful”…. You don’t question the basis of a religion without offence being taken. One of the bases is that it needs ever more resources, ever more people, ever more pay.

    So a complete change of mindset is needed by YOUR leader the Snake as well as Labour and Libdems. It’s a failing Soviet-style bureaucracy which needs to either by sold off or closed down and start again.

    Unfortunately no questioning of the High Priests is going to get you anywhere, particularly when Snake and Kneeler worship at its altar.

    1. graham1946
      December 18, 2022

      It is not, nor ever should be a business. It is purely a public service for the public good, funded by the public. It is badly organised, badly run, very costly with duplication in all the 219 Health Trusts, all with CEOs, boards of directors, purchasing, accounts etc. That is even without the Private Finance Initiatives, which is surely the most expensive way of providing hospitals ever invented just to try to save money in the short term, hobbling the NHS in the long term. If the government bought these out, the NHS would have plenty of money for top level everything but of course that would upset chums in the City.

      1. formula57
        December 18, 2022

        Those would include the many Private Finance Initiatives proposed by Gordon “prudent for a purpose” Brown, professing of “Presbyterian values” but destroyer of so much that was good and wholesome? The British people have paid and continue to pay a too high price for his decision to enter public life.

        1. graham1946
          December 19, 2022

          Don’t care whose idea it was, it was wrong and remains so and needs changing, but they won’t dare upset the big money people.

    2. Pauline Baxter
      December 18, 2022

      Sir Joe. If I understand your code correctly then I agree with you. The NHS is a sacred cow. So neither main political party will dare to alter the way it is run.
      As is often the case, Sir JR is flogging a dead horse, by asking his party to run the country better.

      1. graham1946
        December 19, 2022

        They did – in 2012, alter ‘the way its run’ big time and made the huge mess that we have today, so your premise is not correct.

  18. Mark B
    December 18, 2022

    Good morning.

    They are in charge of an organisation that cannot be seen to fail, and therefore, cannot suffer the consequences of such a failure.

    Imagine a shareholders meeting where said shareholders, after gifting another £10bn or £20bn to the CEO and the Board, were told that the business would perform as badly if not worse than before. How lond do you think said CEO and Board would stay in place ?

    Again I find myself writing. Until you make public services and their managers more accountable you will never achieve anything.

    What part of RISK and REWARD do people not understand ?

    1. margaret
      December 18, 2022

      I went on twitter yesterday and the abuse towards yourself was unforgiveable. You suggested using more beds to ease the situation, but rather than explore where we could put those beds, the reaction was thoughtless and displayed frankly a lack of intelligence. They may have degrees and think of themselves as terribly important, however it simply demonstrates a need to senselessly compete and not resolve a situation.

      1. margaret
        December 18, 2022

        What do we mean by free speech. Is it to put an idea or argument together in a sensible and socially acceptable way or is it to allow others to verbally abuse one another and clan up to, in effect ,bully ?
        We all have different ways of self expression , in metaphor , simile, analogy , medicalese, nuspeak, traditional well constructed sentences etc, but surely there are boundaries to how we can speak to one another whether in the media or face to face. Nastiness escalates.

    2. formula57
      December 18, 2022

      @ Mark B “What part of RISK and REWARD do people not understand ?” – for one the part where risk is capable of being measured, and more particularly where one can evaluate outcomes recognizing what risks have been run and whether or not they have crystallized. In the NHS is is hard enough to get a measure of outcomes, especially when trying to match those against inputs, notably resources employed or consumed in delivering them. Recall there is not the constant and unrelenting signal provided by the harsh, ineluctable measure of financial profit and loss.

      For another part, rewards are unclear, with similar measuring and evaluation problems as for risks. Direct rewards to individuals are also less common (there being, typically, no profits from which to afford and to allocate monetary compensation) and in any case frequently enough there is shared responsibility and accountability rather than a clear and certain delivery responsibility bestowed upon an individual with sufficient powers to manage.

  19. majorfrustration
    December 18, 2022

    Agree – but why do some many MPs not take action. It seems we need to do more than change the Government.

  20. Susan Morgan
    December 18, 2022

    A clue might be when it came to light Betsi Cadwaladr Health Board employed a Management Consultant on £2,000 a day while working from his yacht in Marbella? Until the media onslaught convinced them to terminate his contract. A retired nurse from said Health Board commented at the time the Board was trying to avoid paying nurses for a 15 minute tea break? How many more highly paid ‘Consultants’ are being used to he detriment of the NHS and its patients?

  21. Dave Andrews
    December 18, 2022

    What pay rise would the nurses get if it matched that of the NHS upper management over the past 10 years?

  22. Lynn Atkinson
    December 18, 2022

    My niece was an NHS manager. ‘You were not allowed to solve problems’, so she left, works for a big accountancy firm who wins contracts from the NHS to send her and people like her in as consultancy teams to ‘solve the problems’.
    The culture in the NHS, which caused her to have a nervous breakdown, was ‘it’s going to fail so pass the parcel’.
    The culture in the accountancy firm is ‘we all cover for each other and get the projects through on time and up to,standard. Each person can count on team members. They expect to win.’
    My niece now earns double her NHS salary, but she is 1 of 19 in this ‘verticals market’ – the NHS sector.
    The NHS is redundant. We need doctors, proper nurses who do all the jobs in a ward, hospitals that serve us.

    1. graham1946
      December 19, 2022

      Big accountancy firms? I knew a company that went bust with assets and cash enough to pay out creditors 95 percent, but law said insolvency firms had to be used and by the time they had finished complicating matters and putting in their bills, nothing was left at all, and most of the assets including cars were disposed of by associated companies.

  23. Berkshire Alan
    December 18, 2022

    From my own experience, front line staff seem to produce results eventually, but management and administration is in many cases absolutely shocking.
    No new hospitals or expansion in bed numbers locally for decades, whilst the local population has increased substantially.
    Just how much of the NHS Budget goes on funding the pension scheme ?
    I would suggest a very, very significant amount, so why not make pensions of all government employed positions self funding.
    Allow training of Nurses and doctors to be free of any course fees, providing they sign up for 10 years of working full time for the NHS, failure to comply or complete such service means they are charged back the full training fees.
    Triage all A&E entrants (other than ambulance patients) at the door, before being let in.
    Many, many other simple suggestions would provide part of a solution.

    1. Mickey Taking
      December 18, 2022

      A& E use a triage ‘at the door, being a Reception’ already.

      1. Berkshire Alan
        December 19, 2022

        MT
        Not in all A&E departments, some let in everyone and they then wait according to severity of their problem, when many with non urgent problems should be simply turned away at the door, the problem is people cannot get a GP appointment easily, so the default position is to go to A&E, and take up a more expensive departments time for a non urgent problem.
        Only a few hospital Triage properly on immediate entry.

    2. margaret
      December 18, 2022

      I can see a problem in general practice where registered medics refuse to do any hand on work and farm out forms to 2 -3 different parties all with queues and waiting lists .It means many visits to the practice or other venues to complete an original consultation .Skills are wasted and become redundant. It is no use in saying we have a phlebotomist who will come on friday’s when some blood sampling needs to be done on the day. They wont do it , they refuse. The excuse is that there isn’t any time, so I suggest give them an extra 5 mins per consultation , but the answer is that it is not cost effective. Now I cant get my head around this, surely one visit is more cost effective than three.
      Following this I get remarks that I should support colleagues .. how about the patient?

  24. acorn
    December 18, 2022

    BTW. My reply yesterday to your BoE losses post, didn’t even make it to the “Your comment is awaiting moderation” page after a couple of attempts. Was I banned by an automatic word blocker or similar censoring software?

  25. Donna
    December 18, 2022

    The Soviet Union failed because collectivism and top-down micro-management doesn’t work. It killed millions of people because the Prize Pigs of the Animal Farm variety believed in the Communist Dogma, benefited from it, and they were insulated from the appalling consequences of Communism.

    The NHS is run like a Soviet Collective and the Prize Pigs who run it benefit from the set-up. They have no incentive to improve anything since, every time it fails, they demand and get more money from the cowards in Government.

    The Soviet Union was dismantled from the inside when Gorbachev admitted that the Communist model had failed and was prepared to, potentially damage his own interests, in order to deliver change.

    The NHS desperately needs a Gorbachev. The Government has, and is, doing nothing to ensure it gets one.

  26. agricola
    December 18, 2022

    You want a management plan. 47% plus of NHS employees or about 650,000 are not medical. Some are necessary engineering support for medical activity. We are reported to be 130,000 medical staff short. Remove 150,000 none medicals at all levels of salary and use the money to pay for the necsssary medics. Remove even more and pay for the medical training of a vastly increased number of our own doctors, nurses and other medical professionals. No medical student should be expected to fund their own training, just to give ten years to the NHS in return.

  27. turboterrier
    December 18, 2022

    Mark B
    But those in all these exalted positions would be screaming Witch Hunt, Victimisation, Bullying and then go on stress leave until it all settles down or they get promoted or pensioned off.
    The circle will not be broken.

    1. Mark B
      December 18, 2022

      Give the people a CHOICE . I do not care if Supermarket A goes on strike as I can get my shopping at Supermarket B, C, D etc . . .

      When you have no CHOICE they have you.

  28. a-tracy
    December 18, 2022

    Agency nursing is just overtime at super enhanced rates, without having to pay NI on it, no super defined benefit pension contribution on it (which allows the rate today). It is the stripped out cost of sick pay, pension, which they’d get in their 3 day per week job, so be careful what you’re asking for because the cost of all that overtime + enhanced pension contribution, sick pay and holiday pay would stack up (although agency workers do accrue holiday pay I wonder if it is just at 28 days rather than the 35+ pro-rata).

    How many nurses have been on sick leave for longer than six months? The actual number?
    John, please find out how many vacancies there are on each grade in each region of England? Break it down for people.

  29. Bryan Harris
    December 18, 2022

    It would have helped over the years if the NHS had been free of government interference – Where ministers have stepped in they have only made things worse and more confused. The number of guidelines and requirements that frontline staff have to follow is a nightmare from what I’ve seen.

    To say that the NHS needs a revamp is an understatement – It needs a total re-design – Primarily to get away from the way that hospitals now work as though they were factories, with their products being labeling patients as having certain ailments and creating lifetime users of drugs.

    Hospitals and other services should be designed for patients, not for the convenience of those that look after patients, for hospitals have moved very far away from the old style ones that made patients well again. Nowadays people are sent home as soon as they can walk, and there is no real recovery time or any way for a patient to regain their strength while under care.

    We should remodel the NHS, starting with GP surgeries, within one small area of Britain, then roll out that design and management structure when it becomes workable.

  30. a-tracy
    December 18, 2022

    Left foot forward wrote ‘1 Feb 2022 — So £137.4 billion in 2016 would be about £167.353 billion today, adjusted for inflation. NHS core funding in 2021-22 was £159 billion’.

    What was the amount 2022-2023 taking account of the new 9% inflation for 2022 was it over £167bn.

    We were told that we had over 100,000 excess deaths in a year and also massively higher excess deaths this year, so that has reduced the number of people with the highest reliance on the NHS expectations. Backlogs weren’t reduced with this extra spending those have gone up.

  31. ChrisS
    December 18, 2022

    Bed blocking is just the current fashionable argument for the poor performance of the NHS.
    In Germany, after a serious problem, many patients are sent to rehabilitation clinics to improve their mobility. One of my friends, in his early 80s, had a very serious fall down a set of concrete steps and spent four weeks in such a spa clinic. When he returned home, he was able to look after himself. Had he been in the UK, he would have remained in hospital where . We used to have lots of cottage hospitals that could have fulfilled rehab functions. These patients do not need long-term care but most cottage hospitals have been closed by NHS management. Why ?

    The present situation over the ambulance service and A & E is costing many lives and desperately needs sorting.
    We have the ridiculous situation of queues of 18-20 ambulances waiting outside Bournemouth hospital because they cannot drop off patients ! Why is this ? Most hospitals seem to have big reception areas that could easily be turned into additional A & E space for the walking wounded.

    Emergency measures such as erecting temporary buildings on Hospital grounds could provide space for bed-blocking patients needing rehab rather than acute treatment. This could be a quick but short-term solution and would not need fully trained nursing staff. We have plenty of spare beds from all those unused Nightingales !

  32. RDM
    December 18, 2022

    This is strange coming from you?

    Agency Staff;

    Obviously, it provides flexibility. Flexibility for the Hospital/Care Home/Trust/Home Visits/etc,…, or some combination there of.

    Flexibility for the staff; allowing them to choose the number of days they offer (to have kids), but also they can offer expertise and skills not available in house, or cover for martienity leave or holiday, etc,…

    Agency work also provides independence from the politics and predatory pressures received, especially from the elites!

    But, what I don’t understand coming from you is that this shows an Enterprising Spirit, you’d think you would want to encourage? As long as they are truly independent; so they can redraw Labour, and work to a Free Market Price Mechanism? They can get extra training and skills, and equipment. They can move to other locations, etc,…

    Also; If you stop Nurses, and others, from Agency Work, you will need to stop Consultants working flexible hours (Three days a week, Public, and the rest Private)!

    Besides, are Agency Staff are not on strike?

    RDM

  33. glen cullen
    December 18, 2022

    MPs got a high pay rise, Nurses & Doctors ‘will’ get a high pay rise ….every other civil and public servant are watching the results, no doubt every other union is ready to pounce
    MPs should’ve lead by example and taken a pay cut or at least a pay freeze, and cut back on all vanity projects e.g HS2 & Net-Zero

  34. John McDonald
    December 18, 2022

    The NHS is the classic “Management Culture” example and how it breeds to get bigger and bigger. Its best breeding ground is the the Public Service and Government. But we have to make very strong distinction between management skills and training and the Culture it can breed. If a medical doctor is in charge of running a large hospital she or he has to have some management training. But the focus will remain on medicine as this is the core training of the Doctor. Decisions will be based on medicine with some management skills background.

    1. margaret
      December 18, 2022

      Nurses actually administer far more than a medic would. She / he is required to know why it is given , the side effects, the correct dosage , when to stop , for what problems certain meds are given and which interact, then she goes on to monitor closely the effectiveness and document changes. She will do this many times in a day and every day. Can you imagine how much knowledge of medication she would gain in a few years.
      The trouble with the NHS they think that more and more of the same thing is the answer instead of using staff effectively.

  35. glen cullen
    December 18, 2022

    Has anybody noticed that there’s a nurses strike on …for the last 3 years we haven’t been able too see a GP or dentist, or out patients hospital and A&E limited ….it’s a no change scenario – same with the railways

  36. Bert Young
    December 18, 2022

    The abysmal state of the NHS is no recent thing . Its structure of management and control has been ineffective for years . I questioned the appointment of one of its Chairman some time ago with his previous boss ; he replied , ” The Staff job that the individual concerned had done before in his organisation was beyond reproach but he would never have appointed him to run a profit centre or anything as big and as geographically spread as the NHS !”. The NHS must be one of the biggest operations that exist ; it needs a drastic overhaul .

  37. Richard1
    December 18, 2022

    When the blob interviews the blob we should expect little else.

    I think public ridicule may help. The exposure of the NHS’s intention to hire lived experience tsars on £115k pa is an eye-opener for the public. We must rely on the right of centre media to expose more of this and independent minded MPs must then amplify it and turn the ridicule into rigorous questions.

    With Wes Streeting’s recent remarks there is a danger for the Tories that Labour will get ahead of them on this issue – although in reality there is no chance Labour will upset the statist NHS status quo which suits their supporters in the public sector blob and paymasters in the public sector unions so well.

  38. No Longer Anonymous
    December 18, 2022

    Panto season is here yet again.

    *Exasperated sigh as yet another immigration minister larks about pretending not to understand*

    Suella Braverman, “We must get tough on migrant traffickers.”

    Noooooooo ! Let the audience spell it out. It’s the benefits system that is causing the boom for migrant traffickers and luring their criminal customers who are trying to cheat the British system. UK benefits are world famous, “IT’S BEHIIIIIIND YOOOU !!!”

    Your party, Sir John, is an immediate and existential threat to our civilisation. You, Sir John, are helping it to retain some false hope and credibility in the public eye.

    1. Original Richard
      December 18, 2022

      NLA :

      Yes, the UK must be the most popular country as once an illegal immigrant, or any immigrant gets here, then there is simply no necessity to work ever again.

    2. Mickey Taking
      December 19, 2022

      ‘Suella Braverman, “We must get tough on migrant traffickers.”’
      Why not get tough on the illegal economic migrants?

  39. Original Richard
    December 18, 2022

    I’ve just been told by a surgeon that clerical staff are allowed to work from home even though the paper files they require to do their work are in the office.

    The basic problem is that the NHS is no longer run by medical staff but by fifth column communist civil servants who never get sacked for laziness, negligence, incompetence, malfeasance, corruption, misbehaviour, insubordination or treachery.

    Just like not one of the senior staff who represented the Business, Energy & Industrial Strategy at a HoC Public Accounts Committee evidence session on Net Zero was an engineer. Degrees in PPE, Modern History and “drafted in from social services” is deemed the right qualifications. Even the MP recently selected to review the Net Zero Strategy was a graduate of modern history.

    This is one of the communists’ devices to destroy the West by replacing meritocracy with diversity where anyone can have any job irrespective of their capabilities to do the job.

    They want the NHS to fail.

    1. Mickey Taking
      December 18, 2022

      they are rather good at it !

  40. Delphine Gray-Fisk
    December 18, 2022

    Precisely! Try getting the current Health Secretary to ask them these questions – preferably on television!

  41. Danny Hargreaves
    December 18, 2022

    This needs to be communicated to the general public who tend to blame the health minister thinking it is their responsibility. The NHS needs reforming not privatising, and our investment in it properly managed and reported on. It appears to be a bottomless pit. Where has the additional money post Brexit gone? It doesn’t appear to have done anything constructive. How can we find out?

  42. forthurst
    December 18, 2022

    How much of the NHS exists so that MPs can ask daft questions in parliament and get a reply?
    There is no limit to the amount of money which Arts graduates can waste on maladministration so they all need to go otherwise they will continue to drain resources on activities which they invent for themselves.
    The NHS should be broken up into hospital Trusts run by a medically qualified director under which should be the
    senior consultant in each speciality.
    GPs should be typically full time and allowed to operate as any size group or as sole practitioners if they choose.
    Reorganising the whole GP provision because of one rogue (of alien ancestry) was absurd.

    1. MFD
      December 18, 2022

      I like the sound of that FORTHURST, a bit like health care was in the sixties which worked well, ie one or two GP’s in manageable groups. Then we could also subdivide the woolly mammoths in cities into small independent units under one roof for specialist testing and treatment.

    2. Mickey Taking
      December 18, 2022

      GPs should be direct employees of the NHS, no private groups, proper NHS oversight and comparisons of treatment across the board. Standard payscales (but with some bigcity/regional leeway) using qualifications and years service.

    3. Chris S
      December 18, 2022

      A big part of the problem in General Practice is the fact that so many more GPs are now women and they take maternity leave and then work only part time. It’s a fact that far more male GPs work full time, but they are a diminishing breed. The feminists will object to me making this point, but it is a fact.

      The other problem applies to all GPs : It is so well remunerated that they can afford to retire early, and frequently do.

  43. glen cullen
    December 18, 2022

    The data below is for the 24-hour period 00:00 to 23:59 17 December 2022.
    Number of migrants detected in small boats: 350
    Number of boats detected: 7
    It just doesn’t stop …another 350 yesterday and thousands waiting in Calais

  44. The Prangwizard
    December 18, 2022

    We do indeed need answers to sensible and reasonable questions such as listed. The fact that Sir John’s piece has to be written and forced to highlight such shortages emphasises what a dreadful state we are in.

    As a bit of an aside on money spending, my only observation is via tv and thus rather useless. But the pictures I see of hospital interiors strike me that there are enormous quantities of equipment often seemingly being unused. Does anyone in hispital ‘admin’ know how much time each machine is used per 24hrs or weekly etc. Someone should.

  45. Geoffrey Berg
    December 18, 2022

    I doubt it is possible to entrench efficiency into the NHS within the public sector. That said if health is going to continue in the public sector it should be made far more democratically accountable. Just as County Police and Crime Commissioners were elected at County level, so too should Health Commissioners be elected at County or Trust level. That wouldn’t solve all the problems but in some cases it would help and make the employees sackable by elected representatives.
    As for privatisation, I must admit the American private health system is so expensive as to be exploitative(though huge numbers of Americans, including practically all Republicans, have a horror of ‘socialised medicine’). Much of their problem is if you have cancer or even need a hip replacement, individuals or their families have neither the time nor expertise to haggle the price and extent of the treatment. I think the state should do that and provide the funding for individuals (a little like BUPA does for their members). I say this despite our public sector making a mess of this in social care and nursery education through both often underpaying (making providers dependent on overcharging private customers) and over-regulating (most especially requiring too many employees to oversee the residents or children to allow those services to be cost-efficient).

  46. oldwulf
    December 19, 2022

    Sir

    Over the last 24 hours, the BBC has been heavily peddling (on Twitter) the narrative that it the nurses versus the Government. It is allowing the NHS bureaucrats to escape criticism. Ministers need to forcefully put their point across to the public, preferably with a few facts and figures.

    First and foremost, the Government (on behalf of the taxpayer) is the customer, not the manager, of the NHS.

  47. Peter Parsons
    December 19, 2022

    “Ministers want waiting lists down.”

    This comment shows the problem. It focussed on the wrong thing.

    If I’m waiting for an appointment, what I care about is whether I get seen tomorrow, next week, next month or next year. It’s irrelevant how many people are on the list ahead of me. If the waiting list is 1, but the waiting time is 1 year, I’m still waiting a year.

    Waiting times are what matter, not waiting lists.

    1. Peter2
      December 19, 2022

      That’s rather pedantic PP
      What matters is what the reaction is to those long waiting times.
      At present it seems there is very little reaction.

  48. ukretired123
    December 19, 2022

    Input/ Output analysis at the very least would help show up the mind boggling sums of taxpayers cash going down this Teflon coated mega money pit black hole. Unless you measure this drain hole and account for it to the public and taxpayers in terms they can understand £ £ £ s per person it will continue to be the great unknown NHS that no one understands.
    Maybe this suits both Labour and Cons. Too big to fail? And no one dare criticise it. Labour likes to take credit and ownership but does not know how to run it least of all manage it.

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