More public service for more money

The government since 2019 has not been shy with the cash. Record increases and record sums have gone into the NHS. The output of operations, treatments, medical consultations has not gone up as hoped for with all the extra money.

Of course more money was needed. There needed to be pay rises as inflation picked up. There needed toĀ  be extra capacity as the population expanded considerably given a generous policy towards inwards migration and difficulties in stopping illegalĀ  arrivals. There also needs to be good management choices about how to spend the extra money. There needs to be good employee relations. Management needs to design achievable workloads and create a favourable environment for productive endeavour.

The 36,000 managers need all to contribute to a better mood and mutual support of staff. All need to be focused on delivering more healthcare. More of the extra money has to buy extra capacity – more beds with staff to look after patients, more GP and nurse consultations, faster tests for diagnosis.

Above all the extensive Ā management and personnel functions need to grade, evaluate and create worthwhile and feasible jobs that people are proud to hold. Too many staff leave, work on short term contract and feel unhappy about their job spec and remuneration.These are the very issues within their large budgets managers need to sort out, given the staff unhappiness on display. Did they put in the right Ā evidence to independent pay review? Can issues be remedied in next years settlement? Did the Pay Review body think enough about the impact of higher inflation on their settlement?

112 Comments

  1. Mark B
    February 23, 2023

    Good morning.

    The 36,000 managers . . .

    For context, did you know that there are approximately 75,000 people, from Privates’ to Field Marshal, that serve in the British Army. That is right ! There are half as many people employed in the NHS to defend poor ‘administrative’ service and shuffle bits of paper then there are people to defend His Majesties Realm. And I bet these so called ‘managers’ in the NHS get paid far more.

    We somehow have allowed ourselves to fall into the Old Labour way of doing things – Just throw lots of money so :

    1) We can say we are spending more and look good.

    2) Hope that it will solve any problems.

    The NHS has risen from being a sacred cow to a white elephant. It is bleeding the rest of the economy dry and is becoming more and more unavoidable. With the advent of Digital ID’s we will soon be allocated ‘Health Credits’ where, those who do not take care of themselves may not have enough credits for treatment.

    Health rationing here we come. You mark my words šŸ˜‰

    1. Mary M.
      February 23, 2023

      Mark B, what frightens the living daylights out of me is that ‘those who do not take care of themselves’ could become ‘those who refuse to accept the treatment (including new vaccines) prescribed under the proposed WHO’s Pandemic Preparedness Treaty’.

      Tony Blair’s (and now William Hague’s) beloved ID cards must be resisted at all costs. See Allister Heath’s article in the Daily Telegraph yesterday.

      1. Mike Wilson
        February 23, 2023

        What is wrong with an ID card? For a state to function it must be able to identify people. How do you prove who you are? Birth certificate? I could get a copy of anyoneā€™s birth certificate the same age and gender as me and say ā€˜Iā€™m Spartacusā€™. NI number? If I knew yours I could say I was you. And so on. Biometric cards are fine with me.

        1. formula57
          February 23, 2023

          @ Mike Wilson – the actual card, being the visible end of the system, is not of itself objectionable rather it is what lies behind it, which is a vast database of interconnected knowledge about all aspects of individuals’ lives that could easily be misused and abused. At present the State holds a great deal of data from school records, medical,tax, asset ownership etc. but it is separate, available to those who need it and not anyone with access to State systems. Also the records are deliberately fashioned to prevent lifetime tracking with, for example, a fresh passport number being issued at each renewal rather than the same number for every passport. So I have no difficulty reporting my income sources and amounts to HMRC for there is a clear need for it to know, but that information does not need to be in some database linked to everything else the State knows about me.

      2. Cuibono
        February 23, 2023

        +many
        Terrifies me too.
        To think that our govt. should sign us over in such a way!
        Not sure if it has actually happened yet but the attitude and utterances represent a significant move away from all we achieved in The Age of Reason.

      3. Ian wragg
        February 23, 2023

        So the new Business Extinction and Import Substitution minister says steel making is no longer a strategic industry.
        No doubt he’s been got at by the net zero stupidity.
        Steel making is the most strategic industry for any serious country.
        You really do deserve to be wiped out at the council and general election.

        1. glen cullen
          February 23, 2023

          Lets import steel and coke from China

      4. Beecee
        February 23, 2023

        Electronic ID – an open goal for the hackers and those who attempt to steal our identity for fraudulent reasons.

        I am not surprised that Mr Hague is a supporter as he never seemed to be any good at thinking his policies through. I understand that he is in the inner circle of Mr Sunak’s friends and advisers. Oh dear!

      5. Ian B
        February 23, 2023

        @Mary M +1 It is now called Entitlement

        TB & WH are showing themselves to clueless and luddites. Anything digital simply means central control and open to all and sundry, friends and enemies all get the same access. How did the Chinese and the Russians suddenly get the super fast missiles based on US technology, yes our brave new digital World opened the door to western science and research.
        TB also yesterday stated the UK taxpayer(yes the poor Taxpayer once more) should fund a ā€˜Chatgptā€™ competitor ā€“ why? Chatgpt is 100% open source, meaning not only the software but the code is 100% free to all ā€“ so any one including Government can download and use it. It just doesnā€™t at any level need taxpayer involvement.

        This Government is farming the People of the UK to stroke its own personal ego.

    2. PeteB
      February 23, 2023

      Spot on Mark. Such a big white elephant that nobody (in government) can see it properly.

      Obvious there are massive problem with front line staffing. Friend’s son qualified as a junior doctor last year – he could opt for a paid role at Ā£30k+ p.a. or a locum role at Ā£100k p.a. No prizes for guessing his initial choice. After 6 months he’s off to Australia to do same work at Ā£70k a year.

      1. Cuibono
        February 23, 2023

        More fool the state/NHS for not making trainees sign a contract.
        They used to do that in computing I believe.
        To train and then allow to disappear abroadā€¦more woke wastage.

        1. JoolsB
          February 23, 2023

          Maybe the state should get them to sign a contract that theyā€™ll work for the NHS for so many years as long as the state writes off their 70-80K student debt in return. After all it writes off 78% of the debts of those who come out with worthless degrees, just not for those the country needs.

        2. a-tracy
          February 23, 2023

          They do it before they pay to train pilots or other high cost training, it is ridiculous that we donā€™t.

      2. agricola
        February 23, 2023

        Who can blame you friends son, life is too short to wait for government incompetence to resolve itself. Experience tells us it will not.

      3. Bloke
        February 23, 2023

        This Old Mother Hubbard cabinet contains a Hunt that feeds a white elephant pulling a Trojan horse benefit system with the NHS behind.

      4. Lifelogic
        February 23, 2023

        Indeed, Allister Heath as usual is right.

        ā€œThe Davos Party has seized power in the UK ā€“ and its manifesto is dismal
        Tony Blair and William Hagueā€™s technocratic plan for ā€˜changeā€™ assumes that politics is effectively deadā€

      5. Lifelogic
        February 23, 2023

        Indeed and bear in mind many doctors have student debts of circa Ā£150k plus interest on these of circa Ā£10k so not easy to live in many places on Ā£30k less tax, NI, Ā£10k interest, rent, council tax, heat, light, water, commuting, work lunches, funā€¦

        1. JoolsB
          February 23, 2023

          Exactly LL. My son spent 6 years at Cambridge studying medicine for which he is now in debt to the tune of around Ā£90,000. He now works in a busy central London Hospital on a salary of around Ā£38,000 in return for a 60-70 hour week. After tax, N.I. and student debt at 9% plus interest and paying rent of Ā£1,000 a month for a room plus heating and council tax, heā€™s left with very little for the horrendous and unsociable shifts he puts in. Compare that to MPs on their salaries of Ā£84K and just about to rise by another Ā£3K plus an extra Ā£16K for sitting on a select committee which most of them do. (And lets not forget before they pulled up the ladder, they all enjoyed a free degree themselves.) Add to that their plush taxpayer funded London apartment with council tax and heating costs thrown in. How the other half live. Its hardly surprising that my son is now seriously talking of going to Australia.
          Junior Doctors owe us nothing thanks to our out of touch politicians but then they wonā€™t be the ones to suffer when the NHS is on itā€™s knees because just like Rishi, they can all afford to go private.

      6. Mark B
        February 23, 2023

        PeteB

        Don’t worry, he’ll be replaced by one of those illegal migrants who Auntie assures us are doctors, engineers and university academics. /sarc

    3. Nottingham Lad Himself
      February 23, 2023

      Managers in many walks of life have taken their lead from government.

      That is, none of them are responsible for anything when things go wrong.

      This means that none of them want a particular decision to be conclusively attributable to them.

      It just doesn’t get stuff done.

      1. Mickey Taking
        February 24, 2023

        Mostly true, they take their lead from union bosses, thick, uneducated, mouthy types who enjoy unbelievable salaries, cars, pensions, other perks just to sit around in smoky rooms debating how to screw the system. From time to time they have a few visits to banner waving groups of morons, while the members go along with the drip drip of death to large employing industries.

    4. Nigl
      February 23, 2023

      Spot on. Sir JR in total denial. Pathetically weak politicians who can only see spending money as the solution to everything.

      And in other news we see supermarket shelves empty because ā€˜Sir JRā€™ prefers net zero to feeding us.

      1. Mickey Taking
        February 23, 2023

        Environment Secretary has suggested turnips could be a suitable alternative while other vegetables remain in short supply. Some supermarkets have limited sales of cucumbers and tomatoes, following shortages partly caused by extreme weather in Spain and north Africa. We are told British consumers should “cherish” home-grown produce, but added that people wanted “a year-round choice” and supermarkets were trying to meet that demand.
        Lib Dem leader Sir Ed Davey accused the minister of a “let them eat turnips” strategy – a reference to 18th Century French queen Marie Antionette, who supposedly responded to a bread shortage by saying “let them eat cake”.
        But Downing Street insisted xxxxxx had simply been “setting out the importance of celebrating the produce that we grow here in the UK”.
        Perhaps less consumption could be the advice for the Minister before guiding the rest of us!

    5. formula57
      February 23, 2023

      Administrator numbers reflect the problems of the 1980’s when it was recognized the NHS produced too little information about itself to enable good decision making about resource allocation.

      Work practices, including amongst medical staff, are more likely the root of present problems rather than the number of administrators.

    6. Ian B
      February 23, 2023

      @Mark B +1 – The 36,000 managers . . . what are the managing? on the face of it they are not even administrators. The soft under-belly of the Conservative Party making ‘themselves’ feel good

    7. RichardP
      February 23, 2023

      Completely agree Mark B.
      Itā€™s all about power with the NHS, health care comes a very poor second.
      Every other advert on the television is from the NHS. Itā€™s obvious that you should stop advertising if you have too many customers. They would probably be able to fund a pay rise for the nurses if they scrapped the publicity department.

  2. Christine
    February 23, 2023

    “There needed to be extra capacity as the population expanded considerably given a generous policy towards inwards migration and difficulties in stopping illegal arrivals.”

    This statement makes me so cross. You seem to accept that this policy is OK, well it isn’t and it’s not what the majority of the people in this country want. It is one of the main reasons why your party will not be reelected. We are sick of being overtaxed and expected to work until we drop to support a bunch of money-grabbing migrants whose comfort and rights exceed our own.

    Reply It is a policy I have opposed!

    1. Shirley M
      February 23, 2023

      + many Christine. The government itself created the difficulties in stopping illegal immigration, just like every other ‘difficulty’.

    2. agricola
      February 23, 2023

      Reply to reply.
      You may well have opposed it, but to no effect. There are not enough Conservatives in the conservative party or in parliament as a whole. Consequently Conservatives in the country are looking at alternatives to re-seed Parliament.

      1. glen cullen
        February 23, 2023

        Correct

      2. The Prangwizard
        February 24, 2023

        Sir John does accept changes such as this. He moves quietly with his party. He thinks a vote against is enogh.

        He does not move with us.

    3. beresford
      February 23, 2023

      No measures to limit immigration but an amnesty in all but name for the illegals who claim to be from certain countries. Of course all those who have destroyed their documentation will say they are from those countries. Once the bogus asylum claims have been granted we can look forward to each claiming ‘reunion’ with ‘family members’ who may be equally bogus. No questions asked as to how a ‘Syrian’ migrant has a family in Bangla Desh.

      Meanwhile in Ireland politicians are looking to ban demonstrations against illegal immigration, and in Germany those who flee the new multi-kulti cities to form traditional communities in the country are branded (you guessed it) far right extremists. The destruction of Europe is in full swing.

      1. Diane
        February 24, 2023

        Beresford: The amnesty no doubt will just foment other issues to be dealt with thereafter. What a cowardly decision by this government. Reading your final sentence – An excellent, eloquent, thoughtful & balanced read (IMO) can be found in Douglas Murray’s book ‘The Strange Death of Europe.’ A short excerpt from the cover … (he) travels across Europe to examine first hand how mass immigration, cultivated self-distrust and delusion have contributed to a continent in the grips of its own demise. From the shores of Lampedusa to migrant camps in Greece, from Cologne to London, he looks critically at the factors that have come together to make Europeans unable to argue for themselves and incapable of resisting their alteration as a society. Have just read chapter 11 which looks at past events, actions & decisions in the last decade and before then, ” The Pretence of Repatriation”

    4. Mark J
      February 23, 2023

      @Christine. I highly agree with your post. Extra capacity in public services and housing is only needed due to the reckless and out of control immigration policy of this Government. Rather than say NO to people, they just let more and more in, without considering the knock on effects of such a policy. They naively think all arrivals will be net contributors to the public purse. We then find the opposite is largely true, with many taking out more than they put in – costing UK Taxpayers even more money.

      It really is a ridiculous situation for which our Government is utterly clueless.

    5. RichardM
      February 23, 2023

      Christine you should get cross, but only because you are being gaslit. The extra capacity is primarily required because of the aging population, compounded by poverty caused by the increasing wealth divide between rich and poor, and increasing long term illnesses which have risen exponentially since the start of Covid.
      The levels of immigration to UK is broadly similar to all other higher-income countries. Most of the rest of Europe take far higher numbers of refugees than we do.

    6. Mike Wilson
      February 23, 2023

      If it is a policy you have opposed, why do you refer to it as a ā€˜generousā€™ policy. Letā€™s call it what it is – your policy is for continuous high immigration and the huge house building it demands.

      1. Mickey Taking
        February 24, 2023

        huge demands on everything! – and political turmoil.

    7. Timaction
      February 23, 2023

      It doesn’t matter that you oppose it. Back bench MP’s have no impact, influence or effect on policy and Government inaction or actions. Your Party is a reflexion of new Labour and there is no difference between you all. I listened to Suella Braverman’s interview on GB News last night on the boat people etc. All talk, no action on the boat people, deportations or the Northern Ireland protocol. Taxes up within hours, these issues take decades. Time for you lot in Westminster to go and take your civil serpents with you. All useless.

    8. Timaction
      February 23, 2023

      Oh, and we don’t want mass migration as we have to suffer the consequences of higher taxes, no Doctors or dentists, congestion, housing everywhere, no school places, cultural destruction. Enough, just go. 13 years of lies and lies and lies.

  3. Lifelogic
    February 23, 2023

    Price is what you pay value is what you get. So often the output of the hugely bloated state sector delivers little, nothing or even negative value. Good examples are Test and Trace, HS2, the vast misguided red tape, the pointless degrees, the net harm vaccines (even for the young), the lock downs and furlough, net zero, eat out to help out, the insane subsidies to Drax to burn young coal (wood), the appallingly structured NHS, the rigged market in energy, banking, education, housing, road blocking, motorist mugging…

    1. Lifelogic
      February 23, 2023

      Sunak has turned Ā£s into circa 75p so of course people seek pay “rises”. Not really caused by Putin’s appalling war nor Covid but the appalling response to Covid, Sunak’s vast tax borrow and pointless waste agenda, the counter productive lock downs, the absurd net zero con trick and energy marked rigging, the vast, bloated and largely unproductive state sector, the botched part Brexit… almost all self inflicted by the recent Tory governments Mr Sunak.

      1. Anselm
        February 23, 2023

        OK we all know this, can’t you think of anything nice?

        1. Mickey Taking
          February 24, 2023

          can you? Truth hurts doesn’t it!

      2. Lifelogic
        February 23, 2023

        Also of course Sunak’s money printing.

        I see that “Asylum claims for 12,000 to be considered without face-to-face interviews to fast track them”. So yet another way to encourage more and more people to just get on a rib and arrive in Kent whenever the sea is calm.

        Great plan Sunak!

      3. Ian B
        February 23, 2023

        @Lifelogic +1 The great SocConservative Lie

      4. Lynn Atkinson
        February 23, 2023

        Sorry, to nitpick, but itā€™s the collective wests appalling war. Listen to Biden and Truss and the rest, itching to destroy. At the Munich Conference last week the Estonian Prime Minister Kaja Kallas said ā€˜NATO countries must take control of Moscow and forcibly rewrite the mentality of Russian citizens so that the Russians will never be a threat again.ā€™

    2. Nigl
      February 23, 2023

      Nothing new to see here. Same old list. Sad.

  4. Cuibono
    February 23, 2023

    Every unhappiness has been carefully crafted by governments.
    All this woke cr*p which makes the working life an utter misery.
    But no one ever listens.

    A local doctor died. No one knew why.
    Then I found the govt. report of a lawsuit based on supposed discrimination.
    It read more like something out of the playground yet it led to despair.
    And MPs wonder why we are short of doctors!!

  5. Anselm
    February 23, 2023

    I am a man who has retired and who has worked all my life as a professional teacher and vicar. I have been trusted to look after my people. Actually, I must confess, most of the time, I have been working for God, but to outward eyes, it has looked as if it was for the common good. Trust is a terrible burden to bear, but like my wife (nurse) brother(doctor) grandfather (consultant) uncle (doctor in Kenya), I shouldered the burden cheerfully
    (mostly).
    In return I got enough money to live off, enough for a tiny pension, enough for a house to live in, enough to keep my family of four children.
    That was the deal.
    A friend of mine from Cambridge at a Founder’s Feast told me that he had gone to America to become a millionaire. In our village, the very largest house is owned by a man who contracts for NHS equipment. Both are rich men. That was not the path I chose.
    My question: are the nurses and doctors trusted today? They certainly have as much money as we used to get.

  6. turboterrier
    February 23, 2023

    Today’s post just confirms what private industry discovered over 30 years ago.
    Massive staff numbers with even more managers were not working and change had to happen.
    It came about by many companies realising that the strength of their industry rested with the people who were on the front line every day and could see the problems. Too many people turning up for work and leaving their brains on the gates and adopting autopilot mode for their shifts.
    The change came from Directors supporting a massive rethink of how they did business. Out of this came the cell, self directed team working revolution. Smaller units are faster and quicker to see a problem and resolve it without any real top-down intervention. The teams became highly efficient and effective and above all, they had ownership of what they did.
    There are vast areas within the NHS that could easily adopt SDTW and things would improve because the teams would make it happen. They joined to save life and assist the sick not by creating woke departments to give people a cushy number to cause mayhem, but by action real action to do what they ultimately believe in The Original Ethos of the NHS.

  7. Sakara Gold
    February 23, 2023

    Ban the NHS from any more middle management recruitment and insist that any further investment is restricted to new hospitals and beds. And more UK trained nurses, doctors, consultants etc of course

    There is too much empire building in the NHS and we would not miss 100,000 middle managers

  8. John McDonald
    February 23, 2023

    How many managers dose it take to fix a broken arm ?
    The NHS problem is not unlike the problem with the modern Parliament. Managers and Politicians are very similar in the way they operate. With few exceptions of course. They are in charge of, or make decisions on things they have no training in or front line experience of.

  9. Cuibono
    February 23, 2023

    Has any MP actually absorbed what the media ( is it lying then?) claims the NHS spends on wokery?
    A recent travesty ā€¦millions spent on deciding not to call patients Mr or Mrs.
    Is Westminster such an ivory tower that no one there understands what it is like to work in todayā€™s dystopian workplaces?
    And then go home to equally disturbingly altered neighbourhoods full of noise and chaos and blinding lights.

  10. Mike Wilson
    February 23, 2023

    All need to be focused on delivering more healthcare.

    No – they need to be focused on diversity, pensions and stress.

  11. Sea_Warrior
    February 23, 2023

    You, the political class, do not have my consent for continued population expansion on my beloved, crowded isle. You don’t have my consent to fast-track in another wave of unproductive ‘refugees’ who aren’t remotely suited for settlement in a western country. You do not have my consent to destroy my land.

  12. Cuibono
    February 23, 2023

    I just went out into the garden.
    Spring is in the air and in the distant past I would have felt happy.
    Happiness has been wrung out of me by politicians.
    More recently I always looked forward to winter, after the fireworks that is, as a brief respite from the misery of it all.
    And now even that has been taken away. Winters are now bleak and cold.
    Where are my security, my rights, my warmthā€¦my country?

    1. glen cullen
      February 23, 2023

      Youā€™ve always the 5 Sunak pledges and 5 Starmer missions to fall back on in time of need

    2. Zorro
      February 23, 2023

      Trashed by a slew of supposedly Conservative governmentsā€¦..

      Zorro

    3. Mickey Taking
      February 24, 2023

      and now the young, others with families and the elderly are obsessed with the alarming displays of cost on their smart meters.

  13. Berkshire Alan
    February 23, 2023

    Reported today.
    As many of us have predicted the asylum seekers/illegals are now being fast tracked for approval, no face to face interviews, just fill in a form within 20 days and return it, or get someone who knows how to answer the questions to do it for you, and your in.
    What a farce, and our Prime Minister calls this a solution, and progress !!!
    Taking back control, Protecting our Borders, really ?

    1. Cuibono
      February 23, 2023

      +++100
      Have just read that Sunak is suggesting/mulling over a huge amnesty for illegals.
      And have seen lists of areas where a certain large company plans to take the newcomers to be housed in former buy-to-lets. ( Said company leases from landlords). Many, many areas.
      I always thought there was a reason for the govt. destruction of landlords and their livelihoods.It was obvious that they wanted their housesā€¦and they certainly do!
      It looks as if this was all a long time in the planning.
      Theyā€™d better hurry up and mend the NHS or there will be no care for those who count!

    2. turboterrier
      February 23, 2023

      B A
      All they have to do is pass one law stating ALL illegal immigrants whether by dingy or back of a truck will be immediately extradited with no exceptions regardless of their supposed personal circumstances. Back dated to January 2022. We cannot keep behaving as the “patsy” of the world for all the dregs of society.

    3. Peter
      February 24, 2023

      BA,

      Agreed

  14. Pud
    February 23, 2023

    The NHS can’t be short of money, because it keeps employing Diversity Managers on salaries of at least Ā£50K up to double that. If it can afford to duplicate a HR role then it must have an excess of funds.

  15. Donna
    February 23, 2023

    The Daily Mail is reporting that Sunak is planning an “amnesty in all but name” for 12,000 asylum applicants, including criminals who have forced their way into our country across the channel.

    They’ll just have to complete a 10 page questionnaire (or their taxpayer funded legal team or “charity worker” will) and that’ll be it ….. no further questions asked and they’ll be in the UK for life ….. plus no doubt in due course, their extended families, all paid for by British taxpayers.

    We’ll certainly need more public services to pay for the invasion of our country by these young men from dangerous, violent, misogynistic parts of the world.

  16. AncientPopeye
    February 23, 2023

    36,000 managers, the mind boggles?

  17. formula57
    February 23, 2023

    Where record spend leads to lower outputs and low staff morale correction likely requires organizational change, clearly. Against that background, even large pay increases will likely make little difference beyond an initial, short-lived contentment.

  18. Bloke
    February 23, 2023

    The Government has recklessly wasted vast sums of money and continues with ineptitude in so many areas. It has been unfit for purpose for many years with bad leadership and virtually no adequate sign of improvement.

    1. turboterrier
      February 23, 2023

      Bloke
      Nearly all our politicians are totally scared #####ess about facing the change that is really necessary to propel this country to a better place.
      Not talking about just a change of party fo government. It is a disease that encapsulates the whole country. The fear of real change.

  19. Brian Tomkinson
    February 23, 2023

    The NHS receives Ā£200bn per annum of taxpayers’ money but is probably one of the worst managed organisations in the country. The whole senior management need to be dismissed and people recruited who care about patient outcomes instead of woke empire builders.

    1. Mickey Taking
      February 23, 2023

      and Sir John writes ‘More service and more money!’

      Most of us would like to see better service for less than the country pays currently.

  20. agricola
    February 23, 2023

    The example you highlight, the NHS. Undermanned medically and overmanned administratively. Moral very low. Solution, stop charging for medical training at all disciplines and levels and train twice as many as you are from UK sources as you do at present. Contract those trained to the NHS for their first ten years of qualified employment. Recruit lower grade, none university, nurse apprentices, to fulfil those hands on patient needs. Drastically reduce the admin from 47% of NHS employees to around 25%. Pay particular attention to removing all none jobs of a diversity nature and heavily pollard the quango levels between Trusts and the Ministry. Spell out the objectives for all Trusts and tell the medical staff that they are responsible for improving throughput and outcomes while admin is there to support same and control waste.
    If you can start making things happen in the NHS, the principals can be applied to all other ministries of none achievement. Alternatively just keep talking about it and prepare to say goodbye in 2024.

  21. Des
    February 23, 2023

    What we actually have is less service and more government. Increasing over reach into our lives, authoritarian and nonsensical policies that are ruining our country, forcing lethal medical experiments on people and favouring illegal migrants over British people, green agendas that will, not might, kill millions and enslave the survivors and an economy that looks set to decline for many years, that is, if the lunatics in Washington and Brussels don’t manage to provoke a nuclear war to kill everyone.
    The political class has succumbed to collective madness and are a danger not only to our way of life but also to our very existence. We would be far better off if government ceased to exist and we are left to pick up the pieces of all you have wrecked.

  22. Elli Ron
    February 23, 2023

    Sir Redwood, could you please talk more about ULEZ in your output here.
    ULEZ is just a money grabbing scheme by Khan which will damage the economy of outer London and near london, but will have insignificant benefits on air quality.

    1. glen cullen
      February 23, 2023

      I’d like to hear all MPs opinion of ULEZ and 15 min cities

  23. Original Richard
    February 23, 2023

    All public services and institutions, such as Parliament, civil service, quangos, education, judiciary, police, NHS, BBC etc. have all succumbed to Robert Conquestā€™s 2nd and 3rd laws of politics :

    – ā€œAny organization not explicitly right-wing sooner or later becomes left-wing.ā€

    – ā€œThe simplest way to explain the behaviour of any bureaucratic organization is to assume that it led by a cabal of its enemies.ā€

    This is initiated by the educational establishment and disseminated by the agitprop organisation aka the BBC with diversity replacing meritocracy and policy led forecasts of economic and climate crises.

  24. IanT
    February 23, 2023

    I’ve been reading a book by Charles Hugh Smith, an American who has been predicting the end of golbalisation and the ‘scarcity’ this will cause in many things but mostly energy and food. Not sure I accept all his conclusions but unfortunately many of his ideas certainly ring true (much more so than Net Zero). Scarcity (I believe) is going to be a far greater problem than Carbon Emmission. He makes some observations that are worth repeating given oil and gas reserves are (for many reasons) limited…

    “Reactors take many years to construct and are costly to build and maintain. Cost over-runs are common. A new reactor in Finland, for example, is nine years behind schedule and costs have tripled. The U.S. has built only two new reactors in the past 25 years. The world’s 440 reactors supply about 10% of global electricity. There are currently 55 new reactors under construction in 19 countries, but it will take many years before they produce electricity. We would have to build a new reactor a week for many years to replace hydrocarbon-generated electricity. This scale of construction simply isn’t practical. Supplying all energy consumption globally–for all transportation, heating of buildings, etc. would require over 10,000 reactors by some estimates–over 20 times the current number of reactors in service.”
    “Many believe so-called renewable energy such as solar and wind will replace hydrocarbons. But as analyst Nate Hagens has explained, these sources are not truly renewable, they are replaceable; all solar panels and wind turbines must be replaced at great expense every 20 to 25 years. These sources generate less than 5% of global energy, and it will take many decades of expansion to replace even half of the hydrocarbon fuels we currently consume. To double the energy generated by wind/solar in 25 years, weā€™ll need to build three for each
    one in service today: one to replace the existing one and two more to double the energy being produced.”

  25. Ian B
    February 23, 2023

    The Conservative Government instead of the Party that we relied on to keep the Countries finances on track have turned into the throw away Party. Throw everyone else’s cash anywhere it makes you feel good, no attachment to supply, no requirement to account for spend. A policy of ā€˜not me guvā€™

    Its not logical to increase exponentially all taxpayer funded entities and then receive reduced services for all.

    It smacks as jobs-for-the-boys, just to keep them onside and employ friends that cant get a proper job elsewhere.

  26. Lynn Atkinson
    February 23, 2023

    I understand Australia is offering beer pay and conditions to British medical staff. So now the U.K. will see how it likes having it staff ā€˜stolenā€™ instead of being the thief and taking the vital personnel from African countries.
    Letā€™s have fewer state services for less money. The pool of people paying for this enforced increased population has not expanded, and might beat the medical staff to Australia, so fed up are they!

    1. Mickey Taking
      February 23, 2023

      some might like getting paid with beer. ‘Roo’ steaks are quite acceptable.

      1. Lynn Atkinson
        February 24, 2023

        Better, sorry.

  27. glen cullen
    February 23, 2023

    Home Office ā€“ 160,000 asylum seekers awaiting a decision in UK

    160,000 illegal immigrants posing as asylum seekers that will be allowed to stay in the UK ā€¦.whatā€™s the point of border control, the visa system while we have open borders

    That figure is only for asylum seekers, it doesn’t include over-stayers, illegal immigrants in the system and illegal immigrants outside of the system etc

    1. glen cullen
      February 23, 2023

      Revised – 166.000 economic illegal immigrants claiming asylum with 99% chance of staying in UK

  28. Mark J
    February 23, 2023

    Today we learn that the Home Office is to fast track 12,000 asylum claims with a stupid questionnaire, with will be very easy for bogus claimees to garner the system. Rishi is reportedly going to give into EU demands on Northern Ireland, giving them a bad deal- as he puts trade with the EU above the ongoing issues in N.I.

    Therefore I have no faith this Government can do anything properly anymore – nor to the will of the majority whom voted for them.

    I think people need to accept the Conservatives will be out of power for a very long time, thanks to their continual policy betrayals.

    I don’t want a Labour Government, however that is where we will be in 2024, thanks to the sheer incompetence of this supposedly Conservative Government (Lib Dems in all but name is what I truly believe).

    Rishi needs to be booted out and Lee Anderson brought in as leader, if your party has any hope of retaining votes for the next election.

    1. The Prangwizard
      February 24, 2023

      How can anyone believe that Sunak understands or cares for the protection of UK sovereignty, or our history. His history is from elsewhere.

      But his party MPs will be loyal to him no matter how much his actions lead to our destruction, because the protection of tbe Tory party is more important to them than our country.

      1. Lynn Atkinson
        February 25, 2023

        Doing a rubbish job of protecting the Party then. Itā€™s terminal.

  29. Judith Hoffman
    February 23, 2023

    excellent article. Sadly I don’t think any of the managers from the top down have the common sense to know where to start to address any of the questions posed.

  30. MWB
    February 23, 2023

    “There needed to be extra capacity as the population expanded considerably given a generous policy towards inwards migration and difficulties in stopping illegal arrivals.”
    This useless government hasn’t even tried to control immigration, becaue THEY WANT IT MORE OF IT.
    Why are immigrants given access to the NHS ?

  31. Cuibono
    February 23, 2023

    I donā€™t see how you can get service ( = productivity?) when many workers get income support.
    Not to mention access to food banks! And supermarket etc.subsidies FGS.
    Surely that means they arenā€™t hungry for promotion or every minute of available overtime?
    And why should those who shut their doors to the taxpayer at a time of alleged need be so rewarded?

  32. ChrisS
    February 23, 2023

    We can only hope that the EU appreciates the risks they are taking by not bringing the DUP along with their inadequate proposals for resolving the present difficulties in NI.

    The cowardly shooting of Chief Inspector Caldwell should be a warning to all sides that it is absolutely essential that all parties are able to buy into the solution.

  33. forthurst
    February 23, 2023

    Get rid of all the managers who are not medically qualified. They are generally people of much lower calibre than those they purport to manage and they multiply like flies as each one attempts to build his own bureaucratic empire without regard to the imperative of subserving the needs of public health.

    The NHS is not a business, it is a public service and the attempts by the Tories to organise it as though it were a business should be abandoned as they have not improved the cost performance or public satisfaction as they have inevitably led to perverse incentives.

    The government should stop intervening in matters of priority in order to present a more competent superficiality or prescribing mass medication as a result of pressure from foreign pharmaceutical companies and bribing the medical profession to go along with it.

    A major role of government is to stop foreigners abusing the medical services to which they have no entitlement. We are being invaded by people who bring with them infectious diseases; we cannot afford to offer a world health service because it severely impacts the services received by patients and the community especially in locations proximate to ports of entry.

  34. Peter Parsons
    February 23, 2023

    Why no mention of a need for increased capacity due to increased life expectancy and advances in medical science devising new (and often expensive) treatments?

    1. a-tracy
      February 23, 2023

      Peter the number of State Pensioners has gone down!

      1. hefner
        February 24, 2023

        Indeed their number has decreased by 1% in 2021 to 12.4 m, who on April 2023 will see their state pension go up by 10.1%.

        1. Mickey Taking
          February 24, 2023

          and the deceased rate will climb as more and more die of malnutrion, hypothermia, losing will to live and basic stress of this shitplace of a UK, where fit young men arrive illegally on dinghies – get medically checked out, fed, put up in 4/5 star hotels with daily spending money…and a Minister tells us to live on parsnips.

          1. a-tracy
            February 26, 2023

            MT I donā€™t think the plan is for you to eat turnips, I think the plan is for multi-generation habitation of British citizens to free up homes for our new illegals. I believe they want to make it so expensive to survive on low level pensions that eventually people will crack and try to move in with their children when their grandchildren leave the nest, if they ever can now. Itā€™s one big nudge, listen out for it in the media the nudges are there every day. People blocking big houses they canā€™t afford to heat should downsize. People should retire closer to their children so they can be on hand to help with childcare and vis-a-versa when elderly care is then required. The social care big charges and the desire that wealth cannot be passed on through your own family you can only protect a small amount of it and for some people in low value homes in the North that is the whole value of their home. The only people really getting free social care are those that donā€™t ever provide for themselves and believe that Britain owes them a life long income and moan thatā€™s not enough, they want MORE.

        2. a-tracy
          February 26, 2023

          Yes hefner, and as you keep reminding us inflation is over 10% isnā€™t it so theyā€™re no better off for the extra 10% tax thatā€™s been generated to pay for it.

  35. glen cullen
    February 23, 2023

    New football independent regulator = New quango = More public money

    1. Mark B
      February 24, 2023

      And completely toothless like all the others.

  36. Barbara
    February 23, 2023

    With Serco offering 5 year rolling contracts all over the country to house ever-increasing numbers of unvetted illegal immigrants, there is presumably no end in sight to the ā€˜generousā€™ public services we are expected to provide and pay for for them, while we go without ourselves.

  37. hefner
    February 23, 2023

    ā€˜They donā€™t have bread. Let them eat briocheā€™.
    ā€˜People should cherish what is available in this country, turnips instead of peppers, lettuce and tomatoesā€™.
    The times they are a-changing.

    1. Mickey Taking
      February 23, 2023

      sadly the grass isn’t growing yet.

    2. a-tracy
      February 23, 2023

      I think the salad on offer in winter in the UK for years has been pretty tasteless. I eat salad nearly every day through the Spring and summer but what we import hasnā€™t be up to par for a long while.

  38. glen cullen
    February 23, 2023

    Home Office ā€“22nd February 2023
    Illegal Immigrants – 192
    Boats ā€“ 6
    More public services redirected ā€“ More taxpayers money spent

  39. brassneck
    February 23, 2023

    More public service for money can mean anything?

    especially when we hear Boris on Sky again sounding off with another disgraceful display of ignorance – doing his Churchill stuff about Ukraine – talking about all we should be doing and giving to the war effort when we havn’t got a penny – anyone should think that he had some standing – and just why is sky giving him so much time? disgraceful display.

    Here’s s buffoon chancer who think’s he know’s it all trying to stir it up and given half a chance will talk us into a war – all – just so that he “bunter” can have a go at the greasy pole again – jeez there’s no end to his BS

  40. IanT
    February 23, 2023

    Well said Camila, Queen Consort.
    Straight to the point and unambigous

    1. Cuibono
      February 23, 2023

      +many

  41. Mickey Taking
    February 23, 2023

    A family member has struggled with confirmed IBS and had several problems with attending secondary school as a result – rumbling tummy heard by the class, urgent need to leave lessons, yobs in the loos and many with broken locks….
    So – after getting nowhere waiting on NHS, family has gone private including a decision on 16 – child or adult? – rapid diagnostics within 1 week, endoscopy, colonoscopy, MRE….
    The other day an NHS appointment arrived which may only be triage type, for DECEMBER 2023.
    I’ve suggested photocopying to Sunak, Health Minister, local MP, Hospital Trust CEO and to local GP who is horrified.
    This is the state of our National Disgrace of a Health Service.

  42. Geoffrey Berg
    February 23, 2023

    I think our politicians are living in Utopian cloud cuckoo lands.
    On the Conservative side having just got less for more money out of the NHS, one cannot in today’s world expect ‘more public services for more money’. That is throwing good money after bad money. What is needed is systemic change (i.e. private, competitive operation but public funding, though less public funding) rather than attempting to tinker with or tweak what is evidently an unworkable system.
    On immigration far from reducing immigration, fast-tracking paper applications is going to increase and encourage immigration. What is needed is not merely speeding applications but refusing applications – how about applying ‘the first safe country’ test to the minority who aren’t really economic refugees?
    However Labour is not to be outdone in the dreamland Utopia stakes. Keir Starmer has apparently promised today that ‘a Labour government would deliver the highest sustained growth in the G7 group of wealthy nations by the end of its first term’. Starmer is yet to explain how he will actually get such growth. However nobody should now criticise Boris Johnson over rash promises when Starmer is now trouncing him on that! I did not know Starmer was hoping not just to run the British government but also the governments of all G7 countries. How can he ensure Britain gets the highest sustained growth rate if he does not control both fortuitous events (which may favour the U.S.A. given its natural resources and its lead in most technologies) nor the governments and governmental policies of the other 6 Countries? Perhaps the current DPP should prosecute Starmer for his con-man tactics!

  43. Lynn Atkinson
    February 24, 2023

    JR, I apologise. You did post the comment by the Estonian PM at Munich.

  44. Frances Brown
    February 25, 2023

    This post is great! I like the way that the government has been very open about how they are spending the money. I also like how they have been able to create a positive environment for employee relations. I think that the management needs to focus more on delivering the healthcare that the patients need, and also ensure that they have the resources they need to do so.

  45. glen cullen
    February 25, 2023

    Ajax Armoured Vehicles coming in at Ā£5.5bn + for 565 vans to carry soldiers ā€¦thatā€™s almost Ā£10 million each ā€¦who signed off on this deal

Comments are closed.