NHS productivity has plunged 18.5% in five years. Thatās despite or because of five years of record increases in money going in, and large increases in staffing, taking it to over 2 million employees. This is a national disaster.
The sackings should begin at Ā the top. There are too many six figure salary managers who manage to lower productivity by over recruitment and by diverting attention away from getting people Ā better to a whole series of woke issues about the staff and the organisation. I was blocked in the Ā past trying to find out how many chief executives Ā there are in the NHS in the alphabet soup of quangos and Trusts. Chief Executives who cannot meet budgets or cut waiting lists with all the extra staff and money they have should be told to go.
Good medical teams need building and supporting. Managers need to be good at organising work flow and ensuring a good patient experience. Wes Streeting needs to start at the top, appraising his reports and expecting a much better performance. They in turn need to expect more from the hospitals and GP surgeries that do the work.
February 11, 2025
Good morning.
Sir John
As someone who has recently been visiting someone in hospital and has witnessed many things I can confirm that the NHS as it is currently run is, as you state, a national disaster.
Nursing has been reduced to a ‘box ticking’ exercise. With forms to fill in to prevent legal action being taken against the Trust and those in charge. It is near impossible to see a doctor, especially at weekends when, if there were, patients could be sent home days earlier releasing pressure on the system. Instead they just pile them up in the corridors awaiting an available bed.
I could go on listing so many things wrong, but we need to move away from treating the NHS with reverence. It is not well deserved. All the NHS is is a unionised bureaucracy protected by Labour as this is were they get a lot their funding from. Patient care, as we have seen recently from Labour MP’s, is not a factor.
February 11, 2025
My son is a junior doctor in Central London & now his pay has climbed to about Ā£45k gross which after tax, NI, student debt interest (6 years of), london rent on a room, tube faresā¦ is still insufficient to live on in London. Even had to pay his own Ā£500 for an exam he needed recently. He does however see loads of patient at A&E each day. A couple of dislocated shoulders relocated the other day. Why do the managers get more than double?
Amanda Pritchard NHS CEO read history and was the Oxford Union Librarian and has worked for the NHS all her career. She gets over Ā£330k PA including her gold plated pension costs. Perhaps my son should have read history and say diversity for three years instead of medicine for six? To double his salary?
February 11, 2025
That or go of to Australia, Canada, New Zealand or the USA – as so many do. To be replaced by cheaper imported medical staff from countries who need them themselves.
February 11, 2025
Please buy him a house so he can focus on his career, curing people. Thank you!
February 12, 2025
I will have to it seems. The two other children too.
February 12, 2025
Good on you, sir (seriously – parents who can afford it will be doing their kids a decent thing – especially as your son is a doctor which we need).
February 12, 2025
It’s not really about other people – but being able to start a family – and then settle down to a career etc (and not handing over lots of your hard-earned money to the government in inheritance tax where it will be wasted by the likes of Rachel Accounts).
February 11, 2025
Having had direct experience of two different NHS Trusts, I can only agree. There are clear differences in practice in both A&E and on the Wards. Anyone who has some management experience can sit and observe how things are organised, either for good or bad. Fortunately my local Trust is the better of the two, not perfect but much bettrr than the other. That Trust’s management needs to just go and watch their staff working to see the obvious issues, both in process and attitude. I find it very hard to believe this has ever been done at one hospital I’ve been a frequent visitor to. I’m certain poor/weak management is at the heart of this problem.
February 11, 2025
Mark B
I totally agree with your sentiments.
Having had my elderly father recently have a ‘failed discharge’ from hospital, I’ve seen it first hand. Transport refusing to leave him alone, the Care manager also agreeing, an Occupational therapist arrived, took one look and then called for an ambulance to take him back to hospital!
What a disaster!
February 12, 2025
I have seen this too. Patients treated appallingly just to try to get rid of them when they were in no state at all to be released and now proper home care. One arm of government arguing with others. Social Care with the NHS with the GP the patient a pawn in the middle.
February 11, 2025
Too true Mark – NHS Managers often introduce new equipment that takes nurses a while to learn but doesn’t do anything to improve efficiency or productivity – far from it, it becomes yet another task that must be done.
Nurses spend too much time collating data or setting up machines, such that they have less time to be nurses.
February 11, 2025
@ Mark B – “those in charge!” the empire builders, the clinicians those that deliver no longer appear to have a say in how the service is run for the ‘Customer’
February 11, 2025
Competition is the well tried and tested solution to low efficiency and productivity but it only works when customers have choices. Patients of the NHS have no choice, ergo there cannot be competition. The NHS is a socialist construct predicated on the supply side being able to divine what patients want and need and always being capable of elevating itself to the highest level of service without any competition. Productivity and efficiency cannot be driven by top down direction alone. The whole ethos of the organisation must be customer oriented in the knowledge that customers can go elsewhere if not satisfied.
None of this obtains in the NHS but it is quite common in other countries. The NHS Confederation runs an exchange programme called HOPE with EU countries. However the NHS seems incapable of learning from others. Further afield than the EU (why does the UK still have difficulty looking beyond the EU?) there are plenty of countries with far superior health care systems. Lord Hannan wrote in the Telegraph that UK should import Australia’s system lock, stock and barrel. Having experienced both Australia and UK I can certainly endorse his proposal.
The most frustrating thing is that it actually not thet difficult to find better systems than the NHS. The great obstacle to change is the people who run it and their culture.
February 11, 2025
@Peter Gardner – if Governments and it appears to be all UK Government since the inception of the National Insurance scheme had first made it a National Insurance scheme and not a tax scam, all free from the grubby hands of clueless politicians. We may have had just that – an insurance scheme paying for a service from those able to provide to meet our health needs.
February 11, 2025
A drop of 18.5% in productivity is unacceptable and it needs to be addressed as a priority. No manager deserves to remain in place when they have presided over such a huge failure.
So much of what has gone wrong with our country since covid is due to woke-Marxism. It has manipulated society into a preference for āvaluesā over āstandardsā. It needs to be the other way round and we should be making reference to āstandardsā again (which we hardly hear of anymore).
Also āvaluesā should not be determined by woke-Marxists either. It is an extreme ideology and it should have no place in our public sector (nor private sector).
It should be seen for the extremity it is and removed from our daily lives. That can be done but it takes leadership from government and regulators.
February 11, 2025
My partner is in hospital recovering from pneumonia. She needs a ā¤ļø heart scan but they only do them on Thursdays. She is taking up a bed unnecessarily. I doubt this would happen privately or in any other country.
There is so much waste in the NHS and things won’t improve whilst the same consultant takes on private work in parallel to their NHS duties.
February 11, 2025
@Ian wragg – sorry to hear that I hope she gets the service required with a great outcome soon
February 11, 2025
Good performance on the Mogg show last night. But where do GB news get these mad, dim lefty guests from? Are they on just so we can laugh at their inability to think?
Mogg asked about why King Charlie does not take a stance on the farming IHT Labour muggings said he is not political! But he is political all the time on net zero, renewable, organic farming, diversity is our strengthā¦ in totally hypocritical ways too. He and his mum, whom he inherited his wealth, is, of course, is exempt from IHT so a bit of hypocrisy there too!
February 11, 2025
Hypocritical and wrong headed too!
February 11, 2025
The NHS is our great talisman, and our biggest failure. By any international comparison it is a middling to poor health service, with bad value for money. Despite this, we can’t reform it. Touching it is one of the few taboos in British society.
If the NHS has saved your life, you might understandably be inclined to defend it vigorously. It’s saved mine once, but I don’t defend it. I know I’d be dead if I had waited for an ambulance on that occasion.
Brits are brainwashed into believing it is a marvellous service. Sure, it saves some lives, but that’s what a health service should do, amongst other things. The point is, it could do so much more. We don’t see the lives lost that could have been saved, or whose quality of life could be improved, if we had a system more like those on the continent run at the same cost. I’ve experienced the French, Spanish and Austrian systems and found them much better than ours.
Meanwhile the masses are fed episodes of Casualty, and mostly don’t understand that ending “free at the point of service” would not deny them good healthcare. The failures of the service are hidden by many of its managers, politicians, financial beneficiaries and via whitewash enquiries, scapegoating good employees, sacking whistleblowers, confidentiality agreements etc.
Simple test: How many here have managed to get onto an NHS dentist’s register in the last 5 years? There are no vacancies in my part of England.
February 11, 2025
@Wanderer – it is also the easiest of all Government command and control domains to privatise. MP’s Parliament and the Government seem to be frightened of letting go of failures, the failures of their personal very personal ideas, seemingly in case the alternative commercial option actually works – then what could they hang their personal ego on. What would happen if the health service focused on the customer, managed the health of the country efficiently and effectively? Instead we have administrative empires(nightmares) more focused on personal ego and KowTowing to a Health Minister who is bizarrely only the Minister for England – not really a Minister then
When things are not working, keep repeating the mistakes, the same mistakes every-time, there should be no surprise that you keep getting the same failure as the outcome.
February 11, 2025
And now every Trust CEO has a Deputy CEO, They have COOs as well with Deputies. Directors of Strategy ( CEO’s job) .Directors of Transformation and Change; Directors of Community Relations
A trust needs :
CEO, CFO, Director of Nursing , Medical Director and 3/4 NEDs
February 11, 2025
@David Peddy +1 nearly exactly, partially reverse the order Clinicians, Doctors head, Nursing head, the others doing what those that do require to run the Customer delivery service. There was a moment in history that it was a Matron that run a Hospital and the patients(costumer) was put first.
All good businesses, enterprises have the Costumer as No1
February 12, 2025
The customer in the NHS is not the patient (who is treated free eventually if lucky and do not die first) it is the government who pay them all the tax payers money. The NHS thus largely serve the government who pay them. He who pays the ferryman calls the tune. The patients do not pay so they are an inconvenience to be deterred by queues and inconvenience as they cannot be by cost in the āfree at the point of delay and rationingā NHS.
February 12, 2025
Just as night follows day, anything that is apparently “free” will get abused.
February 11, 2025
The huge net harm Covid Vaccines given to vast numbers of people by the NHS has not helped productivity to say the least. Not did the net harm lockdowns. Most cardiologist have seen v. significant post vaccine referrals and most never even needed any vaccines ever had they been safe and effective. See the recent Telegraph podcast on the MHRA regulator absurdly largely funded by Big Pharma.
February 11, 2025
NHS staff were forced to have the vaccine to keep their jobs. How much additional sick leave has this caused? How many experienced staff left the service? My previously fit daughter was vaccine-damaged and now has a life-changing medical condition. This was reported via the yellow card system but she has had no follow-up. Let’s hope the Trump administration uncovers the truth behind the pandemic and the midazolam misuse. The facts are a real eye-opener.
February 11, 2025
Further to my partner being in hospital, her son drove down to see her as a matter of urgency. He drives a Ā£55k Mercedes. He set off from north Manchester with only 80% in his battery indicating 280 miles. He drove to MK a distance of 163 miles at night in the rain
When he arrived it indicated 40 miles left.
He charged at the hospital carpark and increased range to 120 miles at a cost ofĀ£18
He then finished charging on the motorway at a further cost ofĀ£46. When he got home he had only 80 miles left. Luckily he had a works van.
It demonstrates the sheer non viability of EVS in an urgent situation.
He has since told me he had a directors meeting in London so he used the van. Crazy really.
February 11, 2025
Why would you buy an EV for Ā£55k with such range limitations just depreciation and finance costs (or loss of other investment returns) must work out about Ā£70k. Perhaps I can sell him my old diesel Volvo V70 range about 600 miles on a full tank for about Ā£1k. Not much depreciation or finance costs from Ā£1k! Cheaper by far to insure too.
February 11, 2025
But EVs still in early tech stage. Fighter jets today started off a 100 years ago or so with the Wright brothers flying some kite-like plane on a windy beach. Things have gone leaps and bounds since then!
February 11, 2025
”But EVs still in early tech stage”
So let the market/customer decide if they want the ‘early tech’ …without government forcing it on them ?
February 12, 2025
How is gov forcing people to buy Teslas ?!
February 11, 2025
The NHS is beyond manageable, is it not or else in the last five years one or more of Atkins, Barclay, Coffey, Barclay the first time, Javid and Hancock would have made it work?
February 11, 2025
Non sequitur. That’s like appointing a new captain to the Titanic after it struck an iceberg.
The fact that there are many health systems in the world both public and private that are far more cost efficient indicates the need for far more radical change than any Tory or Labour politician is capable of conceiving or implementing.
February 11, 2025
Decades of above inflation increases in spending on the NHS has led to this proliferation of waste and poor productivity, a 5% cut in funding might be the only way to make them cut peripheral roles and activities although of course it’s more likely they would cut core patient care. Not a single political party will ever cut funding though, including Reform, so it will just stumble on. In theory it should be a good candidate for AI productivity increases but of course the NHS is incapable of implementing any IT projects, even ones to eliminate paper-based patient records. From a Labour viewpoint I don’t know why they don’t just nationalise the entire GP service, put them all on staff contracts and make them work a full working week – it would be ideologically in line with Labour and would bring some patient benefits.
February 11, 2025
Another example of an institution needing fundamental change. Hopefully DOGE in the US will succeed and lead the way. Top out pensions at Ā£50K. Remove management down to 10% of cost of frontline staff, then get an IT company in to pare admin down to pretty well zero over time using AI. Charge for non-attendance. Tax credits and insurance to transfer elective to private sector. Insurance to cover any adult non-contributors. No ancillary services, interpreters etc.
So much could be done and it’s clear that the uniparty won’t touch it.
February 11, 2025
The woke jobs are needed because the courts find ever more ways to interpret the Equality Act, so management needs to keep abreast of it by reviewing policies and further training. Diversity managers are a necessity because general management don’t have the required legal training and have to concentrate on their day job. If diversity managers were removed, the organisations would soon find themselves victims of the compensation claim industry.
The way to remove the woke jobs is to remove the necessity for them by changing the Equality Act. Make the individual not the organisation responsible for individual behaviour.
February 11, 2025
There does seem to be a realisation, from those I know personally, who work or have worked in the NHS, that money isn’t the factor that has hampered their ability to do their jobs. Money mismanaged and spent on fancy carpet and chairs in non-clinical staff rest rooms yes, while a request for small essential items for clinical staff has to be filled in in triplicate, and much shaking of the bean counters head.
According to a friend who retired from nursing about 2 years ago, the modern day training of nurses is not as broad and far too classroom based.
It’s taking longer to sort out the wheat from the chaff, consequently time and money is being spent training those who are not hands on nursing material. Also a less broad training and specialising in one area earlier, means any staff shortage on any given day could be covered by a nurse without even the basic understanding of the condition prevalent on the ward.
That is just the opinion of a former nurse and some of her former colleagues, retired and those still nursing.
There are some hospitals so badly run and with staff so incompetent, brutal and with a ‘couldn’t care less’ attitude that it is costing millions in compensation, and lives.
Then of course there is a personal responsibility to look after our health, and so not take up time that could be spent on someone with no control over their condition.
The push to make everyone believe they are mentally ill on those bad days we all get where we feel everything and everyone is against us, is going to increase pressure on NHS.
As is the unnatural and unwanted population growth.
February 11, 2025
Many are under the misapprehension that the NHS exists to heal the sick. Nothing could be further than the truth. The NHS exists to provide employment for women who wish to return to the workforce after having children. They do not want low-paid cleaning jobs etc – they want senior level administration posts on huge salaries so they can afford a new Tesla.
The government regularly gives the NHS vast sums in extra money for more doctors, consultants, nurses, lab people, specialists such as radiographers etc. Do we get more clinical staff? We do not. We get extra layers of middle management, more department heads on humungous salaries, more wokery specialists etc. And not forgetting the ridiculously expensive and useless QUANGO NHS England
The NHS is one of the largest employers in the world, employing ~1.45 million staff members. However, this number only includes ~130,000 doctors and ~300,000 nurses. About 30%. Labour should scrap two or three layers of administrative middle management, freeing up whole floors in hospitals that could be converted into wards.
February 11, 2025
Several decades ago, I was involved in the NHS National Programme for IT as my employer had a large team of specialists assigned to developing various parts of the contract. My primary contact worked for NHS England and had overall UK policy control of her discipline. Having agreed the product and service provision with her, I was then tasked with communicating these to local Trust management who had responsibilities within this area. Over several years I visited most of the Trusts and met many NHS managers. Some were clearly competant and a pleasure to work with, however many seemed to have little interest in the NPfIT programme and were often hard to meet and gain any concensus from.
One person in particular told me that they simply weren’t interested in the programme and would not be participating in it, although not until I’d made a very long journey to meet with them. All of this was documented in my site reports and copied to the senior NHS England Manager. When I raised the issues to her privately, all I got was a wry smile and a shrug (although at least she did pay for lunch). Things may have changed since then but somehow I doubt it. The Trusts were very protective of their independance back then and the challenge to anyone trying to make reforms, is that they will need to enforce them in every Trust. All 200+ of them….
February 11, 2025
‘The NHS exists to provide employment for women who wish to return to the workforce after having children’ – GREAT comment. Don’t agree 100% but still very valid point. And you can see the same outside NHS too.
February 11, 2025
The point of the NHS is not to cure us; along with Woke, gender and especially mass immigration its purpose is to narrow the Overton Window of debate and action. Hence we have the chicken nugget issue which sums up the control the malign actors in the legal, political and economic systems have over us.
Talent and wealth is evacuating Britain. We are done and there will be nothing left to put right by 2030. This is little more than a fantasy football blog. “This is what you could have won.”
We as voters did our bit and were let down badly.
February 11, 2025
Don’t give up. Our country still potentially has great future.
February 11, 2025
The actual deterioration in efficiency is virtually double the reported 18.5%.
The telegraph reports this figure, it also informs us the NHS has increased employee headcount by 313,000 since 2020.
That increase in employees is itself an 18.5% uplift in staff. The additional team members has achieved this 18.5% reduction in performance outcomes and patient attention.
The actual downturn when the increase in staff is taken into account is 37%.
That is not so much a downturn, it is a complete collapse of efficiency.
February 11, 2025
Sir John
“Collapse of productivity is unaffordable and unacceptable.” – Yes, but there is no one in Parliament let alone Government that actually has an inkling as to what āmanagementā is.
As to the NHS once the system changed from being run by clinicians to one run by administration it performance drained away. Its no about personal and yes political empire building ā the self-indulgent satisfaction of spending millions of someone elseās money. Delivery to the ācustomerā is a distant past. Thatās the fundamental difference ācliniciansā signed up to serve, serve the customer, the ill, itās in their DNA. PPE administrators joined a cabal of the self-serving as it is the taxpayer they want to be served by.
February 11, 2025
Follow that through to every corner of expenditure of taxpayerās money which after all is approved by the whole parliament and you see the fatal flaw embedded in the UKās structures. They want to spend because they, and only they thinkās it makes them look good. They want to run things they have no experience of because their ego tells them that is their position in life. They want to tax because thatās āincomeā their income.
Follow the ego, last week Rachael Reeves visited a German to give a speech about āgrowthā is that because there are no UK Companies willing to be associated with her or is it there are no UK Companies left to achieve growth.
Parliament and Government fighting the people
February 11, 2025
The ease of funding to the public sector and that public sector leaders do not need to raise their own funds inevitably leads to poor productivity.
The best way to solve this and particularly in the NHS is outcome based funding. The NHS should invoice for its activity based on an agreed price list. As part of this change users should be charged an attendance fee to secure an appointment, refundable on attending and producing a valid, irrefutable NHS number.
This may mean that the NHS actually gets more money, if it over performs. I don’t think many would object to that.
February 11, 2025
Itās too late. The NHS – and all other government departments – is overmanned, over-managed and inefficient. Once people are employed on good salaries, long holidays, plenty of days off sick when a long weekend is being enjoyed and, of course, a great pension is being built up – they are not going to give that up without a fight. And they are in unions so can strike. Despite the inefficiency, some of their work is important and we canāt do without them. Itās too late. Nothing can prevent the inexorable growth in numbers and cost and decline in service.
February 11, 2025
āRachel Reeves says āa deal can be doneā with Donald Trump to avoid tariffsā ā delusional, the Donald s beef is with the inequitably caused by the refusal of balanced reciprocity.
The UK being tied to EU laws and rules means the UK charges the US more in tariffs than the US charges the UK. Pure and simply discrimination on the UK Governments part.
World Trade has to change everyone has to be on the same playing field, the EU and China distort that simply to gain and advantage at someone elseās expense – that usual means the Taxpayer
February 11, 2025
He will break us free.
February 11, 2025
The NHS thinks it is efficient because it employs factory style production lines, but this excludes the human element of repairing a problem.
It is clear that all processes within hospitals are there for the benefit of hospitals and doctors. Just look at how hospital patients are awoken so early in the morning just so the pills can be dished out.
Patients are not treated as individuals, they are prescribed treatment and medicines on the basis of their diagnosis, but not tailored, often without good reason. This is why the drugs bill is so huge, because once on a drug that may or may not have been necessary, they get other drugs to counter side effects of the first drugs, all of which make the patient a life time user.
The use of the catheter is another example of NHS doctrine, fitted by default in A&E, it can be retained painfully in place for weeks, when it is questionable if it was needed in the first place.
I’ve noticed that doctors, including GPs, have forgotten how to observe a patient and relate to them. Their procedure insist that ‘tests’ must be done before they make a prescription, but in the meantime the infection or issue is allowed to get worse and the problem more difficult to treat.
I’m not convinced that extra money will help with all of this – it will require a revolution in thinking from the top down. Individual annual assessments for all NHS managers and staff would be a start!
February 11, 2025
Purely from my own experiences over a lifetime. The NHS has deteriorated to almost third world standards,
When i was taken seriously ill (2018) with what turned out to be a Pulminary embolism, I laid close to death on my kitchen floor waiting for an ambulance. It took over 30 minutes to arrive (on a Sunday afternoon)
Arriving unconscious at hospital i was treated with clot-busting drugs which saved me. However along the way i was ‘thrown’ from one trolley to another resulting in me awakening with whiplash. Perhaps the price of being kept alive !
That was the good story!
Now attempting to see a GP has become close to impossible. The telephone seems to be the consultation media, not much good to a deaf bloke !
My wife needed to have severe left-side abdomen pain investigated. The surgery said we’ll book a scan. Weeks went by, nothing was heard. So she phoned the hospital to see what was going on. They said we are waiting for more info from the GP. The GP had either not been told that or had forgotten. A couple more weeks went by and the scan happened. (awaiting the outcome currently)
When i was working, my employer had an arrangement with private medical care. I had a back issue investgated/scanned and diagnosed in one day ……………………..
February 11, 2025
3rd world indeed. I know people from Brazil and Turkey working in UK and eligible for BHS treatment who have gone back to their home countries for operations as the NHS waiting lists were too long.
February 12, 2025
Hospitals often clumsily lost X-rays and just put the patient through repeat rays as if there was no added risk, loss of time or wasted expense in consequence. Those who make careless errors should receive the weight of consequence they cause.
The NHS is far to sloppy on simple quality standards to run efficiently.
February 11, 2025
Streeting does not have what it takes to sort the NHS out it is an important role we need someone with talent
February 11, 2025
No-one has what it takes.
February 11, 2025
A pity the Conservatives di not realise that!
February 11, 2025
Iām sorry, but what exactly do GPās do. Itās the allied Staffs that run Clinics in GP Surgeries not GPāS. They look after minor issues in a 7 minute slot, anything of concern is immediately referred to a Hospital Consultant. Itās difficult to get an appointment with a GP face to face, Theyāre happy for you to see a Nurse or Healthcare Assistant. This is why A&E Departments are overflowing with disgruntled yet ill people. The GP Contract was radically changed during Blairās days. No more weekends, or night cover as another Service was created to do that and who staffed that Service, the same GPās who were given large sums to do so. Streeting or whoever needs to radically get a grip of this situation and bring GPās into the NHS Terms and Conditions, not allow them to have a gold plated contract on their own.
February 11, 2025
Both my wife and I have had excellent treatment from the NHS when we have had serious health problems. My wife is a retired nurse who trained in the late 1960s/early 1970s, in the era when Matron ruled the roost and hospitals did not have layers of management. So she is more aware of the decline in standards today compared with the past. A big mistake is requiring nurses to have a degree today, where my wife was trained on the wards, with regular days in nursing college. You don’t need a degree to be kind, compassionate and caring.
Wes Streeting talks a good fight, but doesn’t achieve much. For example, some NHS trusts are still advertising for DEI managers and staff, which is a complete waste of money. Our local hospital has painted the zebra crossings in the complex in LGBT colours, another waste of money. One simple action would be to freeze NHS budgets for 3 years, and make these highly paid executives earn their salaries.
February 11, 2025
Wes Streeting may have a better chance than a Tory Minister because he won’t be immediately butting heads with the Union running the service. You’ve got to wonder why all these highly paid DEI execs with no medical training are required often paid a lot more than new Doctors. The NHS is one of the UK’s most diverse workforces; they hire from all over the World, often at the detriment of training UK citizens. Why don’t they include each other to the degree that they need so many DEI hires to tell them how to behave (these are skilled, often degree-level workers, aren’t they)? Are they the most racist workforce in the UK? Are we hiring people not up to the job and thus go off sick because they can’t cope trying to be inclusive? All of this seems to be prioritised over patients. The Tories got themselves caught up in it, rather than dealing with it.
I’ve got to admit I love reading about DOGE in America. Who do we have in the UK to start looking for efficiency.
February 11, 2025
The new health minister thinks “trans women” are women. We need a sensible person in charge of health. Are there none on the Labour benches, to choose from?
This appointment says a lot about Starmer’s unsuitability to be a country’s leader.
February 11, 2025
The Government needs to stop paying for the NHS. Totally.
It needs to pay for the patients until we can convert to a proper insurance scheme, perhaps the insurance scheme needs to be set up now and each citizens NHI goes to a fund to pay the insurance companies.
You will be amazed at how quickly the health industry pulls itself together. It will fund training because the borders must be CLOSED.
JR – we need you as head of our own DOGE.
February 11, 2025
Trump says on camera in a formal interview that the USA has spent USD 500 billion in Ukraine! He also says Russia has won the war. Somebody need to stop the U.K. making (even more of) a fool of itself.
“One day they may or may not become (part of) Russia, but our money is there, and I want it back. I already told them that I want to get the equivalent in the form of rare earth metals worth about $500 billion. And they, in fact, have already agreed to this, so at least we do not feel like fools,” he said.
February 11, 2025
Sorry, interview on Fox News for reference.
February 11, 2025
@Lyn Atkinson +1. We are total fools and hostages to fortune if we “stand by Ukraine for 100 years”. Trump is a savvy operator, our leaders are dopes.
February 11, 2025
Socialism depends upon people remaining poor.
This is why the socialist state will want to pursue nationalisation, low productivity, low wages and a population dependent upon the state. Hence DEI, wokery, Net Zero and the mass immigration of the Worldās poor.
That NHS and Civil Service productivity has collapsed is part of the plan and hence why nothing will be done. High wasteful spending justifies high taxation and this takes money from peopleās pockets to not only make them poorer but spend and hence consume less which aids their Net Zero goals.
February 11, 2025
A&E departments are grinding to a halt as I know of a Doctor who took his own mother to A&E last week and had to be with her all night ! You cannot imagine how he must have felt let down by the NHS. Not a great advert for productivity in a nutshell.
February 11, 2025
I went to A&E recently with symptoms they say you IMMEDIATELY have to go to A&E with and it was 8hrs later having been referred to a different hospital when the necessary tests were carried out. Before finally seeing the specialist this involved getting past 6 gatekeepers one of whom told me I should have been referred to a different hospital and said heād have to get special permission from his boss to allow me to stay (he disappeared for 15 minutes to obtain this) and then announced āNow Iāll have to waste my time writing a complaint to the hospital that referred you hereā. None of this particularly surprised me. We have all heard similar stories. The people who think this service is the best in the world must be rapidly reducing.
February 11, 2025
There has been a collapse in professionalism across the state apparatus, some remains hidden because it has not been tested. The MOD for instance, who still insist Ukraine can win.
Former Chairman of NATO’s Military Committee, Harald , disagree. He called on Western politicians and media to understand that over three years, despite massive financial and material support, as well as training and modern weapon systems, Ukraine has failed to achieve military success.
“And such an opportunity, if it ever existed, no longer exists,” he added.
The MOD needs to account for its incompetence and misleading of the political class.
February 11, 2025
A while back the idea was to let GPs run their own surgeries and doctors and nurses to run hospitals etc. What happened to this idea which was excellent. My GP was very excited but then the big guys took over and it went central (we have 7 surgeries in our group now) and it is so impersonal. Our GP has lost interest and does private work alongside limited time spent in NHS work. How to take the excellence and excitement away from the people who should be running and organising our health service.
February 11, 2025
I was listening to this really smart private doctor who seemed to suggest the real problem with NHS is chiefly to do with management. A kind of bureaucratic system where there is no proper structure and in particular hierarchy. So it’s like a very left wing / WOKE / namby-pamby approach to doing ‘business’. People afraid to tread on the toes of others, type thing (whilst management still being paid loads of money).
February 11, 2025
3 criminals arrived in the UK yesterday; from the safe country of France ā¦someone in Labour has just said āāwell its only 3āā
February 11, 2025
Another big problem is patients! I spent the night by my mother’s chair in the hospital and the amount of abuse the health care workers, nurses and doctors received from patients and their families off the charts. Let alone no please or thank you (some were polite). It’s not just people want something for nothing but the amount of rudeness / aggression towards staff.
And all this vulgarity is related to the problem of people relying on the state in general. Dysfunctionality on a large scale that can only be dealt with by a cultural response as opposed to purely political one.
February 12, 2025
They need CCTV with voice recording, and then they must prosecute to stop it. It is becoming out of hand, and if people think they will be recorded if they kick off, they will self-monitor.
February 11, 2025
Who needs productivity, when we have net-zero and artificial-intelligence to save the day
February 11, 2025
Non operational staff are taking up too much of the wage budget. Many of them need to be dismissed.
However, some operational staff need to be re-organised.
Our local GP service puts a lot of effort in making patients feel unwelcome and when they finally allow you to see someone, all you get is a triage service.
GPs are no longer GPs, they are overpaid triage nurses.
Time to dismiss them as they are also taking up far too much of the wage bill.
February 11, 2025
All Governments should have realised the NHS has become a behemoth. It has been overfunded and over-staffed for decades and is now as of 2022, one of the biggest employers in the WORLD. There are more employees in the NHS than in the Indian railway system and fifth in the total employees league table of State-owned organisations across the planet.
With that number, anyone would think we’d have the best health service in the world. However, thanks to inept and diabolically bad management, there are far too many non-medics in our NHS. So many they approach the numbers of frontline, primary care staff. But why are there so many of them?
We know the answer and its wokeness, DEI et al. Nothing jobs, unproductive jobs for sure.
Until a UK Government does a “Trump” and rejects all of this nonsense, we’ll never get back the NHS that was once ‘the envy of the world’.
Nye Bevin, NHS creator from good “Old” Labour, must turn in his grave in horror and despair.
February 11, 2025
I would set in the concrete of law that every ministry, government department, quango, and local government department, in fact every entity financed from the public purse , should publish in miniscule detail every penny they spend and on what. I would include everyone they employ and at what cost. Lay bare the profligacy of government. You all might be surprised, nay gobsmacked, at what you are financing.
February 11, 2025
How many independent chartered accountants are you willing to pay for that? Their pay rate is between Ā£80 and Ā£500/hour depending on the exact task.
āYou all might be surprised, nay gobsmacked, at whatā your ābright ideaā might cost.
February 11, 2025
Heard of computers? This is one of the (few) things they are good at. Monitoring. The other is dealing with vast amounts of data very quickly nd accurately.
February 12, 2025
None, the spenders fill their own spreadssheets, at risk of dismisal for fraud or camoflage.
February 11, 2025
The way our government has been running for about the last 20 years is as if decisions were made according to whatever an arrow on a Wheel of Fortune pointed to.
Maybe that wasnāt the case, yet the continuing dire outcomes seem even worse than relying entirely on chance would have caused.
February 12, 2025
It really isn’t this or that which is unacceptable about the NHS – it’s the NHS itself.
It has to go. We need a tiered, contributory system, run like a business (or several businesses, as there will be multiple insurers) with a direct ID link between patient and entitlement, and a cost base that is fully accountable at every stage of treatment. Not an institution run for the convenience of the staff in its every sector.
And abolish health insurance premium tax – it is a disgraceful anomaly. Health insurance is currently not a luxury for many, but an unavoidable life-saving decision. Bin the taxes and increase competition and efficiency, and watch the premiums fall to affordable levels.
February 13, 2025
It wont happen, the NHS is finished and unmanageable. Its only hope is for a Royal Commission and to start afresh.