The health Secretary asks the audience

The health Secretary has said a few bold and sensible things. He has said you do not just tip more money into the. NHS without reform. He has said maybe they need to buy in more private sector help to deliver more and better free care to patients.

More contentiously he has said the NHS is broken. Instead of getting on with mending it he now proposes a long and large consultation with staff and patients to see what to do. Itā€™s like asking the audience on a quiz show if the contestant hasnā€™t a clue about the answer.

Patients will tell him they want less waiting time, easier access to GP appointments and better treatment when they need it. Staff will tell him they want more pay, better hours and better working conditions. No great need to go to consultation on that. Consultation with staff should start when he as their top boss decides what changes he wishes to make to working practices. Consultation with patients should start if he wants to change the way they access treatment.

His instinct that there needs to be change is a good one. History is littered with well intentioned Health Ministers who found guiding change was expensive and difficult. Wasting much of the first year on asking the obvious is not a good start. The NHS needs help now in spending its huge sums in the best way, and in hiring and motivating the right staff to get more work done. Firing the Chief Executive of NHS England would be a good beginning to underline the message that currently senior management are not boosting morale or productivity in the way we need.

104 Comments

  1. Mark B
    October 22, 2024

    Good morning.

    Consultation means : Left boot – Tin can – Long grass.

    If he does not know the problems with the NHS, then he should not be in his job. I can tell you one of the prime reasons the NHS is broken. Too many people accessing it. From the elderly, to those who should not even be in this country.

    We do not need consultations. What we need is radical reform. I have mentioned here often enough that private companies and / or individuals should be allowed to have private medical insurance tax free. I believe MP’s get private medical insurance, so the concept and its advantages are not lost on them.

    We also need to make sure that those that come here to visit and even work, do so once they have taken out private medical insurance. There are those who claim that the cost to the NHS of those claiming FREE healthcare from abroad is small, but it is not cost that is the prime issue. It is resources and the time taken up using them.

    I do not expect things to improve not when those administering our affairs go largely uneffected by their poor performance.

    And I have not touched on the number of FAKE healthcare (un)professionals that are in the system. That is another scandal that has been swept under the carpet šŸ˜‰

    Reply Yes, cut migration and require foreign visitors to pay for care are both important. MPs do not get private health care!

    1. Mark B
      October 22, 2024

      R to R

      Thanks you Sir John. I was under the impression (from somewhere I read) that MP’s got BUPA Heathcare. Glad to be corrected.

      1. Roy Grainger
        October 22, 2024

        MPs don’t get private health care but I bet loads of them have it, why wouldn’t you if you can afford it given the state of the NHS ?

        1. Lynn Atkinson
          October 22, 2024

          What is the advantage of private healthcare when the PM can requisition those facilities for which you pay and thus deny you access, as Boris Johnson did.
          I know people who died of cancer during the covid lockdowns, including Tom Parker Bowles girlfriend. If she could not get treatment what hope is there for the rest of us?

        2. Lifelogic
          October 22, 2024

          Well nearly all insurance is a waste of money- especially so with 12% IPT tax on top. For most people it is far better to keep the premiums and pay for your medical care if and when you need too. Most of your premium goes in Insurance company overheads, IPT tax, profits, admin costs, fraudulent claims by othersā€¦ plus this way you do not have the hassle and wasted time of choosing which insurance and making any claims. Plus you can use the NHS if they are OK for the condition and only pay if they are not.

          Often a real bargain is to pay say Ā£300 to the consultant (who often is the same as the NHS one anyway) and then you can often jump the NHS queue by six months or so as they have ascertained you need an X procedure six months early. Do beware of private consultants looking for extra money though.

          Often it is a good plan to get an NHS view and a private ne and split the difference. The NHS under intervene and the private sector often over intervene. The rate of caesarean sections in the USA is about double the UKā€™s. Follow the money?

          1. Lifelogic
            October 22, 2024

            Ā£300 for a private consultation I mean not a bribe!

      2. Everhopeful
        October 22, 2024

        Maybe you saw that petition which sought to force them to use the NHS?
        Outcome would just be ignored as ever and surely a high profile would be treated properly by the NHS anyway?
        Private treatment by any other name!

    2. Lifelogic
      October 22, 2024

      The biggest issue is that the NHS is “free” at the point of use. Which means it is rationed by other means GP phone systems, delays, inconvenience, waiting lists… if you use the private system you pay four times over once for others, then tax/NI on the money you earn to pay you medical insurance, then the insurance premium then 12% IPT on top. A rigged system one Labour now want on private education too with VAT replacing IPT tax.

      As I pointed out yesterday Wes Streeting is so daft he thinks that someone who could have been treated for Ā£40 at a GP costs Ā£400 for the same treatment at A&E so he is obviously rather dim. Are the A&Es 10 times less efficient than GPs for the same five minutes with a Doctor if so why Wes?

      Why can they not get a GP appointment? Simple they are not paid for each appointment. If they were a dog or a cat no problem seeing someone the same day and getting MRI scans, e-rays, cancer tests…

      Free at the point of use is the main problem, all who can afford to pay should pay something for appointments. People on waiting lists should get voucher for 30% of the cost if they can find the other 70%. The NHS saves 70% and it cuts the waiting times for other who cannot? But of course Labour cannot do anything sensible like that.

      The net harm lockdowns, over medication & net harm Covid Vaccines have caused many health issue especially cardio vascular and blood clotting ones and have destroyed confidence in the profession. Especially as Sunak and the rest are still lying/pretending or misguided that the Covid Vaccines were safe when all the evidence say not. See the excellent film “Do No Pharm” – links on Dr John Campbell videos.

      1. Lifelogic
        October 22, 2024

        x-rays rather.

      2. Lifelogic
        October 22, 2024

        Stop the different arms of health care arguing with each other and pushing patients from pillar to post to try to get another department to pay. Social Care, GPs, the NHS – it is all the same tax payer money.

      3. David+L
        October 22, 2024

        True. Big Pharma and Big Food have a dreadful effect on our health as a nation. While there have been some wonderful treatments that have saved lives, sadly there has been a lack of integrity as the chase for ever-growing profits is causing our health so much damage. I read that the total fines in the US courts imposed on one company for false claims about their products is $30 billion. A medical journalist I met recently admitted that “the whole industry is corrupt.” Yet there are still many people who believe that Pharma acts in their best interests and refuse even to query the medication a doctor prescribes them. “Informed Consent” is almost impossible to ascertain and the industry wants it to stay that way! Wes Streeting has a big challenge if he really wants to make a difference.

      4. a-tracy
        October 22, 2024

        Yes, pets can get same-day treatment if they have insurance, but each appointment costs Ā£40, and treatments start at Ā£100. And goodness help you if they need an operation or an X-ray Ā£700, Ā£5500 for a treatment my friend paid last week!

        1. Mike Wilson
          October 22, 2024

          My dog vomited blood 3 weeks ago, on a Saturday, whilst away at friends. Seen within an hour at an emergency vets. Brought him home to my local vet on the Monday. Long story short, transferred to specialist vet for CT scan and biopsy. Back home now. Still donā€™t know whatā€™s wrong with him. Up to Ā£12k so far. You can get treatment for yourself, or your dog, if you are willing to pay.

          1. Lifelogic
            October 23, 2024

            With the NHS we pay and still do not get decent timely treatment!

        2. Lifelogic
          October 22, 2024

          Or if you just pay. If you have a car and pay to get your hair cut why not pay Ā£40 for the GP?

          1. A-tracy
            October 23, 2024

            I can afford to Lifelogic but my parents couldnā€™t, when I was little my Dad hardly ever went the doctors I think I recall him saying up to the age of 65 he only went five times, if he had to pay he wouldnā€™t have gone until he ended up in hospital.

      5. RichardP
        October 22, 2024

        +1 Lifelogic.
        The NHS could save billions if they cut their pharmaceutical and advertising budgets. Every day the TV has adverts for vaccines and every fortnight we get letters from ā€˜our NHSā€™ to get vaccinated, which is beyond ridiculous. We have God given natural immunity and the NHS should encourage people to exploit that.

    3. Lifelogic
      October 22, 2024

      MPs do not get private health care and nor do doctors and nurses in the NHS. Bank of England employees do. My son an NHS junior doctor does not even get his exam frees paid or study leave. He has just had to pay out Ā£500 for one he needs to progress to his chosen field.

      https://www.bankofengland.co.uk/careers/what-we-offer-you

      If you look at the full package (as I have done, I know someone who works their) it is hugely generous. NHS staff get virtually nothing and many have very large student debts some Ā£100K to repay from their salaries too.

      1. Lifelogic
        October 22, 2024

        work “there” (the BoE) even sex changes I think or similar were covered.

        Ā£100K of student debt for a doctor (plus interest) takes about Ā£25K off your gross salary for 10 years to repay. They start on about Ā£34k in London and it rise to about Ā£80K so average for the first 10 years is circa 50K less this Ā£25K leaves them about Ā£20K take home to live on. Less rent on a room say Ā£14K and commuting, council tax lunches – so negative net pay! Yet they (or parents) have to pay for their exams!

        1. a-tracy
          October 22, 2024

          This is a silly argument. All English graduates from 2008 onwards pay graduate tax at 9% in those BOE grads you talk of; if they want PM, I read the link. It is part of a reward package that results in a lower salary.
          They don’t pay more than 9% of the amount over Ā£27k pa so can you provide your working out to get to Ā£20k take home? My three kids all have grad loans, they went to Uni with Scottish students who didn’t pay, EU students in Scotland who didn’t pay. Scottish doctors don’t have tuition fees. It was Osborne’s decision to triple the loan and make it impossible to repay with sky-high interest from 2012, so it became a lifelong grad tax unless they earn over Ā£100,000 pa quickly.

          1. Mickey Taking
            October 22, 2024

            All started by Blur, he got unemployed teenagers off the streets, reduced crime by that group, side-stepped the cost of providing uni-degrees by having the student pay the fees, encouraged businesses in towns all over the country to rent out rooms, flats, houses to students, even sold some to parents!
            A master stroke, but how many are still in favour of what are consequences?

          2. Lifelogic
            October 22, 2024

            Not a silly argument at all – if they want to repay the debt in ten years that is the gross salary it takes to do so and often the debt is increasing after the 9% is paid. If they want a mortgage they can borrow rather less if they are still paying off or incurring a large student loan at 7% interest or so.

          3. Lifelogic
            October 22, 2024

            If they do not pay the debt off it keeps growing. Unless you are never going to pay it off best pay it off early at 7% interest. The loans are of course very sexist as women far less likely to pay them off with lower earning, more part time work, career breaks for children, lower payā€¦ Perhaps why so many more women go to university than do men. Nearly 1.5 women to every man at UK universities. Far higher still in humanities, lamguages and art subjects.

          4. A-tracy
            October 23, 2024

            Lifelogic, itā€™s meant to be a lifelong grad tax of 9% courtesy of the English Tories specifically Osborne, one of the worst things they did to their voters offspring and now many of their voters children wonā€™t support them because of it.

            My son was on plan 1 he paid his off thanks to getting a decent STEM masters degree youā€™d probably approve of! These women you speak of only tend to give up work to raise children for the couple and nowadays she breaks only for a short time unless sheā€™s married a man who earns over Ā£60,000 pa.

    4. Ian Wraggg
      October 22, 2024

      Precisely. Fourteen years in opposition railing against the last useless government only to realise in post he hasn’t got a scooby.
      Another inquiry so at every juncture he can blame the tories, another opportunity to stuff the NHS with more management and big pay rises.
      Will he tackle the BMAs opposition to training more uk doctors and nurses so they don’t have to keep Importing from their home countries. I doubt it. The NHS has so many foreign staff that recruitment from overseas is seen as the norm.
      Will he curb the new GP practice of telephone appointments which fail to spot symptoms and cause problems for hospitals down the line.
      Will he tackle the illegal use of the NHS by foreigner’s flying in to use our facilities.
      Not on your belly. Streeting is just another empty can modelled on the Welsh windbag

    5. JoolsB
      October 22, 2024

      But 1 million immigrants coming into the country every year, whether they are made to pay or not (which will never happen) still puts enormous pressure on the system. Clueless meddling politicians are not the answer. Put the medics in charge and replace the 47% of non medical staff with doctors and nurses. Stop the practise of nurses working three days a week and make them work the same hours as Junior Doctors, after all, they are paid similar. And stop treating people for cosmetic surgery failures, gastric bands, etc. Also, giving tax relief on private health insurance would help take the pressure off. Streetingā€™s ridiculous idea of giving people slimming injections and health monitoring watches will put even more pressure on already overstretched front line staff.
      Labour said they had a plan to fix the NHS. By seeking public consultation, it is proof they are as clueless on this as they are on everything else, another lie to get elected. Like Mark says, it is all a cover for being kicked into the long grass.

      Talking of tax relief, why are MPs exempt from paying tax on all their freebies. Apparently Starmer didnā€™t have to pay a penny in tax on his Ā£107,000 worth of freebies. If that happened in the real world, it would be classed as benefits in kind and taxable.

    6. Dave Andrews
      October 22, 2024

      In regard to free healthcare to those from abroad, 10% of NHS births are to women born abroad. The NHS has a shortage of midwives. If these foreign women went private they would have a surplus.

      1. Know-Dice
        October 22, 2024

        I thought it was between 28 and 30%

      2. Mickey Taking
        October 22, 2024

        We could try imposing a ‘non-returnable maternity fee’ of Ā£500 deposited for future services available, but not before 6 months had elapsed? (joke?).

  2. agricola
    October 22, 2024

    I would ask myself a number of questions.
    1. What is the size of the task, is it geographical, how is it defined by speciality.
    2. Do we have sufficient capital capacity, beds, theatres, CT, MRI, PROTON, scanners, and the professionals to use them 24 hours 7/7 , for as long as the demand is therre.
    3. Is 47% of the NHS being none medical the right ratio. Could better computerisation and AI replace many.
    4. To what extent is the NHS medical service blocked by having an inadequate after care and end of life service. Should this be free to the patient if and when required.
    5. How effective is the NHS procurement service, and is waste monitored and controlled.
    6. Is the balance of GPs, Medical Centres, Local Hospitals, A&E, and Specialist Hospitals, the right one, and is it all working for the benefit of the patient.
    7. Is our laisse faire attitude to what we put in our mouths and the lack of early exercise in schools totally inadequate. To what extent should the food industry be regulated. The Nazis regulated UK food intake during WW2, why can’t we achieve it ourselves now.
    8. Should so many vital services be in the charity sector, hospices, air ambulances etc. Is it to make us feel good in giving to charity . The service they offer is excellent, but are government avoiding financial responsibility.
    9. Can the NHS be funded by a better financial system as would appeare to be the case in other countries.
    10. Are we financially burdining and restricting those who might wish to join the medical services of the NHS.

    Those are just some of the questions that need answers. Answers on which a reborn NHS can be based. My personal experience is that once the NHS takes you in the service is compassionate and effective. Getting through the door is the problem that leads to unnscessary failure for many. Curable becomes terminal. I give you a personal example. I have to wait one month to get a GP appointment for a letter to a private consultant for a knee problem here in the UK. In 2022 while resident in Spain I saw my GP in two days, was referred to my local hospital, had blood tests, a CT scan, a colonoscopy under anaesthetic removing a pollip, and a final clearance, all within two weeks. That is a health service performance we should aim for. Anything less is failure.

    1. Lifelogic
      October 22, 2024

      Claire Coutinho, now the Shadow Secretary of State of Climate Change and Net Zero who, with her half maths degree at Oxford, should know better was full of praise for Chris Stark while she was the minister!

      Let us hope Trump wins for his climate realism, his ability to work at Mc Donalds and his general self-effacing modesty. Betting odds suggest 65% likely.

    2. dixie
      October 22, 2024

      A good list and your last section suggests an initial direction – look around for the world for systems that already work well – perhaps France, Spain, Germany, Poland ..
      Also look at what aspects they do not get involved in ..

      1. Berkshire Alan
        October 22, 2024

        Dixie
        Indeed, no need to review a system that is broken, as we are all aware of that.
        First look at systems that work, and are proven to work. (why try to reinvent the wheel)
        The NHS is the second largest employer in the World I believe, so if true it is not lack of workers that is the problem, so it must be the way they work, or the system they work in, which is failing.
        The first line of our service is GP or A&E, both fail because neither is efficient.
        Trying to get a Doctors appointment now is a farce with the systems in place, and many Doctors (and there are 14 registered) in my local practice, appear to be working part time only, why ?
        Are they paid too much, too little, pension limits reached, stress, age, frustration with the system, other interests etc etc.
        A&E is overcrowded with people who should not be in A&E, but who cannot get an appointment with their GP (even if registered) it would seem.
        Too many people chasing too few beds, with too few consultants.
        Hospitals biggest failure in my view from personal experience, is management, administration, and a sensible use of facilities, personnel, purchasing power, space, equipment and theatres.
        Not enough use of the private sector to reduce lengthy waiting times.
        Suggest a Tax allowance for those who are willing to pay for private health cover to reduce waiting lists.
        Train more doctors and nurses, and make it training for free, providing they will contractually serve the NHS for 10 years only and exclusively, failure to serve means training costs must be paid for.
        Thus to avoid any chancers taking advantage by skipping abroad, training costs outlined at the start, and invoiced each year for later payment or cancellation.

        1. Berkshire Alan
          October 22, 2024

          Look at how other industries function and work.
          The car industry is one of the most efficient industries, with constant improvement in design, efficiency, and reliability.
          Competitors purchase each others new cars, simply to take them apart to see latest developments, because no one single manufacturer has all of the answers all of the time, they learn from each other, why cannot our hospitals, management, doctors etc do the same ?
          We lead the World in some of our research and treatments, but for treatment of the masses we seem to be stuck in first gear, with occasionally reverse engaged.

          1. Berkshire Alan
            October 22, 2024

            Too many people on our little island, that’s the biggest problem !
            Second is they are getting older and more sick for longer.
            Third is we can now extend life sometimes at huge cost, when perhaps we should think about letting nature take its course.
            Prevention is better than cure, but what do the Government do remove the heating allowance from some of the most vulnerable, so many will perhaps end up in hospital at a greater cost when the simple solution would be pay it to everyone, and tax it at their existing income tax rate.
            Far less costly than messing about and deciding who qualifies and who does not with extra administration, extra benefits, and means testing.
            As for food consumption regulation/restrictions, who is in control of what we put in our mouths ?
            Answer the individual.
            All government should do with regulation in the food industry is hygiene, welfare, and safety

      2. Roy Grainger
        October 22, 2024

        The list of countries with health services, free at the point of use, with better outcomes than the NHS is long. I have acquaintances living in the UK who have returned to both Turkey and Brazil for more timely hospital treatment than they could have got on the NHS. Australia and the Netherlands are also notably better than UK. The problem is that the left always present it as a binary choice between the UK and USA systems – the only two systems that absolutely no-one else in the developed world has implemented.

    3. Dave Andrews
      October 22, 2024

      I’d like more healthcare to be in the charity sector, to relieve the stress on NHS staff. Relieve the NHS of its responsibility to treat lifestyle diseases, and put them in the charity sector.

    4. IanT
      October 22, 2024

      You didn’t mention ‘Management’ – at least not directly AG.

      I am very sure that the quality of senior management varies a great deal across NHS Trusts and similar high level organisations within the NHS – not forgetting those in the very top NHS England jobs. We need much better ways to make these people acountable, a problem shared with the Civil Service, BoE and the Quangos. I can look at publicly listed businesses and get some idea of the effectiveness of their managers by comparing relative performance within sector.

      There is no such visibility (nor accountability) in the public sector and there should be. We fool ourselves in beleiving that our politicians control these organisatons, they do not. Wes Streeting may come along with new policies (or not) but how well they are executed remains crucial.

    5. a-tracy
      October 22, 2024

      3. No to more AI and outsourced admin. Have you tried using British Telecom or one of the old public sector companies that have gone down this route? Your number (which does exist) doesn’t exist – cut off. You get passed through five different departments and no-one can help, 2 hours to resolve a mistake on their end yesterday. It took 17 hours to get a line reconnected. No where to register a complaint properly, same issue in August (again it is their mistake) assured it was sorted out, wasn’t sorted out. Its enough to give someone a heart attack if they’re ill. NO, No, No.

      1. Lifelogic
        October 22, 2024

        +1

    6. Peter Gardner
      October 22, 2024

      You’ve missed the obvious question: “How is the flow of available funds controlled?”
      The answer will reveal that patients have no say in it whatsoever. Now compare that with answers to the same question in the many better healthcare systems there are around the world.

    7. Mickey Taking
      October 22, 2024

      If Mr Streeting was not already aware of the above questions/failings in his working career, via colleagues, relatives, then he must be ducking the world around him.
      Immediate upon knowledge that he was to be appointed he should have put those issues to officials directly involved/responsible. Responses required within 2 weeks, no flannel just facts and suggestions wanted.
      We watch this space.

    8. hefner
      October 22, 2024

      a, +1

      Taken from the FTā€™s comments page (21/10/2024) from somebody working in the NHS:
      ā€˜There are 42 healthcare areas in England and each of them can choose what tech they use locally. This means we ended up with a complete jumble of systems that donā€™t speak with each other. If we compare it to Star Wars, it would basically be the Rebel Alliance, when what we need is the order of the Empire. So, hold a beauty parade, identify the best tech and then roll it out everywhere. It wonā€™t be easy but it is better than relying on printersā€™.
      This last bit about seeing electronic messages from one source being printed out and then scanned into other systems.

  3. DOM
    October 22, 2024

    Streeting’s talking bollox. He knows he’s spouting crap for the benefit of the naive halfwits, we know he’s spouting crap. The NHS and its unions will stifle any attempt at efficiency drives as that could lead to cuts in funding if they are seen to be working efficiently.

    The entire public sector is run for the benefit of the unions, the employee, the left and Labour. Its purpose is simple, to protect itself from attack and expand its budgets ad infinitum. 14 years of an appeasing, spineless Tory government only aided and abetted this corruption. as a result the entire system of state provision is now corrupted by Socialist woke parasitism. Thanks Tories there’s a place in hell for your arrogant deceit

    The Tories are not the antithesis of Labour. Those who vote Labour and Tory on that premise have destroyed this country. These two parties are SCUM and they know it

  4. David Andrews
    October 22, 2024

    Setting up a consultation is either window dressing to provide cover what you intend to do anyway or a smokescreen to cover your ignorance about what to do in the first place. Within the NHS there should be no shortage of evidence to identify the better, more efficient performers from the inefficient and why those differences exist. If there isn’t then there needs to be a wholesale clear out of the senior management responsible. I have experienced both extremes when taking my wife for tests for macular degeneration. In one hospital we waited for hours along with dozens of other patients. In another the process was handled efficiently with a timed appointment system so that we were in and out of the hospital within an hour. In both the clinical advice was excellent. Our GP service appears efficient with up to date IT systems that enable on line booking of appointments and repeat prescriptions, access to our personal medical records and to generic health advice. I fear the imposition of a national system will only muck it all up.

  5. Mick
    October 22, 2024

    The main trouble with the NHS is that thereā€™s far to many Chiefs and not enough (workers Ed)

  6. Christine
    October 22, 2024

    NHS staff are the best people to identify where the waste is and where improvements can be made. Bring back the staff incentive schemes to reward those with good ideas.

    Tackle the indemic sick leave that occurs in the public sector.

    Crack down on foreigners using and not paying for NHS services. I personally know many ROI citizens who fraudulently use relatives addresses in Northern Ireland to gain free treatment and prescriptions. I’m sure this happens from many other countries. It can’t be difficult to link HMRC taxpayer records to NHS records to identify these people.

    Reuse equipment. Currently walkers, wheelchairs, crutches etc. are just thrown away because nobody recycles them.

    Bring in more testing to identify life threatening conditions particularly at birth. My granddaughter died because an NHS committee refused to fund a test that cost 58p which is available in nearly all Western countries.

    Put more money into research for groundbreaking treatments like gene therapy and T-cell cancer cures.

    Tackle the obesity crisis and get rid of this ridiculous notion that people need food banks.

    Get people back to full time work instead of rewarding them to feign illnesses and disabilities.

    Of course none of this will happen as our politicians don’t have the bottle to improve anything and the sacred cow NHS will continue to consume to wealth of this country until we are bankrupt.

  7. Roy Grainger
    October 22, 2024

    Yes it is very disappointing. Streeting talks a good game but it turns out he has done no preparation or planning at all to actually implement any NHS improvements, one wonders what he has spent his time in opposition actually doing. Plainly there will be no improvements under him for patients at least, I assume NHS staff will like their pay rises. I would recommend going to the website and reading some of the entertaining suggestions people have already put in, for example “Replace ambulance sirens with healthy eating advice”.

    I see they have resurrected the idea of having an single integrated NHS IT system to hold patient records. This has been tried in the past and failed not because it was a bad idea (the lack of such a system has lead to many preventable deaths) but because the NHS was incapable of managing the implementation of a large-scale IT project and there were massive schedule and cost overruns and functionality not implemented – let’s see how they do this time, I can’t see why it will be any different.

    1. Know-Dice
      October 22, 2024

      They will use AWS but have no provision when the cloud goes down.

  8. MPC
    October 22, 2024

    To be fair to Wes Streeting I saw him interviewed yesterday and he did answer all the questions put to him. I think he is well intentioned, but the fact is that the consultation and future changes will only amount to a revised status quo based on the existing model of healthcare. Thereā€™ll be no fundamental review taking into account the better health outcomes achieved in other (EU) countries and their financing and insurance based delivery models.

  9. Vivian Evans
    October 22, 2024

    Unsurprisingly, this ‘national conversation’ reminds me very much of a similar campaign which ended very badly for those who believed in the goodness of their political leaders. The mention of a ’10-year-plan’ was a dead give-away.
    I’m referring to communist China in the 1950s, where Mao ‘asked the people’ in the infamous ‘Let a thousand flowers blossom’ campaign. Most of those who dared to offer their opinion ended up in ‘re-education’ camps.
    Nowadays, we recall Lockdowns, with Prof Ferguson allegedly wondering at a SAGE meeting if ‘we’ could get away with Chinese methods. And surely, the Chinese Social Credit System doesn’t need to be mentioned.
    My verdict: it’ll all end in tears, with Labour telling us that ‘you wanted it, you demanded it’ …

    1. Everhopeful
      October 22, 2024

      Truly chilling.
      And the possible legalising of euthanasia ( referred ( translated) to during Plague by a politician as ā€œa good deathā€)
      When one remembers the mind manipulation it is easy to imagine the sheeple eagerly ā€œdoing their dutyā€.
      And others will have to hold up sheafs of corn by the roadside when foreign dignitaries visit.
      Oh I agree with youā€¦we are on that pathway. No doubt about it.

      ā€œThey wouldnā€™t do that!ā€
      ā€œReally?ā€

    2. Mark B
      October 22, 2024

      +1

      I have come across such people in my life. All Left or Left of Centre type who, under the cloak of well meaning work to steer things and naive people in the direction they seek.

    3. a-tracy
      October 22, 2024

      That isn’t very comforting, Vivian. I answered their online questionnaire. Re-education camp doesn’t sound fun.

  10. The Prangwizard
    October 22, 2024

    He is just stalling. And his earlier saying that the system is broken is just giving himself an excuse that the next few years of problems not solved are not his fault.

    Labour have had years in opposition to work out what is needed and what ought to be done and to tell us.

    They will take no notice of the people they don’t like in this bluff.

    Time for the Tories to work out and say what they will do, and tell us what they failed on before. Can’t criticise Labour without better practical solutions. General ideal statements are no use.

    1. Mark B
      October 22, 2024

      I said this before. The early GE was a trap set to catch Labour and everyone else off guard. They knew they were doomed and so decided to get it over early and leave Labour floundering in the mess. Not sticking up for Labour but, just like the Tory’s they had 14 years ! No excuses from either one of them.

    2. Peter Gardner
      October 22, 2024

      The argument against the Tories attempting reform of the NHS is a strong one. Essentially a good idea will be rejected because it came from the Tories but the same idea from Labour might be OK. Secondly, the Tories have tried before and failed so their track record is not good.

  11. K
    October 22, 2024

    A bigger problem is that the NHS is no longer a health service.

    It is Labour’s shield. It is Labour’s replacement for the working class that it has abandoned.

    The NHS is now the reason to put up taxes whenever Labour likes “To save the NHS !” to justify mass immigration and ‘bring in doctors and nurses’ “To save the NHS !” and sometimes to put us under restrictions including house arrest “To save the NHS !”

    Britain is the NHS with a nation of taxpayers attached to it.

    Until that changes it can never be fixed. What is the point of a fixed NHS to Labour ?

    1. Mark B
      October 22, 2024

      +1

      It is Labourā€™s shield. It is Labourā€™s replacement for the working class that it has abandoned.

      In the 80’s Labour sided with the miners to keep the pits open. Today they can’t shut them down fast enough. What changed ? The Unions and subsciptions to them which Labour gets it funding. Today that funding comes from Public Service Unions.

    2. Lynn Atkinson
      October 22, 2024

      You are correct, additionally it is reported today that native British are dying sooner and in greater numbers than the non-ethnic population.
      I wonder what percentage of the non-ethnic population rejected the Covid Jabs and what percentage of the law abiding British had them?
      Even Andrew Bridgen had 2 jabs! Unbelievably!

      1. Mickey Taking
        October 22, 2024

        or possibly the ratio of those in work up to a previous retirement age, compared to those not in work?

    3. Original Richard
      October 22, 2024

      K :

      Saving the NHS is no longer sufficient for the Far Left. It is now all about saving the planet, an excuse to destroy our economy.

      We’re not in an era of “global boiling” as claimed by the UN Sec. Gen.. Table 12 in Chapter 12 of the IPCC Working Group 1 (“the science”) report shows no signals for climate change (precipitation, storms, droughts) other than some mild warming (0.14 degrees C/decade) leading to some loss of ice and snow. And there is no anthropogenic CO2 emissions explanation for how we exited the most recent ice age just 11,000 years ago or how temperatures have been higher than today since this ice age.

  12. Michelle
    October 22, 2024

    Stop wasting millions on ‘Equality/Diversity’ is a constant theme of the patient suggestions, so I’ve heard.
    This will be scoffed at as ill informed, indeed racist. Possibly prompting more money to be thrown at it to convince themselves it is the bedrock of a sound health service.
    The NHS like all our institutions has become nothing more than a politicised, grossly mismanaged (financially and culturally) dead weight.
    If the Health Secretary could agree medicine/patient care and tapping into our own talent for training and retaining is more important than pandering to every special group, then perhaps the NHS could get back to basics and deal in health. It could make them more efficient and that can only be a good thing all round.
    Looking at the numbers pouring in and using the system sounds a simple solution to some of the problems, but often the simplest answers are the right ones.
    How much is this new obsession of convincing people they have mental health issues costing in finances, resources and furthering problems for the genuine cases of mental health sufferers?

  13. Ed M
    October 22, 2024

    Stress causes 90% of illnesses / diseases (other than natural aging, leading to death).
    Stress is like a poison that kills the person (including making the person less productive in the work place and home).
    There are various forms of stress. From bosses who bully, to family members who bully, to existential crisis of being, from being caught up in an addiction (obsessed by social reputation, people pleasing, being controlling, putting people down, greed, alcohol, and so – literally thousands of different forms of addiction, psychological to physical – all lead to stress / natural imbalances in the psyche and body etc).
    And the biggest stress of all. NOT FEELING LOVED (and not loving in return)!
    Love is a super power (tough and soft love – both). Selfishness is a super weakness.
    Love isn’t about emotions (although can be to a degree). It’s about wilfully wanting to objectively meet the legitimate needs of the there (which might involve challenge but also encouragement etc – and just being yourself, warm, kind and humorous – without being a pushover).

    So the government would spend BILLIONS and BILLIONS in the costs of healthcare and lost productivity at work and costs in social welfare, if the Tories focused more on building relations with the churches, media, arts and those in education to foster healthy cultural Conservative values into society (work ethic, spirit of adventure / being entrepreneurial, taking personal responsibility for self, not depending on state but depending on family instead, family values, being patriotic).

    We need a holistic approach to Conservatism (not just politics or economic policy). This is about helping people to bring the best out in themselves (this is what leaders to – they don’t control but they try and bring the best tout in others). As well as rebuilding our economy (and with great jobs like in High Tech and producing beautiful and brilliantly engineered British cars under British brand names that don’t exist sadly). And getting taxes right, right down. And getting immigration right, right down.

    Our country has potentially a GREAT future but we have to focus on the cultural approach to Conservatism not just the politics / economic policy – as well as trying to attract higher quality Tories into Parl / Tories with more proper business experience (including to a degree entrepreneurial experience) – and less lawyers, PR people, journalists and people like that (although we still need some).

    1. Ed M
      October 22, 2024

      ‘So the government would spend BILLIONS and BILLIONS’

      – I meant the government would save billions and billions.

      It’s essentially about how to help bring down DYSFUCTIONALITY in our country (in the work place, homes, society in general). Not by imposition and control. But by benign influence (which is what people in the churches, arts, media and education are meant to do to an important degree). And so Tory politicians could do more to work with churches, arts, media and education (Rather than David Davies wasting his time on Lucy Letby – the medical consultants appear to think she was guilty – he’d be much wiser to spend his time trying to foster Conservative cultural values in the country by working closer with people in the churches, education, media and arts etc)

      Even if we had SOME success here (full success is impossible in an imperfect world), it would still have a profoundly positive impact on our economy and immigration (bringing it down), saving lots of money (in particular, NHS and social welfare) and more.

  14. Paul Freedman
    October 22, 2024

    I believe we need to start at first principles. The NHS was set up to provide free healthcare for those who cannot afford it. It was designed that the heathcare would be to good standards and the system would be run efficiently and sustainably.
    Looking at the NHS today it provides free healthcare to everyone (not just the low / no income persons as intended), its standards have slipped (hospitals are overcrowded and too often unclean and the staff are often overwhelmed and the patient food is awful), it is inefficient (it is the third biggest employer in the world after the Indian railways and the Chinese red army – this was the case 15 years ago and I doubt much has changed), it is unsustainable as it would be bankrupt without an ever growing unaffordable budget and despite that patient waiting lists are still too high. It is evident therefore the demand on it is far too high and that is not fair given the impact on patients who cannot afford healthcare as well as the NHS staff.
    The only solutuon is to means test it.
    The debate the Health minister should be having is at what point on the income scale patients qualify for NHS healthcare. For those who dont qualify there should be a gradation of state-assisted private healthcare up to the cut off point. The exact scaling and cut off points depend on the outcomes of the research yet to be performed.
    For welfare, you need to qualify for it and the NHS should be no different. My admiration and affection for the NHS is as much as anyone elseā€™s. That is why I want to see it funded well, operating well and the dearly treaured staff who work in it not toilworn and struggling.

  15. Magelec
    October 22, 2024

    Back in 1946 or whenever the NHS was created the civil servants and politicians started with a blank sheet. The NHS is far more complex now but essentially that is what I believe should be done now. Itā€™s no good trying to modify the existing organisation, that would only bring temporary benefits. An insurance based system should be part of the solution. That would relieve the NHS from some of the most routine problems and leave the most complex for serious healthcare. Also increasing care in the community should be a long term aim.

    1. Mark B
      October 22, 2024

      We have to ask ourselves, what did people do BEFORE the creation of the NHS ? Much like, who built the railways BEFORE British Rails were created.

      My guess is, private enterprise.

      I am not saying we should go full on USA Heathcare but, we should be looking at other health systems and adapting to change.

  16. Everhopeful
    October 22, 2024

    Has it ever occurred to any ā€œministerā€ that the NHS has been a disaster since its unfortunate Marxist conception?
    The doctors didnā€™t want it because they could see where it would lead.
    They did their best to prevent it taking off but as with all these lefty ideological bonnet bees it has staggered on down the weary years like a wounded terminator.
    And now thanks to decades of utter stupidity we have virtually no healthcare.
    And ā€œgood newsā€ stories about ā€œour NHSā€ make no difference .
    A healthcare system has to surely at the very least be equal?

  17. javelin
    October 22, 2024

    When I went for a BUPA appointment a week after hurting my hand with a possible fracture after tripping whilst running.

    I got to the hospital did paperwork for 5 mins, waited 5 mins, saw a surgeon for 10 mins, waited 5 mins, had 3 x rays for 5 mins, saw a surgeon for 10 mins. Then went home with exercises to do.

    In and out in well under and hour.

    If that was the NHS it would have taken months and cost three times as much. The cost would have been caused by administering the multiple appointments, not the time with the receptionist, surgeon or radiologist.

    Plus there have been millions of immigrants many with health problems arriving. For example Indians are six times as likely to get type 2 diabetes. When one million arrive itā€™s the same as 6 million more British people being born.

    If that was the

  18. Everhopeful
    October 22, 2024

    Instructions from on high are to reduce all medical procedures.
    To save the planet.

  19. Bryan Harris
    October 22, 2024

    As a regular NHS user I’d say there were more fundamental issues to be addressed than access to services.

    The NHS tries to do too much – it should reconsider what the core services should be and stick with them. It should leave research to properly funded external organisations.

    It should review and reduce its drug bill – all too often patients are labelled and put on drugs for life, with no consideration that the condition could change. The body is not something that is static. Cocktails of drugs are often in use to suppress side effects. The bill for drugs would be a lot less if the NHS would stop its prejudice against cheaper natural solutions. The bond between the NHS and drug companies needs to be broken.

    My biggest complaint is that the NHS has become a factory environment, more attuned to providing doctors with a smooth supply of work than looking after the needs of patients. Where is the recuperation for patients. Doctors dismiss patients at the first opportunity with little regard to their strength or ability at home to recover from surgery. Recovery should be an important part of the treatment.
    That is not to stay patients should remain in hospital until they can walk unaided, but we used to have recovery homes, years back, where patients could regain their strength.
    Certainly being in hospital too long is bad for your health. You become weaker with little opportunity to gain strength.

    Hospital food is generally awful, brought in from outside catering companies, and warmed up. The NHS should have it’s own kitchens and cook things fresh to meet dietary/medical requirements.

    The level of reports and bureaucracy is far too high, forcing front line staff to spend more time filling out forms than looking after patients.

    Probably the biggest thing missing from management of the NHS is common sense – time that improved.
    I could go on, but that would mean these comments would be too long to be approved.

  20. Cliff. Wokingham
    October 22, 2024

    I watched the Health Secretary yesterday and thought, how many more reviews do we need to have before something is done.. We all know what the problems are but, no one knows how to fix it. All Labour and some so called Conservative politicians seem to believe that the more wheelbarrows of cash you tip into the bottomless pit that is the NHS, the better it’ll be. It won’t, we’ve already tried that many times.
    Take the NHS out of politics.
    Just out of interest, does anyone else think the issuing of smart watches to monitor people’s health is a bit sinister? Is it not just a way for more state monitoring of where we are and what we’re doing?
    I did laugh when the Health Secretary started to talk about digital health passports given the government’s record with It systems. I suppose it’s one way to bring Blair’s dream of state issued Identity cards in through the back door.

    1. Everhopeful
      October 22, 2024

      It is sinister.
      The idea is that we monitor ourselves at home via such devices.
      Presumably any anomalies ( if above or beneath some manufactured threshold or other) would perhaps warrant an online consultation.
      Keep us out of hospital and out of the hands-on consulting room.
      They shut it all down once with the help of gullible idiots.
      Why not do it for good?
      Wonā€™t be any furlough money this time though.
      Except possibly poverty-level UBI.

  21. agricola
    October 22, 2024

    In fairness to Wes Streeting , he is applying a version of japanese Kaizen. Involving the patients and the NHS operatives in a process of continuous improvement could be highly advantageous. He needs first to get the structure as near right as possible and then after studying how the Japanese do it, apply Kaizen. Do not fall into the trap of creating a convenient version.
    Decide what the NHS should be doing , what they need to do it, and give them the structure to do it. Then apply patient and staff generated Kaizen.

  22. William Long
    October 22, 2024

    It is an interesting one this. Normally I would agree with what you have said, and indeed, it is quite possible that Streeting ‘Hasn’t a clue about the answer’. However, with the NHS, he is not dealing just with a normal institution, but with what for a great many people is a religion , and to meddle with it in any way is a sacrilege.
    Therefore, I should have thought there is an argument in favour of starting by getting as many people as possible, both staff and users, to come up with examples of NHS failures, and reasons why it does not work, to provide ammunition to use against those who will very loudly condemn any change at all, particularly if Streeting is serious about making reforms as radical as are needed.
    You are right that this should have been put in motion years ago, and Streeting may just be kicking the can down the track, but his predecessors did not make much of a start for him to build on.

  23. majorfrustration
    October 22, 2024

    Consultation is another political term meaning “can kicking” Failures are obvious so why not get on with them now?

  24. a-tracy
    October 22, 2024

    The patient (customer) is powerless in the relationship. You are an inconvenience to the operation, not a welcome call that means more revenue, so the hardest workers in the NHS don’t get a higher reward; only the most dedicated staff with a calling operate at full tilt. This is the problem with socialised work systems, which level down to middling for all but those who can afford to opt-out at the extra cost. Insisting all nurses (not auxiliaries/nurses) go to university is another mistake; not training people from 16 weakens the training and operation.

    A private organisation would put one more bed on every ward and use the operating theatres side by side over weekends and into the evening (but they can’t do that because NHS consultants work late afternoons and evenings in the private sector to boost their pay, which isn’t available to them in the NHS).

    More money would be in the NHS if all treatments on the GHIC card and for visitors to the UK was billed. We have private GPs now. They should be directed to those private GPs first, who can bill them, no registration to visit with an NHS clinic.

  25. Peter Gardner
    October 22, 2024

    Consultation at this stage is a complete waste of time and resources. All that is required is to choose the best health care system in the world and replicate it. This needs only a short benchmarking study of about 2 months by competent people who do not work in the NHS or DHSS. They must be outsiders. Then consider how such a system can be substituted lock stock and barrel for the NHS. This might take another 6 weeks but, again it must be done by outsiders. Daniel Hannan wrote in The Telegraph a few months ago that the Australian system is the one to subsitute for the NHS in its entirety. I’ve emigrated to Australia and I can vouch for its superiority. Any advance on the Australian system?
    Consultation now will result only in establishing limitations to the extent of changes to be considered. For example it will be established that everything must be free at the point of delivery. Guaranteed. This is the limitation imposed on all previous attempts at change and why they have all failed.

  26. Ian B
    October 22, 2024

    And… the administrators will tell him we need to build our Empires have more staff engaged in politically motivated diversity, inclusion and equalities. Build on Politically motivated discrimination that has infiltrated all taxpayer funded entities. The NHS is to serve the Staff not the Customer

  27. Rod Evans
    October 22, 2024

    They just haven’t got a clue what to do have they?
    We give the NHS Ā£180billion/yr to waste of woke and little else. More DEI please. More COSTA coffee shops and sticky cakes in reception areas, we all know how needed they are.
    The BMI comments about nurses has clearly hit a chord, here is another one they won’t like to hear. Can we have medical staff who can clearly speak and understand conversational English in our British health service.

  28. Ian B
    October 22, 2024

    Why did the Conservative Party lose the last general election so heavily, and what must it do to recover?
    The Tories failed to deliver on their promises in crucial policy areas like immigration, tax and public services. They did not act like a competent government. They too often behaved as though there was one rule for them and another for everyone else (Sounds familiar!)
    Lord Ashcroft KCMG
    https://conservativehome.com/2024/10/22/lord-ashcroft-the-conservatives-need-a-leader-of-rare-quality-for-me-thats-kemi/
    Continuity is signing off on failure with more failure to come

    Labour, Two tier Kier, Rachell Reeves have learned a lot from the previous crowd and have picked up the baton and are running with it. The NHS who cares (other than customers, those in need and the dying). The Talking Heads, those that Rule will keep stuffing it to everyone all the time they have been given a free reign ā€˜To Taxā€™
    Things are no longer balanced, our Rulers just ā€˜Takeā€™.

    1. Lifelogic
      October 22, 2024

      They promised to Control Immigration, deliver a real Brexit and cut taxes. They did the reverse they did not even try to deliver as promised. Plus they got everything wrong on Covid vaccines, lockdowns, vaccines, HS2ā€¦

  29. Original Richard
    October 22, 2024

    The current Far Left run NHS will never work because it is essentially a Soviet style monopoly provider where the patients are often mistreated because they have no choice and the staff are bullied into submission because they have nowhere else to work if they want to remain in the UK.

    Chinaā€™s Communist leaders, after Maoā€™s disastrous reign which killed millions of people, realised that Communism cannot produce goods and hence bring the prosperity they needed to remain in power. So they instituted a Corporate/Fascist system under their Communist rule where citizens can make money running businesses but which are always under the Communist system controlling the land, assets, finance and loyalty. This is what China calls its ā€œone country two systemsā€ approach.

    If the country wishes to continue with a nationalised free at the point of use NHS then it needs to adopt Chinaā€™s ā€œone country two systemsā€ approach.

    Since the annual budget of the NHS is 3 times that of the annual turnover of our largest supermarket I would suggest that the way forward is to split up the NHS into three separate organisations to provide competition for both customers (patients) and staff.

  30. Keith from Leeds
    October 22, 2024

    Isn’t it staggering that after 14 years in opposition, Wes Streeting now wants to have a consultation with NHS staff and patients? Why was this not done before? I think Agricola’s list of ten items makes a good starting point.
    Nor should we assume the way we do it in the UK is right; we should be looking at other countries’ health systems.
    But the No 1 problem that virtually all of our MPs won’t face up to is immigration. You can’t bring in six million people in 20 years without it impacting housing, hospitals, GPs, Dentists, Schools, Roads and infrastructure.
    It seems our MPs don’t understand cause and effect!

    1. Mark B
      October 22, 2024

      And, supply and demand.

  31. JayCee
    October 22, 2024

    Firing the Chief Executive should br just the start. What about the massive admin resources in the Integrated Care Systems? Are they delivering anything? The public meetings are a farce. The Board reports run to 100’s of pages of garbage with not one KPI or performance related target measure.

  32. K
    October 22, 2024

    The NHS is the industrial wing of the Labour movement. The Health Secretary wants it to grow, he doesn’t want to fix it.

    In our society in which so many expect the state to feed-me, clothe-me, house-me, cure-me the NHS is the single excuse for the socialists to tax capitalism into submission.

    Our society cannot survive the slovenliness and helplessness which has infected it.

    1. Mark B
      October 22, 2024

      +1

  33. Sharon
    October 22, 2024

    A caller on Talk yesterday, said they’d started to fill in the questionnaire… each question had three boxes, tick one! He decided there were desired answers that were the only options to select! Waste of time, the caller had decided!

  34. agricola
    October 22, 2024

    Apologies for doing a Lifelogic, but here is todays experience of the NHS.

    A week ago I had a flu and covid jab at my local farmacia. They identified me by birthdate and address on their computer. I assume they must tell the NHS to get paid. No problems during or after the process.

    Before and since, today in fact, I have had SMS messages from my GP practice to make an appointment with them for a flu and covid jab. No provision in the message for me to reply saying I have had the jabs, the practice does not even have an email address in 2024. On ringing them, number 7 on the options list covers flu and covid jabs, but the line is only answered after 4 in the afternoon. At this point I gave up with questions in my mind, hoping that Wes Streeting reads your diary.
    1. Why is the computer in my farmacia not lodging the fact that I have had the jabs in a data base available to the GP practice.
    2. Why is it not possible on the GP SMS invitation to book a jab, to tell them you have had one.
    3. Why can the GP service on the subject of jabs only be contacted after 4.00 PM.
    4. Why does the GP service have no email address.

    I conclude that the GP service sees, as one of their principal functions, the necessity to distance themselves as far as possible from their customers ( patients). A secondary function is to act as gatekeeper to those parts of the NHS that saves lives or allows patients to function. You have one hell of a task Mr Streeting MP.

  35. Mickey Taking
    October 22, 2024

    from BBC.
    Government borrowing rose last month, marking the third-highest September since records began in January 1993. Official figures show that borrowing – the difference between spending and tax take – reached Ā£16.6bn, continuing a trend of overshooting official forecasts. The numbers present a challenge for the Treasury at the Budget next week as it has decided it will not borrow to fund day-to-day spending.
    It is, however, expected to change its self-imposed debt rules to give it more leeway on investment, meaning it could spend more on longer-term projects.

  36. Robert Bywater
    October 22, 2024

    I have just filled in the “change” questionnaire about the NHS: https://change.nhs.uk/en-GB/projects/start-here

    Noted that the words “change” and “the NHS is broken” figure very prominently in the text. No prizes for guessing who is behind those soundbites.

    On the whole I thought it was a very weak questionnaire (in keeping with the method of operation of the present government, which is also weak, to say the least. (weak, and devious). No opportunity was offered for making suggestions as to how to mend this broken NHS. So here is what I would have written if given the opportunity.
    >>>>>>>>>>>>>>>>>>>>>>>>>>>>
    The two reforms that NHS most acutely needs are 1) making the management (much) more efficient and cost-effective and 2) funding.

    I shall here restrict myself to the funding question. There is one simple step that needs to be taken but before I state what it is I note that many leading politicians are always going on about “why can’t Britain be more like Scandinavia?” and forever extolling the virtues of the Scandinavian countries. Strange, because they don’t seem to know much about those countries and have not lived there.

    I have lived and worked abroad (mainly Scandinavia) for a large part of my life and can comment on health-care arrangements in different countries. In Scandinavia and Netherlands health care is not free for the patient. It is very inexpensive but definitely not free. The amount of money that it brings in is however significant. It pays for much of the overheads of the modern well-equipped installations where the health care is carried out and goes some way towards covering the payroll costs.

    So, what does the health care cost?

    Here are the figures for Sweden (I have converted the Swedish crown charges at the rate 1ā‚¬ = 10 Swedish crowns) but they are similar in Denmark and Netherlands.

    Visit to:

    District nurse ā‚¬20
    GP ā‚¬30
    Specialist care on a referral ā‚¬10
    A&E ā‚¬40

    There is a “ceiling”: the maximum in a 12-month period is ā‚¬120.

    For comparison:

    To go to a doctor’s surgery in the Republic of Ireland costs ā‚¬50

    Some system of charging, along these lines, needs to be introduced in the UK. I know this will be anathema to many who are wedded to the idea of health-care “free at the point of service” but it has to be done. The bullet has to be bitten.

    >>>>>>>>>>>>>>>>>>>>>>
    — and it would be poetic justice for a Labour government to HAVE to do this.
    <<<<<<<<<<<<<<<<<<<<<<

  37. Peter Gardner
    October 22, 2024

    Why restrict your comparison to the EU? There are better healthcare systems beyond the EU. SInce when has the EU been a benchmark of excellence in anything?

    1. agricola
      October 22, 2024

      Peter,

      Very simply, quality of life, start to finish. My only reason for being in a very uncertain, fragile UK is family responsibilities. There are a few pluses, like the embattled english pub, but beyond, it is all thin gruel with a veneer of insanity. A realisation that gives me no pleasure.

      1. Mickey Taking
        October 23, 2024

        You seem to claim quality of life for the EU, when that might be true in some countries where relative wealth is had. Compare immigrants and the very low paid! That sector in the EU does not support as well as in UK. Why do immigrants wish to come to UK rather than the countries on their hazardous journeys to reach NW France? Why are there riots and racial disturbances regularly? The UK benefits systems make it a better quality of life.

  38. The Prangwizard
    October 22, 2024

    We often hear that the NHS use of private surgical facilities will cut their waiting lists, and thus should be expanded.

    How many private patients lose the benefit they have paid for by being delayed?

    More state theft of personal freedom and choice. The Labour ministers and particularly Keir Stalin PM will be happy to let it run that way.

  39. glen cullen
    October 22, 2024

    Until all consultant & GP doctors become employees of the NHS, and until the care of the elderly and ambulance service comes under the umbrella of the NHS (one single organisation, one single pay scheme)ā€¦.weā€™ll continue to have issues

  40. outsider
    October 22, 2024

    Dear Sir John,
    A genuine “conversation” would be good if only because most NHS users and providers have a lot to get off their chests.
    1) The NHS, as Europe’s biggest employer, is too big to manage efficiently and is inevitably dominated by the needs and interests of the critical care sector (hospitals). Other sectors are paid lip service but neglected. Centrally it should be broken up into smaller units: National Family Doctor Service NFDS), Mental Health Service, Convalescence Service (instead of bed-blocking), maybe Natal Service etc with practitioners closely co-ordinated locally and usually sharing the same buildings.
    2) In the Hospital Service, A&E should be a flagship service, with the highest paid consultants, partly competing with GPs, who could be charged for the many non-A or E arrivals that they should be dealing with.
    3) The Family Doctor Service is now the weakest sector, mainly because competition through patient choice has often been eliminated by movement to big “Hobson’s choice” group surgeries and
    by takeovers/mergers of local practices. To reverse that, patients/families should ideally pay an annual subscription to an individual GP of their choice, equivalent in size to the TV licence. An alternative would be an annual voucher for use only within the NFDS or more widely.
    4) Qualified pharmacists should (as a default) be free to sell any drug over the counter that had survived beyond its patent years without ill effects, provided that it was attached to a large print explanation of its uses, misuses, dosage, dangers and side-effects and the customer could read it.

  41. forthurst
    October 22, 2024

    Firing the Chief Executive of NHS England would be a good idea because she is an Arts graduate and therefore is unqualified to run a science-based system. Furthermore why are there so many non-executives? Clear out the whole Administrative hierarchy which is massively top-heavy with even more Arts graduates and even the totally unqualified. The whole Civil Service is a massive job creation scheme for Arts graduates which are produced in overwhelmingly large numbers in comparison to the number of actual jobs such people are qualified to do. The NHS does need other specialists than doctors such as for IT, statistics, resource planning but what use is a history graduate? What other country has this pathetic belief in the so-called generalist? There is far too much amateurism in this country.

  42. MBJ
    October 22, 2024

    A big problem is not always a lack of staff but the calibre.Some staff plod along,talk and don’t do,call for more staff if out of a day an hours work becomes very busy.Language problems and a lack of basic understanding of health issues from hygiene upwards causes problems.Systems are not understood.Migrants can not distinguish between simple illness and more serious issues.Some come from countries where every little issue has to be addressed by a ‘doctor’ who earns his living by piece work.These perceptions are carried with them but now an appointment for a cold or pimple is free.Basic manners and hospital/GP etiquette is not understood with whole families including themselves in a trip for a consultation for one.Clanning of groups of staff takes place and if 2or more say it it must be true.
    Roles of staff have changed and from area to area a person who on paper is said to be qualified cannot do the job.The speed on the whole of staffs speed has slowed down considerably and these type of staff are more concerned with their own importance than getting it right.Amongst all this a few brilliant staff are stood on for being good.

  43. ray warman
    October 23, 2024

    Force the CEO’s and Managers to manage or sack them, might be a good starting point?

  44. David Paterson
    October 26, 2024

    The budget for the NHS should be dependent upon the country’s GDP or preferably upon tax revenues and that %age should be immutable until agreed by the voting public. The NHS excutive should work to allocate that expenditure in the most effective manner. We all know that health services is a bottomless pit but the expenditures must be limited to what the country can afford which should be no more than the agreed %age of GDP or tax revenues. Leave the allocation of the budget to the executive. It is a tough job being CEO of the NHS but the appointment and responsibilities should be clear. There should be overall financial limits. Government’s role should be solely to ensure, so far as it can, to judge the CEO’s ability to form a team which will work within the strict financial parameters. Priorities will be key but these should be dictated by the experts and not by short term politicians who are moved from one department with disastrous results.

  45. MBJ
    October 30, 2024

    Every time they change the academic rules ,they wipe out experienced practitioners… progress?

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