The day before yesterday we looked at the different approaches to the health and financial sectors when large companies make mistakes. I agree with those who wrote in to say one of the worst features of banking was the way the state bailed them out instead of making them pay their own losses and sort themselves out, whilst protecting depositors rather than bondholders and shareholders. You may recall I was against the bail outs at the time. One of my reasons for opposing the equity bail out was the likelihood it would fuel resentment at bankers on a large scale. Today I want to look at the different approach we take towards serious error in the public and private sectors.
This week came confirmation that a young man died of thirst in an NHS hospital. Instead of responding to his expressed need for a glass of water, the hospital overrode his wishes and he died. Apparently they did not understand his condition which left him short of fluid, and failed to monitor it. The hospital has apologised profusely for its mistake, and accepted much of the blame.
I suspect if such an event had happened in a private sector hospital we would be now be in the midst of a huge row. There would be some who demanded that the Chairman and CEO of the hospital company resigned. There would be others who argued that that the hospital company should lose its licence. Some would expect tough regulatory or legal sanctions to be applied. Others would say it proved that we needed to regulate the private healthcare industry more, or even nationalise it.
Because it happened in the NHS there has been an eerie silence. Parliament has not taken up the matter in a big way. There is no demand for a show trial of the hospital managers, no demand for resignations of top staff, no demand for more regulation of the sector.
Meanwhile, a private sector security company has let it be known it has failed to recruit all the people it needs for a future contract. Fortunately they told the governemnt, the client, in advance. They have said they will pay the bill for troops to make up the numbers, so the job can still be done. Parliament will investigate how well the contract was constructed, how long they had to meet the extra numbers, and how well the failure has been managed.
The political and media response is much more intense and condemnatory. This is after all a private sector company which has let us down. So far no harm has occurred in the security case. There is time to plan our way round any shortfall. The young man did die in the hospital. Some media reactions are different because there always seems to be more condemnation if it is a with profit company rather than a public body at the bottom of it.
I am all in favour of the security company paying for its mistakes. The troops who have to be drafted in to help should be well rewarded for their trouble, at the company’s expense. Their shareholders must decide what to do about the management of the Group, as they I am sure will be worried about the reputational damage done, and the failure to impress one of their most important clients, the British people.
July 16, 2012
Unfortunately John the Private sector will always get punished more in the press because of a dirty word called PROFIT.
The Public sector also has a dirty word called WASTE, but it is not thought to be as bad a sin by most people.
July 16, 2012
The BBC is once again much of the source of the problem, treating the incompetent public sector in one way and any minor mistake in the private sector as a reason for yet more regulation or expansion/takeover by the state sector. Endless staff and even the police attending yet no one does anything still to ensure he is taking the correct medication or call a specialist to investigate. They just treat him as a nuisance and sedate him until he died.
To the free at the point of rationing NHS all “customers” are a nuisance and are usually treated as such.
One of, the very few, good thing this government has done, the abolition of the M4 bus lane, has today been reversed with a Zil lane for the jumped up sports day. Fortunately I will not be in the UK until the whole wretched waste of money is all over and everyone is just left with the huge bills and the white elephant stadia.
I see Clegg and Cameron are to announce spending of £9Bn on the railways (Clegg describes them as “clean” for some bogus religious reason). Doubtless ticket prices, taxes and subsidies will have to rise still further to pay for it all.
Can we assume that the roads will get £130Bn in proportion to their relative importance/use and the fact that car users actually pay large sums in taxes, unlike trains which don’t and still need endless subsidy. What about air transport and shipping too?
Still the bogus green religion is all to Cameron and Clegg.
July 16, 2012
It is reported that the the John Terry case has cost the tax payer £500,000 over a potential fine of £2,500 (30 seconds work for him). Yet the judge decided there was insufficient evidence.
Why on earth did the DPP make the absurd decision to prosecute? Why on earth is there such a silly law. Why on earth does it cost more than manufacturing 100 new cars to decide such a simple/trivial issue? The legal system is a monopoly racket that needs addressing. The country will not get any wealthier by all suing each other and having yet more lawyers.
Bringing these cases surely actually damages race relations not helps them.
July 16, 2012
Lifelogic
Agreed, this particular case should never have reached Court.
Apparently no one heard anything, it would seem from press reports that the only person who made a complaint, appears to have been an off duty police officer, who was watching the game on TV, who was not called as a witness.
Meanwhile according to press reports today, 400 sex offenders have been released early from prison over the last 3 years, and have since committed a further offence of rape.
One wonders on what grounds these decisions are made, and indeed what logic or commonsense if any, is applied.
July 16, 2012
@AJ
I probably sound like a a member of the tin foil hat brigade, but just look at what is happening – dangerous offenders being released early to re-offend and millions being spent on cases such as this.
It’s clearly not right and yet the government doesn’t lift a finger to stop it.
Stand far enough back from the trees and you will see the wood.
It is by design to destroy the society we had to enable it to be rebuilt into the centrally controlled state that they have planned.
July 16, 2012
I assume they perhaps just want more work for lawyers, social workers, courts and all the rest of the state sector hangers on from the 400 extra new rape trials they have generated.
July 16, 2012
It need not have cost £500,000 if –
1. The police had said they had better things to do that investigate whether abuse directed by one foul-mouthed footballer against another foul-mouthed footballer might be considered “racist”.
2. The CPS had said that it was not in the public interest and not a good use of public resources to pursue the case.
3. The magistrate had stopped the case at an early stage as a waste of the court’s time.
July 16, 2012
I wonder whether anyone would be prosecuted for calling someone a ‘white celibate gentleman’?
July 16, 2012
@stred
I have never heard of such a case.
The CPS would not even consider it.
July 16, 2012
Agree. Terry works with Ashley Cole who testified on his behalf. Or is a distinction being made between ‘racist remarks’ and ‘being racist’?
July 16, 2012
Is it any surprise that people get angry when people are maltreated so companies can make a greater profit.
July 17, 2012
Blimey that’s terrible, who is it thats doing this uanime5? If you name the company (s) and show us how maybe we can boycott their products so that they won’t profit from maltreatment
July 16, 2012
The CEO of the security company has behaved well. He also let is slip that he was preparing, as agreed, for 2,000 staff and then it was mysteriously increased to 10,000. I wonder who ordered that? I wonder when? I wonder why?
What a democratic government is excellent at it being decent. A jury may not be perfect, but it is a lot fairer than a secret judge (family courts). Parliament represents ordinary people. It believes what we believe – or ought to.
But ordinary people are not experts. When you think about it, why should an elected person run a big multi billion pound enterprise like the NHS? Or the Army? Or British Rail? Putting an elected person in charge is simply ludicrous. And that seems to have been what happened in the Olympic Games under Labour (and perhaps even today too). Even the Labour party could see this over Clause 4.
July 16, 2012
Theresa May has been summoned to Parliament to answer for what appears to be incompetence among her officials, who failed to scope and negotiate an adequate contract. Officials who lack this kind of competence seem to be rife and to be found wherever there is a PFI deal or public procurement generally.
July 16, 2012
Very much agree with Mark. The public servants who let and supposedly monitored this contract should take an equal amount or even more of the blame, especially if they significantly changed the requirement for security personnel upward as has been suggested.
July 16, 2012
That all depends on who actually told them to renegotiate the contract at a late stage. Who decided that the requirement should be upscaled and on what basis/advice? Somehow, I doubt that the civil servants would have taken that decision without some direction…..
zorro
July 16, 2012
May states in Parliament that this is the first time that G4S has admitted to her that it could not fulfill it’s contract….It may well be correct…….However, that is not the point. What was she doing in not properly monitoring a contract which would deliver security for a special once in a life time event in the UK?……How can she claim not to have known (at all) that G4S would not be able to deliver?…..Incompetent?…..or just not to it?
Zorro
July 17, 2012
The golden rule for delivering a contract on cost and time was to obtain a fixed price on a tight specification and then make as few variations as possible. In anypublic contract, this seems to have been forgotten over the past 20 years.
July 18, 2012
I really don’t think it is the job of a minister to monitor the day-to-day operation or negotiation of such a contract. No large organisation would operate in that way: the task would be delegated. It isn’t even reasonable to expect a minister to select the delegated team, as they are unlikely to be known personally to the minister.
July 16, 2012
The real double standards is the fraudulent set of books you are running.
If a bank accepts money from a client for their pension, it is record as a liability. It is not recorded as income and spent. That is what you do.
For government and yourself to use the excuse (and I’m not joking here because its the treasury view), that you can always change the law and deprive people of their pension, its not a liability.
ie. There is a criminal intent. Government wants the money and it intends defaulting.
July 16, 2012
Nick,
Governments make laws for the rest of us but specifically exclude themselves from them – all in the name of democracy!
July 16, 2012
Even giving themselves special tax, pension and expenses laws too.
July 16, 2012
Well observed.
July 16, 2012
Sorry, but who is the “you” you are referring to?
July 16, 2012
#welovethenhs
(even when it kills people through neglect or leaves the elderly to lie in their own filth)
July 16, 2012
Worried by governments using troops instead of employees, national banks instead of commercial banks – they are increasingly using entities of last resort.
I am grateful we still have a Queen as it looks like we will need her soon 🙂
July 16, 2012
Not even slightly worried. Would you prefer highly trained, motivated and discipined British paratroopers looking after security or some wastrel students?
No contest.
July 16, 2012
If the jumped up sports day really needs this absurd level of security best not to have the games at all.
The security clearly cannot guarantee safety from attack anyway – however many people you have standing about or however many rockets we have on top of council flats.
July 16, 2012
The death of Kane Cronin was as a result the incompetence and callous neglect which is everywhere in NHS hospitals. The nurses pay almost no attention to patients’ needs and do not care about them. They rarely get any closer than the end of the bed. If I hear any more tosh about how wonderful they are I’ll scream. It’s not the system, it’s the people who are to blame. there ought to be mass sackings, not just managers, but nurses too, but will we get any, of course not. The massive bloated bureaucracy which is the NHS will carry on as if nothing has happened. The unions will continue to run it. Think carefully, you might be the next person to starve to death while the nurses watch from behind the door, thinking ‘He’s just making a fuss over nothing, leave him.’
July 16, 2012
You are right to draw attention to this other instance of double standards. The mother of the boy who died in hospital appeared on the BBC Breakfast programme this am. She asserted that staff there could not be bothered to read the extensive case notes on her son`s condition and believed they were under trained. Apparently, such was his desperation, that he dialled 999 in his efforts to get water. The police turned up, but evidently that did not help him either in the face of an unsympathetic hospital staff. My wife, who was comprehensively qualified in these matters, is constantly amazed at the apparent ignorance displayed so often in NHS cases that come to public attention. Neither of us has much faith in the NHS, not least because of all the hazards that admission to a hospital might bring.
July 16, 2012
@oldtimer
You should never leave a loved one in the care of the NHS.
Make sure you keep a close eye on them.
When my daughter broke her elbow my wife and I took it in turns to stay with her around the clock until she was discharged.
The experience was a real eye opener.
each patient needs their own personal companion/guardian who is fully informed about their condition whilst in hospital
The first Wednesday in August is known as the start of the killing season. Its when medical students arrive for their first day of work as junior doctors, and is associated with a 6 per cent increase in deaths in the wards. The deadly effect lasts for around 4 months before the new recruits are finally able to recognise one end of a test tube from the other.
This is no joke.
July 16, 2012
I have, fortunately, not had to have too much dealing with the NHS. But when I have, I have usually had the impression that you could die in the waiting room and often no one would even notice. Nurses who clearly had no knowledge of the patients and had not read the notes, buildings often filthy, clearly no proper management of anything to meet the needs of patients.
The only aspect that seems remotely efficient was the extraction of money and fines from the patients who brought their cars.
July 16, 2012
JR: “Their shareholders must decide what to do about the management of the Group”
Agreed and in the NHS case what will the shareholders i.e. the government do? So far very little except to offer a statement of regret. No one is prepared to challenge the received view that the NHS is wonderful; it isn’t, particularly in hospitals. The recent sad case was a vivid example of neglect and that is only one of many that are reported each year and others which go totally unreported. What happens? – nothing. I have no confidence in the state (politicians) running anything properly and efficiently, unlike the BBC who for obvious reasons are now gleefully reporting that G4S is a private company which has failed to deliver.
July 16, 2012
I’ll tell you another thing John, unless this government and particularly Lansley picks up the gauntlet and starts reminding Burnham just who is actually responsible for the financial black hole in NHS funding [PFI debt mountain] – the bbc and the liberal bleeding hearts will forever, have a field day at the coalition expense.
On the appalling standards in the NHS – well this is not an isolated incident is it?
I can think without really trying, of two egregious examples – the ongoing Mid Staffs debacle and then Mid Kent where it is reckoned scores of patients died due to lax cleanliness, poor nursing and staff turning a blind eye to patients dying in front of their eyes and remember this insult?
Professional nurses and degrees for nursing? Well that has turned out well hasn’t it?
We have a situation where nurses tend to themselves rather than their charges.
Teach nurses to tend to the sick – isn’t that their calling?
You know what – ‘the NHS get away with murder’.
July 16, 2012
Doctors bury their mistakes!!
July 16, 2012
Why are other European countries able to create slick systems that just work whilst ours seem to get strangled in debt and red tape. I visited someone in a hospital in Norway years ago and there wasn’t a speck in sight, the place was immaculate. Likewise Germany and France appear to have good systems – the end of the day it doesn’t matter how they are paid for, we still have to pay for them in one way or another
All we get are overpaid lazy doctors who no longer work weekends thats to Tony Blairs Working Time directive and horror stories. With the huge budget they have surely they must be able to do better than this.
July 16, 2012
Every EU country is bound by the Working Time directive yet they don’t have the same problems. I wonder why it only effects the UK.
July 17, 2012
Euan. It’s because the UK is the only country that takes any notice of directives. On the continent, they have system based on personal health insurance, state regulated so that the cost is kept down. As a result, the patient has control of the service.
In Europe, if a hospital, diagnostic clinic, GP or consultant is not up to the job, the customer gets to know and take their custom elsewhere. Unfortunately, here we have a system based on a communist economy.
Mistakes are buried and whisteblowers silenced. Even the reorganisation is being carried out to perpetuate the existing model, with the new GP lead management boards being replacing similar structures and controlled by the ministry.
July 17, 2012
So why can’t the torries instead of arguing about things that don’t really affect us like the lords grab this by the scruff of the neck and simply copy a good European model that works?
Do away with National Insurance, replace with compulsory medical insurance (and subsidize those not in work) well regulated to keep costs down.
NHS Trusts could then with a leg up from the government where needed run hospitals like stand alone businesses funded by this mechanism.
And why not stop there? Do the same for pensions so there is no National Insurance Pension Pot for clowns like Mcbroon to raid in future should we ever (God help us) get libour back in govt. All pensions in the public sector could be private with employer/employee contributions like the rest of us
July 18, 2012
replaced by.
July 16, 2012
It’s because the NHS is untouchable due to the reaction of any bleeding hearts any time it is criticised.
The guardianistas always jump to the defence of the NHS saying it is ‘unique in the world’ and a ‘beloved national institution’.
I don’t know what planet they’re on, if it’s unique – is that because the method is terrible, or because everyone else too dim to realise the benefits of the system?
As for beloved national institution – every time I’ve had to use it (thankfully very few) it has been a miasma of unhelpfulness, delays and incompetence.
I don’t use the NHS unless it’s unavoidable.
What private company would get away with booking all the appointments for a certain time then seeing the clients in the order they turned up?
It doesn’t help when the culture secretary says it is “completely normal” for a firm like G4S to be unable to deliver on its commitments.
http://www.telegraph.co.uk/sport/olympics/news/9401913/London-2012-more-troops-may-be-called-up-for-Olympics.html
All this does is foster or nurture in the minds of a lot of people the idea that public = good, private = bad (to, quite appropriately, paraphrase George Orwell’s allegorical novella on the rise of Stalinism, Animal Farm).
Personally I think the public sector should be held to higher standards than the private sector as we have less control over how the money is spent – in the public sector I only get an indirect input over proposed spending and budgets at elections, where my input is only one of many. In the private sector I can just go to another supplier, removing my payment from a company entirely. If I tried that with the public sector and didn’t pay for services which I don’t use (like education, NHS (I’m now private), libraries, etc) I’d end up in prison.
Chance would be a fine thing though – the state just gets bigger and bigger, taxes just get higher and higher. Eventually the whole edifice will collapse under it’s own weight.
July 16, 2012
Adam5x5,
Some of us foolishly thought that the Conservatives were the party of smaller government – not any more!
July 16, 2012
Already some of your commenters are pointing out what drives these two different responses – ideological predisposition against the p-word, profit.
I have little doubt that some of that strong disposition against is because of many of the hatchet job privatisations that have taken place over the last 30 years. Few complain against the obvious successes, notably telecommunications. Many complain about the abject failures, notably the rail system.
The profit motive can be a powerful and positive influence towards firms providing better service – in the right context, and the nature of government intervention (tax/subsidy, regulation, producti0n) must suit the context. All too infrequently the latter is the case.
July 16, 2012
Contrary to the accepted view, I would suggest that the National Health SERVICE has not improved one iota since its formation. When I was young, I could go to the GP’s surgery at the appropriate time and would be guaranteed to see my doctor, maybe after a long wait. Now I have to wait several days and in spite of having an appointment, I have never been seen on time. When I was younger, if one had an emergency during a weekend, you could see your GP, or more likely he would come to you (ours came on a bicycle!). I recall at school, a boy falling and breaking his arm during morning break – he was taken by a teacher to the hospital, and was back, arm in plaster by lunch time. These days he’d have been lucky to have seen the triage nurse in that time.
Any so-called improvements to the NHS have been brought about by more advanced drugs and surgery techniques, usually forced upon the NHS by patients’ organisations who became aware of their use in other countries.
Now today, we learn that one of the simplest operations, cataract surgery, is being cut back by most NHS trusts, to save money. So when I am likely to need the service for the first time in my life (other than for minor ailments), it seems that I am going to be refused treatment.
No, the National Health SERVICE has not improved; the service is abysmal; this in spite of the large number of quangos which allegedly supervise various aspects of our treatment and care.
I’m all for private hospitals (and schools) – If someone can do a better job (as seems likely) at the same or cheaper price and can still make a profit, good luck to them.
July 16, 2012
Private healthcare isn’t cheaper. That’s why every European country with private healthcare spends a greater percentage of its GDP on healthcare than the UK.
July 16, 2012
Theoretically, there is a major advantage in the state owning and operating some service that the people agree there is a universal need for and a shared cost. It allows a common proven physical / technical standard to be applied, attracting economies of scale at all points of use. So, when we do it, why is it always perceived to go wrong.
Does having to pay for at least four sets of Cell-phone capital equipment (Transceivers etc) make sense or would one set have done with the same single OFCOM Regulator? Should we have at least four sets of railway lines for true rail competition? And four sets of railway crossing gates, but still one Regulator ORR.
So what buggered up the National Coal Board; British Airways; Fleet Street; British Leyland, to name but a few. What legacy from the seventies would you say, was buggering up current state megaliths like the NHS; State Education and the now Franchised Railways? And, can we expect anything to change after the Olympics? >>>>>>>>>>Discuss 😉 .
July 16, 2012
Does having to pay for at least four sets of Cell-phone capital equipment (Transceivers etc) make sense or would one set have done with the same single OFCOM Regulator?
But we don’t have to pay for four sets of cell-phone equipment – only the customers of the networks do. If I choose not to have a mobile, then I will not have to pay for the network or its’ upkeep. the same could not be said if it was a nationalised provider.
Should we have at least four sets of railway lines for true rail competition? And four sets of railway crossing gates, but still one Regulator ORR.
If we had the space, or the technology of rail hadn’t been superseded by the invention of the automobile…
These things always go wrong as they inevitably morph into inefficient, expensive money pits run for the benefit of the worker not the client – see the Soviet Union, where the cars were coming out of the factory with less value than the cost of material and labour…
Then no-one wants the service/good as it is inevitably second rate and overpriced.
In a free market, such a product and company will be swiftly removed via the vehicles of bankruptcy and/or hostile takeover.
July 16, 2012
Addendum
The state should only supply those things that are the monopoly of the state – defence, policing, justice.
Everything else can be subcontracted out, be done better and more efficiently than the state ever can. The contracts just have to be written properly and have strict penalty clauses and standards to be met.
July 16, 2012
Everything else can be subcontracted out, be done better and more efficiently than the state ever can. The contracts just have to be written properly and have strict penalty clauses and standards to be met.
What a load of nonsense – PFI has turned out well hasn’t it ?
The penalty clauses are never enforced, CEOs rarely resign….
July 16, 2012
Very good arguments – the private sector is always more accountable than the public sector, which is why we need the state to be scaled back. When a private sector enterprise fails, it goes bust (unless it’s a bank in which case it’s bailed out by the state).
I would vote for a party that fulfilled a promise to reduce the proportion of state spending to GDP from 50% to 30%
July 16, 2012
John,
The difference between the responses comes about because this present Government has made a big thing about saying how good the private sector is and how bad the public secor is. This hype has lead to many profitable contracts being let to organisations who are not up to the job – or don’t even do what the Secrataries of State have said in Parliament they were meant to be doing.
You are right to critise what happened in that hospital and complain about double standards. However in the matter of some private so-called health service providers in the welfare area I have direct experience that can only be explained by it being them milking the system. Perhaps you can ask the SoS Iain Duncan Smith exactly how he does check that these contractors are doing what he has said in Parliament they are meant to do.
Reply: The private sector security contract was originally let by Labour.
July 16, 2012
A man has been unlawfully killed by professional neglect. Where is the Police investigation and when can we expect the criminal charges?
July 16, 2012
There’s no crime of professional neglect so there won’t be a police investigation. Though there is the crime of gross negligence manslaughter this requires a high level of negligence by the person charged with it, consequently only doctors who botch surgery are normally charged with it.
July 16, 2012
I think a major reason for this extraordinary disparity is the fact that the BBC constitutes c 50% of media – and well over that for news & comment. Being 100% state funded, and having – as is widely recognised – an institutional leftist bias, the BBC acts almost as an in-house media outlet for the public sector. It sees private companies, especially where they are an alternative to or competition for the public sector as targets to be attacked relentlessly. One of the oddest thing about the last 15 years is the way the public sector has risen from c 1/3 to c 1/2 of the economy for very little noticeable benefit, and without coming under any real scrutiny for value for money.
July 16, 2012
The public sector has risen partially because the private sector has shrunk due to the recession.
July 16, 2012
Not only should the troops be well rewarded for stepping into the Olympic security breach, those who have been inconvenienced by changing their R&R periods should be given extra time off as compensation. However, I cannot help thinking that Olympic security duties is far better for their health than being bombed and shot at in Helmand. The soldiers involved may not think that way, if they have the same approach as Patrick Hennessey portrayed in his book The Junior Officers’ Reading Club.
July 16, 2012
The core purpose of the NHS has always been and still is to provide people with medical care which they could not afford out of their own private resources. Unfortunately the level of medical care which the population has gradually come to expect is now not just beyond the private resources of a large part of the population but probably beyond the collective resources of the population as a whole. Necessarily efforts have been made to limit the inexorable rise in the cost of providing the high level of medical care which is being demanded as of right, but with the result that to some extent basic standards have been compromised. I don’t see any convincing grounds for assuming that this wouldn’t have happened if the state had not been providing the largely free medical care, but instead had just been paying for it to be provided by private companies. The problem is not that the NHS is publicly owned and therefore it will inevitably be inefficient, but that too many people – who, of course, make up a large part of the electorate – are expecting far more for free than they could possibly afford as individuals, or society as a whole can afford, and that would remain the case if the providers were private companies.
July 16, 2012
Apart from the obvious oddities of the media, I suspect there are several contributors to the differene in reaction:
(1) Conviction looking for supporting evidence incorrectly dominating hypothesis looking for data
(2) Profit portrayed as an objective not as a constraint
(3) ‘Profit’ not being such a pleasant word as ‘surplus’ used by not-for-profits. Yet private organizations can reinvest or disburse for the social good, whilst not-for-profits cannot disburse.
(4) All political parties have history on saying civil servants are the best in the world – the best police personnel, the best military personnel, the best health personnel – how can constructive criticism then follow?
(5) A state dominated education system, acculturating to state provision.
(6) State institutions being given an image of repairing society – police, judiciary & prison repairing behaviour, military repairing world freedoms, NHS repairing illness whereas the private sector is imagined as taking from society, almost in opposition – legalised theft, destroying freedoms and making people ill. There is little done to counter this view – a transaction is win-win (otherwise it wouldn’t happen), much innovation is private, a market mechanism is a pricing (same units) and coordiantion process, without the ‘evils’ of banks, oil and a commercial food supply chain many of us would be dead (business enables life!) …etc.
What I find startling is that the PM and DPM has the opportunity to be more than the sum of the parts and develop an economically and socially liberal agenda, to recognise when state spending crowds out and when it crowds in, to balance market coordination with vertically integrated coordination, to recognise the appropriateness of extrinsic and inrtrinsic motivation …. instead the PM and DPM aeemed to have allowed their parties to be less than the sum of their parts and for the ‘leader’ of the opposition to pick up the leftovers.
July 16, 2012
Nobody complains about abysmal NHS treatment because it is “free”, and there is a universal feeling that we should be grateful for the fact that it is free, and because it is free, we have no right to complain when things go wrong.
In the private sector, companies or individuals who are incompetent or negligent don’t get paid; that option does not exist in the NHS.
What we have is a Communist system where the Camerons and Milibands and the various other politburo chiefs get the best treatment that money can buy, and the plebs can expect only neglect and abuse. I would expect that BBC staff get the same deference and high standard of care as our politicians.
The politicians and the media protect the NHS because it gives them a high standard of care without any payment being necessary. That is blatantly corrupt.
July 16, 2012
To put it in simple terms; there is no contract between the patient and the NHS, which means that the patient has no contractual rights and the NHS has no contractual responsibilities.
July 16, 2012
A contract isn’t the only way to make a hospital legally responsible for their patients. There’s also torts, such as negligence, which don’t require a contract but allow the patient to sue the hospital if anything goes wrong.
July 16, 2012
The poor, the elderly, the sick, the disabled and the dead are at something of a disadvantage when it comes to suing the average Hospital Trust.
The Hospital Trust has access to the finest legal brains and unlimited resources; the patient doesn’t, without health the patient is helpless.
July 17, 2012
First relatives can sue on behalf of someone who has died or been injured.
Secondly suing the NHS is one of the few circumstances where you’re eligible for legal aid. So lack of money doesn’t stop the patient or their families suing the NHS.
Thirdly one of the main parts of the cost of legal aid is lawsuits regarding maltreatment in hospitals because these hospitals will never admit fault or try to settle out of court. This is something that governments have ignored for far too long.
July 16, 2012
Why does everbody fall for the propaganda that the Security stuff is needed or will work? Perhaps a study of the Maginot Line and Fort Eben-Emael is needed to remind folk of how easy it is to waste money on false security promises.
July 16, 2012
The Conservative government decided to increase the number of security staff from 10,000 to 23,000. No doubt they know something that we don’t. In December 2011, E4S were asked to increase their number of staff from 2,000 to 10,000. That’s difficult. Remember that E4S had to recruit, the Army didn’t.
As for the NHS, making health care free at the point of consumption increases demand hugely, more than can be funded. Health care has to be rationed somehow or other. Perhaps the young man would have survived had there been fewer patients with obesity related diseases in the hospital, taking up nurses’ time.
July 16, 2012
I wonder if the decision to increase overall security from 10,000 t0 23,000 was taken on the back of the (unpublished) HMIC report which the Government is claiming did not look at/evaluate the credibility of the original G4S contract…?
zorro
July 16, 2012
http://www.hmic.gov.uk/media/annual-report-2011-12.pdf
zorro
July 16, 2012
The NHS varies in standards, apparently because of the abilities and efforts of the individuals working in particular areas. My friend, who was denied proper diagnosis after falling in his garden, suffered with 3 cracked ribs for 5 months before being given a scan for what turned out to be a terminal disease, possibly brought about through lack of early treatment. The actions of his GP and the first radiography department were appalling.
Having been taken into the very expensive NHS hospital, his treatment could not have been better. The consultant overuled any management attempt to send him home to be treated by visiting carers, because this had resulted in a fall and injury when tried before. I should also mention that the ward is taking patients who are terminally ill and would have been taken by a hospice, had it not been for the halving of numbers of beds, because of the financial squeeze on charities. Some have died in open wards.
Perhaps the reason for this inconsistency is the rise of managers who thrive on large scale reorganisation rather than those who concentrate on outcomes. I note the silencing of the latest whistleblower, who dared to complain that target chasing was resulting in treatments being mis-allocated, and involved large amounts of taxpayer’s money. And who did he complain to? One person now heads the NHS and is implementing Mr Lansley’s ideas, while another is in charge of GP commissioning. And the head of the NHS used to be in charge of reorganising the structure of the West Midlands NHS, while no-one noticed the appalling ‘outcomes’ in Mid Staffordshire.
July 16, 2012
Why wasn’t the military employed in the first place? Was it sensible – I think not – to rely on a single private company being able to hire 10,000 people on temporary contracts? At the very least it should have been two companies so if nothing else they could compare notes– each would automatically police the other better than the government.
July 16, 2012
No, it wasn’t very sensible at all, bearing in mind that the security requirements appear to have been grossly underestimated bearing in mind the number of venues…
zorro
July 16, 2012
The NHS ceased to be a National Health Service sometime ago and has become a National Employment Service, interested only in the welfare of current staff and recruiting more staff. I don’t need to go into all the anecdotal evidence of this.
July 16, 2012
Another extraordinary example of double standards between the public and private sectors is the recent Hammersmith flyover fiasco. Just imagine if a private company, rather than TfL, had been surprised to discover that their maintenance schedule and inspection regimen had missed that one of their major, critical and key assets was unsafe to the point that it needed to be closed or severely restricted for maintenance for a very long period of time; heads would have rolled, the management would have been excoriated in the press and on the BBC, the furore would have been never-ending. As it was the disruption with concomittant costs were just accepted.
Now imagine that shortly after the flover re-opened it was discovered that another floyover, just down the same road, on a critical arterial route was so in need of urgent repair that it had to be closed.
That is what has happened but because TfL is possibly the most powerful and unaccountable quango in the country there is no outrage. TfL had over 160 staff earning £100k+ or bungling over-paid fat cats as they would be known if they were a private company. This is our own little London transport omnishambles on the eve of the Olympics yet I have yet to hear a call for one head to roll let alone a need to clean the Aegean stables.
Utter despair.
July 17, 2012
Given that the main cause of the Hammersmith flyover being closed was that salt was used to grit this road (it hadn’t been designed to cope with salt water as it was meant to be heated) I doubt that a private company would have accepted any blame for it becoming damaged far quicker than anyone expected.
July 16, 2012
All part of the British disease- or Socialism as it is more accurately known.
July 16, 2012
@Alison
Firstly, get rid on the TV licence.
Everything after that will be curable.
July 16, 2012
Yep.. its about time NHS managers & staff were prosecuted for this kind of stuff. This being independent of the internal NHS disciplines. I would like to know how the Police investigated this or didnt ?
Are standards so low that all hospitals deaths should now be reviewed by the Police?
First do no harm … is a phrase i heard once!
July 16, 2012
Private versus Public is a false dichotomy. In the cases referred to by JR, the underlying failure is that of the government.
Gordon Brown used our money twice, when he sold off our gold in such a way as delberately to achieve a rock bottom price and again when he “saved the world”. The bailouts of people whose importance to the real economy is either slight or totally nonexistent has dwarfed all the bailouts of all other failing public and private enterprises in the past. Meanwhile the problems for Ulster Bank customers, part of RBS, after a month, are still not entirely resolved. Politicans have allowed banks which used to serve the public and the business community to become greedy dishonest inward looking derivative trading monoliths with little residual interest in subserving the functions for which they were founded.
Gordon Brown was also responsible for the PFI contracts which give the very clear impression that the spivs concerned would not be looking for repeat business (but you never know) and have put huge strains on the NHS as well as education budgets. (Gordon Brown also used our defence budget to build a couple of WWII vessels whose likely survival time in a real war, ie not one under the ‘War on Terror’ brand, would be measurable in minutes).
The failures of the NHS are again caused by the government. Most of the ‘good’ private hospital sector is actually serviced by doctors who also work in the ‘bad’ NHS and nurses also who have worked in the NHS. The private sector can filter out the intellectually or otherwise underqualified whereas the NHS run by the government, apparently cannot. The NHS, inevitably, employs juniors under training; however, these would not be a problem if their supervision were adequate.
With regard to G4S, there appear to be serious questions to be answered by the Olympic planners and the negotiators of the relevent contracts. Did the negotiators discuss the gross profit per day G4S were expecting on temporary staff? Were G4S restricting themselves to local ‘talent’ many of whom apparently can’t speak English, in order to avoid temporary subsistance costs. Are such people capable of operating an effective dragnet etc? Lastly, if the reports of 200,000 temporary caskets are true, what on Earth is going on and who sanctioned such an expense?
July 16, 2012
John,
I agree that G4S should pay for the troops to cover their ineptitude. You are correct that companies make mistakes, and that the NHS should be more rigorously examined (by the way, as you may know I do not think that the NHS is the best way to provide quality medical services or treat a patient/customer’s needs). It is true that a man died, but there are many other deaths per year in NHS hospitals which can allegedly be ascribed to poor quality treatment or ‘mistakes’.
But we are talking about G4S which I mentioned on a previous blog along with some stats and figures. They have potentially put the Olympic security and the participation of some countries in jeopardy with their incompetence. More will come out on this which will be difficult to rebut……They have woefully failed to get enough guards ready and the quality, competence, linguistic ability of those already employed has been credibly challenged.
This is potentially very serious. If something did happen because of security blunders which should have been more closely scrutinised, there will be no excuse. it’s impact will be very high…..It appears that G4S have already had 200 million pounds wiped off their share value. I hope that certain politicians who might allegedly have share interests in G4S don’t suffer too much…….
Zorro
July 16, 2012
Whilst it is good that the troops have stepped in so to say……A lot of them have just come back off arduous tours of duty or have had to cancel leave/live in a tent longer than they might have hoped. It is not in the Olympic spirit to have such an overtly militaristic feel to the security preparations.
Zorro
July 17, 2012
It works for Wimbledon…
July 16, 2012
Can anyone cite a country in the world that has replicated the British NHS as its model for healthcare?
July 16, 2012
Cuba libre!
zorro
July 16, 2012
or not as the case may be…..
zorro
July 17, 2012
Hence the saying “NHS – Much admired, never copied”.
July 16, 2012
I had four days in the West Middlesex hospital last month and the care and service was first class as well as the food when I was able to eat. Regular visits and excellent care.
The police that went to St Georges hospital should have insisted that he was supplied with water. We all know by now that the NHS has its failings and for a patient to dial 999 is an indication of his desperation. As a former police sergeant I would have had a word in their shell like when they returned to the station.
I should hope that this is taken on board by the police and action will be taken in the future.
It is stated that doctors and nurses will have to have a reduction in pay. Will this apply to managers who are on sallaries of £200000 plus? How good are they? Are they not supposed to be the best that can be had? If they are why are so many complaints about the NHS? Will there be any sackings at the top rather than for doctors and nurses who do the caring?
They after all run the place and must be ultimately responsible, not just those who actually do the work.
July 16, 2012
@Badgerbill
“The police that went to St Georges hospital should have insisted that he was supplied with water. “
We are talking about a dumbed down Police “Service” that refused to save a man from drowning on a duck pond on the grounds that the water was more than ankle deep.
Can you not see what is happening to this country?
Wake up before it’s too late!
July 17, 2012
How was he drowning in ankle deep water? Why didn’t he stand up?
July 18, 2012
I have noticed that whenever the sun shines the police are out on their bikes, keeping fit. Also, the mobile speed cameras only appear when it is a sunny day. Thank God. (etc etc) Thanks Boys.
July 16, 2012
I regret John that you are using the left’s two wrongs make a right approach.
They should all be pilloried. This is our tax takings that are being used poorly.
July 16, 2012
You’ve knocked it on the head there – unfortunately as many commenters point out we have this monster called the Biased Broadcasting Corporation who always seem to want to push the big state agenda in their news coverage, all too willing to go to town on anything bad in the private sector whilst putting the death of a patient due to NHS incompetence on the back burner – the BBC is something we all pay for but have no say in who pulls the strings.
Talking about elected individuals, why don’t we have the right to elect the board of the BBC?
July 16, 2012
The BBC Trust is supposed to look after the interests of the licence fee payer, and it is their board we should elect. The Corporation are responsible to the Trust.
July 16, 2012
I won’t comment on the private security firm, as I’m sick to death of these games well before they start. The BBC is filling each day well before they begin. I for one will be glad when they are over. As for the disabled games, now there are real sportsmen and women, who do it against all the odds. That I do support. The rest is just hype and waffle. Needless to say I think there are far more important things going on than a world games.
As for the boy dying from thirst, well it says it all really. What we should be looking at is the structure of staff within wards, years ago a sister was in charge and the buck stopped there. Now we have ‘ward managers’, which I think are suspect in reaching the old standards of care and expertise like ward sisters had. They had to pass exams to get the position, do they now?
There’s to many managers within the NHS, interfering in it’s every day work, I’m a trained nurse so know full well what and how its gone down the pan over the years. Nursing and medical care should be left to doctors, who know best, we used to have no managers but an overall hospital secretary who delivered the things a hospital needed. Smaller, more qualified, and a tighter knitted team. We now have those who think it OK to chance systems to suit the purse strings, and in the end cost us more. Even the changing of the nursing training as led to many not being able to speak English, or if they’ve come from foreign shores not trained to our level at all. Back to basics should be the rule, like when I trained in the 60’s, we didn’t have these crisises way back then, just simple hard work, and you knew what you were trained for and level.
July 16, 2012
Barbara
Interesting that you feel the way you do about the present HNS.
We know a number of nursing staff who were trained around the same period as you , they all say the same as you.
Even the younger trained staff in their late 30’s are now saying the same thing.
My Mum was 4 years in a local nursing Home, recieved excellent care from people who had all left the NHS for the very same reasons, suggesting that nursing is not like it was in the NHS in years past.
No job satisfaction either.
If all these people are singing from the same song sheet, how come the Government, not just this one, but previous ones as well, do not understand.
Is anyone feeding this info back to Government, or are the “managers” simply doing their own thing.
Thought we had checks completed by quango’s on such Hospital performance, or is all of this just box ticking, which misses the real point by a mile, and is thus a complete waste of time.
July 16, 2012
Strangely, it seems patients do not die of neglect in private hospitals, nor do they suffer from MRSA, CDiff or other hospital acquired infections. Why is the private sector able to clean its hospitals and yet the NHS cannot?
July 16, 2012
Does the private sector have large mixed wards? Are their staffs too busy to wash their hands?
July 17, 2012
Not until you insurance runs out.
July 17, 2012
Depends on your policy.
July 16, 2012
@Nationalist
Do private hospitals employ staff based on ability as opposed to disability or some other perception of persecuted minority status?
July 16, 2012
Could it be because the private sector gets more money per patient.
July 16, 2012
uanime5
Correct, a dead patient can no longer pay the bills.
Keep the patient alive and well for as long as possible and you get more income.
Just like dentists, they used to extract teeth, now they realise that, that is the last thing to do, the more you can keep the more you can treat the greater the income.
July 18, 2012
Alan. Heard recently of a young and very competent dentist ( he treated me) who could not get any NHS patients and therefore went bust and had to give up his investment in a new surgery. If it is correct, that the NHS board consists of dentists controlling the entrants and potetial competitition, this is corrupt. Maybe A. Lansley could sort this out relatively easily, if his mate JR could have a word.
July 16, 2012
No chance of the coalition itself taking your approach, I suppose?
July 16, 2012
I have just heard Menzies-Campbell (not sure if there is a hyphen and don’t care much) on his idea of the “consequences” (quake, quake I’m sure) of the Commons’ not going along with the Liberals’ daft ideas on House of Lords Reform. He has joined the lowest of the low. What he said was drivel–either ignorant or mendacious or more likely both. What an embarrassment for the Liberals. I almost but not quite feel sorry for them. He needs to glance at the Telegraph’s simply factual first leader today and hang his head in shame. David Steel I thought spoke good sense though, I have to admit.
July 16, 2012
The NHS – envy of the world – but the world, outside of the UK doesn’t seem to want it.
The organisation is given special dispensation from criticism.
Yet the true advances in healthcare are driven by the private sector – drug development, development of equipment. Nuclear medicine, the development costs…£billions. All for profit motive…yet doctors pick up the credit for the benefits of this research. No one thanks the drug producers.
All high tech stuff – yet if, say, hospital laundry is outsourced to the private sector (for profit company) … profit is mentioned, Labour and Lib Dem politicians run to the TV studios to denounce the “profit before people”
Imagine if the NHS had to develop drugs and equipment, we’d probably have leech shortages.
(We’d still have leeches).
July 16, 2012
The public sector isn’t normaly short of leeches.
July 16, 2012
forthurst
Made me laugh.
July 17, 2012
Looks less relevant today? Maybe we do not understand enough because of the BBC huh? 57 million in management fees? Idiot.
July 16, 2012
All projections show that the cost of the NHS will become overpowering on a increasingly elderly society who must rely on Government pensions. The ‘welfare state’ is demographicaly impossible to maintain without allowing immigration on a large scale or taxing the children of the future such that they cannot afford a house. The answer is to end the ‘welfare state’ or allow anyone in. Perhaps that should be made clear to the Labour Party and it’s supporters. The public are not afraid of the truth – just ignorant of it at present.
July 16, 2012
The present generation is long lived, however ours and the next one won’t be. Poor diet and lack of exercise will pull back the next group of the elderly.
July 17, 2012
They should try doing some physical work like I have been doing today. Desk jockeys and fat kids can ram it.
July 17, 2012
I wonder what projections you would have made during the time of Malthus.
July 16, 2012
This comment is about the Olympics security contract. I would hold to account the Government department responsible for monitoring such an important and expensive project, and I have some experience in these matters. No responsible organisation commissions such a huge project and fails to monitor performance regularly. Problems like those which have become evident don’t happen overnight; they’ve been festering for months. No amount of spin can alter that. As for Jeremy Hunt’s comments about such problems being “completely normal”? They demonstrate an attitude of complacency and incompetence which would result in summary dismissal in any well-run organisation. Over to you, Mr Cameron.
July 17, 2012
If you hold the governments department responsible then they can overlook another government department and not hand over money to companies that are not responsible for anything can they not? No amount of spin can alter that one.
July 16, 2012
Given that there wasn’t a huge row when a certain private care home were shown to be abusing patients I doubt people would object if someone died due to maltreatment in a private hospital, unless they were a celebrity and their relatives sued the hospital.
When it was shown that the management of Stafford hospital was very poor and this lead to several deaths the public was outraged and demanded that the management be harshly punished. I guess this is the difference between someone dying because the nurses weren’t properly trained and someone dying because the management didn’t care.
Regarding the health sector I’d recommend clarifying the law on gross negligence manslaughter. This would make it much easier to bring criminal charges against poor hospitals in the public and private sector.
July 16, 2012
Channel 4 News this evening led on G4S. John Snow made a big play of the fact that they had seen an Company internal document that pushed a “just-in-time” approach, and that they were all for making a profit.
Why Channel 4 should think “just-in-time” is so terrible I do not know. It is a widespread practice that makes a lot of sense, as long as you do deliver “in-time”.
Why Channel 4 should think it in some way inappropriate for a private company to seek to maximise its profits I can not imagine. Perhaps they should consult the shareholders and employees on the matter so as to get a better canvass of public opinion.
July 16, 2012
“Just-in-time” works well for eg car assembly. What it actually means is that a supplier has been selected to supply a part, he has agreed a specification, he has produced prototypes which have been tested in a laboratory and been accepted, he has negotiated a price per thousand, he has agreed that he can produce a specified maximum delivery rate, he has been given a delivery schedule months in advance based on forecast sales, he has received attenuated schedules to match the actual factory production schedule as each specific delivery approached, he produces and delivers each batch just-in-time. Is that what G4S means? They had it all planned months in advance to that level of detail? If so, why did it go wrong?
July 17, 2012
Limitations of just in time in the car industry foxhurst? Do get back to me.
July 17, 2012
The main limitation of ‘just in time’ is that if all the parts aren’t delivered on time cars can’t be made. Kind of like now when not all the guards are turning up and everyone is trying to find replacements.
July 19, 2012
Unlike the games cost Toyota and Honda huge losses.
What we are seeing by the closing of reservoirs is a just in time method of water supply relying on the consumer using less by the use of water meters especially in the south East and London where twenty reservoirs have been closed. They are now derelict sold for housing, industrial sites or nature reserves despite Thames water paying out 5 billion in dividends that should have been used for infrastructure. As in more reservoirs. Just in time? more like just in. Ram it.
July 16, 2012
The NHS case is as harrowing a read as it is possible to read. Surely there is a case for bringing manslaughter charges against some of the people involved. It might at least make others think when they disregard the requests of their patients.
July 16, 2012
As to the man in hospital who died of dehydration, the media news report I heard said that when the police turned up at the hospital in response to his 999 call they were turned away by hospital staff. Also, that he was sedated.
Makes you wonder if sedation is their normal response for people who cause a fuss.
I also wonder what action the police are now taking: at the least they should be giving consideration as to whether a criminal offence has been committed.
July 16, 2012
Mr Redwood has overlooked the self evident truth that each and every employee of the NHS is a saint and any shortcoming of the NHS is the direct consequence of cuts in government funding. I hope this has clarified the problem for everyone.
July 16, 2012
A company can hardly be classed as private when its only customer is often the government. What we are dealing with is communism for the rich.
July 16, 2012
Bazman
I certainly tend to agree.
July 16, 2012
Bazman
Same could be said of so called charities which get government funding for a large percentage of their income.
July 16, 2012
I’m surprised that criminal charges haven’t arisen from the St George’s Hospital case.
Of the media silence you mean the BBC ?
July 16, 2012
The NHS is, first and foremost, a huge socialist body. Healthcare comes second to its primary purpose as giving raison d’etre to the Labour party.
July 16, 2012
The NHS is, first and foremost, a huge socialist body. Healthcare comes second to its primary purpose of giving raison d’etre to the Labour party.
July 18, 2012
You think you are going to push the system used for trains, banking, finding jobs for those not working, energy and the rest of the incompetent money grabbing companies onto the NHS just to satisfy your ideology?
July 16, 2012
There is another problem. Making a complaint against NHS medical staff, and having that complaint upheld, is difficult to an extent approaching impossibility. A complaint is initiated through the local Primary Care Trust (PCT). If satisfaction is not achieved, an appeal may be made to the ombudsman. What is not apparent is that the decision of the ombudsman is dictated by the medical profession. Following the death of my mother, I had complaints against her GP which I have recorded in an extensive file. Finding no satisfaction with the PCT, I complained to the ombudsman. Incontrovertible written proof of my complaint was met with obfuscation concerning verbal comments. I found that I was just wasting my time. Having worked in the NHS. I am well aware of how the medical profession “close ranks” when faced with a complaint.
July 17, 2012
A company run providing security for the Olympics who’s head does not understand the term ‘fluent English’? Able to express oneself readily and effortlessly in that language. Bazman. secondary education only. There is no other term applicable. Taking the piss. At this point should have been sacked along with his company. This company who thinks they can staff the security with personnel who are of a census collecting level. As in nothing better to do at that moment in time. I applied as a census collector went through the process and saw all. A job applicable to my real skills came up and I did not eventually do the job. Your private companies running Britain got found out big time. Even the professionals were just filling in time and spitting on the people above them. If you pay peanuts you get monkeys. If you pay coconuts then you get monkeys unable to open them. Ram it.
July 19, 2012
Indeed
The public sector gets an easy ride, including public-sector politicians who make a balls of most things these days for their own self-serving interests.