Questions about health spending

I am asking the Health Secretary to share more of the detail of how extra money could be used to reduce waiting lists. I am also asking why some senior NHS managers think there is going to be a further bulge in waiting times, given the much lower level of covid cases in hospital  now, the progress of vaccinations, and the extra cash allocated to health budgets.

He needs to know how many senior managers and Chief Executives there are now across the public health sector. How is their remuneration aligned with the public interest in high quality care and low waiting lists? Is there a continuing danger of overlap and blurred responsibilities within  what is a complex structure?

As the state embarks on recruiting  a large number of new Chief Executives for the Integrated Care Boards and for the Integrated Care Partnerships, what reductions if any will there be in the old management architecture this replaces? What arrangements are there to transfer appropriate staff to these new bodies to cut the costs of recruitment and to avoid redundancy costs and disruption to staff?

How will these new Care bodies arrange their purchasing of medical and care services from the NHS Trusts and other health providers? Are the current procurement organisations  now withdrawing from contracts with private hospitals, or will they be needing and using more private sector capacity to help reduce waiting lists?

Presumably much of the answer to workload, stress on staff and high waiting lists lies in  recruiting additional nurses and doctors to undertake the necessary procedures and treatments. What is the latest view on how many people can pass successfully through training?  What action is being taken to encourage the return of already qualified people? How can new technology assist in raising quality and productivity?

The use of temporary and contract staff is expensive and too common. the NHS needs to have more permanent staff members.

232 Comments

  1. Sea_Warrior
    September 12, 2021

    A long list of questions, Sir John, but perhaps you could also ask him for:
    (1) an update on the NHS’s lamentable efforts to secure payments owed by foreign users (ca. £1 bn/p.a.);
    (2) an explanation of why some 97% of COVID tests come back negative;
    (3) his plans for rolling-out COVID sniffer technologies, across the NHS and more broadly around the country.

    Reply
    1. Lifelogic
      September 12, 2021

      On testing one school I know last week had over 50 positive lateral flow tests. So these people all then got a PCR tests – only 2 of these 50+ were positive. So much for the quality of the tests it seems?

      Reply
      1. Everhopeful
        September 12, 2021

        I suppose it might be too prosaic to ask how many + PCRs actually go on to get ill?
        By any sane standard this testing is a scandalous waste of money,manpower and anxiety expended.
        Ah…a good way of curing NHS bulges….
        Wait until people actually become sick!!

        And there may not have been such huge waiting lists and deficits had the NHS not spent so much time and money on pointless screening exercises.

        Reply
        1. Lifelogic
          September 12, 2021

          Indeed testing people without symptoms (other than in a few special cases) seems rather mad to me.

          Reply
          1. Everhopeful
            September 12, 2021

            +1

      2. Sea_Warrior
        September 12, 2021

        Fizzy-pop will do that!

        Reply
        1. glen cullen
          September 12, 2021

          and other things teenagers have been known to take

          Reply
      3. Lifelogic
        September 12, 2021

        So the delightful Emma Raducanu (having already won about $2 million) will doubtless be advised to become non UK resident from 6th April next year given the appallingly high tax rates in the UK (plus she will be overseas touring on the tennis circuit anyway). With her good A levels in Maths and Economics perhaps she could explain to Boris and Sunak the stupidity of their tax borrow and piss down the drain agenda and indeed their net zero CO2 lunacy which would logically prevent her and other sports competitors form flying round the world to compete (were they remotely serious about it that is).

        Reply
        1. No Longer Anonymous
          September 12, 2021

          +1 and good luck to her.

          Reply
      4. MFD
        September 12, 2021

        LIFELOGIC
        Makes one wonder which we actually correct! Possibly it was non of them, all wrong including the PCR as it says on the box “ not for diagnosis “ . We are being lied to!

        Reply
        1. Lifelogic
          September 12, 2021

          +1

          Reply
      5. Hope
        September 12, 2021

        JR, wrong questions. Javid is a LL tax spend and piss down the drain.

        We are still suffering from his failings as community secretary breaking manifesto promise to freeze council tax. It raise it 5% year on year without any improvement!

        As Home Secretary broke manifesto pledge to cut immigration it rose to historic levels all paid for by the taxpayer.

        Now as Health Secretary he breaks another manifesto promise, more taxes without any improvement and no idea how the money will be spent!

        Javid is a useless waster in the wrong party. Rather your party is no longer conservative in any way shape or form. The only difference between your party and Labour is the colour of the rosette.

        Corbyn looks prudent on economics compared to you lot!

        Do not write another manifesto, Javid will go UDI and hike taxes without any improvement in service. He is impoverishing us all.

        Reply
      6. Margaret Brandreth-
        September 12, 2021

        If the antigen is present it will show positive, full stop.One wonders about the PCR test and whether covid antigen has been picked up by the swab taker.

        Reply
    2. Everhopeful
      September 12, 2021

      Further bulges.
      Haven’t they just let an awful lot of people into the country @WarmWelcome?
      And a plenteous supply thereafter?
      One small island. One ( the only one allowed) “Health System”.
      Johnson has overstepped the mark. Or been pushed.
      There may be consequences.

      Reply
      1. No Longer Anonymous
        September 12, 2021

        There is another health system but it was bought up and closed down by NHS managers who didn’t agree with its ideology.

        Reply
        1. Lifelogic
          September 13, 2021

          +1 they do not like any competition in case it shows up how useless they are.

          Reply
    3. gyges
      September 12, 2021

      On testing I’d like you to consider the following counterfactual conditional: if covid did not exist, nor never had existed, and the same testing and recording regimes were in place, we would still have had thousands of covid cases and deaths.

      Absurd isn’t it?

      Reply
    4. NickC
      September 12, 2021

      Robert Peston is reporting that the government’s own figures (Vaccine Surveillance Report) show that “the overwhelming majority of those infected [with covid] in the age group 40 to 79 have been double vaxxed”. He is apparently “surprised” these statistics have received so little attention. I’m not.

      Reply
      1. beresford
        September 12, 2021

        It is now widely reported that Boris is to shelve the sinister ‘vaccine passport’ proposal to soothe party anger over tax rises, reneging on the triple lock, and inactivity over illegal immigration. Macron and Sturgeon must be livid, no wonder they call us ‘Perfidious Albion’. “You go first, don’t worry I’m right behind you”.

        Reply
      2. No Longer Anonymous
        September 12, 2021

        The point of vaccination was never to stop infections but to mitigate the illness.

        Surely the time has come for focused shielding of those over 82 and those with serious co-morbidities. Not the threat of further lockdowns and ghastly masks in perpetuity.

        Reply
        1. NickC
          September 13, 2021

          Not so, No Longer. The covid vaccines were initially promoted as the way of achieving herd immunity – that is not possible if (as is the case) vaccinated people continue to transmit covid. Moreover “vaccine passports” are predicated on the notion that it is only the wicked unvaccinated who are a danger to everyone else.

          Reply
      3. hefner
        September 13, 2021

        On http://www.ons.gov.uk ‘Deaths involving Covid-19 by vaccination status, England: deaths occurring between 2 January and 2 July 2021’, 11 interesting pages.

        Reply
  2. Lifelogic
    September 12, 2021

    Well the state monopoly NHS rationing system can never be efficient. To get more money and efficiency into healthcare you need tax breaks for people who shorten the waiting list by insuring themselves or paying for themselves they should not have to pay 4 times over (for others, tax on the money they earn to pay the insurance premium, the insurance premium then 12% IPT on top). Encourage companies to offer group schemes and private GPs. Consider sending them to India. There is a Charity Mercyships.org that sends ship round Africa etc. to carry operations and train doctors. The NHS could learn a lot from them.

    There is of course no need for someone doing endless knee or eye operations etc. to spend ten+ years learning about all areas of medicine first. You do not need to know everything about all parts of an aircraft before you can change a tyre or a seat. Train specialist doctors and nurses for just one area of activity in two years. Nor to you have to have 4 A*s at A levels. About 50% of expensively UK trained doctor do not even go on to work for the NHS such a poor employer is it. They can earn more elsewhere or go overseas.

    Main problems are it is not their money so they do not care about waste, the money does not follow the patients, GPs paid regardless of not seeing patients, incompetent & could not care less management, free at the point of use so rationing is the only way to control demand, it is virtually a state monopoly so what could go wrong?

    Reply
    1. Sir Joe Soap
      September 12, 2021

      I get the drift, but I think I want to know my surgeon knows the effect of amputating my knee on my cardiovascular system, should it ever come to that.
      The point is, in an insulated system, we should be able to predict demand for the specialties etc. A bit more difficult when we’re importing unknown numbers of folk with presumably some pretty exotic conditions.
      Clearly the thing needs more competition-they can sit back and neglect customers where they’re the only game in town. Around here, though, more folk are bypassing it in any way possible, tax break or no tax break.

      Reply
      1. Lifelogic
        September 12, 2021

        They can always consult other specialist should that been relevant or needed but this would rarely by the case I suspect.

        Reply
        1. Margaret Brandreth-
          September 12, 2021

          Unfortunately degrees and A levels have nothing to do with the competence of clinicians. I have been comparing highly academically qualified people to the people who ‘do’ for about 50 years. It all eventually levels out, but all need to go through the same learning process where a patient’s life and health is paramount to practice . I have a few degrees and believe that extra curricular work and experience related to the days experience on the ward is more valuable. Take a simple example of assessing how many drops a minute a certain IV medication needs to go to deliver a certain amount of a drug in a certain time .I found that the A level maths students could not do this simple calculation on the ward faced with the drug and setting up of the infusion , whereas the professionals who knew the size of a drop and the dilution of the medication to( for example saline) had to teach . The assumption that high marks outside of a practical situation where life is in the hands of Nurse or Dr doesn’t hold ground.

          Reply
          1. Lifelogic
            September 12, 2021

            Much truth in this, it is often a manual job demanding dexterity and common sense.

        2. No Longer Anonymous
          September 12, 2021

          Lifelogic – it’s often the case that doctors trained in general medicine don’t know what they want to do or what they are capable of until they’ve trained in general medicine. A knee or a brain is not wired up like a Ford Escort with colour-coded looms designed by highly qualified engineers to make things easy for indentured technicians.

          Reply
    2. Jeremy Zeid
      September 12, 2021

      Couldn’t have put it better. Add in the billions thrown away on useless non-jobs, directors, managers for managers, divisive “diversity, equality & race” managers etc. over 42% of NHS staff are clerical non-medical make-weights.

      Reply
    3. acorn
      September 12, 2021

      Talking about incompetence, the French are taking some of its ministers to court. Imagine if such was possible in the UK. There would be hardly any left in the Cabinet 😄
      https://apiwp.thelocal.com/20210910/are-frances-top-health-officials-really-likely-to-face-criminal-charges-over-the-covid-crisis/

      Reply
      1. rose
        September 12, 2021

        This will make them super risk averse. A very bad thing.

        Reply
      2. Peter2
        September 12, 2021

        Frightening development of the latest criminal charge of failure by hindsight.
        Who will ever want to stand for election and take big decisions when a year later some lawyers want to put you in prison for not making the perfect decision?

        Reply
      3. MiC
        September 12, 2021

        Yes, in many countries public figures are jailed for what is legal, political business-as-usual here, notably for Traffic-Of-Influence.

        Also in France those responsible for the HIV-contaminated blood products and transfusions were jailed decades ago, and they had fewer victims than did the UK.

        As far as I know no one even lost their job here.

        Reply
        1. Peter2
          September 12, 2021

          Yet you still fail to say if you agree with elected citizens being charged or even imprisoned because, with hindsight, they made poor decisions MiC.

          Reply
          1. MiC
            September 13, 2021

            I agree with people being imprisoned for breaking the law as it was at the time of the offence and where that is the due penalty.

            In some countries criminally reckless conduct is viewed far more seriously than it is here, and the bar for conviction is far lower.

            Here, it is not even Misconduct In A Public Office to lie to that very public.

          2. hefner
            September 13, 2021

            There is little risk of Mme Buzyn being charged. What is happening right now is a very French thing: taking a question out of politicians’ hands and giving the responsibility for clarifying what had really happened to magistrates (assumed to be impartial: the UK could benefit from such a thing). Mme Buzyn in an audition by the French Senate in September 2020 had already put forward the details of her actions for the period she had been Health Minister between May 2017 and February 2020. This audition had hardly been reported in the UK media at the time. Furthermore when Covid-19 really became THE problem in March 2020, she had already left the Ministry on 16 February and had been replaced by Olivier Veran.

            So to make a long story short, no need to become overexcited, one way or another.

        2. Peter2
          September 13, 2021

          Breaking the law is not in the argument MiC
          You deliberately dodge my question.
          Should elected people doing their best be charged with criminal offence when hindsight can show their decision years ago can now be proved to be bad?
          Reckless you say.
          Judged by the next government.

          Reply
          1. MiC
            September 14, 2021

            Civilised countries do not do retrospective criminal law.

            Read properly and understand my comment this time.

          2. hefner
            September 14, 2021

            Not to make too fine a point, ‘judged by the next government’ is a wrong statement. Mme Buzyn and Mr Veran are from the same LREM party. Mr Veran succeeded Mme Buzyn within the same government, simply because she had resigned to be candidate in the March 2020 Paris mayoral election.

  3. Lifelogic
    September 12, 2021

    The Telegraph leader today starts:- It is increasingly clear that Boris Johnson has committed a spectacular error by ditching traditional low-tax Toryism and ordering instead the greatest tax raid in at least 50 years.

    Indeed he has (and it will not even raise more tax in the end or improve our failing healthcare system). But just wait until the reality of his insanely expensive and totally pointless net zero CO2 agenda arrives. When the proverbial hits the fan and people realise what complete and pointless lunacy this it will be the poll tax on steroids politically.

    Reply
    1. Andy
      September 12, 2021

      Net zero was a Tory manifesto promise. You voted Tory, right? Didn’t you read what you were voting for?

      Reply
      1. Peter2
        September 12, 2021

        Who do you vote for when every party has the same pledge.
        Labour and Greens and Lib Dems are even more enthusiastic on net zero.

        Reply
        1. Sakara Gold
          September 12, 2021

          @Peter2
          Thats because its a bloody brilliant idea to solve the climate emergency. Its such a good idea I think the government should nationalise it before Labour do, after they win the next GE thanks to bungling Boris, Sunak and their mad tax rises.

          Reply
          1. Peter2
            September 12, 2021

            Emergency?
            1.3 degree rise since 1885
            Do you really believe the world will end in a few years time?
            But still isn’t answering my question to young andy.
            Who do you vote for if all parties have the same policy?

          2. hefner
            September 13, 2021

            P2, obviously the world is not going to end in a few years time, only nincompoops could say such a thing.
            The 1.3 C global average rise translates as lower or higher temperatures and humidities when looked at on a regional and/or temporal basis. Any average should be considered with its standard deviation, you know, it is a rather basic thing in maths/physics, taught in year 10 or 11. …. And that’s not even considering black swans.

            So … do you think that the Arctic ice melting, the retreating glaciers, the extensive forest fires, the numerous flooding events, the long periods of drought … that have been reported these last few years in various parts of the world by some media are just the fruit of the journalists’ heated imagination?

            Would you not think otherwise if you had lost your house and possessions in one of these events, instead of being there on your Scepter’d Isle, presently (relatively) spared by the consequences of a somewhat freakier weather?

          3. Peter2
            September 13, 2021

            “Only nincompoops say such things”….ER say such things heffy and have just spent two weeks protesting in London.

            I’m not sure what you are waffling about my statement about temperature increase because that is the figure in the IPCC report and in the website you have said you like.. woodfortrees.

            Even the IPCC refuse to link extreme weather events to more than a moderate connection.
            Hurricane events are no more now than decades ago
            And polar bears predicted to become extinct by now oddly still survive in record numbers.
            In fact the IPCC say the number of people killed by extreme weather events has fallen by over 90% in the last century.

          4. hefner
            September 14, 2021

            Dear P2, Again if you were ever to look farther than the tip of your nose you might have realised that Susan J. Crockford, the author of that report to the GWPF, is not as kosher as this ‘august assembly’ thinks she is.
            But as our dear Paul Cuthbertson would certainly urge you: do your own research.

          5. Peter2
            September 14, 2021

            Sadly you show yet again you cannot respond without abuse.
            Someone of your self proclaimed academic brilliance should be a bit more pleasant heffy.
            But I note you dodged every single point I raised.

          6. hefner
            September 16, 2021

            Points, which points?
            Polar bears increase is a myth pushed by Susan Crockford (so did you do your own research?) According to her, their number doubled/tripled between the time of the report she did for the GWPF and 18 months later, and this from somebody who is not involved in actual monitoring.
            The number of people killed by extreme weather events has indeed decreased because people, most of the time (not recently in the case of the German river floodings), can get reasonable forecasts/warnings of what is to happen, often more than 24 hours ahead.
            Numbers of hurricanes might not have increased but their strength certainly has.

            As I think you might have read the IPCC literature you must know what type of probability is behind what they call ‘moderate confidence’ (33-66% probability). Very low confidence is 0-10% probability, low 10-33%, high 66-90%, very high 90-100% probability.

            So you might want to go back to page SPM-23 of the Summary for Policymakers (ipcc.ch).

      2. Lifelogic
        September 12, 2021

        Well firstly I do not live in the UK anymore so did not vote. Secondly people had a choice Boris or Labour/SNP so it was a no brainer to vote Tory where they were the best hope of keeping Labour/SNP out. Thirdly if you vote for a party it does not mean you agree with all of their manifesto (or even any of it) if the alternative is even worse. Fourthly as we saw with Cast Iron Cameron/Clegg, Major, May, Bliar, Brown, and Boris they generally/usually do not do what they promise to anyway. Finally Labour/SNP are even more into green crap than the Tories.

        Reply
        1. Andy
          September 12, 2021

          You do not live in the U.K.? You don’t live in the EU do you?

          Reply
          1. Peter2
            September 12, 2021

            Bit like you then andy with your posh second home.

          2. Lifelogic
            September 12, 2021

            No. But we do have properties France and Italy.

      3. miami.mode
        September 12, 2021

        Since when do Tory governments keep their manifesto promises?

        Reply
      4. Fedupsoutherner
        September 12, 2021

        Andy. We’ll when they are all singing off the same hymn sheet it doesn’t matter who you vote for.

        Reply
      5. bigneil - newer comp
        September 12, 2021

        A cut in immigration was also in the manifesto for many elections – manifestoes are a pack of lies.

        Reply
        1. Lifelogic
          September 12, 2021

          Seems so.

          Reply
        2. Jeremy Zeid
          September 12, 2021

          Manifestly, it seems.

          Reply
      6. NickC
        September 12, 2021

        No, I did not vote for “net zero”, Andy. As has been explained to you many times before, people vote on balance for a party. Quite often people are voting against the other main party, rather than for the party that receives their vote. And the idea that every Labour, Tory, or LD voter approves every aspect of each party’s manifesto is absurd.

        Reply
      7. No Longer Anonymous
        September 12, 2021

        Andy

        If you believed what you were saying you wouldn’t even buy a bicycle, let alone a Tesla with a super dooper sound system and gizmos in it.

        You are typical of the rich liberal elite in Britain.

        You caused Brexit.

        Reply
    2. Richard1
      September 12, 2021

      If Labour ditches Starmer brings in burnham, proposes joining the EEA and maybe even bringing in PR, all with no referenda, there will be a real danger. May have to ditch Boris if this sort of thing continues.

      Reply
      1. Sir Joe Soap
        September 12, 2021

        A danger? That would be a result. It would also give Tice a chance of a few seats. Couple it with ditching HS2 and protecting British jobs by immigration limits, and it’s a winner.

        Reply
      2. turboterrier
        September 12, 2021

        Richard1
        May have to ditch?
        No bloody get rid of him now before he does any further damage, and take the cabinet with you.
        Everyday on this site all the concerns, problems highlighted have one common factor. No to lousy leadership.
        It cannot go on.

        Reply
      3. MiC
        September 12, 2021

        Scared of proper representative democracy, it would appear.

        Reply
      4. NickC
        September 12, 2021

        Richard1, What on earth is the advantage of signing up to the EU’s EEA? Why put ourselves back under EU control? If the “red wall” held its nose to vote Tory, after generations of Labour loyalty, in order to secure Brexit when the establishment was trying to Remain, why would they switch back to semi-membership of the EU? It just doesn’t make sense.

        Reply
        1. Richard1
          September 12, 2021

          It does if the Tories have decided not to take advantage of the potential freedoms of Brexit as seems to be the case. it would sort out just about all the points of friction with the EU, inc NI. Of course its only 1/2 brexit, but there was only any point to Brexit if the UK would diverge from the EU social democratic model. But at least Boris Johnson appears to have decided not to do that. On the contrary, with the tax rises, green crap, HS2 etc, he’s doubling down on it.

          Reply
          1. NickC
            September 13, 2021

            Richard1, The only way of reducing “frictions” with the EU is to remain a colony of the EU. Only then might the EU be satisfied. Yet when we were in, I don’t remember a dearth of frictions either. Or anything significant going our way. Signing up to part subservience again is like giving in to a blackmailer. The alternative is this government could actually give us Leave, rather than BINO.

      5. a-tracy
        September 12, 2021

        Richard, Boris isn’t deciding these things alone, he has a cabinet and other senior Ministers. The other Tories bar five all voted for it. They can’t pass the buck to Boris alone. They all cheered him I read.

        Reply
        1. X-Tory
          September 12, 2021

          I believe that Boris IS deciding these things alone (with a little help from ‘er indoors and left-wing civil servants). Cabinet ministers – like most Tory MPs (our host being one of the few exceptions) – are too cowardly and stupid to think for themselves and vote against him, as they fear for their cushy jobs. The blame CAN be laid at Boris’s door, and that’s why he must go. At the next election I will either vote ReformUK or abstain (as I did in 2017). I cannot and will not vote for a man who has betrayed almost every single promise that he made. Taxes, NI, fishermen, personal freedom, immigration, political correctness, etc, etc.

          Reply
      6. No Longer Anonymous
        September 12, 2021

        I’ll vote Labour to get my local Tory MP out.

        Things couldn’t possibly be worse.

        Reply
        1. a-tracy
          September 12, 2021

          No longer anonymous – Labour have discussed higher inheritance tax lowering the starting level, new banding on the council tax, they want higher corporation tax, they would attack private pensions more than this shower have whilst protecting their unionised payroll masters pensions. They dislike small business even more than the Tories. But to be fair they all called Corbyn for his wild spending promises but Boris has knocked his spending into a cocked hat.

          Reply
    3. Shirley M
      September 12, 2021

      +1. The next GE may well see a breakdown of the LibLabCon stranglehold … or maybe it is just wishful thinking on my part.

      Reply
      1. Lifelogic
        September 12, 2021

        I suspect it is. Against Labour/SNP the Tories will have to try very hard to lose the next G. Election in 2003/4 but Boris/Carrie are indeed trying very hard it seems.

        Reply
        1. Lifelogic
          September 12, 2021

          2013/14 I meant!

          Reply
          1. hefner
            September 12, 2021

            In case the Hipparchus circus needs a clown …

      2. Mike Wilson
        September 12, 2021

        Yeah, it’s wishful thinking. Probably just get a low turnout. Let’s face it – we have a political system that facilitates the election of poly who don’t have to give a toss what the electors think.

        How many people in this country want endless, high immigration? But that’s what we get.

        How many want multiculturalism? But that’s what we get.

        How many want HS2? But that’s what we get.

        How many want us to be in a position where we have to rely on imported energy?

        How many think kids going to university to get pointless degrees and a £50k debt is sane?

        How many want people in the public sector to have unaffordable pensions while in the private sector they are gone?

        How many people want us involved in pointless wars?

        I could go on and on and on. But you get the picture. You support first past the post – this is what you get.

        Reply
        1. alan jutson
          September 12, 2021

          Mike

          Hard to not disagree, the other real problem we have, is that no other Party looks any better, indeed they all appear to be worse, and given the way our so called education and university systems work, we are stuck with this kind of thinking for decades, until someone breaks the mould.

          Reply
        2. NickC
          September 12, 2021

          Mike, A sound list.

          I like immigrants (in general) – I married the daughter of immigrants from two different countries – but England cannot face half a million extra foreigners every year for 20 years without creaking at the seams. We’re overcrowded, and it is not fair on the native English.

          Government should stop endlessly subsidising their wheezes (windmills, battery cars, HS2, foreign aid, diversity spasms, etc) and concentrate on defence of this country, and the provision of universal services (education, NHS, state pensions) to a level decided by the voters.

          Reply
          1. Fedupsoutherner
            September 12, 2021

            Nick C. Legal immigration is one thing. Chancing your arm and coming in for economic reasons without paperwork is another.

          2. NickC
            September 13, 2021

            Fedup, It’s numbers that concern me – around 10 million extra foreigners in 20 years. That alters the nature of our country, puts infrastructure like the NHS in jeopardy, and makes England even more overcrowded. It’s not about whether the immigrants are individually nice or talented, or even in the end whether they are legally here or not.

        3. dixie
          September 12, 2021

          This is not the consequence of first past the post, it is the consequence of the disloyalty, decadence and dishonesty infesting governments and politics in this country.
          The previous parliament was the clearest demonstration of the ruling class’s view of the general citizen so the attitude behaviour of the latest gang should be no surprise.

          Reply
          1. hefner
            September 12, 2021

            I beg to disagree: without FPTP, MPs unhappy with the present configuration would create new parties and could be elected. MPs who tried such a thing in the last but one Parliament simply disappeared.
            How comes UKIP/TBP/ReformUK has never been able to have more than one MP in the HoC when in a more proportional voting system they got the majority of the vote and of the UK MEPs in Brussels?
            How comes that AfD in Germany, FN/RN in France, the M5S in Italy, Podemos and Ciudadanos in Spain, Syriza in Greece … after only 5 to 15 years of existence and scores at elections between 5 and 15+% at elections have representatives in the parliaments of all these countries?

            The usual comments for FPTP on this blog are from people who have never properly looked at other countries, convinced as they are that the UK as ‘The Mother of All Parliaments’ has the best system possible (how Candide can one be, ‘the best in all possible worlds’) and obviously nothing to learn from abroad. Some are even so short-sighted (ignorant?) they comment about the US collegiate system without considering why history had originally brought such a system.

            The usual vacuous argument is that a more proportional system would be more likely to bring coalition governments, with ‘secret’ ‘close doors’ arrangements between parties to forge such coalitions. What a laugh! Do they know what ‘internal’ discussions there were when Thatcher, Major, Blair, Brown, Cameron, May, Johnson formed their Cabinets? And how much the ‘minorities’ within the CUP or Labour were listened to, accounted for or not?

          2. Peter2
            September 12, 2021

            We had a vote on AV hef.
            A very mild form of voting system reform.
            It was rejected.

          3. dixie
            September 13, 2021

            @hefner – I think it is more to do with the lack of credibility of these parties in administration than simply people believing the vote is wasted on minor parties.
            Perhaps if UKIP etc bothered to demonstrate competence and delivery at local government level then voters would have some confidence and basis to vote for them in the GE.
            After all, UKIP seem to not actually represent our best interests in the EP but instead spent their time and our money complaining and disrupting. So where was the actual achievement from the perspective of governing as opposed to simply protesting?

        4. rose
          September 12, 2021

          And if we had PR we would still be in the EU.

          Reply
          1. Peter2
            September 12, 2021

            Well spotted rose.
            This is why many want PR

          2. hefner
            September 13, 2021

            P2, Indeed, that vote was 10 years ago. Has anything changed in these last ten years?

          3. Peter2
            September 13, 2021

            Little has changed in my opinion hef.
            But perhaps you have some alternative view.

          4. hefner
            September 14, 2021

            P2, ‘Little has changed’: so you do not think that the UK now out of the EU could do with a bit more real democracy and a Parliament, both HoC and HoL, more representative of the various political expectations in the country?

          5. Peter2
            September 14, 2021

            I dont see what your obsession of Brexit has to do with voting systems.
            The AV vote was rejected.
            I think if we had another vote on AV today it would be rejected again.

          6. hefner
            September 15, 2021

            P2, obsession with Brexit? No such thing, just pointing out that without interference from the EU, the UK might now want to display more real democracy.
            Once again, when you are out of argument you just bring back ‘Brexit’: feeble, feeble.
            As feeble as you (and others here) talking of woke-socialo-communo-marxists, getting drunk on meaningless logorrhea.

            About the voting system, you might think so but you might be in a minority at least on this blog: it seems that a number of contributors here would certainly welcome a more proportional system that might allow ReformUK and/or parties other than CUP or Labour to get some MPs.

            And tell me, as a dyed-in-the-wool Conservative, are you really proud of that clutch of second/third rate politicians that makes up the pre/post 15/09/2021 Cabinets?

    4. Everhopeful
      September 12, 2021

      +1
      In another rather muddled article it also states that he has ditched the Plague Act!
      Has he been studying the polls or has he been instructed to “cool it”?
      The peasants are revolting!

      Reply
      1. Lifelogic
        September 12, 2021

        Let us hope so.

        Reply
        1. Everhopeful
          September 12, 2021

          +1

          Reply
      2. No Longer Anonymous
        September 12, 2021

        Don’t tip them off.

        I want them to try locking us down and forcing masks again.

        Dare they see how much authority they’ve lost over the last two months ?

        Reply
  4. Mark B
    September 12, 2021

    Good morning.

    As the state embarks on recruiting a large number of new Chief Executives for the Integrated Care Boards and for the Integrated Care Partnerships . . .

    And there in a nutshell is where you have the problem The STATE !! Or to put it a more cynical way – Jobs for their mates.

    Reply
    1. Everhopeful
      September 12, 2021

      Jobs for their mates
      At inflated rates!

      There’s a name that rhymes with that…but I’d better not!

      Reply
    2. NickC
      September 12, 2021

      And all of them with the requisite beliefs in “diversity” (doublespeak for “conformity”), undermining parental control, wokeism, and the CAGW religion.

      Reply
  5. Nig l
    September 12, 2021

    Sir JR, all good questions but really a scratch compared with the overall budget. Many commentators and politicians say that the current model is not fit for purpose and doesn’t stand up against other countries.

    When is the question going to be asked about the big picture. ‘When is a root and branch review going to be made of the NHS with particular focus on both models and best practice in other countries to ensure it is fit for this century and beyond’

    Reply
  6. Andy
    September 12, 2021

    Who will pay for this army of new health workers you demand Mr Redwood? Will it be old people – who are largely the ones who need the treatment? Or will the Tories be passing the bill on to young people again? Like you did with Brexit. And with climate change. And social care. And so much else.

    Reply
    1. Everhopeful
      September 12, 2021

      They’ve already paid!!
      In more ways than one.

      Reply
      1. Lifelogic
        September 12, 2021

        Indeed & then they pay yet again with 40% inheritance tax and the 55% tax on pension pots.

        Reply
        1. hefner
          September 12, 2021

          55% is only for money taken as a lump sum which was over the lifetime allowance of £1,073,100. (www.gov.uk ‘Tax on your private pension contributions’, well worth reading in its totality if only to debunk the usual BS proffered by our on-site mathematical and economic genius).

          Reply
          1. Peter2
            September 12, 2021

            Lifelogic is correct.
            Changes to pension taxation has ruined decent pensions for the current generation.

          2. a-tracy
            September 12, 2021

            So how does it work Hefner? Do you pay tax on the money going into your pension if it is over the lifetime allowance and tax again when you draw it out? I thought there was a limit to the amount you could take out as a ‘lump sum’. Is the tax applied on every £1 you draw over the annuity rate of a million pound pension pot? I don’t understand? The lifetime allowance of a pension pot sounds like a fortune until you realise a million pounds worth of savings in a pensions pot will buy you the grand sum of £20k per annum if you take it at 65 with spousal transfer.

          3. Lifelogic
            September 13, 2021

            Correct I know – But I did not suggest anything else did I? So what BS exactly were you referring too?
            Also you missed out Physics, Energy, Electronics and Engineering.

      2. Dave Andrews
        September 12, 2021

        They may have paid, but the money has already been spent, on election bribes for the electorate of the day. Today’s state care for the elderly is entirely paid for by today’s taxpayers, and borrowing of course.

        Reply
    2. Peter2
      September 12, 2021

      Define young people.

      Reply
      1. NickC
        September 12, 2021

        Good point, Peter2. Andy’s definition appears to cover what I’d call the middle-aged. No doubt after he’s spent a decade in his mid 40s he’ll adjust his definition of “the young” to include anyone under 60.

        Reply
        1. Peter2
          September 12, 2021

          Correct Nick
          andy’s definition would be anyone older than him.
          Same as all lefties who define wealthy people as anyone better off than themselves

          Reply
    3. Fedupsoutherner
      September 12, 2021

      Andy. Laugh of the day one. It’s getting tedious though.

      Reply
    4. bigneil - newer comp
      September 12, 2021

      Andy – Who will get the bill for the WHOLE lives of every dinghy arrival? Arrive, get housed, benefits, NHSW etc etc etc. ALL FOR GETTING HERE. And the govt does WHAT??? KEEPS LETTING THEM IN.

      Reply
      1. Andy
        September 12, 2021

        Asylum seekers still don’t get benefits. No matter how often you claim otherwise.

        Reply
        1. Everhopeful
          September 12, 2021

          Sod the benefits…have you seen the hotels they get sent to?
          Anyway what about the £40 pw pocket money?

          Reply
        2. bigneil - newer comp
          September 12, 2021

          Andy – A friend’s daughter works at a “home” for so-called young “asylum seekers” that arrive here, claiming they saw their families die back home. She told me how many suddenly get contacted by their “dead” parents once they are in England a few weeks and convinced the authorities here they are “under 16”. Then their parents – and inevitably the rest of the families, get to come to – for free EVERYTHING. It may not be “benefits” in the official lists – but it is free – and just called another name.

          Reply
        3. Peter2
          September 12, 2021

          Look again on .gov asylum help and come back and apologise.
          Stop the lies andy.

          Reply
    5. NickC
      September 12, 2021

      The same people, Andy, who paid for your army of 55,000 new customs officers! And, at least with Brexit, the young will benefit from independence whereas the oldies had to endure 48 years of EU subservience. As for climate change, the young could benefit from it (until the next ice-age!) provided they drop their supplications to the CAGW god. And that is their choice.

      Reply
    6. a-tracy
      September 12, 2021

      Andy, just how many ‘old’ people do you know in the UK? They do pay for their care currently if they have assets or savings. Even home care arrives with a bill. Many are seeking private operations because the NHS isn’t seeing or treating them. Do you actually still even live in the UK and speak to retired people? I don’t believe you do.

      Reply
      1. NickC
        September 12, 2021

        I no longer believe anything Andy says about himself. He started off sneering at “rich” Tories (2017) before declaring himself oh so rich himself. So no hypocrisy there, then! He’s been about 45 for 4 years, and his children never seem to grow older either. As for his political views they seem to be a mish-mash of Grauniad/BBC moans with a suitable splash of teenage self-importance and sanctimonious authoritarianism. Still, its always funny to watch his twists and turns.

        Reply
        1. a-tracy
          September 12, 2021

          He or She I know a couple of females named Andy – is an ageist bully. They never reads the posts that refute their claims, this latest about asylum seekers not getting benefits the links to gov.uk saying what they get is just ignored. Housing benefits, food benefits, heating, clothing allowances, children’s costs covered, we don’t keep asylum seekers in tents in the mud as they do in other EU countries or old disused office blocks with one toilet between 100 even the UN have complained to France about this with no recourse. We need to look at how asylum seekers can work and contribute to their cost of their own care whilst waiting asylum decisions. We need to look at offshore ships to process applicants. We need to tighten up and speed up decision making.

          Reply
          1. alan jutson
            September 12, 2021

            a -tracy

            Simply send them to a proper refugee camp in the Lebanon which already costs us millions a year to operate.

            They can make an official application for asylum there, like all the others who are trying the Legal route.

          2. a-tracy
            September 13, 2021

            Alan – from 2015 – gov.uk “The UK is the second largest bilateral donor to the Syria crisis. The Prime Minister announced a further £100 million on 4 September and an additional £115 million at an emergency meeting of the European Council on 23 September. This takes our total contribution to £1.12 billion since 2012 to help vulnerable people in Syria and refugees in the region.

            In addition, DFID has allocated £9.5 million from the UK Conflict, Stability and Security Fund to support local capacity and build longer term stability. Our support is reaching millions of people and has saved lives in Syria, Jordan, Lebanon, Turkey, Iraq and Egypt.”

            “No other European country has come close to this level of support.

            Sixty million pounds of this additional funding will go to help Syrians still in Syria. The rest will go to neighbouring countries – to Turkey, Jordan and Lebanon where Syrian refugees now account for one quarter of the population. Britain’s aid is supporting these camps – if we were not doing that, the numbers attempting the dangerous journey to Europe would be far far higher.” David Cameron Sept 2015

            The Lebanon can’t cope with any more people. Apr 2021 source – concern UK “Lebanon’s population has increased by around 25% since the start of the Syrian conflict in 2011. As a result, public health is deteriorating and living conditions are worsening, severely affecting the lives of both the refugees taking sanctuary and the host population.”

  7. Oldwulf
    September 12, 2021

    Sir
    You seem to be asking basic management questions. No doubt the Health Secretary has matters in hand and will be able to respond promptly.

    Reply
  8. Ian Wragg
    September 12, 2021

    How about askwhy we’re paying 4 hundred thousand a month to private hospitals and not referring anyone.
    We know the NHS is a soviet organisation but this is a blatant waste of taxpayers money.

    Reply
    1. bigneil - newer comp
      September 12, 2021

      Every dinghy arrival is also a blatant waste of taxpayers money too. THAT bill just keeps going up and up. And the govt do NOTHING.

      Reply
      1. No Longer Anonymous
        September 12, 2021

        I stopped my 17 year Lifeboat subscription and was contacted by their office several times. I just said “My family never go to sea. They are more likely to be hurt by a new-arrival driving a car illegally than by drowning. You are now a risk to my family, not a help. Please stop contacting me.”

        Doubtless Andy and MiC will berate me for stopping my contributions rather than thanking me for having made them in the first place.

        Andy says he’s taken up my DD contributions x2 but I doubt he’s doing so @ £40 pcm.

        Reply
    2. The PrangWizard of England
      September 12, 2021

      In my view it is more than blatant – it is criminal. Those responsible should be locked up but since corruption in government and its agencies is considered creditable we, the people, must start stacking bricks and not forgetting the need for empty milk bottles.

      Reply
    3. Ian Wragg
      September 12, 2021

      Wind today is contributing 0.89gw or jus 2.9% on a quiet Sunday morning.
      Net zero my armpit.
      John, get rid of these lunatics in government.

      Reply
    4. MikeP
      September 12, 2021

      A good list of questions to add to other equally valid questions suggested here.
      Can you please clarify the process Sir John, when you ask questions in the Commons are Ministers obliged to give you a written response to each point or can they fob you off with a short verbal response like, “I thank and agree with my honourable friend for raising these important points….blah blah”, so no use to anyone.

      reply Many of these will be written Qs that they need to answer

      Reply
    5. a-tracy
      September 12, 2021

      Ian, I pointed this out on this blog at several times during the pandemic that private care had been sequestered and wasn’t being used by the NHS. I was complaining that private medical insurance companies were still taking all the premiums without giving the service.

      Reply
      1. rose
        September 12, 2021

        NHS patients have been going into private hospitals in our city for major routine surgery, such as hips and knees, and still are. It seems a very good system.

        Reply
        1. a-tracy
          September 12, 2021

          Do you pay the sky high private medical insurance rose, and did you have treatments cancelled?

          Reply
          1. rose
            September 13, 2021

            Sorry, I wasn’t clear. The NHS pays for its patients to be treated in the private hospitals of their choice (it is called choose and book), and no, the staff in private hospitals don’t cancel or fail to turn up on time. I suppose you might say it is annoying for people who have paid sky high insurance, but then a famous trade union used to do this too by paying BUPA on behalf of its members.

      2. No Longer Anonymous
        September 12, 2021

        +1

        Reply
  9. Sharon
    September 12, 2021

    JR you ask some very pertinent questions, questions that really need answers… but does the Health Secretary, or anyone else for that matter, have the answers. On previous track records, doubtful.

    My husband and I have managed to find the money to fund private health care for some years now, because of the bad state of the NHS. However, each time you claim, the cost goes up, so you develop a tendency to avoid using it unless necessary.

    I’ve just had my eye watering renewal cost for next year. If the NHS had some kind of private tiered system, that would, I’m sure make it more efficient. But people’s attitudes would need to change. In Sydney, my daughter pays up front and claims back from the state, some things are free… but they always get seen promptly.

    Someone really needs to get a grip and sort out this behemoth institutional mess that is the NHS.

    Reply
    1. Nig l
      September 12, 2021

      Any private system means money jumping the queue. More private, equals people who cannot afford it wait longer.

      Politically and morally totally unacceptable.

      Reply
      1. NickC
        September 12, 2021

        Oh don’t be so silly, Nig1. Additional (private) money being spent on health care increases demand (meaning additional doctors, surgeons, nurses, etc, provided there is no artificial limit on their training), together with a lower demand in the NHS which should reduce waiting lists.

        Politically and morally exemplary.

        Reply
    2. Lifelogic
      September 12, 2021

      My general approach with insurance is to save the premiums and the 12% IPT tax and pay the bills with the money you save where you can. If you pay for insurance you are mainly paying the overheads of the insurance company, admin costs, sales costs, advertising costs, claim processing costs, others fraudulent claims, IPT, plus you waste time choosing policies and claiming. Plus as you say they up the premium if you claim.

      So I only insure if either I have to by law or where I judge we are a much higher risk than average but can get an average premium. It is just a form of gambling so judge the risk and reward and odds.

      Reply
      1. Lifelogic
        September 12, 2021

        Boris’s scheme is a sort of second rate insurance scheme to protect your ability to pass some you house value on (though less IHT at 40% often). What is evil about it is you have no choice, you have to pay the premium like it or not use it or not. Rather like the dire propaganda outfit the BBC, the second rate NHS, state schools …

        Reply
      2. Lifelogic
        September 12, 2021

        and the insurance companies profits and CT taxes too.

        Reply
      3. alan jutson
        September 12, 2021

        Lifelogic

        I use the same Logic, be your own insurer and save on the overheads and their profit.

        Only ever insured our house (sensible as it is a big risk if lost) Car insurance, and health cover if travelling abroad.

        Reply
        1. Lifelogic
          September 12, 2021

          +1

          Reply
    3. Nota#
      September 12, 2021

      @Sharon – the Health Secretary despite the pay and the title is an England only event

      Reply
      1. rose
        September 12, 2021

        Not for vaccines, PPE, medicines, and advice.

        Reply
  10. Mary M.
    September 12, 2021

    An elderly relative in a care home tells me that a lot of staff, with whom he has built up a relationship over the months, are leaving. They have not told him why. With his failing eyesight (hospital visits for his AMD postponed), he just about manages to discern what these known carers are saying from behind their masks. He will probably struggle to understand the voices of replacement untrained and inexperienced carers.

    Perhaps some of those leaving are anxious about the ‘no jab no job’ stance of the Prime Minister and his coterie?

    Etc ed

    Reply
  11. Sea_Warrior
    September 12, 2021

    I see from the Mail that there’s to be an outbreak of common-sense concerning air-travel next week. Good – but such a shame it didn’t come in time for the summer holidays.

    Reply
    1. miami.mode
      September 12, 2021

      S_W, pity there is not some common sense on the predicted deliberate rundown of oil and gas usage and the effect the dearth of these will have on our lives and cost of living. We used to have mad cow disease but now we have mad MP disease and it’s a lot more contagious than Covid 19.
      Foreign Aid will likely be going in the opposite direction after we completely impoverish ourselves.

      Reply
  12. Bryan Harris
    September 12, 2021

    Excellent attempt at trying to insert some much need logic and accountability into all of this.

    ..but be prepared to receive more fudge

    Reply
  13. DOM
    September 12, 2021

    Your party’s leadership and those Tory backbenchers who back them are destroying our country and our freedoms. Why? Is it simply to promote their own personal and party interests by climbing into bed with Labour and its now all powerful Socialist power bloc across the unionised public sector?

    I’m no longer interested in the legacy issue of how this money is spent. We all know IT IS BEING USED TO CONSTRUCT an all powerful political State. I want to know why Tory backbenchers approve of this vile development?

    Please change the name of your party. You no longer offer a contrasting vision to Labour’s Socialist dystopia. Your party has become Socialist and every Tory backbencher has embraced Labour’s vision for if they confronted it it would damage the interests of their now dead, decrepit party

    Reply
    1. NickC
      September 12, 2021

      Dom, I have tackled my own Conservative MP about this, and he has no answers. On every single important issue – the Northern Ireland Protocol (BINO); covid19; CAGW; swallowing NHS propaganda; etc – he is indistinguishable from Labour. I have not bothered about the NWO (WEF), domestic terrorists (BLM, XR), wokeism, the BBC, usurping parental authority, etc, because all he replies is that we’ll have to agree to disagree. What a waste of our independence from the EU, and an 80 seat majority. Johnson is not quite as bad as May yet (who could be?), but it’s not for want of trying.

      Reply
  14. Donna
    September 12, 2021

    Perhaps, whilst asking all the above, Sir John could also ask for an explanation for the massive increase in NHS Managers over the past 12 years.

    Google informs us that in 2009 there were 42,000 NHS Managers. Now there are 77,000, with more being recruited for Integrated Care and to “manage” Diversity and Inclusion.

    In 2010 we had a Con/LibDem Government and from 2015 supposedly Conservative ones. So why the explosion in NHS management?

    Whatever Jeremy Hunt was doing, he certainly wasn’t asking difficult questions about a 40% increase in NHS Management. Or pandemic preparation, since he shelved the Operation Cygnus Report showing how unprepared we really were.

    I’m glad to see the Daily Telegraph has gone on full attack mode against the Commie-CON they used to employ. And the reader comments below the line, most of which are by people who were the Conservative Core Vote, are a sight to behold.

    Reply
    1. NickC
      September 12, 2021

      Donna, Those figures for the increase in the number of (and pay of) NHS managers are shocking, but unsurprising.

      Reply
  15. Maylor
    September 12, 2021

    It’s not connected to the NHS funding, but I would like to see the figures relating to the flu cases. In particular, how many flu cases/deaths in 2020/21 and a comparison with the last 5-10 years.

    It seems to me to be highly suspicious that as covid has surged, cases of influenza have virtually died out. There must be a connection. Have flu cases been re-classified as covid cases and if so, why ? Can the tests used to identify covid differentiate between the different respiratory illnesses ?

    Reply
    1. J Bush
      September 12, 2021

      Flu didn’t disappear.

      I read a footnote, if I recall correctly, on the ONS website, that flu and ‘covid’ numbers were collated into one ‘covid’ total, which was used in the media. Very useful gerrymandering propaganda for the Johnson regime’s fear mongering crew of despots, as a means to justify their draconian rules and economic destruction.

      Reply
    2. Hat man
      September 12, 2021

      Maylor – good questions. PHE say ‘The overall influenza positivity remained very low at 0.0% in week 35, with none of the 2,107 samples testing positive for influenza.’

      It’s true that influenza cases are very low at this time of year.

      However, in the 5 year reference period 2015-2019 it never happened that in late August- early September that there were no influenza cases at all.

      So I suspect the answers to your questions are:-

      Yes,
      We know why,
      No, they can’t.

      Reply
    3. MiC
      September 12, 2021

      Covid19 is more transmissible than flu.

      So the measures against it have been even more effective against the spread of flu.

      Reply
      1. NickC
        September 13, 2021

        Yet for each of the three untargeted national lockdowns, Martin, the infection wave had begun to reduce, before the UNL was started. Moreover it is widely accepted that the types of masks used by the public were next to useless. And the vaccines do not prevent either catching or transmitting covid. So where are these “effective” measures then? And you used to condemn the governments measures anyway.

        Reply
    4. bigneil - newer comp
      September 12, 2021

      Months ago I had a nurse tell me she had, that very morning, been doing the paperwork while the chap was cutting the dead bodies apart to find out “Cause of Death”. One man was brought in, that she actually knew, was there as he actually died, and knew he had died of a heart attack. She told this to the person she was writing for. HE, told HER, COVID – – or else you can get someone else to replace you.
      Only one lie? – – no – doubtless many many more lies. Just to push the Fear and Control through.
      ALL politicians should – BY LAW – have to go on LIVE tv, on truth drugs and equipment. LETS SEE THE TRUTH.

      Reply
      1. Augustus Princip
        September 12, 2021

        Bullshit story as death certificates are written by junior doctors plus another medic if body is for cremation. If sudden death in community or unexplained then coroner’s PM & pathologist ascertains cause of death.

        Reply
        1. SM
          September 13, 2021

          No, regulations for 2 doctors to sign a death certificate were lifted as the pandemic took off, there are many accounts from people I trust to verify bigneil’s comment.

          Reply
  16. No Longer Anonymous
    September 12, 2021

    Why are so many doctors able to go part-time ?

    Why are so many candidates who are chosen to train to be doctors likely to go part-time ?

    As in my own industry. Many of the candidates for training get the job and then become exempt from much of the work and much of the shifts and take large blocks of time away from the coal face. In effect needing two trainees to cover the job of one.

    Reply
    1. Sea_Warrior
      September 12, 2021

      Because so many medical students are female. A rational Health Secretary would take action to increase the proportion of places awarded to men, who, I suspect, don’t leave the profession to bring up children. (The doctors at my GP surgery are overwhelmingly female and most work part-time.)

      Reply
    2. Sir Joe Soap
      September 12, 2021

      Because they give half their pay away in tax above £50K. It’s one of the few really well paid jobs outside academia where you can take a sabbatical or just go and wander off part time when the kids have left home and you don’t need the money. Nice work.

      Reply
  17. Sakara Gold
    September 12, 2021

    The NHS is one of the largest employers in the world. However, counting NHS staff isn’t as simple as you might think. The NHS counts its staff in two main ways: ‘headcount’ and ‘full time equivalent’. There are roughly 1.5 million people employed by the NHS across the UK, however many work part-time and this equates to 1.27 million FTE

    Of the 1.27 million, only about 52% are professionaly qualified cinical staff. This group includes doctors, consultants, qualified nurses and health visitors, midwives, qualified scientific, therapeutic and technical staff and qualified ambulance staff. It follows that the rest are middle and senior management accountants, payroll bods, procurement and purchasing types and other dead wood.

    One of the best ways to compare efficiency across the four UK nations is to divide FTE’s by the number of beds. (there were roughly 140,000 beds in the total NHS in 2019 – down from 299,400 in 1988) On this basis Scotland comes out worst with roughly 9.51 FTEs per bed, which accounts for why Scotland has a seven year waiting list for hip replacements under the SNP.

    Clearly, the number of hospital beds has been savaged in order to pay for the middle and senior management. Most large commercial enterprises periodicaly cull headcount to prevent excessive middle management “empires” building up and to cut costs to improve the bottom line. This should be the first task of the new NHS head and her senior management. And not to cut the number of beds further to cover their tremendous salaries.

    Reply
    1. NickC
      September 12, 2021

      Sakara, An excellent comment, both informative and rational.

      Reply
    2. Lifelogic
      September 12, 2021

      @ Sakira 1.27 million FTE employees means each person should be getting about 35 hours person hours attention PA. In my circa 60 years I think I have had about 25 person hours from the NHS. A tiny % of my 2000 odd fair share of hours. Plus they made two serious diagnosis error in that 25 hours that could easily have killed me.

      Also it suggests NHS UK spend about £200,000 per person employed employed by them. What are they all doing? In my 60 years I have had from the NHS little more than my birth, a few vaccines, some paracetamol twice, an ankle x-ray, my appendix removed, three fillings, dental check ups, plus a few stitches in a couple cuts. Total cost of which should have been (at most) £30,000. I have probably paid at least 1,000 times this in taxes for the NHS so far.

      Reply
      1. Sakara Gold
        September 12, 2021

        @Lifelogic
        The NHS has some of the most advanced medical equipment money can buy, particularly in the field of oncology and cancer equipment. They have state of the art diagnostic laboratories, highly advanced microbiology suites (that can identify what you are infected with and which antibiotic could best treat you.

        All this is brilliant, but it costs. Where they fail is buying in excessive numbers of agency staff/nurses/anethesists/specialist surgeons etc. They should all be directly employed.

        Some time ago, before the Chinese plague virus epidemic, I was visiting a family member in an NHS general hospital. Whilst sitting next to her bed, I noticed a lady with a clipboard wandering about making notes. Upon being asked what she was checking, the reply was “‘I’m counting the number of nitryl gloves in use on this floor of the hospital. We buy thousands of boxes of them every month, but nobody knows where they go…”

        Reply
        1. Lifelogic
          September 12, 2021

          +1

          Reply
      2. Mike Wilson
        September 12, 2021

        You’ve paid 30 million in taxes? For the NHS alone?

        Reply
        1. hefner
          September 12, 2021

          MW, indeed 😂

          Reply
        2. Lifelogic
          September 12, 2021

          Sorry 10 times too high! My mistake.

          Reply
          1. MiC
            September 13, 2021

            Have you realised that it’s 2021 and neither 2001 nor 2011 yet, LL?

  18. J Bush
    September 12, 2021

    Around 1950 there were 460,000 available beds for a population of approx. 50.5 million. Today there are only 129,000 for a population of nearly 70 million and that is only the ones they admit to. Further to this shockingly incomprehensible reduction, the DoH state ‘A couch or trolley should be considered as a hospital bed provided it is used regularly to permit a patient to lie down rather than for merely examination or transport’!

    In the 1970’s, a hospital was run by a Matron and across the country there were about 500 senior managers, today there are 43,000 plus the ones mentioned in the article!

    To most logical people it would appear TPTB should keep their sticky (what’s in it for me) inept fingers out of health, because as the above figures show, all they have done is cost the tax payer a fortune for a seriously diminished and sub-standard service.

    How and in what way can the TPTB justify that we need this excessive multi-tiered management structure in this now comparatively small health service?
    And given the stupid rules regarding the covid virus that have exacerbated the waiting list problem, why are they letting thousands of people come into this country on a daily basis?

    It is no wonder that no other country in the World has copied their ‘envy of the world’ delusion.

    Reply
  19. William Long
    September 12, 2021

    One of the more (and there were many) disturbing, and irritiating, things about the debate on Wednesday was the inane grin on the face of the Health Secretary. It makes me doubt very much that he will have any of the answers to your questions, since it has been clear from the start, if what we heard about a hypothecated tax for Social Care being a precondition for his accepting the job was true, that all he was concerned about was getting extra money without and thought about how it should be spent. And I have seen no sign of any wish at all to face up to the Unions and deal with the NHS’s many structural weaknesses. The introduction of two new sets of Boards and Partnerships to deal with Social Care to me says it all.
    And as someone who acts, like so many others, as an unpaid carer, having to pay the new levy on top is pretty near the last straw. It seems that once again, we have been forgotten.

    Reply
    1. No Longer Anonymous
      September 12, 2021

      Indeed. A family like my own who has looked after parents can still take the hit in the last few months of life, even after years of family caring.

      One doesn’t actually mind this. One does mind that Mum goes into a care facility and has to pay double what she needs to to subsidise the bed next to her.

      For this NI rise we should be seeing a return of council provided care homes, so that Mum can see a difference in what she herself is paying for.

      Alas this is nothing to do with care.

      It is about the lockdown economic black hole to pay for the holiday that much (not all) of the NHS has had.

      Medals for all – a GC for the WHOLE of the NHS and the Tory Common Purpose Cross with Tea Leaves and Nut Clusters for Cressida Dick who now has a chest of ribbons bigger than my Grandad’s after his rise in rank from Sapper to WO1 in the heat of battle in WW2, a veteran of both Dunkirk and D Day and survivor of a creeping barrage in which most of his unit was killed.

      Reply
  20. SM
    September 12, 2021

    About 20 years, a London NHS Hospital was in serious financial trouble, and its management were instructed to slash the non-medical staff salary budget. Rather than sacrificing one penny of the senior management’s generous renumeration, clerical staff numbers were drastically reduced (this was leaked to me by an employee) . Guess what happened – amongst other dire outcomes, attempting to make appointments for outpatient clinics or follow-up tests became a lengthy and serious ordeal for patients/carers and of course waiting lists rapidly grew even worse.

    I could give many other examples, over many years, of senior NHS staff, both managerial and medical, who have been far more interested in their own empires and well-being than their patients.

    Reply
  21. Kenneth
    September 12, 2021

    My personal experience across the public sector is that it has recently become far more lethargic than ever it was before.

    The last thing they need right now is yet more money. They are wasting money by the bucket load.

    Performance is very poor and I have personal experience – as do friends and relatives – of public sector bodies failing to do their job.

    For example, doctors are refusing to treat patients, the police are refusing to chase crimes and social services are doing virtually nothing.

    Contacting anybody is very hard and any contact is usually preceded by a message that Covid will had limited services.

    We need to order public sector employees to do their job.

    A go-slow is unacceptable and, even if it takes a year of “discontent” to flush out lazy people, it must be done so that the proper services can resume, whether this is carried out by the public sector or private sector.

    Reply
    1. bigneil - newer comp
      September 12, 2021

      Kenneth – – wasting money by the bucket load. – – Can anything THAT big actually be called “A BUCKET “???

      Reply
  22. alan jutson
    September 12, 2021

    So many questions JR, and so many more that need answering.
    Surely the simple thing to do is use the Private health care that exists now, and will grow if demand is placed upon it.
    Good grief we are already hearing that the NHS purchase bed time with many private hospitals to spread the load at busy times, but then does not fill the beds, a double whammy as those empty booked beds cannot be used for those that can afford to pay, thus lengthening the pain queue for all.
    Why not encourage people to take out Private insurance with tax breaks against the cost, perhaps even promote workplace schemes with tax allowances, give people a sensible option to use other services, other than simply waiting for the NHS.
    Yes I know the Socialists and Woke Brigade will say everyone should be treated the same, but why should healthcare be treated any differently to any other service or product.
    Private medicine is not about NHS queue jumping, it isabout jumping out of the NHS queue to shorten it for others.
    Before others ask, no I do not have private medical insurance, although I have paid for private treatment (physio usually) in the past, simply to avoid a long wait for the NHS, and to get out of pain as rapidly as possible.

    Reply
    1. SM
      September 12, 2021

      +1

      Reply
    2. No Longer Anonymous
      September 13, 2021

      Not so sure. Read Trust Me, I’m A Doctor.

      NHS employed Consultants do work in their ‘own’ time and get NHS juniors to write up their paperwork in NHS time according to this account.

      Reply
      1. No Longer Anonymous
        September 13, 2021

        Correction

        Trust me, I’m a Junior Doctor (Max Pemberton.)

        Reply
  23. Nota#
    September 12, 2021

    From the DT – “The Conservatives must fight the expansion of the state and embrace free enterprise or risk making Britain poorer and putting the country on a course of decline, the Trade Secretary will say this week.”

    Everyone on Sir John’s diary along with SJ himself has been saying that for ages – yet this PM is heading in the opposite direction, centralised command and control and an ultimate Socialist state whos moto is never ‘trust the people’

    Looks like with a speech lick that while the PM doesn’t ‘Trust’ the people he will have to get rid of Truss as well

    Reply
  24. NickC
    September 12, 2021

    The good thing about the NHS is that it provides a form of insurance which removes the anxiety about availability and cost of health care for everyone, paid for by a consensus that its costs are paid out of general taxation with the rich paying more.

    The bad thing is, the NHS is a typical state monopoly. Every failure of the NHS (and there are many) is used as an excuse for “more NHS”. It is similar in that respect to the EU – for every EU failure its adherents demand “more EU”.

    I do know, from inside information, that NHS management is an appalling litany of waste, corruption, incompetence and empire-building. The NHS handling of the covid19 pandemic (now endemic) has been dreadful. Far from clapping the NHS, it shows it’s clapped out.

    Reply
  25. ChrisS
    September 12, 2021

    I would like to see the figures for the current number of nurses and Doctors employed compared with same numbers pre-pandemic. For the same periods, we also need to know how many expensively-trained, qualified doctors and nurses are employed in roles that do not involve treating patients. I think that number will be much larger than we think and far more that can be justified.

    As of Saturday, September 11th, the Govt website shows that there are 8,098 patients with Covid in English hospitals. NHS Data shows that as of June 2021 there were 123,707 beds available for use in England and the occupancy rate was 83.8%, hardly that busy when in mid-winter the rate is supposed to rise to 95%.

    Source : https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/bed-data-overnight/

    Using these figures, there are probably around 103,666 patients occupying beds so Covid patients make up just 7.8% of this total and there are more than 20,000 available beds that are not occupied. It’s clear that the NHS is hardly running flat out is it ? Why therefore are waiting lists increasing and, why, as the Health Secretary told the Andrew Marr programme this morning, is that number going to rise before it falls ?

    What percentage of the total number of Doctors and Nurses employed in England are treating these 8,098 Covid patients ?

    Only with these figures can we see if there is a genuine reason why the waiting lists are still rising.
    I suspect there isn’t and that the NHS has become significantly less efficient over the last two years.

    Reply
    1. Sharon
      September 12, 2021

      I read last year that, in a London hospital (can’t remember which one) the managers, presumably working from home, were absent and so the running of this particular unit was being run by the doctors. Apparently, it had never run so smoothly, for years!

      Reply
    2. ChrisS
      September 12, 2021

      Perhaps, Sir John, you would consider putting my questions to the Secretary of State ?
      I think we deserve some detailed answers.

      Reply
      1. Chris S
        September 14, 2021

        I have submitted a freedom of information request to the Health dept as follows :

        Dear Secretary of State
        As of Saturday, September 11th, the Govt website showed that there were 8,098 patients with Covid in English hospitals.
        NHS Data shows that as of June 2021 there were 123,707 beds available for use in England and the occupancy rate was 83.8%, hardly that busy when in mid-winter the rate is supposed to rise to 95%.
        Source : https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/bed-data-overnight/
        Using these figures, there are probably around 103,666 patients occupying beds so Covid patients make up just 7.8% of this total and there are more than 20,000 available beds that are not occupied.
        It’s clear that the NHS is hardly running flat out is it ? Why therefore are waiting lists increasing and, why, as you told the Andrew Marr programme on Sunday, is that number going to rise before it falls ?
        Perhaps you could explain why this is ?
        For example :
        1. What percentage of the total number of Doctors and Nurses employed in England are treating these 8,098 Covid patients ?
        2. How many trained Doctors and Nurses are currently working for the NHS compared with the same period in 2018 and 2019, before the pandemic.
        Raw numbers can be misleading with many female staff working part time, particularly GPs so perhaps the figures are best expressed in manhours or perhaps that should be person hours to be PC ?
        3. What proportion of the available hours are being lost because expensively trained doctors and nurses are being diverted to management roles rather than treating patients ?
        4. Your department took up block bookings with private hospitals in England to counter increased demand. Can you please tell me the cost of this, the number of bed days purchased, and the percentage of bed days when these beds have actually been occupied ?
        As you have been unable to tell Parliament how many extra patients on the waiting list will be treated and there appears to be no measureable target to reduce waiting lists, there is clearly going to be no way of holding the NHS to account for the vast sum of extra money you are providing.
        This is a recipe for waste and inefficiency.

        I await clear and unambiguous answers to questions 1-4 above and your reasons for not setting targets for return on the additional investment with great interest.

        I have copied this email to my own MP, Christopher Chope, in the hope that he can ensure I get a substantive response from your department.

        Yours Sincerely

        Chris S

        Reply
  26. Nota#
    September 12, 2021

    Sir John – efficiency, responsibility and accountability are off the agenda. Its a club of protect me and I will protect you style management, its a trickle down of this Governments style at the top.

    The people that get punished are the patients and those that directly attend to them, for every one else its a gravy train.

    Get back to having the NHS lead by clinicians and nursing staff, let the be the ones that employ the management they deem necessary for the job. The NHS should be removed from the Political arena, no politician should be involved or have a connection with anyone at any level in NHS Management.

    The NHS is not a political point scoring dartboard it a service funded by the people for the people. Its all those in the HoC that have destroyed its purpose. Compounded even more that while Government might want to send out their ‘grand standing virtue signals’ not one of the will take up proper responsibility for any of it. Just on this subject alone and with all his meddling the PM should resign and hold his head in shame

    Reply
    1. bigneil - newer comp
      September 12, 2021

      NotA – – a service funded by the people for the people. – – nearly – now it is – a service funded by the people for – – anyone who arrives from anywhere – wanting to use it – for free. And needing translaters – also use up extra time and MORE money – making the people who PAY for it – UNABLE to get treatment.

      Reply
  27. Iago
    September 12, 2021

    There is a letter In TCW this morning (formerly Conservative Woman) which begins –

    The NHS should not receive one penny more in funding until it withdraws its offensive drive demanding staff ‘check your white privilege’.

    The rest of the letter is equally vital; it states truths about vaccine coercion and ‘vaccination’.

    Reply
    1. J Bush
      September 12, 2021

      +1
      ‘check your white privilege’!!

      And the taxpayer is being forced to fund this woke drivel!! No wonder its is failing hand over fist.

      I mistakenly thought NHS stood for National Health Service, however, these days it appears it stands for Nonsensical Hate Sewage.

      Reply
  28. acorn
    September 12, 2021

    If you want to know how a business is doing, follow the cash, to paraphrase from Terry Smith’s book. Try doing that with UK Treasury accounts.

    If you would like a real head-banger, try the “DHSC annual report and accounts: 2019 to 2020”. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/956855/Department_of_Health_and_Social_Care_Annual_Report_and_Accounts_2019-20__print_.pdf

    Don’t bother with the first 210 pages, go straight to the Annexes A to E. The DHSC is the sort of mess you get when you try and command and control everything from Westminster. TBTM “too big to manage” . Any institution is TBTM, if its size prevents executives, managers and stakeholders from effectively monitoring the organisation. Is it achieving what it was created to achieve?

    Reply
    1. dixie
      September 12, 2021

      Size does not prevent executives, managers and stakeholders from managing anything – incompetence does.

      Reply
      1. acorn
        September 12, 2021

        dixie. The Peter Principle is a concept in management developed by Laurence J. Peter, which observes that people in a hierarchy tend to rise to their “maximum level of incompetence”: employees are promoted based on their success in previous jobs until they reach a level at which they are no longer competent, as skills in one job do not necessarily translate to another. (See WIKI: Peter Principle.)

        In Western democracies you can turbo-charge this phenomena in the political arena. For instance, you can take an individual who was stacking shelves in a supermarket before a General Election; then, make them Secretary of State of a multi-billion pound government department, after the election! Good init.

        Reply
        1. dixie
          September 13, 2021

          You specified “any” institution – you need to distinguish between public sector and private sector.

          Reply
    2. NickC
      September 13, 2021

      The DHSC is the sort of mess you get when you try and command and control everything from Westminster.”

      Indeed, Acorn, very much so. I am amazed, we actually agree on something.

      Reply
  29. Lester_Cynic
    September 12, 2021

    The government knows what must be done but no one will ever have the courage to overhaul the National Religion, paying £40 for a jar of cream which can be bought in a shop for a couple of Quid, there’s zero incentive to save money and achieve value for money, paper shufflers being paid £zillions for….shuffling paper, the largest employer in Europe, many of whom are clinically obese and could be seen huddled together in a doorway smoking
    And who do we have to thank for this, I believe that a certain Mr Anthony Blair’s finger prints are much in evidence ?

    Reply
  30. Bob Dixon
    September 12, 2021

    Clearly before you transition from your managers position in the previous NHS structure you will be made redundant and compensated.You can then apply for a position in the new NHS structure.

    Reply
  31. Peter from Leeds
    September 12, 2021

    Sir John,

    I have just been looking at the worldbank data and it is clear that the UK (at around 10% GDP) is well down the rankings in terms of overall healthcare expenditure. By various measures (such as life expectancy) we score quite highly for health outcomes.

    Things have changed massively in my lifetime. When I was a child the GP knew the family and came when we were ill in bed. When my daughter was a child (in the 80s) I was amazed that I was asked to take her into the GP surgery waiting room to be told “yes she has chicken pox” by the doctor.

    The pandemic has definitely caused a massive (in my mind for the better) reset for the NHS. I recently had a phone consultation where in previous years I had been required to go in to hospital- park up at great expense and wait over an hour for a discussion about general health and test results.

    As for expensive management- a GP friend recently told me they were not trained managers and resented having to spend valuable time to organise staff. A good meme going around : “If doctors’ receptionists were put in charge of our borders we would have no problem with illegal immigration”.

    As a teacher I used to say “don’t be afraid to make mistakes, but make sure you learn from them”. Again the pandemic has exposed many failings in the NHS, if the government is intent on bringing in new managers I would recommend they spend time and look very carefully at their background of actual achievements.

    I note the Australian system seems to be highly rated by the Commonwealth Fund and another contributor here has commentated favourably – though it will be interesting to see how their Covid response plays out in the long-term.

    PS – Great to see the start of the roll back of many of the constraints and the abandonment of Vaccine Passports in England. I wonder what the youth of Scotland are thinking?

    Reply Figures are not comparable. Most health systems elsewhere include insurance/ revenue collection cost. We should add in the cost of the Inland Revenue which raises taxes all of which are needed for health an£ social care.

    Reply
    1. SM
      September 12, 2021

      Peter – many surgeries employ non-medical managers; their efficiency however is questionable.

      Reply
    2. Richard1
      September 12, 2021

      Reply to reply: Excellent & interesting point – has anyone tried to quantify that cost?

      Reply
  32. Nota#
    September 12, 2021

    I see the talking heads are doing the rounds today. Talking about fairness. The triple lock on the basic state pension after 30 years of payments of £137.65 per week is to be suspended. However, the taxpayer funded pensions for the NHS and other state workers to rise as normal.

    That is not everyone playing the same fairness guidelines. Hit those that cant respond, stroke those that might cause trouble.

    This Government is full of contradictions, ‘grand standing gestures’ – while at the same time doing absolutely nothing real about anything. Creating black holes to poor money into while refusing those that fuel their dream the chance to stand still

    Reply
  33. mancunius
    September 12, 2021

    The NHS is hiding behind the covid scare by pretending its hospital resources are overstretched, although a cursory visit shows the opposite. The latest NHS work avoidance scheme is its failure to procure supplies of blood tubes. Hospitals therefore cannot process blood tests, and they have forbidden (yes, forbidden) GPs from sending them blood samples except in an emergency. As a result the GPs’ annual LTC (long term condition) clinics have been cancelled – so GPs have even less to do, and patients are left in the dark about the progress of what (e.g. in the case of heart patients) may be a critical and even life-threatening change in their condition.
    The long delay in the supply of blood tubes is the result of the NHS’s commissioning a single (US) supplier. Once the NHS has made a monopoly agreement with a manufacturer, it makes it unprofitable for any rivals to enter the field, providing the supplier with a perfect business moat: the ability to raise prices and create a blockage at will.

    Reply
    1. Paul Cuthbertson
      September 12, 2021

      Spot on and remember the real conspiracy theorists believe their government cares about them, the media would never mislead or lie to them and the pharmaceutical industry that makes billions from sickness wants to cure you.

      Reply
      1. MiC
        September 12, 2021

        I agree, Paul, but why do you appear to believe some of the worst whoppers?

        Reply
  34. paul
    September 12, 2021

    You may think that you are religious John but I can assure you that you not religious because you have had the jab, that is a no no for a religious person.

    Reply
    1. Paula
      September 12, 2021

      John who ?
      Nearly all old people have been innoculated because they trust the government and the media.
      It’s absolutely not about religion.

      Reply
  35. Enrico
    September 12, 2021

    Why are GP’s still receiving full pay when you can’t even go to one of their surgeries to be seen without having to go via a receptionist,fill in an e form to see if a GP will deem you unwell enough to warrant a consultation?I’ve had to see a plastic surgeon face to face to carry out a mundane injection of cortisone because I couldn’t see a GP.The plastic surgeon consultant says this is happening regularly as his clients are having the same issues thereby taking him away from his extremely important job as a surgeon.Questions must be asked and the government to insist that all surgeries are fully reopened,no excuses but no doubt it will never happen!!!

    Reply
  36. Reader
    September 12, 2021

    A lot of this is insoluble as it’s globally driven.
    Many books and films from the past foresaw current events.
    One I read recently, written in 1970, is
    This Perfect Day by Ira Levin.
    Simple Sci fi maybe but interesting I thought.

    Reply
  37. X-Tory
    September 12, 2021

    Being on holiday in Italy at the moment I stopped following the news for a week or so, but having had a look today to see what’s been happening I see that it is the same depressing story as before – if not even more depressing tghan ever! Boris Johnson has betrayed his manifesto promises and all those who voted for him and decided to increase taxation. He is so stupid he can only see one answer to the problem of insufficient funding, and that is to increase the funding. The better answer, of course, is to cut the costs! And then we have Priti Useless, who is trying to decieve us into believing she will finally tackle the problem of the Channel invasion. The truth is that the proposal to turn the boats back is so loaded with restrictions and caveats that it will NEVER happen. It is all a LIE, and the migrant invasion will continue. On Covid the government is clueless and flip-flopping over children’s vaccinations, enforcing a vaccination passport, holoidaying rules and everything else. On the economy, they have managed to stall this, by not following through on the freedoms offered by Brexit. No action taken to scrap the NI Protocol, no progress on freeports, or gigaplants, or gene editing, or anything else. God, this government is utterly hopeless.

    Reply
    1. MiC
      September 12, 2021

      Let us know how long the wait is in the non-European Union passport holders queue on the way back, eh?

      Reply
  38. Will in Hampshire
    September 12, 2021

    OT: I am trying to figure out why so my many people in the UK are in an excitable state about the victory yesterday by Ms Raducanu in the American tennis. It was undeniably an impressive display of sporting skill, but has nothing to do with this country. By parentage, she’s half-Chinese and half-Romanian. By birthplace, she’s Canadian. She’s a child of the great pre-Brexit globalization that the 2016 referendum rejected in the most robust of terms: one of Mrs May’s “citizens of nowhere”.

    Reply She is British, recently a Bromley schoolgirl.

    Reply
    1. MiC
      September 12, 2021

      What an appalling post.

      Reply
    2. No Longer Anonymous
      September 12, 2021

      She is the product of a grammar school, a selective sports system, a traditional family of two parents and a close-support community.

      I’d be more excitable about that if I were at all interested in sport.

      Reply
      1. No Longer Anonymous
        September 13, 2021

        She is a product of traditional conservatism, small ‘c’.

        Reply
  39. paul
    September 12, 2021

    One of the bigger threat you face is the green bank network, it will be worst than the PFI which was also started by the torys, one sample of this is councils applying for green bank funding of millions of pounds each as in Kent to save money on street lighting not by changing the bulb to LED lighting but by ripping out every street lamp in Kent and making new ones to replace them to save a few pennys on their electic bill.

    Reply
  40. Margaret Brandreth-
    September 12, 2021

    All people who contribute to the comments on Johns blogsite can use a pseudo name . For instance Andy may actually be Tony and lifelogic may even be Charles .. We don’t know.. but John does . We are at a disadvantage and cannot correlate views to any person who may want to stand for parliament.

    Reply
    1. beresford
      September 12, 2021

      OMG, is Andy standing for Parliament? I fear he may have lost the votes of pensioners and Brexiteers already.

      Reply
    2. SM
      September 12, 2021

      How on earth would our host know, from our names and email addresses, whether any poster here is a would-be Parliamentary candidate?

      Reply Quite. Nor do I have any info on names other the ones you see submitted.

      Reply
    3. Lifelogic
      September 12, 2021

      I would and could never be a politician and would certainly not want to be.

      Reply
  41. Original Richard
    September 12, 2021

    As a start I would like to see a breakdown of how many people are in each position/post and the total salary cost of each of these positions/posts together with an employee structure.

    Reply
  42. DavidJ
    September 12, 2021

    The NHS needs to spend less, not more. In my fairly recent experience it is grossly inefficient. Throwing more taxpayers’ money at it will simply make it worse.

    Reply
  43. Diane
    September 12, 2021

    New expense / new contract ? An article in the media currently, says that the Home Office is looking for a private sector firm to carry out assessments, which will be undertaken at several sites and initially 1000 assessments a year though numbers changeable. The title is “ Priti Patel backs medical tests to prove ‘young’ migrants’ real age” It was stated that the UK is one of only a few not to use scientific methods, having just previously relied on statements made by individual claimants, to check ages of asylum seekers claiming to be children and that Home Office research had found up to 54% of migrants claiming to be children were in fact over 18. Migration Watch has also said that this has been a problem for quite some time. No doubt this will be controversial & requiring funding but obviously something well overdue and needing attention.

    Reply
    1. Original Richard
      September 12, 2021

      Diane :

      The Home Office’s definition of a child is anyone who is 25 years old or younger.

      I remember seeing pictures of illegal immigrants with beards and stubble whom were deemed to be children by the Home Office.

      Reply
  44. Margaretbj.
    September 12, 2021

    In the 90,s many of us were conned into losing NHS service and forced to go through agencies to keep the roof over our head.Thousands of overseas staff were recruited supposedly due to a shortage of staff.Few UK staff could get a job.We were belittled ,accused of racism, blamed for mistakes as we were not there to defend ourselves and when complaining to executive advised investigations were not available to those without NHS contracts.Those coming to the country in the late nineties are oblivious to the corruption we experienced. The Health cultures and sets of responsibility are also foreign to these professionals who see their native countries service as a base line.

    Reply
  45. paul
    September 12, 2021

    You are absolutely right paula, it not about religion, it about fear and no belief in oneself.

    Reply
  46. paul
    September 12, 2021

    I believe there are no autopsy being carry out in hosiptals and that they stopped in March 2020, as this vaccine is a experimental gene therapy drug I would thought that autopsy on the vaccinated would been carry out as matter of course as this is a experiment on the human body or have stopped autopsy for good.

    Reply
  47. paul
    September 12, 2021

    I am not worried about tax rise, it debt, tax rise’s can be reversed debt cannot, with PFI still running of over 300 billion and now green bank network expanding fast to over take PFI, I would like point out that they are same thing with different names, they could not use PFI because of the political fallout from that policy so they change the name, altogether 2.9 trillion minimum debt by next April and expanding fast.

    Reply
  48. paul
    September 12, 2021

    Fed to cut back on bonds starting next quarter, whether they will reversed after market reaction is to be seen and will finish by next September 2022, that the plan anyway and EBC is following.

    Reply
  49. Lindsay McDougall
    September 13, 2021

    You can be certain that there won’t be ANY reductions to the old management architecture.
    Giving the (failed) NHS power over and responsibility for social care is a positively DISASTROUS decision. Social care provision should be the responsibility of Local Government, with powers to raise extra money to fund it properly (two extra council tax bands, charges for home visits).

    A secondary benefit would be an end to bed blocking. If a hospital wants to discharge a bed blocking person who is not ill, all they need to do is dump that person in the head office of the relevant Local Council. They’ll sort things out, necessity being the mother of invention.

    Reply
  50. Rhoddas
    September 13, 2021

    Best-in-class companies have average spans ranging between 10 and 15 direct reports and no more than seven management layers. (Source Bain & Co.) Benchmark NHS and transform it according to best practice. All costs need optimizing e.g. supply chain, IT/Tools/Automation, staff -performance management. I imagine the NHS property portfolio is also a massive area to dig into and optimize.

    NHS pensions (and all state pensions) need reform to make them affordable to future generations.

    To avoid the NI hike, just close down Benefit Fraud.. Universal credit accounted for £6bn of the estimated £8.5bn of “overpaid” benefits in 2020-21, the figures show. Fraud levels soared as normal verification checks were suspended in order to process the new benefit claims last spring (Source: Guardian 13/5/21).
    Having complicated benefits = armies of staff to administer and oodles of opportunities for fraud. One simple living payment per person/s etc and return a simplified housing benefit direct to landlord/council.

    None of the above are new, best in class companies do them as a matter of course, HMG and NHS seem oblivious to the correct way to fix their costs. Same applies to Local Government.

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *