Public services that can be improved.

This is my latest Conservative Home article:
When I go shopping I do not set out to maximise what I spend. If I tell friends and family I do not report that I have bought £70 of goods only to face a barrage of complaints that I had not spent £80 instead. I go to the shops with a list of things I need. I compare prices and qualities . I might tell them what I have bought. I might only mention what I paid if I had found some bargains or been given a good offer.
Nor when I go to the shops do I need to ask how much the shop has spent on providing its service, in order to go to the one that has spent the most. I go to the shops that combine a good environment, friendly and prompt service and value for money goods. I would not regard it as a defence for poor service or shoddy products if the shop told me they had nonetheless spent a lot on delivering this. Nor would I take pity if they told me the experience was rubbish because their owner had left them short of cash to spend on staff and stock.
So why then when daily I listen to the government and Opposition hammering at each other over important public services, do they spend most of their time talking about costs? The NHS must be great says the government, because we have just spent £20bn more on it. That is not enough thunders the Opposition. It would be perfect if we just spent a bit more. Ministers rarely give us any detail over where all the extra money is going, and the Opposition rarely tell us what extra items or staff they would want to hire. It is unusual to hear a normal debate about the quality and range of service, its availability, and how these could in detail be improved. Money is national and political. Service provision is local and outside politics. The detail of why a service is poor is apparently too difficult or too embarrassing for politicians to discuss.
The government should change this pointless debate. They should tell us what improvements to service and what increase in service they are going to buy, and tell us how they will seek to achieve better value for money. They may need to incentivise public sector staff to align their interests with the consumer interest. Ministers may need to change the odd Chief Executive of whom the public sector has so many to ensure better performance. Senior managers should report openly their successes and failures and encourage grown up understanding of what needs doing to improve. As we approach a debate on strengthening our nation’s defences we should not debate how much money we should spend. We should debate what extra capabilities we need and then set about providing them to the right quality for an affordable price.
The danger is monopoly provision gives too much power to the professional providers and not enough to the consumers. We have a monopoly nationalised road network. The users pay many times its cost through special taxes on owning and using a road vehicle . Highways England and many Council Highways departments seem to delight in closing roads or parts of roads as often as possible. They allow utility companies access to dig them up and put in cables and pipes in ways guaranteed to create many future needs to close the highway and dig it up again. Why not place these networks in reinforced conduits for ease of access and why not put more of them away from the centre of a main road? They often keep parts of the roads closed at evenings and week-ends when no-one is working on the closed portions. There is no sense that the user taxpayers have any right to expect the road to be more freely available more often. Many Councils regularly change the signs, paintings, lanes, junctions and crossings in ways which make the life of the car commuter or business van driver ever more difficult
Last week I went to speak in far away city by train. The fairly new rains were a lot less comfortable than the old ones they replaced. There was no hot meal service even though I was travelling at meal times. The computer system telling you where your seat was did not work. Overall it was a bad and expensive service. Train services are now hugely subsidised so they should think more about how to make themselves more attractive to the users. The collapse of office working post covid is in part a large revolt of the commuter against train services they regard as both bad in quality and too dear. Too many commuters have been let down by cancelled and delayed trains, by a shortage of seats and by season tickets going through the roof. The wrong kind of snow, leaves on the line and the late running of the train ahead pall as reasons for delayed arrivals.
Public services like health and education that are free at the point of use have plenty of demand which they struggle to meet. Public services like trains and buses with user charges struggle to fill their seats. The public sector is reluctant to close services and facilities that lack users and finds it difficult to keep up with demand where free offers help make a service very popular. Recent years have brought a passion to take the management of many of these services out of politics by delegating the use and control of resources and the recruitment and training of staff to expert managers. Labour and Conservative Ministers favoured this, thinking it meant they would not be to blame when things went wrong. Instead the Minister is still blamed for every failing, whilst the management usually escapes criticism and may even keep their well paid jobs despite some disaster. Parliament concentrates on playing party politics, where the Opposition blames every management failing on too little money, and the government claims they had enough all along. No wonder the services often cost a lot and do not deliver the quality and range we want. We want an NHS free at the point of use and free places for all needing them in schools. We need better ways to debate successes and failures, with more attention on how the money is spent. Ministers who provide the cash need more control over how it is spent all the time they are held responsible.

168 Comments

  1. DOM
    March 22, 2022

    This is a pointless article without reference to the public sector unions and Labour’s grip over many areas of the State. This convenient omission doesn’t surprise me though. It’s a reflection of a Tory party cowed into submission, which by the way I fully understand.

    Labour’s thug culture is intended to intimidate Tory MPs into silence and it works. That in itself is tragic for democracy and this nation as it means important decisions are, rightly, not taken for fear of personal safety issues. No one wants to feel exposed

    Without internal opposition from the Tory party who appear to have embraced Labour’s progressive barbarism and demonisation of the majority to Labour’s politics our freedoms and liberties will be destroyed

    Labour to a degree used to be a moral and human movement but they have become a threat that will destroy our nation as the SNP will destroy Scotland

    If the Tory party continues down the path of State authoritarianism egged on by Marxist Labour then why would Mr Redwood want to belong to a party that promotes such vileness?

    The Tories like to pretend all is hunky dory but all is NOT hunky dory. We are facing totalitarianism, destruction of voice, history erased, people demonised, feminism slandering white males, real terrorists portrayed as victims..this is LABOUR’s politics embraced by a Tory party that have thrown in the towel and we, the majoirty, are paying the price

    1. Michelle
      March 22, 2022

      Bravo.
      I was thinking along the same lines reference the iron grip of Union bully boys and by extension Labour, but you’ve gone further and sketched out problems that show it’s not always just about the money.
      It isn’t and no amount of money or pointless debate will alter anything.

      1. Hope
        March 22, 2022

        According to House of Commons Library it is estimated £11.8 billion lost to fraud from Treasury support schemes. It strikes me this is worth investigating before asking for more tax rises. It could also be used for public services! Oh well, Sunak happy to write it off.

        1. alan jutson
          March 22, 2022

          +1

        2. DavidJ
          March 23, 2022

          +1

      2. Fedupsoutherner
        March 22, 2022

        Quite right Dom and Michelle. The unions and bad management have a lot to answer for. A friend is a train ticket collector on the Welsh line. He often sits around doing nothing for as long as 3 hours. If he goes in to cover a Sunday shift he can earn £400. Something is very wrong somewhere but it goes a long way to explaining why rail fares are so extortionate.

    2. Everhopeful
      March 22, 2022

      +1
      Agree about “pretend”.
      I was never more shocked than by the reaction ( or lack of it) to the horror that occurred in Southend.
      Where was the outrage? Where was the breast beating? Utterly, utterly amazing. And disgraceful.
      Cowardice comes with a huge price tag.
      And as Dom says …WE are paying it!

    3. Sharon
      March 22, 2022

      Dom
      Apart from the first sentence accusing the article of being useless; I agree with what both you and JR have to say.

      There are a small number of Tory MPs brave enough to speak out, JR included, but too many are cowards.

      There is a bottom up push back from many groups and campaign organisations. GB News and Talk Radio both give these MPs and push-back groups a platform, and a voice. Change will occur, but slowly. GBN and TR bring in other voices from a larger group, which allows an alternative view point to be aired.

      I suspect that Reform UK and Nigel Farage are worrying some of the Labourites, judging by the reaction to the debate in Bolton that was hounded by the pack, forcing it to be cancelled. I also think that, as with the Brexit vote, there are more people fed up with everything, than is thought. The Torys need to have more more faith in the electorate, and take courage that if the Tories do the right thing, the electorate will be behind them. But will they?

      1. Fedupsoutherner
        March 22, 2022

        Sharing. Your last two sentences sum it up. There are many of us who would applaud some common sense and not all this creeping around the minority of woke luddites.

    4. JoolsB
      March 22, 2022

      Totally agree Dom. The party calling themselves Tory are fake to the core.

    5. Sir Joe Soap
      March 22, 2022

      Yes I scan read this; it’s a monologue of Life in Tory Britain, which we all already know all about. PC Plod the stupid spending months investigating attendees at a party when there’s a world war in prospect aren’t mentioned, but would add to the general tone of fin de siecle idiocy and weakness which again we already know about.

      A good monologue on how we got to be standing by while a nearby sovereign nation is being pulverised might be more appropriate. Who were/are the apologists? Where do we go now as the UK and NATO, or do we just stand by and watch?

      Really, author, if we’re going to change things then b-oody well change them properly, not just provide general commentary and suggestions about spending less on this or that or making the other more efficient.

    6. Nottingham Lad Himself
      March 22, 2022

      Your problem with these hyperventilated rants at the moment Dom is this: people can see what real thug rule actually is on their screens every day, in fact it’s impossible to avoid.

      So your fanciful protestations are seen for what they so clearly are, i.e.theatrical, melodramatic, downright silliness.

      1. Peter
        March 22, 2022

        NLH,

        Blood pressure monitors for home use are inexpensive devices. DOM might be wise to use one on a regular basis.

        1. Fedupsoutherner
          March 22, 2022

          Peter. With the dire performance of the Tories and the ridiculous demands of Labour we all need a blood pressure monitor.

          1. Mickey Taking
            March 22, 2022

            no! we need a party and government that has balls, does what it says it will in campaigning, selects Cabinet and Committee personnel that have morals and experience of the real world. Thats what I’d agree is fanciful Martin.
            I’m not holding my breath.

          2. Nottingham Lad Himself
            March 23, 2022

            Oh, come on this is pure Kenneth Williams à la “Infamy! Infamy! They’ve all got it in for me!”

    7. Donna
      March 22, 2022

      Correct. In sequence, the Not-a-Conservative-Party adopted:
      1. The language of the left
      2. The objectives of the left
      3. The agenda of the left
      4. The strategy of the left
      5. The policies of the left

      With the first two they gave away the ability to change anything ….. even IF they wanted to, which they don’t. Mrs Thatcher recognised it, which is why the language she used was so different to any other post-WW2 Prime Minister.

      1. BOF
        March 22, 2022

        Yes Donna, and then became just another party of the left!

      2. glen cullen
        March 22, 2022

        Donna I believe you’re being too kind – the Tory Party are now full of careerist, woke, green extreme politicans

        1. Mickey Taking
          March 22, 2022

          who have friends to look after…..

          1. glen cullen
            March 22, 2022

            In order of MPs priority
            Parliamentary Party Members, Party Donors, Tory Party, The Media, Tory Party Members, Tory Voters, The Country, The People

    8. Peter
      March 22, 2022

      ‘The detail of why a service is poor is apparently too difficult or too embarrassing for politicians to discuss.’

      It’s often because the service is either run by apparatchiks who never carry the can for failure; or else the service pays for a lot of work from favoured suppliers (another form of crony capitalism).

      The government strategic suppliers list is stuffed with notorious companies. I will not name them because it would probably be deleted but google will reveal them. They could not organise a ‘party’ in a brewery.

    9. No Longer Anonymous
      March 22, 2022

      Dom.

      You saved me writing it.

      “We are spending more” is to placate union bullies, those that produce the BBC News cycle and to keep trouble off the Tory’s backs. It has nothing to do with value for money, especially the NHS.

    10. Your comment is awaiting moderation
      March 22, 2022

      @Dom
      Sir John makes a valid point regarding the ludicrous one-upmanship over squandering of taxpayers cash and you make a good point over the failure of the Tories to defend conservatism in general. It takes courage to move the Overton window in the way that Nigel Farage did and there are very few Tories that have the right stuff, they even prioritised Tony Blair and Chris Whitty for Knighthoods over Nigel Farage, a man who fought a courageous battle against the centralisation of power.

    11. BOF
      March 22, 2022

      +1 DOM.
      Personally, I am very angry that Conservatism has fallen to such a low ebb that it has been subsumed by Marxism and the Conservative party is happy with its fate.

    12. Giselle Brannan
      March 22, 2022

      So, how do we begin to effect change? Writing to our MPs would be a start. Asking for forecasts & budgets would be another for all the money spent. Writing off £11.8b is & should be criminal! It wouldn’t take too much but a few decent auditors with full authority to follow the money to track much of this down & bring people to justice. As an owner director of a small company denied equal furlough because HM Treasury claimed it was open to fraud; I would want those responsible in HM Treasury brought to book for gross incompetence! As an auditor myself (ACA) I would happily volunteer to do said investigating with a like minded & independent team of others.
      The apathy of most MPs to even raise issues of incompetence, stupidity & bias in the civil service & public sector shows either cowardice or ignorance or both. By writing to MPs with specific examples of public sector incompetence and/or intransigence at least Jo Public could alleviate their ignorance! Political correctness & a tendency to overlook poor performance of all public sector roles has developed into the extremely poor value for money and poor service we, the funders & consumers, now experience. Standards have fallen, processes are inefficient & as JR says no one is prepared to grab the bull by the horns! Right now I do not recognise Labour or Tories as being competent or in touch with the general needs & wants of the public. Any party willing to tackle these issues will get my vote .. especially if they put a stop to all “climate change levies” & pointless green projects. I am not against the pursuit of more efficient use of energy nor the research & due diligence into future energy sources but these should & must come from universities & scientists who think outside the box. It should not come from ridiculous climate change zealots who repeatedly use computer modelling to generate fearful extreme predications; a la Prof Neil Fergusson & all of his scandalous failures!
      If we don’t start levelling the playing field for all workers (not shirkers) to spread wealth across society we also limit our future!
      Rant over!

  2. Everhopeful
    March 22, 2022

    We all know why lefty ( and obviously that includes Tory) councils delight in closing roads.

    1. Ian Wragg
      March 22, 2022

      And libraries.
      Our council is closing 3 to save money always front line services, never the bloated backroom inclusion and diversity staff.
      What happened to all those EU departments in councils, the staff redeployed or still beavering away for Brussels.

      1. Everhopeful
        March 22, 2022

        +1
        And all of it stops people from travelling …keeps them buying books from Amazon.

      2. Hope
        March 22, 2022

        Ian, I bet the council you refer to has diversity or inclusion officers, or crap about climate change.

      3. Ian Wragg
        March 22, 2022

        It might be worth mentioning that on this relatively quiet Tuesday wind is only supplying 9.3% of demand or 3.1gw. Gas is supplying 48% so I think there is a very strong case to commence fracking so we are more self sufficient on what is the biggest supplyer of electricity and heating.
        Enough greenwash, just get on with it.

        1. Everhopeful
          March 22, 2022

          + several million.
          And notice that a crackdown on so called disinformation is creeping on apace.
          Soon there will be no room for discussion and debate.
          The cornerstones, surely of our culture, freedoms and world?
          Unbelievable that we should have been brought to this!

        2. Fedupsoutherner
          March 22, 2022

          Hear hear Ian. I’m fed up with the pathetic excuses for no action on any front.

    2. Lifelogic
      March 22, 2022

      Indeed let’s improve productivity we will block the roads and dump more and more taxes amd red tape on people and businesses.

      Are there any public services that deliver any real value or efficiency to the public? The only thing they seem efficient at is mugging motorists when they are a minute late back to their car (perhaps because their toddler needed the loo or something). Or perhaps a tyre strayed into an empty bus lane.

      1. Lifelogic
        March 22, 2022

        What about out appalling court system. More than 700 branch managers were given criminal convictions when faulty accounting software made it look as though money was missing from their sites over four years. The Guilty get off the innocent convicted!

      2. Lifelogic
        March 22, 2022

        So Sunak is now planning to tax electric cars with road charging soon it seems. They already cost about 5 times more per mile than keeping your old car running. So if they level up the tax system it will be more like ten times. So will they level up the tax but still keep the grants and the ULEZ congestion zone perks while taxing with the other hand at the same time. More insanity from eat out to help out & economic illiterate Sunak.

        1. Fedupsoutherner
          March 22, 2022

          LL. About time they were taxed. The weight of the car causes more damage to a road and where we live parking on pavements.

          1. Mickey Taking
            March 22, 2022

            It is more likely to be damage caused by the green lobby stamping their feet in protest at cars. /sarc

          2. hefner
            March 23, 2022

            non EV SUVs
            Mercedes G class SUV 6,825 lbs
            Average SUV 5,000 lbs
            ‘Average’ non-SUV non-EV car 2,500-3,500 lbs

            non EV (typical) vans (GVW)
            Renault Master 7,700 lbs
            Ford Transit Courier 3,920 lbs
            Ford Transit Connect 4,488 lbs
            Ford Transit Custom 7,700 lbs.
            ———————-
            EVs
            Tesla model X 5,390 lbs
            Tesla model 3 4,416 lbs
            Tesla Roadster 2,723 lbs
            Nissan Leaf 3,905 lbs
            Opel/Vauxhall Ampera 3,544 lbs
            Renault Zoe 3,256 lbs
            BMW i3 2,955 lbs

            So roughly 500 lbs more for an EV car. Not sure they will damage the roads more than the Amazon, DHL, DPD vans going all over the country … or the big Tesco, Aldi, Asda, Morrison’s, … lorries (between 3.5 and 30 tonnes – 7,700 to 66,000 lbs) daily delivering products to supermarkets.

            But who am I to contradict? I check before writing, something mostly unknown from the present ‘habitues du Cafe du Commerce’.

      3. Lifelogic
        March 22, 2022

        Lee Anderson Conservative (MP) for Ashfield just now on Talk Radio says one garage charging 20p more per litre for petrol is criminal rather a stupid comment showing a lack of understanding of markets. But what about sensible governments taxing at say 10%-20% of GDP and others like the UK (under an allegedly “Conservative” Government) taxing/spending/ wasting at nearly 50% of GDP while delivering fairly dire public services too? That really is criminal.

        At least you are not forced to buy the petrol!

        1. graham1946
          March 22, 2022

          It’s not a market, it’s a cartel. Not forced to buy petrol? How, from you physics knowledge do you suggest we run our cars? Especially here in the countryside where buses are like hens teeth and the railway is miles away? I think yours is the stupid remark, not Lee Andersons.

          1. Lifelogic
            March 22, 2022

            Well not forced to buy it from any particular petrol station anyway – the criminal activity is surely this government that spends nearly 50% of GDP & yet delivers so little of any value!

          2. Mickey Taking
            March 22, 2022

            then do what Andy suggests and buy an EV. /sarc

    3. glen cullen
      March 22, 2022

      Why does every policy of this government & councils want to restrict our freedoms and control our every thought and movement….bring back the principal of magna carta

  3. Richard1
    March 22, 2022

    Excellent article. What is needed also is a radical change of mindset in much of the public sector towards serving the consumer. It’s far too producer- focused, which endless discussion about total amounts of money spent encourages. The reason your train service was bad and expensive is because it is subsidised. Those running it know they only have to bleat about ‘withdrawal of services’ for more money to be available. They don’t have to provide a better or more competitive service to keep their jobs. So it is in much of the public sector, especially the NHS. The continued existence in some parts of it of dinosaur socialist unions hell bent on finding ways to confront the government doesn’t help either.

    1. Mike Wilson
      March 22, 2022

      I’d say it is impossible to run a train service without subsidy. When the network was built the choice was between travel by horse or travel by train. Now it’s between train and car/coach/plane. The train is an outmoded form of transport that, possibly, has a viable use for transporting freight. But not people. Unless you subsidise transporting people.

      1. 37/6
        March 22, 2022

        People will use rail at the right price and in huge numbers. As fuel costs rise more will come over, so long as the price gap closes.

        The problem with lack of profitability on UK railways is that it was primarily designed to replace canals and to move freight – passenger services were just an add on, subsidised by the freight, even in the early days.

        I agree with Sir John. The new services are not better. The uncomfortable trains were bought to deal with London commuter corridors and to provide rapid and high volume transit over 50 to 100 miles, long distance with-suitcase provision was very much secondary. It was all based on never ending growth in commuting to London and – of course – in a green and electrified way which, as Andy tells us, comes with HUGE up front costs.

        Much of the UK is better suited to modern versions of diesel HSTs. With comfortable seats, PLEASE !

        1. Mark B
          March 22, 2022

          As fuel costs rise more will come over, so long as the price gap closes.

          Trains also run on fuel. It use to be coal, not it is either diesel or electric, with the latter generated mostly by gas. So prices, due to wage rises and costs of maintenence will also increase prices.

  4. Everhopeful
    March 22, 2022

    Here they have made the train “service” 600% worse by the imposition of a totally unfathomable ticket machine ( which foxes two extremely techie relatives) and by cutting the number of trains in half making every appointment etc a triple burden.
    The govt should just stop grabbing our money and keep its nose out of everything.
    It just causes mayhem and real suffering wherever it intrudes.

    1. Andy
      March 22, 2022

      The Tories sold off your trains telling you you’d get a better service. Actually, what happened is that your services got worse and more expensive and the foreigners the Tories sold it to got rich.

      Most of western Europe has state run railways. They are virtually all better than ours and cheaper too. Perhaps Tory policy failed?

      1. Peter
        March 22, 2022

        Andy,

        On this point you are correct. Railways were sacrificed to the daft notion that everything would be better if it were privatised.

        When it all started to go wrong the government could not bring itself to admit that it had made a huge mistake.

      2. Original Richard
        March 22, 2022

        Andy :

        The privatisation of the railways was initiated by EU Directive 91/440 in 1991.

        Most of Western Europe ignored the Directive and our Parliament/Civil Service even allowed our nationalised assets to be sold to foreign governments.

        1. Nottingham Lad Himself
          March 23, 2022

          They did not ignore it.

          The approaches in France, Italy, Germany etc. are fully compliant.

          There is absolutely NO requirement to remove the public sector in its entirety.

      3. Everhopeful
        March 22, 2022

        I’m certain that every single policy of both Tory and labour ( forever) have been crafted to destroy us.
        Our railway is franchised to Trenitalia.
        Great…just great.

        1. Everhopeful
          March 22, 2022

          *have =has

      4. 37/6
        March 22, 2022

        Many of ours have been run by those very same state run foreign railways.

        1. Andy
          March 22, 2022

          But foreign companies run them here to make a profit which is then used to subsidise their operations in their home country. Commuters in France and Germany thank you for your contribution.

          1. Mickey Taking
            March 23, 2022

            In a wider context the whole EU used to thank UK for our contribution.

          2. Peter2
            March 23, 2022

            That’s the Single Market young andy.
            Thought you were a fan of it.

      5. Hat man
        March 22, 2022

        Hard to disagree with you on that one, Andy. Subsidised privately-owned railways should be anathema to left and right alike.

      6. Everhopeful
        March 22, 2022

        OK agreed. You speak freely Andy!
        Our railway is franchised to Trenitalia.

      7. Richard1
        March 22, 2022

        As is regularly pointed out by Sir John, the railways are in effect nationalised as the state owns much of the infrastructure and private companies operate under heavily conditioned licensing with price controls. Its nowhere close to a free market system.

        Bad as it is it is nevertheless better than when it was state-owned. It carries about 2x the passengers, has a better record for safety and performance and makes much lower losses than was the case. Of course it would be better if we hadn’t had the Labour govt you voted for which effectively re-nationalised it, but its better than it was pre-Thatcher.

        1. Peter
          March 22, 2022

          Richard1,

          ‘ In effect nationalised’ is not nationalised.

          The track maintenance had to be taken off the privatised firms because they could not be trusted with passenger safety.

          The franchise model is poorly thought out. The franchisees simply take the subsidy and do not look to the long term, let alone improving the system. If things go badly they bail out or have to be removed.

          You also lose those staff who had a lifetime working on the railways and their experience is not easily replaced with contractors.

    2. JoolsB
      March 22, 2022

      “The govt should just stop grabbing our money and keep its nose out of everything.”

      + 1000 Everhopeful but socialist Governments, which this one is, just can’t help themselves.

      1. Everhopeful
        March 22, 2022

        +many

    3. Lifelogic
      March 22, 2022

      But they have all those pensions and wages over paid “workers” to pay. Just Cressida Dick’s pension seems to have been circa £5 million so about 1000 average people’s PAYE taxes for a year just for her pension!

      1. Everhopeful
        March 22, 2022

        +1
        Does it pay to fail in this country?
        Or is spectacular failure what they pay for to beak the system?

        1. Lifelogic
          March 23, 2022

          +1 certainly in the state sector it seems so.

  5. turboterrier
    March 22, 2022

    When you supply a bad service it is the norm for the client to tell between 11 and 15 people about that experience.
    Only 4% ever actually complain so the company get four complaints and over a thousand potential clients know your rubbish.
    Why are ministers not thinking outside the box and actively chasing down the feedback and the waste? It’s not the ones you know about that cause the damage and unrest. Hence beware the silent majority.

    1. Lifelogic
      March 22, 2022

      I rang HMRC on Friday it seems they cannot be bothered to open or answer on Friday now! Plus you get a message about not abusing staff now! It had not occurred to me to do this. I managed to get through today (after a 30 minute wait) the lady who answered was very efficient indeed for once!

      1. Mickey Taking
        March 23, 2022

        What was called ‘dress down Friday’ is ‘ phone down Friday’.

      2. graham1946
        March 23, 2022

        Perhaps it is the old Tory story – understaffing – doing everything on the cheap (buy cheap, buy twice). NHS the same. How can anything give close to a good service with a perpetual 10 per cent understaffing, poor wages lower down as you have said about junior doctors, staff treated like rubbish being charged to park at work, whilst managers bask in huge salaries and just inventing more paperwork. It has become a bureaucracy with a bit of health care tacked on. No understaffing in Whitehall though. Wait for Rishi to appear this afternoon with his red box with about a dozen advisors and Lord knows how many actually in the office, all to make a huge cock up.

  6. turboterrier
    March 22, 2022

    Ministers that provide the cash should not only be responsible but accountable also. Same for their department heads and staff both in the civil and public services. Until people are held to account nothing will change as the mindset is “its not my money”

  7. Mark B
    March 22, 2022

    Good morning.

    Second hand car salesman. That’s what they sound like. Talking up an old banger to some would be punter in the hope of moving this old wreck off their hands. ie “We spent a fortune on these go-faster stripes !”

    No matter how much you spend on the tarting up, if the mechanicals are not sound then a lemon is still a lemon.

    1. Everhopeful
      March 22, 2022

      +many
      And oh my goodness…doesn’t it all leave a sour taste in the mouth!

  8. Everhopeful
    March 22, 2022

    I just love that description “free at the point of use”.
    No, not free but paid for by every ancestor going back to 1948.
    We have a relative’s documents showing that she was forced to give up her health insurance policy and was legally obliged to pay into the new communistic system.
    ( Apparently this Online Harms Bill is Stalinist!)
    She was then obliged to watch as the “goodly creatures” closed hospitals, increased waiting-lists, removed the personal touch, made neglect a cornerstone of treatment etc etc.
    Good God, considering the amount of money commandeered by the NHS we should all be living to 110 in perfect health and happiness ( NB Govt …look up the word “happiness”).

    1. Mark B
      March 22, 2022

      +1

      This is the untold truth about our health system – It was not always State provided and was not necessarily bad. This is why I advocate that private health insurance should be a non-taxable benefit as it will not only allow people themselves to get good prompt treatment, it will also reduce the NHS waiting lists for the less well off. The other benefit is that it would reintroduce people to private healthcare and personal responsibility.

      1. Everhopeful
        March 22, 2022

        +1
        Exactly.
        It makes no sense not to incentivise people to have private cover.

      2. alan jutson
        March 22, 2022

        Mark B

        Not only should private medical care not be taxed, the premiums should be tax allowable to encourage a few more who can afford it, to enrol for the very reasons you outline.
        Before anyone asks, no neither I or my family have ever been a member of a private health system, although I have paid for a couple of private consultations myself when the NHS over many months failed to diagnose the cause of a couple of debilitating problems a few years ago, after an accurate diagnosis the problems were then resolved very quickly.
        Front line actual treatment is usually good under the NHS, the problems appear to me to be with Management, Administration and the utter inefficiency of the system, leading to huge waiting times.

        For Railways perhaps we couple learn a thing or two from Switzerland where the trains run to the second, and where the carriages are always without exception, clean and comfortable.

        1. Everhopeful
          March 22, 2022

          + 100%

      3. Iain Gill
        March 22, 2022

        copy the Australian health system fully, dont let anyone here meddle with it, just copy it top to bottom.

        1. Everhopeful
          March 22, 2022

          +1
          Well..if it is good, cost effective and efficient they’d NEVER copy it.
          It just might work and they’d certainly not tolerate that!

    2. Hope
      March 22, 2022

      E,
      English people pay for prescriptions and dentists. JR forgets that free at point of access does not apply to England, we pay excessive taxes for other home nations to have free prescriptions and university education while his party and govt. failed to deliver on their promise of answering the Lothian question, the crumb they gave to con people was recently taken away without a murmer from the backbenches!

      Dom, is correct. This consocialists outfit has built on every Labour policy. More taxes thrown away without any clue how it will be used or improve any public service. How many czars and task forces to hide ministerial incompetence? Patel now hides illegal boat people figures! This is how the Tory party and govt address performance. IPSA has gone back to cover up and not disclose MP wrong doing! Covid figures anyone? Rachel Reeves announced on Sunday £5 billion of below standard PPE being burnt. NHS not forced to reform from wasting tens of billions of taxes but given more by Johnson and Javid. Javid announces that “we” have a moral duty to provide free health care to Ukrainians! No,no,no. How about the people of these islands who have died, will die waiting for treatment they paid for! His comment logically implies to everyone from Hong Kong, Afghanistan, boat people and 6 million EU citizens plus health tourism. It does not make me feel better it makes angry and feel sick for those we have lost and will lose through Tory ultra left wing incompetence.

    3. a-tracy
      March 22, 2022

      Everhopeful, The NHS scheme that is considered a success is a Madoff style ponzi scheme that will go bang, that’s why nest was introduced for pensions to take another 8% off people and their employers. In 2020/21 the government collected £142bn NI and spent on the NHS alone £192bn.
      I wonder in the uk what % of workers pay the required amount to spend on their own healthcare of £1950pa in national insurance. In Germany, 90% pay 7% of their gross wage and their employers match it. I wonder what the UK equivalence is? In the UK people earning less than £9564 don’t pay, the self-employed don’t pay the employer contribution.

      Millions of pounds are spent on staff with long term sickness. £1bn alone in sick nurses, midwives, and paramedics. Instead of training thousands of kids in sports science degrees they could be doing nursing degrees to ease the pressure, the diversity managers need to concentrate on hiring more males they demand better terms and are willing to work more shifts and hours.

      1. Everhopeful
        March 22, 2022

        +10000
        What a blinking scam!
        And now apparently the move is towards “natural” cures. Patches for this that and the other. Cures from the 18th century. Fried mouse for whooping cough? And more electronically monitored functions at home ( not hospital).
        Whatever have we paid for?
        Oh….

    4. graham1946
      March 23, 2022

      This is what was discussed yesterday – it is not the amount of money but how it is spent. We all know there is colossal waste and the govt answer is to waste more. They tried a re-organisation in 2012, cocked it up, made it more costly and more bureaucratic. It needs taking out of political control. Politicians don’t have a clue, are short-termists and are out to make a name for themselves.

  9. formula57
    March 22, 2022

    You ask “So why then when daily I listen to the government and Opposition hammering at each other over important public services, do they spend most of their time talking about costs? “ .

    Might it be because total cost is all they can influence with any ease and because the public is content with a simple message that is easily grasped despite it not indicating very much useful?

    We get the governments (and oppositions) we deserve, alas.

  10. Everhopeful
    March 22, 2022

    What price all our NHS contributions when this ( or the next) govt surrenders our health sovereignty to the WHO?
    The Pandemic Treaty is due to be signed in 2024 but is already underway and I hope that sane MPs will oppose it.
    It will take away all government control of healthcare.
    Yet another sell out.

    1. Christine
      March 22, 2022

      No International Treaty should be signed by any Government without a referendum. Like the appalling Global Compact on Migration that Theresa May signed us up to and the forthcoming one from the WHO. It’s a disgrace that we have no say in these decisions and they are bypassing democracy.

      1. BOF
        March 22, 2022

        Christine, democratic accountability is something quite alien to our parliamentarians.

        1. hefner
          March 25, 2022

          Christine, BOF, EH, What are you talking about, we have a parliamentary democracy and your MP is accountable to his/her electors at the next General Election. Will the choice available then not be to your inner desires? Are you by any chance all members of some kind of revolutionary party?

      2. Everhopeful
        March 22, 2022

        + 100% agree!

  11. Nig l
    March 22, 2022

    Civil servants have an easy life, 9 – 5. no competition, little/no performance management, job for life, bullet proof pension. They are ‘managed’ by Ministers who are in post not because they have the necessary knowledge or competences and move on every 18 months or so. Just look at their background history. Wealth creators mostly they are not.

    Is anyone surprised we get the crap we do?

    1. Original Richard
      March 22, 2022

      NigL :

      Agreed.

      The biggest and most needed improvement to our public services is the reduction and reform of the Civil Service.

      The Treasury caused Black Wednesday by insisting we join the ERM, a precursor to the Euro.

      BEIS are now insisting we follow their economy destroying Net Zero Strategy even though our territorial CO2 emissions amount to just 1% of global emissions.

      No public employee is ever sacked for laziness, negligence, incompetence, malfeasance, corruption or misbehaviour. In fact, incompetence often leads to promotion.

    2. BOF
      March 22, 2022

      +1. Nig L. Leaching on the tax payer.

  12. Michelle
    March 22, 2022

    So we have huge sums of money pumped into a service and a raft of expert managers ( is this expertise just on paper though and lacking in hands on experience) yet still don’t seem to be seeing much pay back for a combination that should see us enjoying far better services than we do.

    It has already been said on here but I’ll mention it again, our public service sector is politicised and run by those who have an agenda of their own.
    The NHS is now virtually a political party all on its own.
    Why are the public paying for Diversity Officers or whatever they are called and diversity training for staff.
    This is outrageous and is in every facet of every institution. It seems to be the main purpose and concern now of every institution.
    I saw a ‘rainbow’ Police car the other day daubed with some silly nonsense about protecting differences.
    How about them doing the job they are paid for and clamping down on criminals instead. Wouldn’t that be a more efficient use of time and money, as well as a relief to the good folks whose lives are blighted by criminals.

    As for public services struggling to meet the demands placed on them, well I can’t believe no one can see the huge Elephant in the room. Mass immigration – all of it legal and illegal.

  13. Maylor
    March 22, 2022

    During the covid crisis, we saw that contracts for PPE and other equipment and services were at times being awarded to friends and family of govt officials, irrespective of their ability to deliver.

    We need to ensure that there are no conflicts of interests when government officials spend public money and that quality and value for money are the prime drivers.

    1. a-tracy
      March 22, 2022

      Maylor, wasn’t the problem also that the NHS asked for too much PPE and when it was delivered it wasn’t used or required, in such a panic order situation that the papers were telling us the Health care sectors were demanding every day.

      I remember the demands every day for new ventilators, then new PPE. The government stepped us fast as demanded by the UK population.

    2. Bill B.
      March 22, 2022

      Ah, but Covid was an unprecedented emergency, Maylor. SARS-Cov2 was a killer virus, we didn’t know what it was, no vaccine for it, masks don’t work, no, masks do work, stay safe, protect Granny, NHS overwhelmed, bodies piling up in the morgue… (cue all clichés). It could surely never happen again, could it?

      Oh wait, what’s this global ‘pandemic treaty’ that’s being quietly smuggled in?

  14. Nig l
    March 22, 2022

    And in other news Matt Ridley highlights the lies and disinformation swallowed/supported by the Government in relation to fracking resulting in a massive lost opportunity to produce home gas resulting directly in my energy prices being higher than they should be.

    Kartengs limp response than any gas created would have to be sold at market price so nothing would change supports Sir JRs accusation of incompetence.

    The government is looking to take Gasprom’s U.K. operation into public ownership to protect gas supplies to key industries.

    Why is Gasprom at risk? Because the government has been encouraging local authorities and others to break their contracts with, guess who? Yes Gasprom. You couldn’t make it up!

    1. agricola
      March 22, 2022

      Yes our oil and gas should retail at exploration cost, extraction cost, plus a reasonable profit. Why does it have to be handed to a volatile World market where our government then load it to cover an infinite number of profligate spending schemes. Is it to benefit their share holdings among the energy giants. A reasonable question when you see the delivery systems for the energy we consume.

  15. Donna
    March 22, 2022

    Sir John has identified some of the problems with failing/inefficient public services but has failed to mention, or maybe has failed to recognise, that one of the causes is legislation.

    For example: the reason the utility companies frequently dig up the road is because they have a legal right to access their services in order to carry out repairs or upgrades and there is a lengthy process to be completed with the Highway Authority before the works can proceed, which includes payment so there is an incentive to limit works and avoid repetition. The utility services are generally sited under the road or pavement because the cables or pipes are linked to all the houses adjacent to the road and generally run in a straight (or fairly straight) line.

    The utility companies are private businesses so they do actually provide a service to their customers, which includes effecting repairs as quickly as possible; upgrading the service when new technology becomes available and reducing costs in order to remain competitive.

    That doesn’t apply to the Public Services which have a guaranteed revenue stream (with regular unearned increases) regardless of their performance and little or no competition to drive improvements. Where there is competition from the private sector (ie health and education) the dice is massively loaded in favour of the public service. In the Public “Services” the incentives are to protect the interests of the people working there (including pandering to their political leanings) and for the managerial level that includes growing their fiefdoms since a bigger budget is the way to signal importance and also a higher level of seniority.

    We can see this playing out with the BBC which has been protected for almost a century by a guaranteed revenue stream and little competition. Now, thanks to technology, the competition has out-performed the BBC it is desperately clinging to the guaranteed revenue stream …. and the cosseted personnel are having trouble understanding that their interests (including their political leanings) are no longer paramount. Unfortunately, because the Government is still terrified of the BBC, they are being allowed almost a decade of the guaranteed revenue stream whilst they slowly drag themselves towards the 21st century. And the other Government-controlled Public Services aren’t even having to do that.

  16. alan jutson
    March 22, 2022

    What you describe John is typical when no one is held accountable, when for most their job is not at stake, and eventually when they are found to be incompetent, they either get a massive pay off, are moved sideways, or get both.
    Add to that mix, little competition with no need to win over customers because by law all have to pay like it or not, is it really surprising failure and poor value for money is the norm.

    1. Iain gill
      March 23, 2022

      When you have a PPE grad at the top of an organisation, who prides himself as being like Cameron, and is indeed mates with him… Then you can expect wokeness and nonsense top down direction. So organisations like the FCA cannot be performance managed because the clownery comes right from the top.

  17. Bryan Harris
    March 22, 2022

    Yes,

    Public services can be improved

    Despite God knows how much money being spent on digitalising public services, why do we still see the same old waiting times?

    Just take passports, they still quote 10 weeks for a renewal.

    GP appointments still often remain elusive.

    Roads continue to be potholed – pavements often unwalkable.

    Wasn’t it Major that introduced the idea of targets for public services? That didn’t work so well, with their statistics now used to justify their existence or more money. The NHS in particular needs real accountability, not reasons for throwing more money at it.

    So yes, public services are far from adequate

  18. a-tracy
    March 22, 2022

    There are some places to start immediately, if I were in charge I’d be looking at GP services first as there are so many complaints about a lack of face to face appointments when needed.

    Yesterday in the Chester Standard I read a report that some practices have more than 5,000 patients per full-time GP! A couple of GP surgeries only have 795 and 831 patients per full-time GP in the posher towns. One has 6,293 patients per f/t GP.

    Are some of these full-time GPs only doing 35 hours and other doing 70 hours per week? Actually to have six times more patients one would need to work 210 hours per week to offer the same quality of service. It seems some GP practices are coining it in fobbing people off with nurse care instead of GP care, it seems to me they are getting away with this in the poorest areas. It would be interesting to see if that relates to extra visits to A&E in the catchment areas of oversubscribed practices. A GP practice receives on average £160 per registered patient, then payments for tests, immunisations, and a range of top up fees.

    It seems to me there is no oversight and this must be throughout the NHS.

    1. agricola
      March 22, 2022

      For answers to your questions I would suggest:-
      1. Customer satisfaction surveys to compare GPs with 1000 patients with those with multiple thousands.
      2. Check the difficulty in recruiting GPs to high density urban practices.
      3. Train many more GPs.

      1. a-tracy
        March 22, 2022

        1. Good idea, but how do they know what to compare with if they’ve been having this lower level of GP support for many years and have never been to a GP practice in a smart area just 10-15 miles away. If all practices were equal there would be 1594 patients per GP, so how on earth can it ever work for one GP practice to have over 6000! This Council area from one side to the other is only about 17 miles from east to west 20 miles at its furthest point North to South. I wonder how the GP with only 795 patients tops their income up.
        2. Targeted Enhanced Recruitment Scheme (TERS), offers a £20,000 salary supplement to attract GP speciality trainees to work in these under-doctored areas.
        3. Shouldn’t full time GPs in under-represented practices share the burden a little and at least take their fair share? Or are their pay and pensions a lot lower than a GP who takes on 6500 patients?

        1. Iain gill
          March 23, 2022

          To be fair some areas struggle to attract long term GP’s, druggies stealing drugs from GP bags etc can make some places very stressful environments except in short bursts. So sometimes lots of short term locums makes sense to avoid GP burnout.

          1. a-tracy
            March 24, 2022

            Iain and this is where an unfair distribution of social housing kicks in all across the board, doctors, schools everything, when 65% of a Borough’s social housing are in one town then the schools suffer, the GP’s suffer. No more than 25% of housing in any Borough should be social housing.

          2. Iain Gill
            March 24, 2022

            a-tracey, if we stopped school and GP allocation being based on catchment areas then this would be far less of a problem.

            the reality is decent people with a choice cannot live in some places they otherwise would do because that would be to condemn their children into the worst schools and their whole family into the worst GP practises.

            catchment areas discourage different kinds of people mixing which is bad for everyone.

          3. a-tracy
            March 25, 2022

            Iain, my town has been in the doldrums for thirty years and more because of failed Council policies, the private estates do send their children to out of town schools because the local schools have such a lot of bad behaviour, swearing, disruptive children people that put their children in them because of their socialist principles didn’t take long to pull them back out again. But you are stuck with the local GP selection take it or leave it or pay privately at £75 per pop.
            The area is overburdened with social needs they are not shared out fairly. I grew up in a Town just like it and it’s still the same 50 years later some things never change. I care and the local councillors hate it and their dislike for me was very clear so I backed off. Life is too short for that level of local strife!

    2. Mike Wilson
      March 22, 2022

      Our local surgery has 3 GPs. They each work a 3 day week.

      As far as I am concerned the NHS is now pointless. As the largest public sector organisation (I use that word loosely), it will grow and grow and get worse and worse and consume the economy.

      I never thought I’d say this but – it needs to be privatised. This cannot be done at once but, for a start, all hernia, hip and knee operations should be outsourced to private hospitals. All diagnostic procedures – MRIs, CT scans, X-rays etc. should be outsourced. The NHS should be gradually and progressively reduced so that it only provides GP and emergency services. The cost savings should not result in a reduction in taxation – they should be used to pay for basic private health insurance for all.

      1. Iain Gill
        March 22, 2022

        Copy the Australian health system top to bottom.

      2. a-tracy
        March 22, 2022

        Mike, people couldn’t cope without the NHS, there are too many people who take but don’t pay in an even share or anything like enough for their own care let alone a contribution to others. This government have put the majority of the extra burden of 2.5% onto PAYE workers. All those part-time earning under £9500 don’t pay, children, students, retired don’t pay. If it was private who would pay in their subs. However, that doesn’t me we should all expect the same service not one GP with only 795 patients with another next door with 6500 patients to care for.

        1. Mike Wilson
          March 22, 2022

          A-Tracy

          If they did as I suggested, the cost savings of outsourcing elective surgery and tests would mean the taxes that currently fund the hugely inefficient and absent NHS would be available to fund the private healthcare premiums. That way everyone would have cover.

        2. Iain Gill
          March 22, 2022

          you can have a state backed medical insurance scheme into which all pay via tax according to ability, and all get out according to need… without the state owning, running, allocating and rationing care and care provision.

          1. a-tracy
            March 24, 2022

            Iain who would take all those “druggies stealing drugs from GP bags etc can make some places very stressful environments” the State has to treat everyone a private organisation would turn them away. Just like private schools pick and choose their students.

          2. Iain Gill
            March 24, 2022

            check out countries that do healthcare far better like Australia & New Zealand. druggies still get healthcare in those countries.

  19. Iain Gill
    March 22, 2022

    John,

    Well said.

    The other thing that needs saying is that its not better management that makes the private sector better, no its power in the individual consumers hands, and their ability to vote with their feet quickly and simply (no need to complain, or write to MP) move supplier, when individual consumer decisions multiply up they are a compelling force which the suppliers have to respond to. So that forces suppliers to innovate, optimise, and constantly try to find new and better ways of keeping the customers happy. Private sector business units quickly shut when they cannot keep the customers happy, and better ones open in their place. None of that exists in the private “take it or leave it, with a bit of rationing & allocation thrown in” sector.

    Cheers

    1. Iain Gill
      March 22, 2022

      should say None of that exists in the public “take it or leave it, with a bit of rationing & allocation thrown in” sector of course

      1. Iain Gill
        March 23, 2022

        So the real thing to ask for John, taking the criticism of the Con Home readers, is not more central control by ministers (although granted in many cases that is needed due to the dire results of the arms length bodies)…
        the real way to drive continual efficiencies in finances and optimising public service levels… is to hand buying power wherever possible to the end consumer. let them have real continual choice, let them have cheques in their hands to take to any provider they choose, let public sector business units that cannot attract consumers fail – dont bail them out. thats the main thing that needs doing, far more power in the individual citizens hands and far less in the states. that doesnt mean the state cannot insure the citizen financially for when they need these services, it just means the state doesnt need to run them in this top down way.
        the next thing is even where you cannot hand buying power over to individual citizens introduce competition between different public sector business units. the army has shooting, running, fitness, etc competitions between its regiments, which encourages them all to “up their game”… there is no reason this approach could not be adopted more widely.

    2. BOF
      March 22, 2022

      +1 iain Gill

      1. Iain Gill
        March 22, 2022

        thanks

    3. Mark B
      March 22, 2022

      +1

  20. agricola
    March 22, 2022

    Monopolies, which is what most aspects of local and national government are, have no concept of service to those they are expected to serve. Individuals may well embrace the concept of service, but these organisations do not. When approximately one third of what the general public pay for these services is absorbed by the pension funds to support their retirement, that is what they will focus on preserving, above all else.

    The result in supposedly the fifth largest economy in the World is rubbish service wherever you look. In terms of quality of life we are a third world country. Ask the question, who is creaming off the bulk of our supposed success at the expense of the majority. I would suggest it is government feeding their own profligate incompetence.

    Take a simple example of the cost of travel. Railways, effectively a government monopoly, the use of which costs an arm and a leg, but Airlines in a highly competetive market with normally many customer choices can carry you ten times the distance for the same price. Everything government has a hand in costs a fortune but produces indifferent service. Tell me what government does that provides value for money. In most cases we would be better off , and notice it, were the whole ponzi scheme to be privatised.

  21. Original Richard
    March 22, 2022

    The railways have found a way to reduce costs and subsidies and at the same time improve the cancellation and punctuality statistics.

    The new version of the ‘Conditions of Travel’ published last month no longer requires rail companies to adhere to their twice yearly published timetables.

    Instead they are allowed to change the timetable from day to day and produce what is termed the “The Published Timetable of the Day”. This daily timetable must be published by 22:00 hrs the day before on the National Rail website.

    This change will make operating the railways a lot less stressful and cheaper as the rail operator will no longer need additional staff to cover for sickness or pay overtime and they will be able to reduce maintenance costs. Trains can just be cancelled as and when necessary.

    Compensation will only be paid based upon the performance compared to the “Published Timetable of the Day”. Discounted advance tickets will be a gamble.

    https://www.nationalrail.co.uk/National%20Rail%20Conditions%20of%20Travel.pdf

    1. a-tracy
      March 25, 2022

      Original Richard. Bring back Virgin, the west coast service is much poorer, much more expensive and much less reliable now.

  22. Sea_Warrior
    March 22, 2022

    Could we please have a discussion on options for financing the reconstruction of Ukraine. I dare say that MPs will soon be discussing the matter.

    1. Iain Gill
      March 22, 2022

      I thought the plan was to move the entire Ukrainian population to the UK, and leave that country empty for Russia to do with as she pleases?

    2. glen cullen
      March 22, 2022

      I’ve no doubt that Michael Gove would be happy to including Ukraine is his ‘Levelling-Up’ campaign

    3. Nottingham Lad Himself
      March 23, 2022

      Halting its systematic destruction would appear to be the more pressing matter, SW, but yes.

      1. a-tracy
        March 24, 2022

        Hold on NLH last year you were telling us we are now an insignificant little country, so why is so much falling on the UK?

        1. Nottingham Lad Himself
          March 24, 2022

          It isn’t possible to assess how much reconstruction is needed and what that will cost until the extent of the destruction is known, and that cannot be established until it stops.

          So discussions on the first are pointless until then.

          I can’t see why anyone would have thought that I meant anything else.

  23. ChrisS
    March 22, 2022

    A very important contribution to our national debate on public services.

    I have frequently suggested here that the disaster area that is the DVLA should be broken up. Services for English drivers and vehicles should be transferred to a new centre located in the North of England where there will be lots of citizens keen to take on the work and do a first class job, unlike the staff in Swansea.

    Scotland can stick with Swansea or take control of their own service. Scottish taxpayers are used to appalling service from their own devolved administration so I guess Sturgeon will spend millions setting up a new Scottish DVLA which will probably perform worse than Swansea ! Just as long as English taxpayers don’t have to pick up the bill.

    As for NHS England, the civil service should have learnt the lesson from the Blair/Brown years that just throwing billions at it achieves almost nothing, yet here we are doing exactly the same, decades later in 2022.

    The NHS needs to be removed from the political arena entirely so that perhaps English MPs sitting as a separate entity can debate and agree a set of objectives and a budget proposed by the Health Secretary. An improved NHS board of management with a Private Sector CEO would then be 100% responsible for meeting the objectives and staying within a set budget. If they don’t, they get fired.

    1. Mark B
      March 22, 2022

      The NHS needs to be removed from the political arena entirely . . .

      Won’t happen. This is Labour’s primary cash cow and favorite political football. They (think) they own this and are its moral guardians.

    2. a-tracy
      March 25, 2022

      Chris they wouldn’t have to move the English DVLA far it could go to Hereford or Gloucester.

  24. Christine
    March 22, 2022

    “Ministers rarely give us any detail over where all the extra money is going”

    That’s because the public would be appalled that it is being spent on Net Zero and Diversity Managers and changing the names of any departments with the word WOMAN in the title.

    Your Government has become a WOKE-controlled entity and is no longer fit for purpose.

    The British people deserve better.

    1. DOM
      March 22, 2022

      The Inequality Act of 2010 is destroying the very nature of Thatcher’s meritocracy but the jolly band of Tory MPs sit in silence while woke destroys all that we are and condemns millions as aggressors

      The Tories have one purpose, to protect the party from the fascist left. All else is irrelevant all else will be sacrificed in the pursuit of that one purpose

  25. Kenneth
    March 22, 2022

    The public sector is not working.

    Doctors not available; NHS dentists unavailable in some areas; phones not answered; web sites not updated. Backlogs everywhere etc

    There is no point in keep throwing taxpayer money at the public sector until it is made fit for purpose.

    1. Iain Gill
      March 22, 2022

      correct, and its corrupt “some are more equal than others” is alive and well in social housing allocation, NHS queues, best school allocation, etc.

    2. Mickey Taking
      March 23, 2022

      Scientists claim a nearby ‘black hole’ – some have known as NHS.

  26. BOF
    March 22, 2022

    Sir John I think you have described something that is the result of the creation of the NHS and its complete domination of the health sector with the reduction of the private sector to a miserable rump. We witnessed this when lockdown was declared and the private sector was effectively taken over by the NHS, so the NHS withdrew its services and they then shut down the private sector.

    Because of the unions, Labour and disgracefully, many in the Conservative party, nothing will change. Our NHS will not be the best in the world and certainly not the most efficient. But it will always be by far the most expensive.

    The aim should be to have at least 50% of both health care and schools in the private sector to put both competition and efficiency back into the system.

    1. Nottingham Lad Himself
      March 22, 2022

      No, measure-for-measure the US “system” is four times as dear as the NHS.

      1. Peter2
        March 22, 2022

        Sad that anytime anyone wants an improvement to the NHS you (and others) always compare it to America.

        There are some other excellent systems in the world.

        Better than the NHS

        Why not copy the very best in the world ?

        1. Bill brown
          March 22, 2022

          Peter 2

          Document and prove it, stop just telling us what you don’t know

          1. Peter2
            March 23, 2022

            There are some excellent health systems in the world.
            Some in Europe.
            The facts are out there Billy.
            Look it up if you think I’m wrong.
            Otherwise you are just trolling.

        2. Nottingham Lad Himself
          March 23, 2022

          Yet again that is exactly my point.

          The choice is not binary, but pretending that it is serves to inflict what US interests want upon us.

          Again.

          1. Peter2
            March 23, 2022

            Who pretends that American health system is the only one to emulate?
            Not me.
            And not any of the main political parties in the UK
            So I don’t understand why you are claiming they do.

          2. a-tracy
            March 24, 2022

            NLH would you be happier if we gave it over to the German private health companies?

          3. Nottingham Lad Himself
            March 24, 2022

            I think that the UK should look very seriously at some of the countries on the Continent for ideas on public health, certainly, but definitely not at the US.

            I’d prefer this country to set up its own institutions and entities to implement any change, whatever.

          4. a-tracy
            March 25, 2022

            But this Country’s NHS is clearly not capable of necessary change and movement within its institutions which seems to a lot of the patients stuck with the service they are offered inadequate. It is a postcode lottery and some areas have very good service and don’t understand what others are moaning about. When one GP has 900 patients and another GP 6500 then is just one indication of the unbalanced resources that a blind eye is turned to.
            No one here is proposing a US version of healthcare, Iain said Australian yesterday why do you keep going on about the USA?

          5. Nottingham Lad Himself
            March 25, 2022

            Tracy, because it is US vested health interests greedily eyeing NHS assets right now, that’s why.

      2. Mickey Taking
        March 22, 2022

        but they get immediate service, prevention care, early diagnostics which then reduce later costs of allowing a health issue to get worse – costing more. Downside – only the comfortably off can afford it.

  27. Geoffrey Berg
    March 22, 2022

    It was ever thus. Over 40years ago I was a young Conservative Councillor in Bury when Bury was ‘Conservative controlled’. The Committee Chairmen used to boast how much the Committee they chaired spent, oblivious to whether it was providing value for money(which, as now, it wasn’t). Most Committee discussion was on items about how to expand and beat the budget by squeezing more money(such as social services forming disadvantageous ‘partnerships’ with the local health authority). The poor taxpayers who elected us were forgotten between elections and Councillors heeded instead senior Council Officers who were greedy for money, none too competent and certainly not Conservative in outlook even though some of them voted Conservative at elections. How I wished the budgets were rigidly fixed by law so that debates would change to how to get the maximum value for the budget.
    Bury Council then was not particularly bad nor good for a Conservative Council, just run of the mill. Most of the failings(and I made myself noticed and unpopular with some, not all, my Conservative colleagues in trying to resist some of them) came from the two facts that Councillors keep bad company(self interested Council Officers) and they are just freely spending other people’s money. These are inherent and systemic public sector failings but they can be alleviated somewhat by privatising what one can (even if as in the NHS it is publicly funded) and secondly by making each part of each public body spend only what the least expensive public body in its sector spends.

  28. forthurst
    March 22, 2022

    One of the disadvantages of services paid for by the taxpayer is that they are invariably run by Arts graduates, a category of educated persons that some countries seem to be able to manage very well without. The reason that other countries dispense with this category is that they are not beholden to the myth that learning about something irrelevant, uniquely qualifies the gradate to meddle in matters they do not understand; thus someone with an Oxford politics degree is qualified to perform any administrative task in the public sector and even some in the private sector until the complaints from dissatisfied users reach a crescendo. What many Arts graduates like is to organise everything into an hierarchy; this provides them with the things they love, namely, the endless opportunities for writing reports for each other to read and the endless opportunities for debating amongst themselves and, not least, the opportunities for massive salaries for those higher up the food chain.

    Needless to say some of the worst examples of the Arts graduate as ignorant meddlers are politicians which is why we have the worst public services in the western world apart from the USA where everything is done for profit and anything else doesn’t get done (apart from giving freebies to foreign invaders, a Tory trait also).

  29. X-Tory
    March 22, 2022

    An article that gives lots of examples of how the current system is failing but offers few solutions. The problem was very succintly and accurately described by Milton Friedman when he explained that people who spend other people’s money on other people have no interest in getting either good value or good quality. So the problem is well known and the real question is: ‘how do you incentive officials to spend more wisely?’ Your suggestion that we should “change the odd chief executive” touches on the answer but is much too limited. Not only are you only talking about the NHS but most day-to-day spending decisions are made lower down the chain.

    The only effective solution is to change the terms of employment of ALL public servants so that they are ALL liable to dismissal if they underperform, without the current long-winded and convoluted system of written warnings and second chances. And since public officials may be reluctant to sack their colleagues, the power to sack officials who do not do a good job must be extended to their political masters, be they government ministers or local authority councillors.

    The government, however, are much too weak, cowardly and stupid to do this. They would be afraid of the inevitable strikes that would arise, instead of seeing these as an excellent opportunity to get rid of all the dross. Officials should be warned that anyone going on strike will be sacked – this will ensure that only the most militant do so, and sacking these would be a huge bonus which would improve the quality of the services we get immensely! We are cursed however by politicians who do NOT want any real power. Why they are so pathetic, useless and stupid I have no idea.

  30. acorn
    March 22, 2022

    Sadly JR, Westminster and Whitehall combined, have no engineering capability to enact your fantasy Brexit vision. A laissez faire neoliberal capitalist government, dedicated to a “free market” ideology, can never orchestrate want you desire.

    For example your “free market” delivered Smart Meters for gas and electric services. The government allowed multiple propriety systems to be implemented and ended up with systems that could not communicate with each other. Likewise, the electric vehicle charging infrastructure. The government has allowed multiple different charging regimes,requiring customers to sign up to several different and incompatible supplier systems. Fortunately, the industry has itself decided on what standard plugs and sockets to use.

    In nature, random development is allowed to flourish; but, nature carries out selection events at some point and decides what will go forward to the next selection event. It resets the previous random development process back to zero.

    Conservative governments are incapable of carrying out the selection event. Incapable of choosing a system that will be the national standard forthwith.

    1. Peter2
      March 22, 2022

      Who is this free market laissez faire neo liberal government you refer to acorn?

      1. Bill brown
        March 22, 2022

        Peter 2

        It seems pretty clear to everybody else

        1. Peter2
          March 23, 2022

          That isn’t an answer to my question Billy.

  31. Bill brown
    March 22, 2022

    It seems pretty clear to clear to everybody else

    1. Peter2
      March 23, 2022

      And that isn’t an answer to my question either.

  32. glen cullen
    March 22, 2022

    Public service survey – does anybody recall the last time they saw a policeman/woman walking the beat (and I don’t mean police in a car or police community support officers or police following an incident)

    1. hefner
      March 23, 2022

      Why should they walk the beat?
      There are between 5 and 6 million ‘public’ CCTV cameras in the UK. Don’t you think it is much more convenient to be comfortably seated and watch a screen when the software might (possibly) trigger an alarm because of ‘unusual motion’?

      For that, I only got a 4.3% increase (wrt last year) on the Thames Valley Police & Crime budget on my recent Council Tax bill. Don’t you think it is a bargain given the 6.2% inflation rate? 😉

      1. glen cullen
        March 23, 2022

        So you can talk with them, pass on any intelligence, feel reassured….prevent crime

      2. a-tracy
        March 24, 2022

        hefner, this is ridiculous you can’t rely on CCTV alone, recently I reported a group of kids in a skate park that had an Asda trolley at the top of the ramp with little kids with them and I asked for a pcso to go and confiscate the trolley and make sure they didn’t put a little one in it to send down the ramp.

        A teenage boy with a balaclava whizzed past me on his expensive electric bike on the pavement on his usual drug run, if I know where it happens local beat bobbies would.

        There is a CCTV loud and proud near a local shop but it doesn’t stop kids being put in bins and raced around a car park, it didn’t stop a young man being stabbed and losing his life within site of the camera. In some leafy suburb cctv might be sufficient but other areas they are not.

        1. hefner
          March 25, 2022

          I see that even putting a 😉 to end up my comment with did not ‘ring a bell’ with you. Sorry.

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