My Speech on the NHS Long-term Strategy – Opposition Debate

Rt Hon Sir John Redwood MP (Wokingham) (Con): No one can deny that the health service is under extreme pressure. No one can look at it and not realise that there has been a big surge in extra demand, that there are problems from the hangover of covid when a large waiting list for less urgent treatments built up, and that we are short of doctors and nurses, not because Ministers will not authorise their appointment but because there are vacancies to be filled. As one of those who has been urging for some time to see a published workforce plan, I welcome the decision of Ministers to insist on that, and the sooner we get it the better. However, I am quite sure that there are a whole series of workforce plans already in the many dozens and hundreds of working trusts and quangos that constitute the NHS. It is about aggregating and making sense of those plans.

Yes, indeed. From my hon. Friend’s own expertise, I am sure she is right. When people talk about productivity, they do not believe that hard-pressed staff have to work harder; they are saying there must be smarter working, making jobs more manageable or enabling them to concentrate on the things they are most skilled at, with more relief for the other necessary record keeping, which may indeed need slimming.


Dr Caroline Johnson (Con): We often talk about the shortage of doctors. We know we cannot create a doctor overnight. It takes a substantial amount of time to train them. The Chancellor, a former Health Secretary, invested in five new medical schools to increase the number of doctors in training. Does my right hon. Friend agree that the Chancellor, with the Health Secretary, needs to invest more money in more medical schools and medical school places, but also look at how we increase the Toggle showing location of Column 647number of doctors by reducing the amount of bureaucracy and paperwork they have to fill in, so that they can spend more time doctoring and less time filling in forms?


Rt Hon Sir John Redwood MP (Wokingham) (Con): My hon. Friend is right that we could expand our training places further, but as we have heard there has been a big increase in educational provision and it takes seven years for it to flow through. I am glad we are getting to the point where we will see some benefits from that. We need more homegrown talent. Many people are attracted to the privileged career of being a doctor and the more we can allow to do that, the better. However, given the immediate urgency of needing more capacity, and therefore more doctors and nurses, the most obvious place is to look at all those who have already had the training and have left the profession or the NHS for one reason or another. Some may be in early retirement. That is probably not something my hon. Friend wants to change because she enjoys her new job, but there are many others who are not in a very important job like her who might be attracted back. I hope the Treasury will be engaged in the review, because I hear from doctors, as many do, that the quirk in the tax system at just over £100,000 where some of the better paid doctors are resting, producing a more penal 60% rate, is an impediment to extra working. I also hear about the pension problems that have been cited on both sides of the House. The Government need to take those issues more seriously if they wish to accelerate returns.

Ministers have very clearly set out that they want more NHS staff and have obtained much larger budgets in the last three years to help bring that about. They have also said very clearly that the public’s priority—and indeed the Opposition’s priority—is to get more treatments and get those waiting lists and waiting times down for those needing more urgent or emergency care. Those Ministers must translate that through the senior health service managers into ways of spending that extra money. If it needs a bit more extra money, there is always some extra available—every time we meet another additional sum is announced—but it has to be well spent. It has to be spent on motivating and recruiting the medical workforce.

I had better not, because we are very short of time for colleagues.

The money has to be well spent and I hope that senior managers, as they give us a published workforce plan, will share more of their thinking. It is not good at the moment that there is such a breakdown in relations with talented and important staff in the health service. There is a complex system of pay reviews, increments, promotions and gradings of activities. All those things have flexibility within them. I look to the senior managers

We need more supply because there is excess demand, for understandable reasons. Huge sums of money were tipped into the system to deal with covid. Not all of it was well spent, but that was understandable given the unknown nature of the beast at the beginning, and the obvious pressures in this place and elsewhere to get instant results with personal protective equipment, testing and so forth. That is now behind us, but unfortunately it disrupted normal hospital work and normal GP work and created backlogs.

I urge the Government to understand that part of the answer is having more bed spaces in hospitals, with the staff to back them up. I do not know why so many senior health executives never want to admit that. They always say that there are lots of bottlenecks and other issues. Yes, of course we need to move people on from hospital as soon as it is safe to do so, and of course we need more capacity in social care, but I say to Ministers that it would be great to have a bit more capacity in the main hospitals to give us extra flexibility and take some of the pressure off. Could not some of the extra £20 billion, £30 billion, £40 billion or £50 billion that has been found in recent years be spent on the combination of physical capacity and the staff to support it that we so need?


  1. Javelin
    January 13, 2023

    The strongest argument against the soul-destroying 50+% taxes are often 50+ years old. I will call them the 50++ people. They have paid their mortgage and most of their pension off. These people are often the most productive not just for their company but also for their country.

    The argument is simply weariness. These 50++ people often don’t have to actually work that hard. They earn that money because have found a way to be very productive. This is not what Marxists want to hear, but it is true. So when you tax them at 50+% and they get to 50+ years they just start counting the days down to retirement when they will become a burden on the tax system. Which is exactly what is happening.

    1. Nottingham Lad Himself
      January 13, 2023

      Sir John conflates issues.

      Yes, the NHS would benefit from more UK educated clinical professionals.

      However, today’s acute crisis is caused largely by bed occupancy caused by a lack of capacity in intermediate care.

      That is largely down to the people who used to come here from other parts of Europe to work in it no longer coming, and many who were already here going home.

      Apparently we were supposed to “suck it up” and “get over it”.

      1. Sir Joe Soap
        January 13, 2023

        Why should we need to rely on stealing folk who trained elsewhere?
        These people are needed where they themselves trained.
        Are we too slow or stupid to train our own people?

      2. Dave Andrews
        January 13, 2023

        In most societies, the family would care for their old, but in ours the family all have to go to work because of the astronomical cost of living. We also have the problem that people who previously would have died of old age, are kept alive with modern medicine in a decrepit state.
        We’ve got it wrong if we have to depend on cheap foreign labour to do care home work.

        1. Narrow Shoulders
          January 13, 2023

          very well put

        2. Mickey Taking
          January 13, 2023

          But due to the difficulty in making a home anywhere near parents combined with work or even university, the young move away miles from parents. When the time comes for possible support, geography, their own social life, children and schooling rather get in the way. Mobility of labour doesn’t do us favours in society.

      3. R.Grange
        January 13, 2023

        NLH You forgot to mention the many care home workers who did not accept the government’s vaccine mandate in late 2021, and left the sector.

        You also avoided mentioning the ‘health tourists’ who according to Fullfact in 2015 were costing the country £1.5 billon a year.

        How much now, I wonder?

      4. James Freeman
        January 13, 2023

        There are 11% more nurses now than in the pre-pandemic period, but NHS output has reduced by 5%. There might be a shortage of care workers, but this is likely due to sacking many of them for being unvaccinated rather than conflating it with Brexit.

        The real issue is the NHS now has got the funding, medical staff and structure it wanted. It now needs to deliver in terms of treating more sick people. Sir John is right to push the government on this point.

        We set up fully equipped Nightingale hospitals in 2 weeks. It should be possible to create much more basic convalescence wards to relieve the pressure at the drop of a hat. With their lack of action, the Health blog is telling the public to “suck it up”.

      5. a-tracy
        January 13, 2023

        In June 2016, there were 58,702 NHS staff with a recorded EU nationality, and in June 2022 there were 70,735 – an apparent rise.22 Nov 2022

        1. Bill B.
          January 13, 2023

          Nice work, a-tracy.

        2. Narrow Shoulders
          January 13, 2023


        3. Mickey Taking
          January 13, 2023

          I won’t bother to research exactly what year but I was admitted for a minor procedure to RBH about 2016 possibly a year or 2 later. I realised a very pleasant female was going to deal with me, she sounded ‘foreign’. I casually asked whether she was British or not. She smiled and replied Portuguese. I smiled back and said why do you work here? She again smiled but said in a pointed way ‘I wanted to work, and I like England’. I answered you are very welcome here. End of conversation.

        4. Mike Wilson
          January 14, 2023

          In June 2016, there were 58,702 NHS staff with a recorded EU nationality, and in June 2022 there were 70,735

          But that would mean the Nottingham lad is talking undiluted nonsense when he says there are less due to Brexit. How can he have got it so wrong? Making up figures to try to justify his beliefs? Surely not.

    2. Anselm
      January 13, 2023

      When, as a young teacher in the 1960s, I asked my Head of Department why he didn’t do night school, he told me that, thanks to heavy taxes, he would be paid just 6d an hour and it wasn’t worth it.
      Now my own children are in their 50s. The one that works in UK is thinking exactly as you describe. Abroad, where the taxes are much lower, my children are all, without exception, earning a lot of money and thoroughly enjoying their lives.

  2. turboterrier
    January 13, 2023

    It is not just about learning the basic and core skills of the profession. It’s about learning about the associated subjects and skills that impact on life in the real working place.
    Communication , problem solving, team working, right first time, cost of non conformance costs in time and identifying waste in procedures and processes.
    In too many visits to hospital it is common to hear “not my job, don’t get enough time to do that” and the problems that impact on their job by other internal departments is not fully understood.

  3. Mark B
    January 13, 2023

    Good morning.

    Sorry off topic again. But where is Lifelogic ? Is he gone on holiday again or something ?

    . . . there has been a big surge in extra demand . . .

    To the tune of over half a million a year it seems. And they want more !

    Clearly stupidity, like our immigration policy, knows no bounds.

    1. Nottingham Lad Himself
      January 13, 2023

      Ahh, missing your safety-in-numbers companion?

      Sir John may well write about the NHS, but his party really don’t care – it wouldn’t have come to this if they ever did.

      No, their intentions are more clearly revealed by the recent declaration that they want to turn the UK into a cryminocurrency hub.

      1. Mickey Taking
        January 13, 2023

        I have wondered whether you are missing your protege? Pointing at all UK issues revolved around the elderly, and the sooner we were gone the better often gave us a satisfied grin, as do some of the points you make regularly when not noticing the curtains twitching.

    2. Hope
      January 13, 2023

      I suppose if you invite the whole of Hong Kong, Afghanistan and Ukraine here plus 1.2 million visas issued it might cause extra demand!! Idiots wonder why there might be a problem or taxpaying people get cross! This probably escaped JRs questioning.

    3. Cuibono
      January 13, 2023

      Agree 100%
      They will soon get trampled by all those elephants in the room!
      Unless of course it is really about answering to a higher authority?
      Not we, the voters, of course.

      Or maybe in their all consuming arrogance, they think they can repeat The Miracle of the Five Loaves?

    4. Lifelogic
      January 13, 2023

      Few can surely deny that the NHS is appallingly organised and run and has been so for years. This despite having many excellent and often very underpaid medical staff. Why was Amanda Pritchard (a dopey history graduate) I think ever appointed? Why was she preceded by another dope (PPE) this time. Put some experienced quality medics in charge who understand what customers want and need. Also charge all customers who can afford to pay something and get customer feedback.

  4. Donna
    January 13, 2023

    It’s very optimistic to have a debate about long-term NHS Strategy when you’ve been in power for 13 years and are – deservedly at around 20% in the polls.

    There’s not much point training thousands of new doctors and nurses if they are not “locked into” the NHS for a lengthy period. Change the training and employment contract so that they pay no university tuition fees (not accommodation, just the training fees) in return for a commitment to work in the NHS for 10 years after qualifying.

    1. Sir Joe Soap
      January 13, 2023

      This is such an obvious solution that it will never be enacted.

    2. Anselm
      January 13, 2023

      Labour is paid a lot of money by, of all people, Unite and the Boiler Makers Union to prolong the NHS strikes. We voters just do not seem able to have much of a choice here.

      1. Mark B
        January 14, 2023

        This is the point I have been making – CHOICE !!!

    3. Berkshire Alan
      January 13, 2023

      + many

    4. Stred
      January 13, 2023

      Over 40% of newly trained docs now prepared to emigrate to avoid working in the NHS. More than half new doctors are now women who then wish to work part time and look after their children.

      1. Mark B
        January 14, 2023

        If only we had a low tax economy ?

    5. a-tracy
      January 13, 2023

      Donna just don’t charge the graduate tax 9% when doing 40 hours per week for the NHS.

  5. DOM
    January 13, 2023

    ‘No one can deny that the health service is under extreme pressure’. This statement explains perfectly why the Tories will never confront the issue of a dysfunctional NHS.

    1. Narrow Shoulders
      January 13, 2023

      Succinctly put!

    2. Lifelogic
      January 13, 2023

      It will never work while free at the point of use and is run largely by non medical people (like the dire current and last CEO) mainly for the convenience of senior staff. How many thousands have dies just due to the far worse care given at weekend (clearly not run for customers who fall ill at all times of the week). Free at the point of use means you have to deter by delays and non delivery of services so that is what happens.

  6. BOF
    January 13, 2023

    Good speech Sir John. But no mention of the insane waste of money on diversity and inclusion managers and presumably the mini empires that each one creates. This is a golden opportunity to scrap all all of these waste of time jobs to provide money from within the NHS budget.

    Or is this another area that may not be mentioned. Career destroying, like coming out against the untested, life and health threatening, gene therapy jabs. Even quoting official government data on victims is dangerous.

    My MP, always keen to reply to emails, is non responsive to my questions on this subject.

    1. Donna
      January 13, 2023

      To do what you suggest they would have to repeal, or substantially amend, the Equality Act 2010.

      A Conservative Government might summon up the cojones to do that, but we don’t have one of those: we have a Pretendy-CON Government which is terrified of being thought of as “nasty.”

    2. Pauline Baxter
      January 13, 2023

      BOF. Yes I agree. You have hit the nail right on the head. Or rather – several nails bang on their heads!

  7. turboterrier
    January 13, 2023

    The consultants I know would rather go back to the old days of cell (team) working where they had their own team trained to accommodate their style and method of working by where everybody knew what happens and is needed next from patient arrival to discharge.
    Not wondering what scrub, theatre nurse would be there on the day.
    It is better for the patient because every part of the procedure is dealt with by people who know exactly how the system works and what is required.

    1. Cuibono
      January 13, 2023

      +many, many
      Oh dear me no!
      You can’t have that!
      It WORKED!!

    2. Anselm
      January 13, 2023

      I know a consultant very well and he said exactly the same thing.

  8. Narrow Shoulders
    January 13, 2023

    We keep hearing that the NHS has suffered from 10 years of underfunding. The NHS gets money every time it asks for it and at present has much higher funding than ever as the Covid boost does not seem to have been withdrawn.

    Someone should respond to those shouting about funding “Where has all the money gone?” because it certainly hasn’t gone into front line care.

    I chased an invoice owed by an NHS Trust last week, I became embroiled in an email trail which involved 10 (yes 10) internal people all denying responsibility and passing the buck which went on for two days. In my world it would have been solved with a direct telephone call between two people. Eventually the Director of Procurement solved the issue (email recipient number 11) who I would hope has larger responsibilities than payment of a relatively small invoice.

  9. Mary M.
    January 13, 2023

    ‘ – there are problems from the hangover of covid . . .’ I beg to differ. There are problems from the hangover OF THE GOVERNMENT’S RESPONSE TO covid.

    Sir John, you also said ‘the most obvious place is to look at all those who have already had the training and have left the profession or the NHS for one reason or another . . . ‘.

    I’m sorry you didn’t mention one of the main reasons for people leaving the profession – the vaccine mandate that was heading their way. Many jumped before they were pushed. The Government had already shown it meant business when it mandated the vaccine for care workers (no jab, no job), forcing about 40,000 to leave the industry. This huge loss would cause a devastating knock-on effect on the NHS, one of which was bed-blocking by patients fit enough to leave hospital had there been a care package in place at home. This was obvious to the average man and woman in the street but not it seems to the Government.

    One way that pressure on the NHS could be eased is for the Government to attract those care workers back. As I’ve mentioned before, “together” in their open letter to Health Secretary Steve Barclay suggest ‘apologise, reinstate, compensate’.

  10. Cuibono
    January 13, 2023

    People can not wait to leave the jobs that successive govts have utterly ruined with their ludicrous nonsense.
    Why else was that abysmal imprisonment so welcomed by workers?
    Workplaces now are the stuff of nightmares.
    Get rid of wokery and the workers will come!

    1. margaret
      January 14, 2023

      Let me make this clear. I have worked in every aspect of primary and secondary care for 50 years . There is nothing that I haven’t been a part of in this time . I have seen all the changes and welcome some very advanced surgical technology and medical advances.
      Management cannot think of the patient/ person as a whole ;they try to piece work everything putting tasks as the centre of the whole person.
      As an Advanced Nurse Practitioner for 20 years I consult a patient . take the necessary physiological tests at that point and on the day , prescribe for new problems and adjust medication. Anything more complex where i need support would go to the lead GP . I refer patients to specialists where they need attention including 2 week referrals for suspicious pathology.
      Due to unfortunate illness , management have stepped in . They say we need more Drs .and have acquired locums who see patients but don’t do anything else, so now we have hundreds of referrals not done , we have hundreds of requested blood sampling labels without anyone to take urgent bloods, We have lots of reviews , titration and monitoring of newly medicated patients, but because the young Drs have got into the habit of piece work and taking the credit for everyone else’s work , the situation is getting worse and overloaded. Prior to management interfering, things ran smoothly and I knew the patients and where I was up to on a daily basis. They are creating havoc. This is with three extra Drs.!
      The problem is patients need all their physiological tests to aid diagnosis they need ECG’ which I undertake and get contact with a very good telephone remote service . I have results and print outs sent to myself or the lead GP. Myself , having opened 2 Coronary Care Units in the past, been a peripatetic cardiac specialist Nurse , undertake these tests. The locums who have only done a few years then take the credit for the work I do ,and everyone says it is the Drs . It is not.
      The Drs will not do smears or gynaecological investigations. They write labels for a phlebotomist to take incomplete investigations , don’ t follow them, up so I have to start at the beginning again. It seems as though the patient turnover has improved and managers will report this , but all the patients come back to me to be properly investigated and everything started again. When will the establishment stop giving the credit to these green half hearted locum GPs’ who refuse to complete these ‘tasks’ and what is more do not have the skills. They are not consultants ,, they should be practitioners.

  11. Anselm
    January 13, 2023

    I know a very senior executive in a world class oil company. He makes a point of visiting each of his oil wells regularly. Good Senior Teachers are there watching over the children in the corridors. Good headmasters are there welcoming the parents and children in the morning.
    I went for a blood test and people were waiting for the nurses to arrive and open the clinic. They were ten minutes late. When it got to 20 minutes, I knocked on the door of the “Patient Waiting Time Management” office. Nobody there. When the lady officer in smart suit and spectacles finally turned up, I asked her why the clinic still was not open. She looked at me in amazement: “What has that got to do with me?” she asked.
    I wonder how many of the people who appear on telly as experts on the NHS have actually emptied a bedpan or diagnosed terminal cancer recently? I wonder when any of the thousand Senior Managers have actually set foot in a ward in their own hospitals in the last week?

  12. majorfrustration
    January 13, 2023

    The political essentials of both Labour and Tory Governments towards the NHS have been four policies:
    financially kick the can down the road, don’t rock the boat , talking of change in the vain hope change will happen and appointing retired civil servant /general to undertake a review which takes the problem off the table for twelve months or so.

  13. IanT
    January 13, 2023

    “However, I am quite sure that there are a whole series of workforce plans already in the many dozens and hundreds of working trusts and quangos that constitute the NHS. It is about aggregating and making sense of those plans”

    And here we get to the heart of the problem. All these Fiefdoms that no one seems to be managing. We either have 150+ separate (unaccountable?) Trusts, plus all the other NHS Units/Quangos or we have a single NHS. Which is it? In my business dealings 20+ years ago – the Trusts were largely self-governing it seemed. In my more recent personal experience, there are large differences in performance between Trusts – in effect a Post Code Lottery. NHS Central should get a very hefty kick up the Buttress and told to produce their headcount plan pronto – and likewise for all NHS ‘Cost’ (P&L) Centres. The fact that this doesn’t seem to be happening currently is beyond belief!

  14. Bloke
    January 13, 2023

    Previously, an individual’s case of extreme suffering was regarded as national disgrace. It attracted headlines spanning weeks, prompting singular investigation in rigorous pursuit of remedy.
    Now there are hundreds of such cases near-daily and many not even mentioned. Patients waiting 12 hrs for an ambulance, writhing in pain on the floor and being left unattended by hospitals are now so common their plight is widely accepted as the norm.
    This unhealthy Conservative Govt is engaging in national self-harm as if intent on its own destruction. What next?

  15. Bryan Harris
    January 13, 2023

    We hear talk of getting more doctors, which of course is vital, but what is being done to get more home-grown nurses trained and available.
    Nurses are the backbone of the NHS, without them there would be real chaos, but we need them badly because it is doubtful that they can currently give the full attention to patients that is required.

    More beds – Yes please, but the procurement processes and service level agreements the NHS has must also be vastly improved. Over and above this of course bureaucracy must be reduced and we want an end to diversity managers!

    We hear about a vast increase in mental health problems – The government can, if not cure it, greatly reduce it, and save a small fortune, by stopping the constant barrage of worrying information about covid and new lockdowns that scare people silly.

  16. Original Richard
    January 13, 2023

    Although there are many good people in the NHS it is infested with fifth column communists acting like parasitic wasp larvae eating the NHS from the inside with Marxist devices such as diversity to destroy meritocracy and team spirit.

    The NHS is a perfect example of Robert Conquest’s second and third laws of politics :

    – “Any organization not explicitly right-wing sooner or later becomes left-wing.”

    – “The simplest way to explain the behaviour of any bureaucratic organization is to assume that it is controlled by a cabal of its enemies.”

    The NHS is further pressured by deliberate mass immigration (legal and illegal).

  17. forthurst
    January 13, 2023

    What proportion of English doctors went to selective schools whether private or one of the few grammar schools not destroyed by Thatcher? Medical training starts from an early age with children having the opportunity to study
    the academic sciences: Physics, Chemistry, Biology.
    If the Tory party was really concerned about the shortage of doctors, it would make sure that every child with academic ability was able to attend a selective school where their potential could be developed and from which some would select medicine as their career choice.
    The promotion of equality of outcome and Critical Theory needs to be deep-cleansed from the school system.
    The process of giving heavily enriched local authorities more cash than others needs to end; getting more third worlders into careers with high status is not a public good; it’s ant-English spite.

  18. glen cullen
    January 13, 2023

    The Pareto 80-20 rule
    80% of the NHS is okay – 20% in crisis ….and always will be in crisis without structural change and alignment similar to our military ie a national service and not a fragmented service
    We’ve designed a perfect organisation to deflect blame – doctors blame management, ambulance blame A&E, nurses blame politicians, management blame social health care and patients blame immigrants, the trusts blame the budgets …its always someone else to blame

  19. Mickey Taking
    January 13, 2023

    off topic.
    Richi needs to save a simple £4bn in the coming tax year.
    Solution: HMRC DATA revealed to the Resolution Foundation think tank, that 70,000 (0.1 % of population )of rich people claimed up to 5 tax reliefs saved on average £50k each.
    Instant vote winner – apart from the mean ones among the 70,000!

    1. glen cullen
      January 13, 2023

      again off topic
      As of January 1st, the Chinese government no longer provides subsidies to buyers of electric vehicles. Britain should also stop subsidising the purchases of these EVs to the wealthiest in our society
      Also reported today that Tesla and other EVs manufacturers are reducing the price of EVs by 10-20%, so our taxpayer subsidy was just upping the profits of these companies
      Start being a conservative government, have confidence in freedom of choice and free market forces

  20. Rhoddas
    January 13, 2023

    A not untypical experience would be this… my mother in law aged 84 visits GP with persistent back pain and indigestion issues. Scan arranged at local hospital scanner .. 1
    week, then GP phoned her to indicate scan showed it was likely ovarian cancer (wrong to telephone this serious news) and referral to oncology consultant at another hospital.. different trust. Attended said appointment in 2 weeks and consultant claimed he could NOT see scan results as different health trust. Didn’t have right IT access, so a waste of time. Pathetic. So insread if resolving IT access, he ordered another scan at his hospital… 2 weeks.. cost of duplication £300. Another consultation 3 weeks, more cost. Outcome was thanjfully no cancer, but diverticulitis and sent on her way without dietary advice.

    All the worry about cancer for well over 2 months.

    And the NHS wonder why patients are hacked off, plus family members. Petrol costs, nhs car park costs..

    Plenty of nhs capacity if they did their work right first time. …

  21. Ian B
    January 13, 2023

    All fine words once more Sir John

    This question could have been asked 12 years ago when the Conservatives came to power. In those 12 years not a single thing appears to have been put in place to address the problems of what by World comparisons is a broken unworkable system.

    The NHS as one of the Worlds largest Marxist projects that just can’t be made to work because it is dis-incentivised from the get go. The problem is not with the amazing clinical staff, but the system that keeps generating a management structure that isn’t required to achieve to earn. There is no responsibility or accountability placed on management to function effectively, it come over as one of these jobs-for-the-boys that couldn’t find employment in the real World.

  22. Ian B
    January 13, 2023

    Sir John
    A recent Publication from The Kings Fund looking at NHS funding and expenditure shows that the comparison to the pre-pandemic year and now the NHS has received and an additional £88 billion in funding. That equates to an uplift of 27%.

    After allowing for inflation the NHS could used that money to build and commission some 40 plus state of the art new hospitals. They haven’t

    Obviously more hospitals, more beds, more doctors, more nurses etc. could not have be gained in such a short space in time. So the money wasn’t spent on those. However, the NHS Management have still consumed and spent an additional £88 billion of taxpayer money – they had to spend the money or loose it. Bizarre thinking. That plays into the MsM theories that management have boosted their own empires with expansion in unnecessary non-clinical staff, the WOKE brigade, the Diversity managers the Inclusion managers. But serving the Customer no chance, ias we have seen t just didn’t happen.

    All this once more falls at the door of Government, they refuse to manage. As we have seen money is not the answer, when no one in Government knows were and for what purpose it goes on, they just no they threw it somewhere in hope, no one takes responsibility or is accountable, what we have a Government in denial of its job. They do not recognise they are the problem by persueing the miss-guided concept that it is tax and not the economy that will solve all ills. They are conditioned into seeing tax as a magic money tree and not a finite resource. This then plays into the NHS, as warm and cuddly and altruistic the dream without real accountability, real customer service( the value for money bit) it will remain a tortured problem. It is broken o amount of money or tinkeing canmend it – but, good Government if it wanted could.

  23. Ian B
    January 13, 2023

    Reading the Comments here I would suggest people are missing the real issue. No one not even those we appoint on our behalf is ‘Managing’. Without that one element nothing will change.

    We are forced to dump bucket loads of our hard earned money having removed it from the economy as tax into the Governments hands for them to spend on our behalf. Government has got into the habit of just throwing it at the wall in hope. No one in Government is held accountable or is responsible once this money leaves them. In turn they don’t hold or require every hard earned tax pound to be accounted for or produce a service from those in receipt of it, in fact they just ‘give’ it away.

    1. Nottingham Lad Himself
      January 13, 2023

      Well, I broadly agree with your opening point.

      Managements in Tory Britain are part of the intended in-group whom the law protects but does not bind – like government – and the front line workers are to be the out-group, whom it binds but does not protect. (See also Grenfell Tower).

      Consequently they will never be required actually to manage, because then they could be held accountable when things went wrong, as they all too frequently and terribly do in the world of public health provision.

    2. Mickey Taking
      January 13, 2023

      Do any NHS staff, especially ‘managers’ have objectives set and agreed, with KPIs identified ?
      How do any line managers perform even a slight assessment of performance of people in their team/structure?
      Seems like an intention to just shrug and blame ‘the System’.

  24. X-Tory
    January 13, 2023

    I now can only laugh contemptuously whenever I hear ministers talk of their strategy, or plans, or promises, or the like. They are so STUPID, and so INCOMPETENT, that they will NEVER achieve ANYTHING. They are beyond hope, because they do not understand the two main causes of almost all the problems that they face. The first is that they are utterly powerless – and are too gutless to resolve this. On today’s topic of the NHS, we have the recent examples that despite Steve Barclay, the Health Secretary, apparently wanting “a crackdown on diversity jobs in the NHS” these posts are costing the NHS Trusts around £15 million per year. Why hasn’t he sacked these useless parasites? Oh yes, because he CAN’T. And what has he done to take the power to do so? Oh yes, I remember now … NOTHING. Just like he has done NOTHING to sack the management of The Royal Free London NHS Foundation Trust who have demanded that interview panels either recruit ethnic minorities or justify hiring whites. I have previously explained that nothing will ever be achieved until ministers get the powewr to SACK anyone they are not satisfied with. But the government is too gutless to adopt this policy.

    The other problem that ministers refuse to face up to is that almost all the UK’s problems stem from the fact that we are GROSSLY OVERPOPULATED. This is why we have a housing shortage, a need for more energy, transport congestion, rising welfare spending, and, of course, excessive NHS demands. I am in favour of migration by highly skilled professionals, but most of those who come here do not meet this criterion and are a huge DRAIN on our resources. They do NOT increase GDP per head, they reduce it. They are benefit parasites who need to be housed, schooled, fed and medically cared for. Reduce the demand on the NHS by deporting the 2 million-odd illegals here and things will immediately begin to improve. But will the government do this? Of course not – it would require repealing the Human Rights Act, which Sunak the Traitor will never do. That’s why I will never vote for him.

  25. a-tracy
    January 13, 2023

    In England in a 2013 paper I read written by nhsproviders, it said the NHS in England did 10 million operations per year in 3000 Operating theatres, 1200 procedures per theatre pa.

    The majority of these patients undergo planned or ‘elective’ operations, but 18% of procedures are for patients requiring emergency surgery.

    So in 2020-21 if 8 million operations were cancelled it is going to be a feat to make that up without importing medical specialists who can work in the operating theatres that are active for 35 hours per week in that report. 10% of operations are cancelled in some theatres although the best performing only cancelled 3%.

    Each theatre hour was worth £561, £65% being staff cost, I wonder how much it is in 2023 if I find the information I will share it.

    In 2022 I found the following: According to the NHS, A TYPICAL DAY includes: Over 835,000 people visiting their GP practice or practice nurse. 94,000 hospital emergency admissions. Almost 50,000 people visiting A&E departments in a research paper to Parliament.

    So every extra bank holiday cancels how many operations? How many visits? September is typically one of the busiest months so the backlog from then would be large.

  26. John Hatfield
    January 13, 2023

    A priority must be to sort out the reputedly top-heavy management.

    1. Nottingham Lad Himself
      January 13, 2023

      If you have enough, then no one person can be blamed for anything, no matter how appalling the consequences.

      That is absolutely paramount.

  27. Lindsay McDougall
    January 13, 2023

    The NHS is providing a health service that is clearly not fit for purpose. There is no demand management, which would involve some sort of charges, and they clearly cannot cope with the resultant surge in demand. In these circumstances it is absolute madness to assign responsibility for social care to the over centralised NHS.

    For centuries we have had a Poor Law allowing someone to declare themselves a pauper and throw themselves on the mercy of their local authority. Let us extend this to cover social care. The local authority would provide social care on an emergency basis and send the person concerned (a discharged patient) an invoice for its provision. It would be up to the person concerned to prove inability to pay that invoice and the local authority should be provided with data about the person’s financial status by the Exchequer. Attempted fraud – a false claim to pauper status – would result in prosecution. Local authorities should be allowed to increase Council Tax to fund the social care of genuine paupers.

    Given that local authorities should know the social care facilities available in their area, it should take no more than a month to set up a suitable system. After that, hospitals should be free to dump bed blockers either in the social care centre organised or their home (if support has been organised) or in the Head Office of their local authority if it fails to do its job.

    When, oh when, are we going to see the smack of firm government instead of all this hand wringing, mewling and puking?

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