Public officials do know how to stoke the age old UK debate about “inadequate funding”. This week the media is alive with claims that the NHS will run out of money if it is not given large real increases to cater for rising demand and increasingly costly treatments.
Private sector industries never debate like this. You do not hear leaders of the mobile phone and smart phone industry on tv demanding higher allocations of future individual budgets to comunications, or threatening a shortage of capacity if prices do not rise. We used to have capacity and service quality problems with phones when we had a nationalised monopoly service, but have solved most of these by competition, choice and private capital. The changes to the range and types of service delivered, and the cost reductions owing to better technology and productivity have been stunning.
It is true that the UK is wedded to the admirable principle that health care should be provided according to need, with much of it provided free at the point of provision. We pay for our health care over our lives, paying more in when we are healthy and successful, and less in when we are not. No main political party wishes to change this approach.
What we need from the officials who help Ministers lead and grow this crucial national service is constructive advice and help on how to adapt and develop the service, not screaming headlines of future crises imagined if more taxpayer money is not forthcoming. As we develop our NHS model, we need to ensure that it can embrace the innovation and productivity improvements that we rely on to keep the bills down in successful private services,without having to confont Granny with a bill when she visits the GP or hospital. I intend to look at ways to boost income , improve quality and performance and increase productivity over the next few days, without resiling from the popular underlying principle of “free” healthcare for all.
July 12, 2013
Free at the point of use is one of the main problems, that and the absurd way in which hospitals and gps are paid for treatments. The incentives to the nhs are all totally wrong they do silly small ops to delay having to do needed big ones, they ration treatments with artificial contrived delays, the keep you waiting for 4 hours so as to to encourage you to go elsewhere. They fail to charge even those with insurance. They cancel ops at the last minute at great cost due to lack of proper organisation. They should stop vanity treatments forthwith, insist on insurance for sport injuries and similar. They should encourage insurance with tax reliefs then charge those who have it, should they use the Nhs. They are also unable to fire incompetent staff easilys, which is surely hugely dangerous. No surprise how many they kill through incompetence then. Some of the staff are superb but the system is rotten to the core thanks to politics and the counless wet pathetic Tories who are too scared to sort it out. They have much blood on their hands.
July 12, 2013
JR Do you think hs2 will actually happen? Are the government and the MPs going to let this pointless waste of money actually go ahead? Unfortunately I have some properties in Camden that they will have to purchase, I have just been notified. So no doubt this will involve lots of pointless extra work for me. No doubt I will lose out financially in the end too.
July 12, 2013
Lifelogic
This poses an interesting conundrum for others perhaps in the same position.
I guess you have owned such properties for some years, and would want to hang onto them, as one reason would be the Capital gains tax you would have to pay if you chose to sell.
Given you may be forced to sell against your will (compulsary purchase), would you still be liable for Capital Gains Tax
Just a point of interest, as I do not own any other properties but the house I live in.
July 12, 2013
Indeed to be put in the same position you need compensation for legal costs, stamp duty to re-buy, lost of the old cheap lending at 0.8% over base interest only compared to the new rates at more like Libor +3% on short repayments and lower LTV.
July 12, 2013
And the considerable CGT that is brought forwards at 28%.
July 12, 2013
I assume that JR is referring to the musings of the NHS CEO. It is a shame that he wasn’t so vigilant or vociferous in identifying and dealing with the scandalously poor ‘care’ often received at certain NHS hospitals. Perhaps if he hadn’t authorised massive payouts to stop/prevent medical staff from whistleblowing about these scandalously poor levels of ‘care’, he might have some money to invest in improvements…..
zorro
July 12, 2013
So your plan is to force people to buy insurance, then punish them for using the NHS. Why not just cut out the middle man and punish them for being ill in the first place?
Also please name some cases where incompetent staff couldn’t be fired. Incompetent managers don’t count.
July 12, 2013
Lifelogic: “they do silly small ops to delay having to do needed big ones”
Yeah, why worry about treating the vacuous veins, just chop the leg off and be done, it will save both time and money in the long run, never mind trying to treat intestinal problems, just perform the full colostomy and be done, why bother with the heart bypass, just wait until a full heart and ling transplant is needed – no private health insurance or service would treat patients that why so why would the NHS, but of course Mr “non-Logic” is only thinking about that extra case of bubbly he might not be able to afford should he have to pay a little more tax, which as a non-dom he doesn’t do anyway, nor does he have to use the UK’s health service…
July 12, 2013
Do you mean varicose veins?….If only they were vacuous!
zorro
July 13, 2013
They do for example minor knee wash operations, when really a full knee replacement is needed, I understand, just to meet the “targets”.
I am not non dom (overseas people now living in the UK), I just live outside the UK now, so I am non resident. I am not a drinker of bubbly either, indeed we live rather frugally with my perfectly satisfactory 10+ year old estate car and similar.
Fortunately, I do not have to use the UK health service any more, not that I ever did very often, my birth, a few inoculations and my appendix out is all I can think of, in 50 odd years.
July 14, 2013
@Lifelogic: You do not live in the UK, so you are non domicile for tax purposes, or are you stating that you pay UK tax etc. (on your personal, not business, earnings)?
But back to your silly idea that a minor knee complaint should be treated with a full knee replacement, if a light bulb blows in your house do you first try replacing the light bulb or do you jump right in and have the house rewired?! Many people simply need to have damaged cartilage removed, living another 50 years without any more problems, some will go on to need knee replacements but that is a very costly treatment and thus the NHS is actually saving money not tacking your one-treatment fits all approach.
Oh and I am surprised at your apparent age group, you come over as someone barely out of their teens, such youthful optimism about how the world can be put to rights so simply. 🙂
July 12, 2013
But £830 million of taxpayers’ money is being used for subsidies intended to stimulate private investment in improved access to broadband services and better mobile phone coverage:
https://www.gov.uk/government/policies/transforming-uk-broadband
So it’s not entirely true that private enterprise is being left to solve public communications problems on its own and without government intervention.
July 12, 2013
Daft interference in the Royal Mail too with the same charges for a letter Land End to the Scotish Isles, as from Camden to Kentish Town.
July 12, 2013
Its called service and is part of the infrastructure. Infrastructure that allows rents to be as high as they are. Do you understand what infrastructure is? Why should London have the cheapest rates and everyone else pay more? Old ladies in Scotland paying for couriers and being told this is fair? Like the bedroom charge huh!? More idiocy from you that you cannot defend.
July 13, 2013
People should pay the true costs of mail so that they can make sensible judgements, perhaps by using an email instead.
Infrastructure – could that be all the road in London that they keep blocking with bus & bike lanes, environmental areas, huge islands, one man buses and anti car traffic lights?
July 12, 2013
@Lifelogic: “Daft interference in the Royal Mail too with the same charges for a letter Land End to the Scotish Isles, as from Camden to Kentish Town.”
It’s called swings and roundabouts, what is lost on the swings is gained on the roundabouts, it’s similar to principle that the big capitalist, profit making, supermarkets use with loss-leaders, get the plebs coming in for the cheap petrol and sell them their weekly shop at a profit that pays for the loss on the petrol or what ever – I would have though a man of your intelligence and education would have grasped the idea but perhaps the need to get your five-a-day rants trumps all logic…
July 13, 2013
It is called pissing money down the drain and sending the wrong price/cost signals to customers. Tell them to do it on line by making the charge reflect the costs.
July 13, 2013
@Lifelogic: Go find a clue; firstly what about those who do not have a computer, second what about those who even if given a computer wouldn’t know how to use it, third what about people who have a computer and know how to use it but -for what ever reason- can’t actually access the internet, fourthly, not everything can be done online etc, the list is endless.
But hay-ho, if you are right LL the government won’t be able to privatise the service, if you are wrong they will, time will tell…
July 13, 2013
We need to invoice all business with the correct tolls by this logic and we know many of them pay nowhere near what they should pay for what they use and you know it.
July 14, 2013
We would see how you dislike the Royal Mail if you had to post heavy items such as car parts. Have a look how much it would cost to send a set of drive shafts compared to a courier. Of course your rant about ‘true costs’ will apply and the rise in the cost of car parts will be OK with you? Oh! You don’t use car parts? I see. Sending dried flowers will be much cheaper because of this of course and all will be self balancing. Or special postage companies would be formed for both with certain couriers competing to lower prices and profits ploughed into the businesses further lowering costs especially of heavy items not invested offshore in ‘sensible’ way. Or the rise in costs will ensure further efficiencies of car parts suppliers and make cars more reliable needing less parts? New car sales would rise due to the price of car parts adding to the economy? All creating more jobs and business.Etc etc.
Maybe they both could just be e mailed as you do your simplistic fantasies. Ram it.
July 15, 2013
Baz
Re your post on heavy car parts and the Royal Mail
Don’t despair Baz many private parcel companies already exist to offer you a service at good prices.
Look at couriers like UPS, Tufnells,, City Link etc who charge per parcel not per kilo and even offer a next day service.
Royal Mail is not the best way to post heavy items, even their own subsidiary company Parcel Force do it better.
The joys of private enterprise and competitive industry are waiting to satisfy your requirements.
July 13, 2013
But the supermarkets etc can make these type of decisions for themselves whereas the Royal Mail has to operate to a set of restrictions placed on them by politicians.
July 13, 2013
@Edward2: Not according to the statement from Vince Cable, nor the Tory grandees who backed him up – “the RM is owned by the state but run by the RM as totally independently”. This was why even under the last Labour government the RM was able to close sub-post offices, even some main and sorting offices, and change T&C for both staff and customers etc. without having to first obtain governmental approval.
July 13, 2013
The supermarkets make large profits and this is not reflected in the wages and tolls they pay to the country. The Royal mail is or should be a state run business run for the benefit and convenience of the population not hedge funds sending money to offshore accounts. This idea that the private sector is always more efficient and provides better service at a better price is for the birds. It may do for a minority, but what about the majority that have no’ choice’. Your choice is like a room at the Ritz. Don’t start telling me about bad service when the alternative is no service.
July 13, 2013
Rubbish again Jerry.
The Royal Mail is restricted on what it can charge and has to charge the same price whether its a delivery of ten miles or several hndred.
July 14, 2013
@Edwartd2: As are prices in other private businesses, the most obvious being the utilities and rail. Your point is what, exactly?
July 12, 2013
Don’t forget the conversion of coal burning power stations to burn huge amounts of American manufactured wood pellets, at 3x current price, is being helped by loans from the government financed green investment bank. Mrs. Thompson, the Drax CEO was on Evan Davies programme on R4 last night, claiming that they had traced carbon emissions through the process and that it was carbon neutral. He did not take the opportunity to ask whether this included shipping or land use change. She was happy to predict that the future would guarantee the subsidy by ‘grandfathering’ following 8 years of preparation with DECC. Ed Milliband is pictured on the original document in which large scale conversion to biomass is proposed.
July 12, 2013
Dont forget the large money slug the British state is giving to develop “new car engine technology” which the international car makers will just take abroad as soon as it is obvious to them to undercut this country. Why we fund so much intellectual property only for it to be used abroad to undercut this country is beyond me.
July 12, 2013
Under license , so some money will come to the license holders (UK taxpayers?) and it will trickle down and the billion will have been well spent , again. Sorry , I try not to be cynical but give any ” great new scheme” a year or two and the usual suspects have dined well and prospered greatly from it.
July 13, 2013
The project is to develop engines that do not use carbon fuels. Probably hydrogen or ethanol. According to DECCs adopted book, these do not work to well unless there is 100% non carbon input to make them. There isn’t. In fact, according to the latest news, large electricity users are being asked to consider intalling diesel generators. Has anyone in charge of this project actually considered whether ther will be any market for non carbon combustion engines?
July 12, 2013
JR cut/privatise the NHS at your own peril, the voters are not stupid as they know what the American alternative is of being “free to choose” your healthcare provider, if you can afford it.
As I have written here before, you really need to seriously shake up the senior management of the NHS. Look at their CVs and see if they are really worth a pay packet bigger than Dave’s. If necessary do as Sir Michael Edwards did when he took over British Leyland (and look at the similarities) and force them to prove themselves with an IQ test. Cut away at the admin staff. As you can see how many of them are in too much proportion to frontline staff by looking at the traffic jams they cause around hospitals when they all depart at 5pm. While nudge the patients into turning up for their appointments by charging them and stop wasting doctors time if they fail to show without good reason. Oh yes and its the NHS not the IHS so make sure its business is mostly conducted in English, Dr Andreeva will testify to the number times the interpreter has sat in the corner twiddling her thumbs with nothing to do as the patient has communicated quite effectively without her.
July 12, 2013
That old scare store.
Look, the NHS (experiences the deaths of -ed) 40,000 a year, for 63 million of population.
The US health system (experiences the deaths of ed) 75,000 for 230 million that use it. [70 million uninsured]
That’s a death rate many times that in the US.
Now no one would recommend the US system, but the NHS is worse.
Instead we should be looking to places like Switzerland where for basically the same cost as the NHS, [and no pensions debts as well] you get universal coverage and a vastly better standard of service.
Cut the wrong leg off there and you won’t be working again in the country. Unlike the NHS.
July 12, 2013
Is the GMC doing enough to protect patients from negligent and incompetent operatives? Is the GMC doing enough to ensure that operatives are fluent in medical English and in Anatomy, Physiology and Pathology? Why did surgeons removing an ovary mistaking it for of a diseased appendix. Should the GMC be obliged to hand over case files to the police after a complaint where death or injury has been occasioned?
July 12, 2013
Well given that 70 million Americans lack health insurance it’s no surprise that far fewer of them die in hospital.
July 13, 2013
I would take treatment in a free public USA hospital over UK ones like Stafford everytime Uni
July 13, 2013
@Edward”: Assuming you could find one and they agree to treat you, in the USA you might not even arrive, being left on the side-walk because the ambulance that did arrived on the scene of your misadventure, illness or medical-need happens to be from a private health care provider…
July 13, 2013
Jerry, you plainly have no experience of USA free health provision for those USA citizens that don’t have insurance cover.
Many are teaching hospitals which provide good standard of free care.
As I said before I would prefer to take my chances if I was a USA citizen any time over the NHS standards in UK hospitals like Stafford.
Slowly the religion that is the NHS where criticism is a heresy and change is not allowed, is being revealed as a old fashioned centralised system which is no longer the best in the world and is declining further against cheaper and better systems in other modern nations.
July 13, 2013
PS
At the time of this post nearly 40 posts out of 128 are from you Jerry
Please note its supposed to be one per day not one per hour.
July 14, 2013
@Edward2: There is no free health care in the USA, even Medicare is provided by private heath providers (those funded by government), charities are not government run – before treatment you need to prove entitlement, which is of course what government [1] wish to bring to the UK.
[1] both Labour and Tories, indeed this was part of the rational Labour used to promote their national ID card scheme
July 15, 2013
Come on Jerry don’t be so pedantic
By free we mean the USA citizen doesn’t have to pay.
July 15, 2013
@Edward2: Makes one wonder why so many buy private health insurance then doesn’t it, could it be that you are just plain wrong about your assumptions and that the reality is that only very specific groups of people in the USA actually get ‘free’ health care. Or perhaps you are foreseeing the day when “Obama Care” is fully up and running (which took at its inspiration the British NHS, ho-um)…
July 15, 2013
One day on here Jerry you will finally agree that someone else has made a point that is right.
I wonder if you really just want an endless argument and much of what you write on here is not really your opinion but just anything that is contrary to whatever anyone else has written.
July 16, 2013
Well indeed Edward, and perhaps one day you to will accept that you are wrong, but it will be noted though that you chose to play the man rather than the ball though – QED…
July 12, 2013
@Nick: Where do those figures for the USA come from please?
July 12, 2013
nonsense all the voters I know realise how substandard the NHS is and want the better care they see all the time abroad.
July 12, 2013
Iain Gill: Indeed but that doesn’t mean they want it privatised, nor any real change in the way is (meant to be) funded. As I said the other day, I strongly suspect that if the voter was given a choice they would opt for a more Beverage style NHS than anything we have had for the last 40 years and certainly not a USA style non service.
July 13, 2013
they want to control where they spend their healthspend, and take it where they want dynamically according to who gives them the best service. just like in most other walks of life.
July 14, 2013
@Iain Gill: They can, no one is stopping people from buying medical insurance, what you mean and want is to pay less tax, meaning that others will suffer from an underfunded health service – even more than they do now.
July 12, 2013
Cut away at the admin staff. As you can see how many of them are in too much proportion to frontline staff by looking at the traffic jams they cause around hospitals when they all depart at 5pm.
The admin staff work in shift patterns so they have to leave when the staff for the next shift arrive. There aren’t enough resources for double the number of staff.
Perhaps you should learn the difference between a business operating 8 hours per day and a hospital operating 24 hours per day.
July 13, 2013
@U5: A lot of the people Nina is referring to work normal office hours, not shifts, because there work is purely administration -and much of that is pointless form filling that has no direct connection to medical care but gets used by statisticians to write endless report telling the real health care workers what they already know.
The NHS back offices were bad enough under the Tories by 1997 but it grew even more like Topsy under the 1997-2010 Labour government, if governments want to waste money on pointless form filling to employ countless statisticians etc. I would prefer they count the number of people who step on the paving slab lines than mess about within the NHS, disrupting the important matter of health care.
July 12, 2013
JR just as an aside are you willing to endorse this claim from Osborne as to why I should vote Conservative in 2015?
http://www.telegraph.co.uk/news/politics/10174817/Vote-Conservative-in-2015-for-no-more-tax-rises-George-Osborne-says.html
Reply I strongly support the policy of no more tax rises and it is one of the reasons why I will vote Conservative
July 12, 2013
@JR reply: LOL! A reason not to vote for someone else instead of yourself, or do you not live in your constituency John, or is this a coded suggestion of your retirement? You may want to edit your own reply before the tabloid press pick on it – MP John Redwood to …… at the nest election
Reply I plan to stand at the next election and I plan to vote Conservative. I cannot see how either of those statements are newsworthy!
July 12, 2013
@JR: As if you would not vote for yourself?! That is why I wondered if you don’t actually have residence in your constituency. Never mind.
July 12, 2013
I did it find it quite amusing too Jerry….Shock horror examination of previous ballots do confirm that JR voted Conservative as opposed to Labour!
zorro
July 12, 2013
Yes but its this bit I am intersted to read your views on …
“Taxes will not need to rise after the next election to fill a £25 billion blackhole in the public finances, the Chancellor has said.”
Reply I agree
July 12, 2013
Nina,
Wasn’t it Osborne who said that he would eliminate the budget deficit in 5 years by 80% spending cuts and 20% tax increases before the last election? He immediately reneged on that promise, as our host has illustrated many times – overall spending has increased and without tax increases there would have not even been the modest reduction in the deficit. Do you really believe a word the man says? I’m afraid I don’t.
July 12, 2013
No its worse than that I think Osborne actually believes he can cope with the national debt and budget deficit without increasing taxes. Its a warning that you can expect a whole new set of indirect and regressive taxes or him and Carney are going to print like mad. So you have been warned and you should prepare for the worst post 2015. Its really amazing JR endorses the DT headline as well.
July 12, 2013
It’s simple – All he has to do is not spend a penny for two years and the government debt (only that debt mind you) will be gone……How could anyone not take Gideon at his word? 😉
zorro
July 12, 2013
Based on record to date against previous pledges (80/20% split) who would believe Osborne. You previously agreed with me that it has been 100% tax rises to date. This blog has commented many times on the lack of spending cuts in contrast there has seen the 299 plus tax rises under Osborne. No to mention the ratting on IHT , changing RPI to CPI to make things look a little rosier and many other issues.
Any Tory who votes in 2015 for Conservative under Cameron has lost leave of their senses.
July 12, 2013
A claim of no more tax increases from IHT ratter Osborne! Was it not just the other day they increases the parking fine taxes by 70% or so? Who will trust ratters Osborne or cast iron Cameron on anything at the next election, unless they are very gullible indeed. If they do not cut the vast waste, HS2, the absurd conversion to 3 times the price bio fuel at power stations, the green deal, the PV and wind subsidies ………………… then they will have to increase taxes, not that it will raise very much when they that do as the sensible money will have gone.
July 12, 2013
“Private sector industries never debate like this. You do not hear leaders of the mobile phone and smart phone industry on tv demanding higher allocations of future individual budgets to comunications, or threatening a shortage of capacity if prices do not rise.”
Err, I seem to recall the private utilities doing just that not so long ago, within this governments tenure. As for Telecom’s, that was more to do with the governments than the actual industry, funny how so much new technology appeared so quickly after BT was privatised, makes one think that the technology was being held back in R&D, never mind the fact that the old GPO had and demonstrated a video-phone prototype back in the early 1970s.
It is thus so often the political paymaster who cause the problems and not the nationalised or public industry, there is no reason why the NHS could not have more than enough money, there was no reason why the GPO could not have provided more individual subscriber lines, no reason why each subscriber could not have had a ISDN/Telex line either as standard – the technology existed but the politicains preferred businesses to suffer extortionate tariffs and the plebs to suffer the stupidity of the “party line”, both telecommunications and political…
So another of John’s blogs full of cherry picked facts to paint a rosy political picture to push a very partisan message to his willing readers to lap-up like milk from the bowl, so much for the websites strap line, nothing incisive about pure party politics! 🙁
July 12, 2013
It is not the public service or the nationalised industry that cause the countries ills but the size of the bureaucracy and government, what is more for every public service or nationalised industry that has been (semi) privatised there has grown up a whole new bureaucracy, not less, of state regulation – and in some cases whole government departments – Ofcom, Ofgem, Ofwat, Ofsted, Audit Commission, NAO, you name it and there seem to be a regulator of some sort costing either the tax payer directly or the tax paying end-user money, keeping countless numbers of extra ‘pen-pushers” employed. Oh and of course, in the case of the privatised utilities etc, if there wasn’t this layer of ‘independant’ regulation it would still cost the end user far more due to extortionate charges these industries would be able to inflict as an industry of sector.
The day a government tackles the real problems will be the day the government starts sacking their own, the cost of government and regulation has increased since the 1980s, not decreased, the size of government has increased, not decreased – we now have government multiple departments doing the work that could and used to be done by one.
July 12, 2013
Love the last paragraph Jerry.
If there is one person on here who endlessly writes blogs full of cherry picked facts…
to push a very partisan message. ..then its actually you Jerry.
None so blind……….
July 12, 2013
@Edward2: The only person who writes blogs on this site is John, everyone else writes comments (and yes many people do write partisan and cherry picked comments, but I would expect nothing less of the sites readers), have a nice weekend!
July 12, 2013
Irritatingly pedantic as ever Jerry.
PS You failed to put an apostrophe in “sites” and it should have been a full stop after “John”.
July 12, 2013
Remember, politicians promised we would have the fastest “cable to every home” in the world!!!
…”A number of conclusions can be drawn from the cable story. The first is that it is extremely difficult for governments to pursue sophisticated policies. Government tends to operate at the lowest common denominator and is a very blunt instrument. Governments find joined-up thinking virtually impossible. All of this is in spite of good intentions. The prime law of government is the law of unintended consequences. The second conclusion is that politics is about words and science is about facts. Politics is about compromise, science is about immutable laws. When politics mixes with science or technology, unintended consequences are virtually guaranteed. Lastly, how do you now get the UK re-wired? Easy! Change Building Regulations and make a minimum of 50 Mbps broadband mandatory for new build homes. Then sit back and wait another 20 years. Michael Aldrich June 2011. Part of the Michael Aldrich Archive: “Teleputers and Cable Systems”.
July 12, 2013
fastest “cable to every home” in the World.
Has Vince got a new means of transport ?
Not sure why the Government is involved with cable of any sort, if it has been privatised.
July 13, 2013
@alan jutson: I think it was because the private telecoms companies had to admit that market forces could never supply the more remote areas with reliable internet (never mind broadband, I’m talking about just 56kps dial-up here) and as so much of government [1] now want us plebs to “do it online” I suppose the government felt that they needed to buck the market…
[1] ask any farmer, who is now being required to fill in countless online forms for Defra, never mind like everyone else with HMT etc.
July 12, 2013
@Acorn: Funny, under the government supervised GPO many homes had (at least the option) for a telephone, and yes politicians have indeed promised we would have the fastest “cable to every home” in the world but it has been the private cable/telecom companies who have failed to provide this, the government do not dig up the roads… As for the lowest common denominator, that actually goes to the private companies, what makes them a profit, not what the people need.
July 12, 2013
Jerry
“Funny, under the government supervised GPO many homes had (at least the option) for a telephone”
Er you obviously weren’t around then. It took 6 months plus to get a phone under the GPO. Now thanks to private enterprise not only can every home have a phone, every individual can have a phone too.
By the way its also possible to have broadband access anywhere in the uk it doesn’t require cable or fibre optic, but then why ask a telecoms specialist when you can ask a government socialist.
Sorry the problem we face in this country is politicians and people like you who know naff all about a topic then interfere, destabilise the market and cause problems.
Do you know the population of Africa is nye on 1 billion people do you know that totally due to private enterprise there are 700 million mobile phone users in Africa. I guess all Africans must be rich Jerry as you tell us that private companies are only interested in the money
July 13, 2013
@libertarian: But why was that, not because the technology wasn’t invented but because the paymasters (the government) wouldn’t fund the GPO adequately, indeed I seem to recall that government used to raid the GPO’s profits meaning money was flowing in the wrong direction – both the telephones and postal services were being used as cash cows by government…
All I can speak about is my own experience, we had a new phone and line installed within a month or so, this was in the early 1970s.
Also, what do you not understand, what ever the quality of the internet, fixed or mobile it is down the the market not government, the internet (as most people know it and understand it) wasn’t even available when the telecoms was still being run by government department – the fact is, the state of UK broadband and mobile phone system is totally down the the free market. If you really believe that the telecoms industry is spending money in Africa to provide mobile data networks as charity you are sadly deluded.
But of course your argument is so thin you just had to use the “S” word, after all what is a rant without calling someone or other a “socialist”…
July 13, 2013
Jerry: ““Funny, under the government supervised GPO many homes had (at least the option) for a telephone”
Many homes may have had (at least the option) for a telephone, but they might have only had one line between several homes in a street.
July 14, 2013
@APL: Indeed but that was due to funding, not the fact that the GPO/BT was a state run telecoms industry, other than who was pulling the strings – try actually thinking about it, as I’ve said before, after BT was privatised the unions were just as strong [1] and BT was still the only (universal) telecoms provider but because BT was now free of political control and could raise funds from where ever the service rapidly improved.
[1] perhaps stronger because their member might well now have investment shares and thus a definable financial share in the company
July 15, 2013
Jerry: “Indeed but that was due to funding”
Thus illustrating that the government isn’t a very good telecoms provider.
Jerry: “free of political control and could raise funds from where ever the service rapidly improved.”
Er, yes.
Jerry: “unions stronger”
Ah yes, to the extent that their members cut whole segments out of the trunk cabling system in order to frustrate the management of the privitised BT.
Over manning and inefficiencies was also the hall mark or the publicly owned BT. Contributing in no small part to the funding problems you alluded to earlier.
July 16, 2013
@APL: “Thus illustrating that the government isn’t a very good telecoms provider.”
No it doesn’t, it just proves that the government (for what ever reasons) refused to fund the state owned industry properly, nothing more and nothing less.
Having it your way though, by your own rational, because there have been some woefully underfunded private telecoms companies [1] that it shows that the private sector is not a very good telecoms provider, ho-hum!…
[1] and thus the service soon became as worse as the old GPO, what with low network capacity and woeful customer service etc.
July 16, 2013
Jerry: “that it shows that the private sector is not a very good telecoms provider”
No it doesn’t. It shows that some of the telecoms providers in the private sector may not be very good.
The good ones will of course take market share from the bad ones. Or, what actually happens, is that customers of the poor companies voluntarily move to the better companies – because they are better.
Let’s see how that works in the public sector – ah! it can’t because the government is the public sector.
Now, I’m bored with instructing you in basic economics.
Jerry: ” ho-hum!…”
Exactly!
July 16, 2013
APL: Do try and follow the debate, if there is an underfunded telecoms company they will give a rubbish service, thus a properly funded GOP/BT would have offered just as good a service as the best of your oh so precious private companies do, the fact that there is more than one private telecoms company is totally irrelevant to the point you were meant to be replying to.
Oh and the only person who doesn’t understand basic economics is you APL, you do not seem to understand that a “nationalised” £100 worth of investment is worth the same as a “private” £100 worth of investment, both will buy the same!
July 17, 2013
Jerry: “the point you were meant to be replying to.”
This is the Socialist philosophy of discussion. You can only address the point you have been given permission to address.
You know what? Tough.
I think I’d rather gnaw off my on foot that continue this discussion.
July 12, 2013
Jerry – “the technology existed but the politicains preferred businesses to suffer extortionate tariffs and the plebs to suffer the stupidity of the “party line””
Incorrect. The problem for the GPO was that the government of the day starved it of capital investment. This is the perennial problem for publicly funded enterprise for which PFI is not the solution. This falure of capitalisation was also highly damaging to the indigenous telecommunications industry.
July 12, 2013
@forthurst: Exactly my point, the problem wasn’t the public service but the political pay masters, we should have kept the public services and changed the governments!…
Oh and PFI is part of the problem now, meaning more cost to the public service because the private sector also want their cut of the cake.
July 12, 2013
@Jerry “we should have kept the public services”
Obviously, you had not had professional dealings with GPO telecoms exhibiting the worst excesses of a monopoly supplier: overmanning and a disobliging attitude to those wanting to connect both people and equipment into the network in order to support their businesses.
July 12, 2013
@forthurst: No worse than many a private telecoms company once they have you locked into a contract, my own provider has multi pages in four sets of T&C but they actually only need one page, one sentence “We reserve the right to change any T&C as we see fit, we reserve the right not to inform you in writing of such changes”. Another provider wanted to charge their customer £150 for a fault even though the fault was with a cable join out under the road 1,000 yards away from the subscriber, fortunately my friend refused point blank and told them that if the money was taken via his direct debit account with them he would be seeking legal advice – they backed down very smartish, they where obviously just trying it on…
I’m not saying that public services always get things right, they don’t but nor do the private companies, even more so if the company is operating in sector with little proper competition.
I’m not sure what you meant by your last comment, LLU didn’t exist until this century, but if you mean that the GPO/BT would not allow non GPO/BT supplied equipment to be directly connected to the national telecoms network that was because there was real risk of inappropriate equipment being used, not all telecoms networks are born equal. Yes it annoyed a few but the GPO/BT policy protected the many, eventually in the 1980s a proper mandatory testing scheme was put in place for those wishing to supply telecoms equipment.
July 13, 2013
Jerry: “they backed down very smartish, they where obviously just trying it on…”
Try that with the ‘Public services’!! You’ll find the full extent of the bottomless public purse aligned to destroy one small individual. Contract be damned, we don’t even have a contract defining what we can expect for our Council tax payments.
You cite an example that illustrates the superiority of private contract, all you can say against it, is that one of the contracting parties produces a lot of paper – which happens to defines exactly what you are and are not entitled to for your money!
If only we could get that from the local authority!!!
July 14, 2013
@APL: The law is the law, no mater who runs the service!
All I am pointing out that it was the FUNDING and not the fact that it was a public service that caused the problems, get an under-funded private provider and they suffer the same issues as the GPO/BT did pre privatisation, as is the case with the NHS.
July 15, 2013
JR: “The law is the law, no mater who runs the service!”
Except when you don’t have a contract in place, as invariably in the public sector a member of the public doesn’t, the ‘provider’ of whatever service; health, telecoms – can and does ignore the law. To prove that they have done so is far too costly for the average subscriber to the ‘public provided’ service.
Jerry: “it was the FUNDING and not ”
Wrong again, it was not exclusively the funding. It was overmanning and inefficiencies inherent in a government operated organization that caused the publicly owned BT to be crap. It had plenty of ‘funding’ but spent it on the wrong things.
End of conversation.
July 16, 2013
@APL: “It was overmanning and inefficiencies inherent in a government operated organization
EXACTLY, thus had the GPO been allowed to run their own industry, had the GPO been allowed to raise their own funding on the open market etc. No company can survive long if the shareholders keep refusing to allow the board to do what the board should be doing.
Oh and one still had a contract, mostly T&C, with the old GPO/BT.
July 16, 2013
Jerry: “No company can survive long if the shareholders keep refusing to allow the board to do what the board should be doing.”
You are deranged.
State operated companies (and we seem to be discussing BT in it’s nationalized incarnation ) only have one share holder, the state. The board and the share holder are one.
Take en passant, IPSA it is notionally independent, but in reality is stacked with current and former Public sector Nobs. Their interests are aligned with the collective interests of MPs.
Same on the ‘boards’ of public sector entities. There isn’t one that (a) would know an independent thought if he stumbled across one in the street. And (b) these same people have an interest aligning themselves with their political masters.
July 17, 2013
@APL: “State operated companies (and we seem to be discussing BT in it’s nationalized incarnation ) only have one share holder, the state. The board and the share holder are one.”
EXACTLY, that is my point! Try actually thinking about it for a moment (rather than throwing the insults around), just think want a great telecoms service the GPO/BT could have been had it been allowed to access investment money like the private sector – nationalised industries owned but not controlled by the government, and thus free to access loans on the open market etc. are not unheard of you know.
Sorry APL but you seem to be so welded to your dogmatic political views to actually have a meaningful, deep, debate with, lateral mental thinking is not something you seem to understand or be capable of. /END.
July 18, 2013
Jerry: “EXACTLY, that is my point! ”
And you neatly ignore both the failure of the Public sector and the potential of the Private sector.
But neither is it about funding, it is about the allocation of the avaliable funds according to priorities; in the private sector – keeping your customers happy, or in the public sector, keeping the politicians happy.
Two diametrically opposed priorities, leading to radically different outcomes.
Jerry: “/END.”
Thank the Lord.
July 12, 2013
I had my NHS appraisal last night and our trust certainly does not lack the suggested competition, the first of our objectives being” To be the best in our class of organisations.”
We have reduced our deficit by more than targeted, we are continually looking for ways to improve and all the staff are included in that goal. There are 3 other objectives which are equally as aspirational and will be met.
The comparison between mobile phone companies and NHS is not a well balanced argument as the type of demand is on opposite poles. People , unless they have a Munchausen problem,do not want to become ill, whereas mobile phones are seen as desirable.
I will now go to my other job , where I having been qualified in medicine and prescribing and have practiced for 40 years , have appropriate qualifications will go to work taking half as much money as most private concerns and a quarter as much as other medical practitioners , yet results are more than equal. We in the NHS are doing this not solely for ourselves and for big private consultation rates , but rather we feel a sense of responsibility to use our knowledge for people in this country.
July 12, 2013
I have some experience of working for the NHS. Would you agree that there are far too many middle management, highly overpaid jobs that add little value (and, in fact, may impede the effective delivery of services)?
I looked at a notice board in the reception area of a large hospital a few years ago. Four jobs were being advertised by the trust.
2 staff nurses – long list of qualifications and experience required – 23k a year.
2 other positions – can’t remember the job titles – but I read them and could not discern what the job was. Read the job descriptions and still had no idea what the job actually involved. These 2 jobs had salaries in the 60k to 70k range.
The Guardian public sector appointments page is (still!) full of adverts like this. Incomprehensible jobs with massive salary and pension packages.
Apart from ineffective IT systems, the NHS seems to be lumbered with a massive layer of unnecessary and very expensive middle management.
July 12, 2013
On the wards they have changed the structure in many places so the sister in charge and deputy are now called managers. They don’t involve themselves with care as much, being inundated with paperwork. The paper work has to be completed for these middle mangers , who collect the paper work for their managers so that all care is written down in text, so the all important evidence is always there to present in courts of law (where exceptionally high amounts of money are spent)
In reality the nurse/ doctor still does mountains of paper work to back her/hiself up when some ill person , unable to be ‘ill with good manners’ decides to sue for having to wait whilst another patient has priority attention. It is text before patients, but anything which is self evident cannot be taken to court and is not strangely and paradoxically evidence. (Most of the clinical staff, including the highly paid consultants work extremely hard and have to literally run around to get their work completed. )
This is the reality of ‘evidence’ based medicine and the problem has caused streams of managers sparring for their high salaries and competing against each other. We did mean evidence to better clinical care, but we can’t have research for everything , some have to use expertise from learning throughout life.
We cannot cope without IT technicians , but try and find one when the system fails almost weekly.
I myself have applied for nurse executive positions and management posts , but they do seem to have been already taken. It is so sad that we cannot get into the management system and stop the non clinical abuse of resource. This incidentally happened when Universities had a greater say in the running of hospitals. A Phd is required for everything notable..never mind the welfare of the patient.
Middle management: If you create a job and make work , they can’t do without it.
July 13, 2013
Thank you for your reply – which made me feel almost despairing for the future of the NHS. It looks as though our litigious society means that more money is spent on proving that good health care was delivered – rather than on actually delivering it.
Seems the NHS is a big bowl of treacle that no-one can manage.
July 13, 2013
Problem is Mike that The private side is even worse. Buildings with rows and rows of computers and little girls making decisions about care from afar when not even qualified. They have their management structure and all kow tow to each other bothering more about , the 5 mins toilet break in their building than what is happening to the patients.
July 12, 2013
1) “most private concerns” wouldn’t give you anything like as generous a pension.
Do public sector workers ever know what their pension pot is really worth?
2) Any time I have had a minor ailment abroad the medication I buy is much better than the second rate stuff we get to buy in this country. The medication sold for sinus in Germany is light years ahead of the so called medication approved for sale in the UK. Ointment sold for sunburn in Swiss pharmacies ditto.
Maybe the continentals have the sense to value self help more than we do?
July 12, 2013
Imagine working for a Swiss or German health service. Everyone working for the same sort of salary, free to the user through state backed insurance, about the same cost relative to income, but without hundreds of highly paid administrators devising targets, comparisons with other trusts, mission statements, time consuming assessments, national computer records which never work, payment incentives for preventive medicine sent to out of date patient lists and top managers promoted following disasters and the covering of tracks through gagging clauses.
July 12, 2013
its not competition unless the individual end consumer can take their business elsewhere
July 12, 2013
What we need from the officials who help Ministers lead and grow this crucial national service is
=============
It’s not crucial. Many other countries have universal health coverage that is affordable. Those services do not (have the same death rates as the NHS ed).
It’s time to axe the NHS.
You cannot have an organisation that is regulator, insurer and supplier rolled into one without (safety issues ed).
July 12, 2013
@Nick: Why does one need to “axe the NHS” when you admit that other countries have similar universal health care systems, we should be copying those countries – not throwing the baby out with the bath water.
The USA doesn’t have a universal health care systems, I doubt anyone has either counted or cares how many early deaths have been caused by people not being able to access a proper universal health care system.
July 12, 2013
Oh dear Jerry not a good choice of argument, whilst I’m no supporter of the US system of healthcare preferring the Singapore, French and Italian systems I’m afraid the numbers have been counted and the US has a lower rate of death per head of population than the UK by a long way
July 12, 2013
@libertarian: I would have no problem with many of the European heath care systems, certainly no problem with the French or German systems but they are not that far removed from the NHS and the concept that a lack of money shall not be a barrier to the health care one needs. Not having any direct experience of the Singapore health service I take your word but from what I have read it seems work better because it is managed better (costs are controlled) and thus there is no reason – if the politicians would stop trying to play political football – why the NHS could not be better managed.
July 12, 2013
We could actually ensure those using the ENGLISH NHS are those entitled too……..
July 12, 2013
Old Albion: Hmm, the last time I checked the people of Wales and NI pay the same taxes as those in England, even the people of Scotland do, what do you propose those people of the UK should entitled to should they be travelling within the country to which they have both citizenship and pay their taxes?
Check you Passport old chap, you are a citizen of the United Kingdom, not of “England”…
July 12, 2013
I think we have to face facts.
With the advancement of medical science, and the huge cost of new treatments and drugs, we could spend the entire Country’s GDP on health care, treating everyone for everything, and prolonging life (no matter the quality) for as long as possible.
Thus I think it is inevitable that at some stage, some sort of rationing/limit will need to take place eventually.
The big question is when, and by what method.
Clearly “what method” is a huge topic for discussion.
In order to extend the period before any possible rationing takes place, we need to run the NHS in as economic way as possible, so that money spent, is spent well and gives good value, as well as good results for its patients.
Thus we have another huge topic for discussion as to how we get the best out of the NHS.
Food for thought;
Given so many people think the NHS gives the best treatment in the World, why do we not expand it, and attract people from overseas to use it, at a cost which would make a profit which could be ploughed back into treatment for our own citizens.
We keep on hearing from many people that the NHS is better and cheaper than going for private treatment, so let it compete and the expanded service if not taken up, would help reduce waiting times for us who cannot afford private treatment.
Yes fully aware that It may be a disaster in the making, because doctors and hospitals cannot even seem to charge visitors/health tourists, but perhaps where there is a will there may be a way.
The simple but untennable solution, is to spend more and more money that we simply do not have.
We do not want a tick box NHS, but we may need to think outside the box for a solution.
July 12, 2013
I agree with you Alan.
July 12, 2013
Your point about ‘if we are that good why not expand it and treat people from around the world’ is brilliant.
But you can hear the arguments now … ‘I’m waiting 6 months because the NHS is too busy making money treating foreigners.’
Can’t win I think.
July 12, 2013
It already happens that overseas people do pay for treatment
July 12, 2013
Nina
I think they may only pay for treatment when asked.
As has been reported recently, no one seems to bother to ask them.
It would appear with so many people employed by the NHS (one of the larget employers in the World) we do not have the system or the people in place, to check who is entitled and who is not, to so called FREE treatment.
July 12, 2013
No I should have expanded on this a bit. NHS hospitals do specialist treatment for overseas patients with cash up front. The problem it has, as has been covered in the press, is where people fly into the local airport, sometimes within hours of giving birth and the embassy concerned refuses to cough up when sent the bill. What are supposed to do, send the woman away?
With regard to all the NHS knockers who have posted here today. It would be nice for them to actually state their financial worth on the basis that they are being quite open that they can afford to go private (and remember BUPA does not do A&E) Or if not that they are quite clear in how much private medical insurance American style actaully costs. I have challenged people here before who thought private is cheaper, to remember the excesses, the exclusions and the co-payments that you must pay for on top for the “hotel” costs of your stay. Full disclosure as always, I am married to a NHS hospital doctor and I as a user cannot recall the conditions they like to bring up when I have used a NHS hospital. Sometimes you really need to think critically and ask does someone have agenda when you read about filthy deafdly hospitals
July 12, 2013
Nina
“Send the woman away”.
That is one solution, the other is to ask for travel insurance documents, or a credit card.
Or retain their passport until payment made in full.
Remember it is free at the point of use for US, so it must be pay at the point of use for OTHERS.
They had enough to pay for an air fare, why not treatment.
Absolutely pointless sending an Embassy a bill after treatment, and after they have gone home.
If they refuse to pay or hand over documents, then contact their Embassy immediately and get authorisation for payment.
Sorry but I have absolutely no sympathy for health tourists who rob the system, our system.
July 12, 2013
@Nina Andreeva: Well said! Also I would like people to be honest when they suggest that the NHS should have more or be totally privatised etc. Just what if any financial interests they have or would hope to have, irrelevant asking such people if they are paying for private health insurance policy if they are a shareholder in a private health provider or perhaps even on the board of it – which is no different to the right criticising the public health unions when they support their own members.
For the record, I have neither worked directly for the NHS nor profited from it.
July 12, 2013
@alan jutson: ““Send the woman away”. That is one solution, the other is to ask for travel insurance documents, or a credit card.”
Hold on there that woman, your baby can’t be born yet, we have not agreed to treat you and it – oh dear – to late, put her and baby on that stretcher and bring a mop…
“Or retain their passport until payment made in full.”
What better way of someone staying in the UK, even more so considering that baby would likely be entitled to duel nationality – Duh! I would have thought for all those who keep banging on about immigration you would want non British nationals to be high tailed out of the country as soon as possible, even more so if some ‘do gooder’ might suggest that they have reason to remain…
July 12, 2013
@alan jutsonn: Before suggesting health care rationing just remember this – By the grace of God go I…
July 12, 2013
Jerry
“by the grace of God go I”
Perfectly understood Jerry, but I would sooner have an open discussion about the details, than find myself on some PATHWAY, without my, or my families knowledge.
Face facts, I assume some rationing goes on now (do not resus on your notes).
So let us be honest about it and perthaps agree a consensus, before it becomes simply an age, or a particular type of illness thing.
How do I know.
My mother had a series of strokes at 90 years of age (until then completely independent) I was informed she would not survive, so they did not give her treatment.
She did survive, for another 5 years, competely, totally and utterly disabled, so much so, that her nursing care (in a nursing home) cost the NHS £250,000 over that period under the Continuing Care proceedures.
Had she had urgent treatment, she may have been less severely disabled.
I thought about taking what would have been very protracted legal action, but decided we as a family had gone through enough.
July 13, 2013
@alan jutson: I fully understand were you are coming from, although I had the exact opposite experience with my father, the NHS wanted to try and save him but warned him (and his family) that the surgery would be life changing and might leave him needing care (of the sort your mother required) for the next 20 or even 30 years, thus he with his families consent told the NHS just to make him conferable (pain free) and allow nature to take its course. So “do not resus on your notes” is not always there because of costs or rationing, sometimes it is there because in the best knowledge and estimation of the specialists it is better to allow nature takes its course – sometimes they call it wrong though, nature being an imperfect science.
July 13, 2013
Jerry: “Before suggesting health care rationing just remember this ..”
What on earth do you think waiting lists are Jerry?
July 13, 2013
@APL: “What on earth do you think waiting lists are Jerry?”
They are not a point blank refusal to treat the patient, as can be the case -for example- in the USA simple because one doesn’t have the right medical card, credit card or bank balance. Nor are they rationing, which is another way of refusing treatment, they are simply a list of who will be treated – eventually.
July 14, 2013
Jerry: “They are not a point blank refusal to treat the patient ..”
A characteristic ‘Jerry’ ploy being deployed here. No one on this particular topic has yet suggested that treatment is withheld.
But since you broach the topic – yes treatment is withheld, from the elderly in particular.
Again you are wrong, waiting lists are a means of rationing – a queue, simply the more culturally acceptable form of rationing to British sensibilities.
Any system where you have limited resources but potentially infinite demand must employ some form of rationing.
The NHS happens to use queues, but they also deny treatment to the elderly. As one of the contributors to the comments pointed out a day or so ago.
July 16, 2013
@APL: A very “APL poly” being deployed here, first play the man and not the ball, then go way off the issue he is replying to. 🙁
But in reply, what do you not understand that sometimes it might be BETTER to allow nature to take its course, that is not withholding treatment, it is doing what is clinically correct [1] – which might actually involve providing an alternate treatment. What can’t be excused is neglect and/or treatment based on cost and not clinical need, but of course these are relatively modern phenomenons, that have formed within the (semi-) privatised NHS over the last 30 years or so (and no, I’m not just talking about the exorbitant costs to the NHS for drugs from the private pharmaceutical industry, that is a whole debate in its self…).
[1] but I do understand (first hand) how it might not look that way to the distressed relatives faced with a terminal or progressive illness of a loved one
July 16, 2013
Jerry: “APL poly”
Perhaps you mean ploy? Just a guess.
But if you think that was ad hom, you’ve simply confirmed what I thought all along, you don’t know what you are talking about.
July 17, 2013
@APL: Think what you like, but just remember that others are not like you, they can actually follow a debate…
It will be noted that you chose, once again, to post nothing but thinly disguised insults than actually try and debate the substance of what I said, rather shows up just who is the person who doesn’t know what they “are talking about”. 🙁
July 14, 2013
Jerry: “They are not a point blank refusal to treat the patient, ”
One addendum to my last post. In South Stafford there was a point blank refusal to properly treat patients, to the extent that a statistically significant number died.
This at a time when Labour had been increasing funding of the NHS to unprecedented levels.
Resources were not an issue. Where the resources were being spent was the problem.
July 16, 2013
@APL: “This at a time when Labour had been increasing funding of the NHS to unprecedented levels.”
Indeed, within the framework of a (semi-) privatised NHS, ho-hum, and to think that some call for the full privatisation of the NHS…
To many chiefs and not enough ward staff, to much pen-pushing and not enough clinical care, to much funding based on patient through-put and not enough based on the quality of patient care etc.
July 16, 2013
Jerry: “framework of a (semi-) privatised NHS, ho-hum ”
Translation from ‘Jerry’ speak into plain English.
‘semi-privatised == NOT PRIVATISED AT ALL.
Having said that, the part of the NHS that is privatized, the GPs and Consultants – have always been so since the NHS was set up.
July 17, 2013
@APL: Much of the NHS is being run by private contractors [1], just go to any hospital and ask, and you have nerve to lecture others on not knowing what they are talking about, you need to get out more!
[1] even the doctors and nurses are often employed via agencies rather than directly by the NHS
July 18, 2013
So the most successful part of the NHS, the Consultants and GP’s have been self employed workers during the whole time the NHS has existed!
Everything else has been subject to interminable political fiddling and interference.
GP & Consultant service is still tolerably well respected, everything else that has been wrecked by the Political class is justly reviled.
July 12, 2013
To my certain knowledge the NHS has failed to adequately treat my mother, my wife, her sister, my colleague, one of my customers and me. I have had to virtually shout to get treatment on several occasions. My wife is left with no medication and the doctor not carrying out promises. My mother has had trouble for 30 years and only now do they suggest surgery when she is over 90. My colleague and my customer have both been given MRSA courtesy of the hospital and I am told by the doctor that my best course is to go abroad and get treatment. As far as I am concerned the NHS is entirely run for the benefit of it’s staff and the patients (victims) are dispensable. The lack of care, massive waste, giant unresponsive hospitals, long waiting lists, and all the other problems are directly traceable to it being public sector. No private company would remain in business and out of court if it treated it’s customers like that. It’s directors would most likely be spending time behind bars if they caused even a hundredth of the deaths that the NHS do. It is an archaic relic of socialist dogma that simply does not belong in the 21st century as is the rest of government.
July 12, 2013
@AndyVan: To my certain knowledge the NHS has adequately treat my mother, my fathers terminal illness (this included leasing with socail services), my sister in-law, my uncle, three of my great uncles, my grandmother – this all happened in at least four widely spaced NHS areas across the country so I’m not just lucky to be living in the right area.
On the other hand I have seen first hand the utter waste upon waste by various NHS Trusts, the company I worked for had a NHS contract so I saw a lot of hospitals, both on the ward and back office, it was no fault of the ward staff that they had problems, if only a fraction of the money wasted by pen pushing bureaucrats had been spent on actual health care.
It is not the NHS that is the problem, it is who manages it, both Whitehall and Trust.
July 12, 2013
yes the nhs let my father die far too early from a condition which he would have realistically lived tens of years longer abroad. i have had to pay for an operation and several expensive treatments after having waited more the 6 months in the nhs queue to for the operation. and so on. the nhs may as well not exist when my family needs it.
July 13, 2013
Same here. My wife is in chronic pain – chronic in that it is long term, getting worse and is now ruining her life. But we have had to pay for consultations with various consultants in an attempt to find out what is wrong with her – while her GP keeps sending her off for pointless visits with physiotherapists and such like.
In my experience the NHS is next to useless. Fine for doling out happy pills and antibiotics or a bit of steroid cream. Or fixing a broken bone. Anything else – forget it. You might just as well pray.
July 12, 2013
It’s time the NHS remembered who pays their salaries and started treating people as valued customers instead of nuisances to be got rid of, or units to be processed.
Those expats who have been treated by national health systems in other first world countries have noticed that paying a small amount for your treatment, often not much more than the price of a meal, focuses the mind on what healthcare really costs and introduces a proper businesslike relationship between ‘provider’, and ‘customer’. It also makes people pay a lot more attention to maintaining their own health.
When this is combined with the free choice of whichever hospital or clinic the patient wishes to use, based on reputation, reviews and feedback, the good ones go from strength to stength and the dirty inefficient or plain rude ones disappear. It’s called the market and it works automatically to eliminate the dross.
The NHS appears to me from a distance to be practically a communist system with some excellent outcomes for challenging cases but indifference, poor follow up and lack of urgency for routine ailments. As for the free-at-point-of-delivery sacred cow I can only repeat what they say here: “There’s nothing so expensive as something that’s free”.
July 12, 2013
there sure have been capacity problems in the mobile phone networks, especially on data speeds etc. the only thing that constantly forces the operators to fix the problems is competition and the fact the customers can go elsewhere. competition is what is missing in the nhs not money.
July 12, 2013
@Iain Gill: The customer ever willing to spend money is what drives the mobile telecoms market, capacity and coverage issues affect all the providers now that so many share repeater and base station masts, competition doesn’t really enter the equation for that reason these days.
We have competition in the energy sector and look what has happened to the cost for the end user, we have competition in rail travel and look at what has happened to the cost to for the end user – Yeah right, lets run the NHS like the railways; OK Sir, your appendicitis will be £100 if you pre book and pay (via our website) for the op at least six weeks in advance, if you just turn up when in pain it will be £1,000…
July 12, 2013
Re “The customer ever willing to spend money is what drives the mobile telecoms market, capacity and coverage issues affect all the providers now that so many share repeater and base station masts, competition doesn’t really enter the equation for that reason these days.” sadly you are talking to an expert. You are wrong. Sadly there wouldnt be space to explain in detail why here but you are massively wrong. Do a bit of research before spouting rubbish.
Competition in the energy sector is different, in that is mainly service and billing where there is competition and mainly people are getting the power from the same power stations and distribution network regardless. Its not full competition.
The NHS has several times failed to deliver the important operation I needed and I ended up paying to go private. I would probably be dead if I had left it to the NHS. The NHS should not be defended by right thinking people.
July 13, 2013
@Iain Gill: You are about 20 years out of date regarding mobile telecoms…
As for the NHS, funny how many millions of people do get the treatment they need, I suspect that your op was not refused, just that the NHS could not/would not do it within the time frame you wished, I suspect that (for example) if you needed your left leg taken off to save your life you would have been treated there and then.
July 14, 2013
fantasy
July 16, 2013
@Iain Gill: That is a matter of debate…
July 12, 2013
When a private sector company has cash problems, it looks at economies within the company, and usually ends up cutting the administrative overhead, or backroom staff whist devoting more effort to its core business. The NHS does the reverse, it increases its administrative staff to “find solutions” and fires workers in its core business, the medical staff at hospitals.
July 12, 2013
@EP: Indeed, the classic management by inverted pyramid, they have created a top heavy NHS and the (various) Ministers in Whitehall wonder why it keeps trying to capsize…
July 12, 2013
The NHS makes a profit. A very healthy profit. At least, its staff do.
It is a professional service where each doctor, nurse, consultant etc makes money from treating the sick.
I think that one way to reduce costs in the NHS is to replace some professionals with volunteers.
I would suggest making GPs redundant. The Labour previous government made an unaffordable settlement with GPs and this still has not been tackled. Also, GPs have delegated a lot of their work away or are working below their skill level by acting as clearing houses for referring patients to other services.
I think that the GP surgery should be replaced by a largely voluntary service that takes on nursing and referrals to medical departments.
GPs will have 3 possible routes out:
1. Specialise in a clinical area
2. Take on regional overseers for the local volunteers
3. Take redundancy
The options they decide upon will surely depend on where their interest lies (clinical or administration) and whether they are up to the job (if not then redundancy would be best).
There are plenty of other efficiencies to be made. You only need to spend 10 minutes walking around a hospital to see where money is being squandered. However, I think the drain of GP salaries paid for doing very little these days is the biggest cost that can be tackled quickly.
I also think we have in our communities many people, some more skilled than others who would help to staff a voluntary health service.
Labour/BBC should be reminded that health care should not always be about profit. Volunteering has many merits and should be utilised for the wider good.
July 12, 2013
@Kenneth: “I think that the GP surgery should be replaced by a largely voluntary service that takes on nursing and referrals to medical departments.”
How are these volunteers going to get their medical training, otherwise how will they know if Mr Blogs needs to have an ambulance called at once to take them to the nearest hospital that can treat the heat attack that is about to happen, or Mrs Blogs who is about to loose her unborn child to a miscarriage, the list is endless.
The GP contracts are a mess, they are not unaffordable in the whole scheme of things, but then GP’s are being asked/expected to provide a lot more now, because the NHS has moved services into the GP practice from health centres and hospitals. Also many GP practises have been burdened with PFI contracts because they needed new, bigger, building because of these extra services they have been required to take on.
July 12, 2013
Just a few problems with your ideas.
1) GPs are private practises that sell their services to the NHS.
2) GPs are able to diagnose illnesses and refer patients because they’re trained doctors. So volunteers will be a completely useless replacement.
3) As the Government is giving most of the control of the NHS budget to GPs it would be unwise to antagonise them.
4) What benefit is there in making GPs specialise in a clinical area? I can’t imagine most people will be happy to wait until an appointment becomes available with the right sort of GP.
July 13, 2013
So, where do you want to live, Kenneth? Utopia?
July 13, 2013
Indeed Kenneth you are right.
If you were first triaged by a nurse most who visit their local health centre would not need to involve their GP, saving the NHS billions
Near me our local chemists perform a similar function already.
But the NHS is our new religion and criticism is heresy and change is not allowed.
July 13, 2013
@Edward2: That already happens in many GP surgeries, the first firewall is the reception staff, they will try and filter-off to nurses any appointment that should not need a doctor, but at the end of the day some will want to see only a doctor, they might not actually want to discuss their medical issues with anyone else – heck some will refuse to see any other doctor bar “their” doctor. Irrational I know but that is human life, and at a time of (possible) illness is not the time to try and re-educate.
July 14, 2013
If you had to pay say £5, to see the GP once the initial review had been carried out and a nurse was felt to be appropriate, then perhaps the habit of always wanting to see a Doctor for free would change.
July 16, 2013
@Edward2: Assuming you had £5 to spare, or perhaps you expect people to chose between having a mean and seeing a doctor, not the best way of treating any illness – starve the body, unless of course it the shi… never mind!
July 16, 2013
Do try reading what I (and others) have actually said Jerry before you rush to yet another reply.
Demanding to see the Doctor after (I repeat, after) a qualified nurse has already seen you and can treat you, is unnecessary.
If the practice nurse said you do need to see a Doctor then this would still be free to the patient.
So no need for anyone to go without a meal to get treated properly.
Its just a little thought to save a bit of money.
July 16, 2013
Edward2: “Do try reading what I (and others) have actually said”
Talk about complaining that the kettle dirty, whilst dressed as a well used frying pan!
“If the practice nurse said you do need to see a Doctor then this would still be free to the patient.”
What do you not understand, if the nurse was fully QUALIFIED to make such a decision the nurse would not then be a nurse but a fully qualified doctor (and would thus need paying as a doctor to boot). Duh! The only person who can, unequivocally, say that a patient doesn’t need to see a doctor is a doctor…
July 17, 2013
You really are the most pedantic blogger, sorry commentator, I have ever read anywhere Jerry
You pick over the implied meaning of words like a contract lawyer looking for a get out clause
In this post seizing on the word “qualified” to claim a nurse that is qualified to triage a patient then will morph into a Doctor!
Just finally to say,the system of triage by a nurse works OK in hospitals but you say cannot be used in a local health centre.
Well Ok then Jerry you are perfectly entitled to your opinion and I know you always want the last word and are always right and never ever wrong, so well done.
PS Do you ever feel you would be better and more content starting your very own blog and giving us a daily article called “The views of Jerry” so we could have a rest from you on here?
July 12, 2013
Whenever change to the NHS is proposed the answer comes back that we don’t want a system like the US.
Yet the thing most dreaded by all my US colleagues and friends is having an appalling state rationed health system like the NHS!
It seems to me that the vested interests in both countries are manipulating us and defending themselves through sowing fear, uncertainty, and doubt.
Perhaps we could look to Germany for ideas?
July 12, 2013
Mr Redwood,
We all know that taxpayers money comes from a never ending supply of cash, and also that Government Departments will spend as much as they get and still demand more. (Parkinson’s Law).
They are also averse to any objective assessment as to the effectiveness of the result of this spending.
At some point it has to be clear that individuals bear some responsibilty for themselves and, that the Government is not their ‘Mother’
July 13, 2013
Whilst agreeing with your general sentiment – we should all take responsibility for our own health by keeping our weight sensible and doing some exercise – it is a bit galling to pour 120 thousand, million pounds into the NHS only to find, when you actually need its services, the wait is so long you pay to go private.
Which is exactly what my wife has had to do recently. Have to say when I send off my tax payment at the end of this month it will be with a more than usual sense of resentment.
July 12, 2013
Mr. Redwood – your recent protestations and comments on spending etc. are surely simply whimsy.
One reads something like this Public sector spending OUR money like there is no tomorrow and, frankly, it makes one want to weep. It certainly makes one feel very angry about paying taxes to see it pissed away in this manner.
July 12, 2013
Sorry, meant to add this one as well:
Civil servants spend a BILLION pounds of OUR money on credit cards
Nothing ever changes. You and your ilk seem incapable of EVER ACTUALLY DOING ANYTHING!
July 12, 2013
Good luck with that, without using the price mechanism. Rationing is what it says on the tin. Nobel prize winner Buchanan (public policy choice) provides the relevant details, if these are really necessary.
July 12, 2013
Let’s hope that IPSA isn’t in charge of the payroll bill!
July 12, 2013
“As we develop our NHS model, we need to ensure that it can embrace the innovation and productivity improvements that we rely on to keep the bills down”
This is clearly a reference to the fact that NHS hospitals are now going into the energy business in a very big way. Are those backup diesel generators to ensure that even with loss of supply due to transmission failure, the work of the NHS will proceed unabated? No. Apparently, they have been reassigned to ensure that the lights don’t go out when the wind dont blow. Under the Short Term Operational Reserve (STOR) scheme, NHS hospitals will be able to charge the Grid £600 per Megawatt hour (MWh) of electricity produced. This is 12 times the rate currently paid to ordinary power station operators, and six times the rate paid to inshore wind farm owners whose unreliabilty of supply is therefore doubly rewarded as well as being grotesquely subsidised by consumers with planet-destroying diesel engines. No wonder, Osborne says there will be no tax rises.
July 12, 2013
” Private sector industries never debate like this.”
But the windmill industry does, proving that it may be private sector as regards the profits but it isn’t a real industry.
July 12, 2013
I think the NHS is the same as the BBC. Too much money shloshing around in their bank accounts so they pay humungous amounts to more and more managers and deputy managers. The licence fee should be halved – the BBC obviously has too much money if it can pay someone nearly £1million to leave and the NHS has too much money to pay for managers.
I would break up the NHS and BBC into manageable blocks. The NHS into hospitals and clinics run by people who could speak English and who had been trained in this country and I would get rid of the huge level of beaurocracy running the BBC at huge cost to us the taxpayer. Both are (prone to corruption or malpractice ed) and unsustainable.
July 12, 2013
@Vanessa: Clues are on special offer this month at all well known clue shops, discounts available for those who need to buy in bulk!
July 12, 2013
The NHS was broken down into 137 trusts, which the Coalition broke down into thousands of GP consortia. The BBC also has regional departments.
July 14, 2013
uanime5: “The NHS was broken down into 137 trusts, which the Coalition broke down into thousands of GP consortia.”
That’s all very well, but there is still no feedback in either operating model; the BBC or the NHS, to tell management what their customers want. In fact the management of both operations prefer it that way.
If there was a genuine market in health care costs would fall – take for example; the NHS being the biggest purchaser of drugs in the UK is actually supporting the price of drugs, making medical treatment more expensive than it otherwise need be.
July 16, 2013
@APL: That is a failing of the (political and local) management, within the NHS they have always had a very good patient to staff feed back route, it is called the ward staff, trouble is that management -these days- tend to think that they know it all ‘cos they have their Phd in “pen-pushing” (and for that, in a subject that often has nothing directly to do with medicine or medical care) and thus it is below then to ask.
July 12, 2013
The problem with the NHS is fundamental and intrinsic in its structure.
Efforts have been made by past ans present governments to “ape” the disciplines of the private sector with targets that have to be achieved but this actually does no more than focus everybodys attention on achieving those targets.
In other words if the targets are imperfect then the ultimate service will be so.
The private sector need to beat the competition and this is what keeps them on their toes; not targets. This is also why the private sector will have customer care as a priority because they know the customer is paying them.
The NHS is devoid of all this. It is clear to them that they are paid by the government and he who pays the piper selects the tune. It is also clear to theem that the government have a lot of money and a lot of sensitivity to public criticism and so overspending matters not a lot. This is of coursse an entirely different situation in the private sector.
There is no doubt that whilst the NHS is left to operate in its present form, no amount of government tinkering will change attitudes; no matter if decision making is tops down or bottoms up, the structure will defeat all comers.
The NHS must be restructured to provide the disciplines of the free market. This does not mean that treatment has to be other than free at the point of use; insurance cover will ensure that it is, nor does it mean the government will not be able to help the less fortunate.
It does mean however the NHS will be provided with the right targets and will need to achieve them to survive
July 12, 2013
‘waramess: “The NHS must be restructured to provide the disciplines of the free market.”
But that is what they have been attempting to do, this is what the NHS Trusts and internal markets were all about, the NHS was far from perfect but it did tend to work in its first 30 years on existence – unlike today. The tax payer, never mind MHS patient, needs more of the free markets within the NHS like they need a lobotomy as treatment for ingrowing toenails. 🙁
July 13, 2013
No, they need proper competition not synthetic competition.
The reason the NHS worked for the first 30 years was partly due to the fact that, after the war, more young fit people were paying into the system than less fit older people wanting health treatment and partly because in the early years it retained the old ethos of the private sector.
July 14, 2013
@waramess: “they [the UK’s medical services] need proper competition not synthetic competition”
Like in the USA you mean, with millions without proper health care because they don’t have the correct health care entitlements? Sorry, as I’ve said, I will vote to be within a Federal EU before I ever put a cross besides any political party promoting such a course.
July 12, 2013
I agree with almost everything you said, John but you are wide of the mark in regard to large swathes of the private sector including the phone industry and utilities :
Mobile networks may give you perfect reception in the Thames Valley and London but I can assure you that in many other areas they are woefully inadequate : reception is often poor and has not been improved for 20 years.
I can do without 4G but it would be nice to be able to make a simple call :
In Dorset ( BH22 ) I have no reception in my house on either Vodafone or O2 and I regularly drive between there, Bristol, Exeter and Southampton on business.
Please note that, although these are main trunk routes, we still don’t even have a dual carriageway or motorway to Exeter or Bristol.
Forget HS2, John, please sort that out first !
On all three of these routes there are large gaps in mobile phone coverage and it’s impossible to maintain a conversation for more than a few minutes. There are large areas limited to SOS calls only. Mobile internet services ? Forget it.
Another perfect example : I need a gas meter moved just 3m in a property in Devon.
I have no choice as to who does the work, ( why not ? ) The monopoly supplier can charge what it likes yet they tell me it will take 11 days to provide an estimate which I then have to “accept” and it will then take up to 6 weeks to get the job done.
Let’s not get carried away, the private sector will invest only just enough to meet minimum standards and where there is a lack of competition such as with utilities and and mobile networks, we have to put up with pricing and service standards hugely worse than the Germans would accept.
The truth is that the private sector only really works when there are a large number of providers ( say, more than 10 ) to chose from.
July 12, 2013
@Chris S: “On all three of these routes there are large gaps in mobile phone coverage and it’s impossible to maintain a conversation for more than a few minutes.”
Whilst agreeing with much you say I was stunned by the above, surely if you are stationary the signal strength will not change?…
Forget opposing HS2 John, I think we need a Act that criminalises anyone making a telephone call whilst driving, hands-free is almost as dangerous as non hands-free. It is the mental distraction caused, just as kids demanding answers or screaming in the back can distract the driver, not the fact that one hand is not on the cars controls (if that was a real issues then disabled people missing arms would not be allowed to drive, nor would police officers ever be allowed to drive single manned vehicles).
July 13, 2013
A phone signal isn’t like a piece of wire linking us Jerry, it can vary in strength even if we both remain in one place.
Physics not your strongest subject I would guess !
July 13, 2013
@Edward2: Nor are you by the sounds of it, moving at speed between base or repeaters will cause even more drop outs, you obviously have no idea how the mobile phones work!
July 13, 2013
Jerry
You said… I am stunned…surely if you remain stationary the signal strength will not change…
Well you have to have a very limited understanding of how mobile phone signals work and basic physics to even make that statement in the first place
PS congratulations on your hundredth post today
July 14, 2013
Edward2: Sorry but you know nothing about RF and even less about how mobile phone network RFs works, oh and thanks for your 101 replies just to argue the t*ss about something simply because it shows your beloved capitalism up as the dogmatic idiocy it SOMETIMES is….
July 15, 2013
Jerry: “shows your beloved capitalism up”
Well, the physics of the electromagnetic spectrum cares not one jot about capitalism nor communism.
However, it may be worth pointing out that it was in the relatively capitalistic west, that mobile phones first achieved widespread use, and at a price that a very significant majority of the population could afford one, or even two.
It is clear that in terms of discovering things that might be useful and developing those things to the extent that a mass market develops, Capitalism wins hands down.
July 16, 2013
@APL: Utter rubbish, the GPO had Mobile phones in the 1970s (mostly car phones, as indeed it was still, until about the early to mid 1990s), the GPO had a prototype for a truly mobile phone in the 1970s to, but it was advances in both battery and IC technology that allowed what we know understand as the “mobile phone revolution” to take place, even the early private network hand-held mobile phones were hampered by overly large batteries (often nick-named the “Brick”) – this advances would have taken place regardless of the mobile phone market or weather it was a state owned industry [the GPO/BT] or the privately owned free market.
As for your last comment, you might be stunned by just how much technology has been born out of one of the highest budgeted state run industries in the world – batteries and IC technologies included – I of course refer to the USA space program and NASA.
July 16, 2013
Jerry: “the GPO had Mobile phones in the 1970s”
I believe the Army had mobile radio communications in the ’60 too. They were built and supplied by GEC, Ferranti and Plessy – what did those three companies have in common?
Ah, Yes! Apart from being in the private sector in the non communist WEST, they were also the major suppliers to, now who could it be? Oh, yea! GPO/BT.
Jerry: “this advances would have taken place regardless of the mobile phone market”
Then explain why the advances took place in the CAPITALIST west rather than Communist China?
Jerry: “I of course refer to the USA space program and NASA.”
Of course we’ll never know how much more advanced the space programme would have been if it had been left to the private sector, since NASA obsessed over the space shuttle and wasted twenty years ( while lots of private consortia were putting satellites into orbit ) – and was forced to acknowledge it was too expensive and too limited. We are only now seeing companies like SpaceX developing lift technology – because NASA no longer crowds out the private sector so we are seeing some real innovation again.
NB. Of course Britain had it’s own launch capability but the dead hand of government destroyed that too.
But I guess you live by the sword and can expect to die by the sword.
July 12, 2013
A government that is serious about reducing the pressure on the NHS should surely be taking every opportunity that will help to achieve that.
Why in that case is it rejecting minimum alcohol pricing and prevarocating on plain cigarette packaging?
July 12, 2013
behindthefrogs: “Why in that case is it rejecting minimum alcohol pricing and prevarocating on plain cigarette packaging?”
Because neither in their self would actually have any real perhaps? An alcoholic will go without food to be able to buy their alcoholic fix, or they will simply steal it. Kids (if it’s still anything like the smokers in my school, far to many years ago) won;t even see the packs, never mind the warning pictures or plain labels, well one kid might whilst kicking them off granny or who ever, once hooked the packaging is irrelevant. And as i said to Bazman a few weeks back regarding this, few smokers being offered a ciggie socially will refuse because the brand is wrong, even if the brand is visible.
A better plan would be to ban both supermarkets and petrol stations from selling either, make people go back to using Pubs, off-licences and tobacconists to obtain their purchases – it is crazy that the bottle of Gin can be loaded in to the shopping trolley along with the cornflakes and the ciggies can be bought on the way back out after checking-out the cornflakes and Gin…
July 13, 2013
I am totally in favour of a policy that moves all sales of alcohol and tobacco away from food and other sales. As in the USA and Canada supermarkets would have a seperate counter and entrance for all such sales.
Even the small local shops should have a seperate counter and till. I would also include lottery tickets in this move.
July 13, 2013
As you have never smoked you cannot know the mind of a smoker Jerry so stop try to pretend you do via proxies. Have a think as to why the tobacco companies spend so much on packaging and advertising and why they have fought tooth and nail against this bill. The colour and style of the packaging is very much a part of smoking. They will not refuse any brand as they are addicted to cigarettes, but this will be smoked under sufferance. If you remember in the 1980’s my brand was advertised the face of a man called Reg who “Smokes em’ cos my names on em”. Cigarettes for woman are given feminine packets and slim cigarettes. Who does not know French cigarettes with their iconic packets even if they have never smoked. Some fools only smoke when they go to France, so they say and so on…Get real jerry and stop your apologist fantasy.
July 14, 2013
Bazman: We have had this debate before an you are as wrong now as you were before, you are simply wrong on all counts. But nice to know that one has to be, according to your logic, a sexual pervert before you can know that child sexual abuse is harmful…
The weakness of the pro-ban argument is shown by the way that many are having to attack the Tories election strategist (for alleged connections to the tobacco industry in Australia) rather than attempting to debate the issue.
Tobacco products have already been hidden in large retailers and will be hidden in the smaller retailer within a couple of years, so how will anyone be able to buy on pack-design alone if at all, they won’t, they will simply take more notice of the actual brand name – which will likely cause even more brand awareness than the pack art-work does. Duh!
July 16, 2013
Explain why the tobacco companies spend so much on branding and as you say as branding is under attack, trying to associate a brand by something that cannot be banned such as a colour or a word. Though a word is less viable than a picture or a design.Why go to all this trouble as you foolishly believe that a cigarette is merely a means of delivering nicotine to the addict? The addiction addiction is not only to nicotine and smoking with no psychological hooks. It has many and pack design is one of these.
You Have no idea how a smoker and their addiction exist. It is not logical and if you make then write a list as to why they smoke they cannot come up with many reasons. The health risks are by the by.
The cigarette companies make every move to maintain their profits like drug dealers do. This is no exaggeration. It took them years to recognise that smoking was harmful and when faces with overwhelming evidence neatly bowed to this and carried on. For decades they argued it was only a habit and not an addiction in the true sense of the word. As if. And so on. Are you going to laughably tell us about the freedom to smoke now?
July 12, 2013
In the bad old days when the Post Office ran telecommunications, the waiting time for having a domestic telephone installed was six months, nine if you were unlucky and hit a bad time for labour relations. A callow youth in the cricket club that I was a member of at the time, and who worked in telephone installation, boasted of the amount of skiving and bloody mindedness that he and his pals indulged in. It really was a case of “You can’t get me, I’m part of the Union.” Once telecoms were privatised, the waiting time dropped to 2 weeks in short order, because the law of supply and demand was allowed to operate.
Bear the above in mind when considering the state of our health care industry and its waiting lists. The NHS is effectively a nasty (word left out ed) monopoly because people paying premiums for private health care cannot set them off against income, even partly. If you go wholly private, you pay for health care twice, once through taxation and once through insurance premiums. Let no one dare to claim that there is a level playing field.
Many people want to pay in to health care costs when young and draw down when old. But you don’t need an NHS with treatment free at the point of consumption to do that; you need a fund, which could be organised by the private sector; better still, several competing funds.
Again and again, we come up against two facts. The first that it is stupid and futile to strive might and main to keep the retired elderly alive until they succumb to Alzheimer’s disease. The second is that without payment at the point of consumption, people incur no penalty for degenerate lifestyles.
What we have got is a chronically rotten health care system that is allegedly retained for the sake of the poor. There is no need for it. Instead (1) Charge for health care at the point of consumption (2) Allow hospitals and GP group practices to set up charities, the proceeds of which will finance treatment for the deserving poor. ‘Yes’ to a kidney donated to a young person, ‘No’ to a liver transplant an alcoholic.
By 2030, there will be one third more over 65s than now. We need to look to a variety of methods for bearing down on the costs of their health and social care, and their pensions. No sane society invests in yesterday.
July 12, 2013
Finally, make clear in medical Statute Law that an error of judgement is not necessarily negligence. That way, we have some chance of hitting on the head the legal costs that are the bane of American health care. Their health care costs are 17% of GDP, as against just under 10% here and 11% in Germany.
July 12, 2013
@Lindsay McDougall: “Once telecoms were privatised, the waiting time dropped to 2 weeks in short order, because the law of supply and demand was allowed to operate.”
Utter rubbish, there was only one supplier, unless you were a business and were lucky to live in an area served by Mercury Communications, the waiting time went down because the financial brakes had been taken off, I’m not saying that there wasn’t issues with some staff but what do you expect when the staff were being treated like dirt by the management because the management was being treated like dirt by their Whitehall paymasters, who in turn were being treated like dirt by their political masters.
Oh and by the way, in the early 1070s, at the hight of the Heath Labour relations strife, my father got a new phone line connected and activated (with the provision of two telephones) to our new house, yes at first the GPO said it would be something like 3 months and might be a party line but one letter from the company he worked for stating that he needed the phone for their work and that (indirectly) they were covering the cost of the phone, it was installed within a or two week.
As for your ‘lets just allow the poor to die’ idea for the NHS, have you any idea just how many people die needlessly, or suffer far worse illnesses in the USA because they have no health care insurance and thus have to go begging for Medicare or charitable treatment, there are even stories of some people using out of date medicines because that is all they could afford (from an under the country supply).
I would prefer to live in a Federal USoE under the presidency of HvR than live in a country that has a medical system as you wish for! Even more so when it is just so you and plebs like you can have that extra case of bubbly, the new BMW in the drive and that extra holiday etc. each year…
Reply Before privatisation I had to wait months to get a phone line installed to a house near Oxford. I also could not get a phone line a few hundred yards from the Stock Exchange to my London office that took data reliably. It was these experiences which led me to champion privatisation of this service.
July 13, 2013
@JR reply: But why was it like that, it wasn’t because the technology didn’t exist, it was because the politicains would not allow the GPO/BT to be funded as it should have been (for example why was it that private companies could obtain commercail funding for expansion or even R&D but not the nationalised industries and services) – in fact the more the politicains kept funding away the worse the problems got and so the calls for “something has to be done”, be that from the political left or right. This didn’t just happen within the GPO/BT either, without trying to reopen the debate about railways, BR suffered too, one only has to look at the world beating national railways of both France and Germany to see what could have been…
July 14, 2013
With the number of over 65s set to rise by a third by 2030, the cost of their health and social care will become unaffordable. The only answer that anyone seems to have is to raise the retirement age. Well, we had better get on with that PDQ, raising the retirement age by one year in each parliament – and that deserves multi-party agreement.
I’m 67, I already suffer from poor kidney function and an arthritic left hip, so it’s not as if I haven’t thought about ‘ending up’. Keeping your dignity means having control over the timing of your own death. I will decide when my life has lost sufficient quality, not the God squad, not the drugs companies, not the medical profession and not the social services. Why should I have to sell my £400,000 house to pay for my health care and deprive my children of their inheritance, when the alternative of £4,000 for a one way ticket to Switzerland and assisted suicide is available?
July 14, 2013
@Lindsay McDougall: Well yes, if someone places monitory values above that of human life I have no doubt they will take such a view…
July 12, 2013
1) Unaffordable for anyone who isn’t a millionaire (you’d be surprised how much transplants and major surgery costs).
2) This hasn’t worked in the USA and it won’t work here.
Also an error of judgement isn’t always considered negligence if the error was reasonable.
July 12, 2013
“The UK is wedded to the admirable principle that health care should be provided according to need, with much of it provided free at the point of provision…”
In my view the principle is the key thing, not that the state must employ everyone who provides healthcare. This is the nonsense that led us to a system so good no one else copies it! It is also Labour Healthcare. We should privatize the provision of healthcare where it works…this is not the same as making us pay at the point of provision. However, it suits the Labour Party, the BBC and Guardian to scramble these concepts.
It would be good to see a party unscramble them.
July 12, 2013
REPay: That would likely cost the state even more, what do you not understand, private companies are in the business to make as mush profit as they can, whilst an service or industry with as assured market (as state health provision would be) would just mean these companies pushing the boundaries. “Competition” doesn’t work as everyone knows the game and everyone benefits from playing it bar the person who signs the cheques at the end of the day – indeed it already happens to a degree within the provision of both the drug and equipment supply chain, similar problems exists in MOD procurement, most if not all is sourced from the private sector and all suppliers know and play the game.
July 12, 2013
NHS, BBC, LTA – what have they in common – more money than sense
July 12, 2013
In The Lawn Tennis Association this may well be true. The others do not have to much money just peole at the top spending it on things other than healthcare and broadcasting. Does your rant also apply to the banks?
July 12, 2013
Funding for the NHS should be similar to a garage. Different procedures can be invoiced to the government at set tariffs. Cashflow is provided through procedural forecasts with balances, either debits or credits, being calculated and settled monthly. The NHS will still be free at the point of delivery and it can be opened up to fee payers as per @alanjutson above. Forecasting of procedures and income will allow the trust to plan better and provide it with the cashflow required to run or expand.
Competition between trusts will be based upon service and availability, private firms could also compete but only be paid what the NHS may bill for that procedure so there can be no shrieks of profiteering.
The taxpayers’ covenant with the government must be to pick up the tab in the following year whether that is more or less than budget. I assume most taxpayers will not accept this covenant if certain procedures remain available and residential criteria remain unchecked.
July 12, 2013
John, don’t waste your time with your research and analysis on the NHS. The only folk to listen to you will be us plebs who have to pay for this behemoth. Downing Street will be deaf to reform because they are afraid such measures will displease the electorate and consequently of being voted out in 2015.
Please establish some hard facts and figures though. Such as how many non-jobs were created under the Blair/Brown disaster and how much they have cost the tax payers in salaries, pensions and increased inefficiencies. As we used to say in the Navy, “there are far too many chiefs and not nearly enough indians”. £110,000,000,000 per year would go a long way to have the best Health Service in the world IF, IF, it were run by Private Sector Professionals. With much less interference by the subversive public sector trade union leaders of today.
July 13, 2013
@Terry: The NHS Trusts came in under the 1979-1997 Tory government, Labour simply carried on, even the costly PFI contracts were simply evolution on a financing system first used by the said Tory government.
July 12, 2013
Private sector industries never debate like this. You do not hear leaders of the mobile phone and smart phone industry on tv demanding higher allocations of future individual budgets to comunications, or threatening a shortage of capacity if prices do not rise.
Your example is flawed because you’re not comparing like with like.
If a mobile phone company has more demand, ie they sell more phones or have more people join their networks, they’ll get more money and can pay to expand of upgrade their services. By contrast in the NHS if a hospital suddenly has more people using its services it will not be given more money by the Government and will instead be told to remain within their budget. So they have to provide more with the same amount of money.
What we need from the officials who help Ministers lead and grow this crucial national service is constructive advice and help on how to adapt and develop the service, not screaming headlines of future crises imagined if more taxpayer money is not forthcoming.
Perhaps if ministers hadn’t been demanding that the NHS has to make £20 billion of savings, then demanded a further £30 billion of savings; while conducting an expensive reorg of the NHS officials wouldn’t need to point out that the budget won’t be sufficient due to the ageing population that the health minister keeps ignoring.
As we develop our NHS model, we need to ensure that it can embrace the innovation and productivity improvements that we rely on to keep the bills down in successful private services,without having to confont Granny with a bill when she visits the GP or hospital.
The private sector often keeps their price low by paying their staff less, paying their suppliers less, overworking their staff, and charging their customers more. The NHS has already copied all but the last of these so don’t expect more improvements without charging more.
July 12, 2013
Taxes will not need to rise as this government believes that the money can be found by cuts to services and the poor and by taxation of the middle not taxation of the wealthy. Pensions by far the largest bill will be for the next Tory government. Just remember this when voting all you miserable pensioners. I hear rumours of a cat food tax too.
July 12, 2013
Jerry
“Also I would like people to be honest when they suggest that the NHS should have more or be totally privatised etc. Just what if any financial interests they have or would hope to have, irrelevant asking such people if they are paying for private health insurance policy if they are a shareholder in a private health provider or perhaps even on the board of it – which is no different to the right criticising the public health unions when they support their own members.”
This is a real problem with socialists Jerry you never bother to check facts. You do know that a large number of private healthcare firms are non profit making, being charities and social enterprises? Provident association mean anything to you? Co-operative maybe? Do you know the Civil Service Union owned a private hospital ( Benenden) for many years?
You just don’t understand do you that in order to have an effective public service its not necessary for the government to run it.
July 14, 2013
@libertarian: If wanting true free at the point of use health care for all makes me a “socialist” then I will fly the flag with pride, far from your intended abuse I actual take great comfort from your comment! 🙂
July 12, 2013
Mr Redwood says “You do not hear leaders of the mobile phone and smart phone industry on tv demanding higher allocations of future individual budgets to comunications, or threatening a shortage of capacity if prices do not rise.”
Technology companies exist to make money and not to stop human suffering and save lives. A slight difference.
However, the private train companies do ask for more public money and the private (foreign) utilities monopolies take more and more of our money (might as well be called extra taxation) to pay executives and shareholders.
July 13, 2013
I’ll believe the NHS is short of money the day it stops funding lobbying organisations like Smoke Free …
If it can afford to fund propaganda it has more than enough money.