Whoever voted Tory at the last election...

Emp_Fab · August 2016

Justify this... http://www.bbc.co.uk/news/health-37186455

The NHS is on its knees already. These fuckers won't stop until we have a US style system where the poor and those with existing conditions won't be able to afford health insurance. If you voted Tory - is this what you wanted ??

FelineGuitars · August 2016

And we lose the human rights act too - wonder if the two things will join up at some point

TheBlueWolf · August 2016

I voted Labour, for all the good that did

Moe_Zambeek · August 2016

Do you really believe the problems in the NHS stem solely from the tories getting into power in 2015?

Do you really believe that all Tories want to dismantle the NHS?

Do you understand that most 'privatisation' of the NHS was started under the Labour Party, because they'd always rather hide their fiscal incompetence through things like PFI than address a problem head on?

If the NHS hadn't become a sacred cow that was untouchable for political reasons, perhaps we could make it more suitable and sustainable for the future. Posts like the OP simply perpetuate this head-in-the-sand approach and are a significant part of the problem IMO.

siremoon · August 2016

George Osborne is at the bottom of this and he is no longer in the cabinet. Hammond has already announced that the new Government will approach things differently. That suggests to me that it is far from certain that what is reported here will happen. I note that the BBC don't bother to point out that the Government is rather different today than it was when this was commisioned.

RandallFlagg · August 2016

I voted Conservative at the last 2 elections and glad we stopped the ever spiralling descent into debt that Gordon Brown was leading.

The burgeoning cost of the NHS is a problem that has been building for a long time and goes beyond one administration. Change is needed to get the costs under control, and has to be approached like any business. Raise taxes or borrow to fund the increasing costs or challenge and enforce cut backs (no department willingly cuts it's own budget)? Or do both?

Do you really think the NHS is running efficiently and there is no room for cost reduction? On the rare times I visit my local hospital I don't see a slick tight efficient organisation, there is always room for improvement in any business and a challenge can yield cost reductions through efficiencies.

Winny_Pooh · August 2016

Moe_Zambeek said:

Do you really believe the problems in the NHS stem solely from the tories getting into power in 2015?

Do you really believe that all Tories want to dismantle the NHS?

Do you understand that most 'privatisation' of the NHS was started under the Labour Party, because they'd always rather hide their fiscal incompetence through things like PFI than address a problem head on?

Do you want to go ahead and say which specific Tories are opposed? You'll first have to put down your copy of the Telegraph and buy some Private Eye back issues to try and weed out those who have investments in private healthcare. Then.... Mmmm Hard... You will have to figure out which of those Tory figures that claim to love the NHS and promise no cuts during elections actually mean what they say. Like David Cameron, OMG! politicians lie! Shock!
Pls see below a points summary:
http://anotherangryvoice.blogspot.co.uk/2014/02/the-destruction-of-nhs.html?m=1

A factual rebuttal is welcome.

Sporky · August 2016

The problem with blaming people who vote for the party that got in is this; look at both options. Until people start voting outside the two main parties it's a pretty poor choice.

richardhomer · August 2016

RandallFlagg said:

there is always room for improvement in any business and a challenge can yield cost reductions through efficiencies.

I have a long term eye condition which requires check ups at least twice a year.

A few days ago, I received a letter cancelling an appointment and a second one (on the same day, from the same place, in a seperately envelope) confirming a new appointment.

In a privately run business, that just wouldn't happen - a completely senseless waste of money, which could have been spent on treatment.

Quite why they have to post appointments out these days at all, is beyond me. Surely e-mail should be their default, with post reserved only for elderly patients?

It might seem I'm carping about a small cost - but multiplied by the number of times this must happen in a year (I've had it occur a number of times) it must cost a fortune.

Teetonetal · August 2016

The NHS is one of the uk's most pressing problems. The current system does not work. Under staffed, under funded and over subscribed is not a good combination.

Problem is any discussion about the NHS brings out responses that prevent the status quo being changed and the us system is always brought up in fear.

Other countries have much better health care systems than us. There are lots of models to look at.

NHS is an amazing idea that does not work.

HAL9000 · August 2016

Sporky said:

The problem with blaming people who vote for the party that got in is this; look at both options. Until people start voting outside the two main parties it's a pretty poor choice.

^This. I actually voted LibDem at the last election - certainly not because I wanted a LibDem government but because I don't believe that Labour can be trusted with the economy, and at least in the recent coalition the LibDems (who can't be trusted either) managed to offset the worst excesses of Conservatism.

Axe_meister · August 2016

I did some work years ago for a medical instrument supplier.
BUPA have a very good purchasing team. Profit margin to BUPA was 10%. The NHS just renew on existing terms without any negotiation, profit margin for NHS 40%. They even tried to explain that the NHS could get a better deal.
This behaviour is rife across the entire public sector.

ThorpyFX · August 2016

Axe_meister said:

I did some work years ago for a medical instrument supplier.
BUPA have a very good purchasing team. Profit margin to BUPA was 10%. The NHS just renew on existing terms without any negotiation, profit margin for NHS 40%. They even tried to explain that the NHS could get a better deal.
This behaviour is rife across the entire public sector.

Laziness and no understanding of the bottom line (whilst remaining cogniscent to patients needs) causes this.

richardhomer · August 2016

ThorpyFX said:
Laziness and no understanding of the bottom line (whilst remaining cogniscent to patients needs) causes this.

Absolutely - whoever is responsible for this is simply not doing their job. The object of the exercise (given the NHS's buying power) should be to squeeze suppliers margins to the bone.

Given their relative size, it should be BUPA paying over the odds, not the NHS.

randella · August 2016

richardhomer said:

RandallFlagg said:

there is always room for improvement in any business and a challenge can yield cost reductions through efficiencies.

I have a long term eye condition which requires check ups at least twice a year.

A few days ago, I received a letter cancelling an appointment and a second one (on the same day, from the same place, in a seperately envelope) confirming a new appointment.

In a privately run business, that just wouldn't happen - a completely senseless waste of money, which could have been spent on treatment.

Quite why they have to post appointments out these days at all, is beyond me. Surely e-mail should be their default, with post reserved only for elderly patients?

It might seem I'm carping about a small cost - but multiplied by the number of times this must happen in a year (I've had it occur a number of times) it must cost a fortune.

The trouble with anecdotes is we've all got 'em. I had a spinal surgery a few years ago; the surgeon looked at my MRI and was worried enough that I was in the operating theatre 24 hours afterwards. I asked him at the time why it's taken him a month to get me in for the chat, and he eventually admitted that the MRI guys had lost my scan. The MRI machine at my hospital was run by the leasing arm of a German investment bank and patient care was clearly not that high up on the list of priorities.

I'd been home an hour after leaving hospital when I had a phone call from said company giving me a rather strident talking to for not attending another appointment that I'd never made and they'd never written to me about. I was in surgery when this fictitious appointment was supposed to be taking place. I explained to the woman what had happened, and she was still grovellingly apologising when I put the phone down on her.

I have a feeling that there could be a massive benefit to the NHS if successive politicians of all party colours gave up trying to reorganise and shape it simply to make their ideological mark and looked solely at the value and service for the patient.

CabbageCat · August 2016

Emp_Fab said:

Justify this... http://www.bbc.co.uk/news/health-37186455

The NHS is on its knees already. These fuckers won't stop until we have a US style system where the poor and those with existing conditions won't be able to afford health insurance. If you voted Tory - is this what you wanted ??

I voted Tory because I thought it was the best option for getting an economy that wasn't spending within its means to spend within its means. So, yeah, I did "want" cuts (sure, I'm as sad about them as the next guy but then I'm sad that I don't have a yacht too, I just see overspending and I don't like it).

TheBigDipper · August 2016

There is a big difference between a business and a public service. The NHS is a public service. Running it like a business is a luxury that the NHS does not have. Measuring it like a business is counter-productive to it meeting its goals. If my business had an unprofitable sector (let's say, for example, my bus company never made any profit on a particular rural route connecting villages to the nearest town) then I could stop doing the unprofitable thing. That's not something the NHS can do, and to try and make it operate like a business is foolish. For what it's worth, I think buses should be treated as a public service, too, but there you go...

The example of the "two letters" given earlier is a case in point. If an appointment has to be cancelled - maybe due to staff sickness/shortage then the right thing to do as a public service is to inform the patient as soon as possible so they do not waste their time and money coming to the hospital. The admin team will notify all the cancelled people first and then try and reschedule everything. Hence the two letters to one patient, but that might have been 20-30 cancellations which then need to be rescheduled as best they can. From the patients perspective, two letters instead of one seems a waste of money. From the organisations point of view, rescheduling everything one appointment at a time would be more expensive than spending a much smaller amount in postage & printing.

The example of purchasing departments agreeing to pay more for medical instruments than a private hospital is interesting. It's entirely possible that NHS negotiators are not as good as BUPA negotiators. It might also be that the instrument supplier is unique. The supplier might believe BUPA when they say they cannot afford (being a business, they must make a profit) to buy those instruments and will just stop doing that sort of work in future rather than make a loss on it. A luxury the NHS cannot have, as whenever someones private health insurance does not cover a medical process, we all know where the patient ends up being treated.

stickyfiddle · August 2016

TheBigDipper said:

The example of the "two letters" given earlier is a case in point. If an appointment has to be cancelled - maybe due to staff sickness/shortage then the right thing to do as a public service is to inform the patient as soon as possible so they do not waste their time and money coming to the hospital. The admin team will notify all the cancelled people first and then try and reschedule everything. Hence the two letters to one patient, but that might have been 20-30 cancellations which then need to be rescheduled as best they can. From the patients perspective, two letters instead of one seems a waste of money. From the organisations point of view, rescheduling everything one appointment at a time would be more expensive than spending a much smaller amount in postage & printing.

The example of purchasing departments agreeing to pay more for medical instruments than a private hospital is interesting. It's entirely possible that NHS negotiators are not as good as BUPA negotiators. It might also be that the instrument supplier is unique. The supplier might believe BUPA when they say they cannot afford (being a business, they must make a profit) to buy those instruments and will just stop doing that sort of work in future rather than make a loss on it. A luxury the NHS cannot have, as whenever someones private health insurance does not cover a medical process, we all know where the patient ends up being treated.

On the letters, you're right about the logistics. But emails still would've cost zero compared with the cost of a letter, and envelope and a stamp.

As for the purchasing, I'd be amazed if the same isn't true for the majority of supplier contracts. The point is, paying lots of money for the best buyers with great negotiation skills and policies will repay itself a thousand times over in cost savings.

We've all heard the anecdotes of "a single aspirin costs the NHS £2" or whatever, and there's always an explanation around contract mechanisms and oversight and whatever but the fact is that's just ridiculous and completely unacceptable and whoever is responsible for those kind of contracts should be fired.

(source: http://www.telegraph.co.uk/news/health/11718631/Aspirin-loo-roll-and-surgery-true-cost-of-the-NHS-revealed.html)

Emp_Fab · August 2016

Wiz to TheBigDipper there. Believe me, I'm not so myopic to think the NHS isn't in need of improvements in the way it's run - name any organisation of that size that couldn't do with some serious scrutiny. However, when a public service, an ESSENTIAL public service is already crumbling (and you WOULD be myopic if you couldn't see that), the solution is not to cut the budget further - that will merely accelerate its demise. Whether you believe that is the intended effect is up to you - personally, I do. I think the NHS is a millstone for the Tories and they would love the UK to move to a US style system.

CabbageCat · August 2016

Emp_Fab said:

Wiz to TheBigDipper there. Believe me, I'm not so myopic to think the NHS isn't in need of improvements in the way it's run - name any organisation of that size that couldn't do with some serious scrutiny. However, when a public service, an ESSENTIAL public service is already crumbling (and you WOULD be myopic if you couldn't see that), the solution is not to cut the budget further - that will merely accelerate its demise. Whether you believe that is the intended effect is up to you - personally, I do. I think the NHS is a millstone for the Tories and they would love the UK to move to a US style system.

I (personally) don't think that the Tories are trying to destroy the NHS. I do think that they are trying to make it smaller, more modular and cheaper. I guess we can't both be right.

The NHS has always been "crumbling" in the same way that this country has always "been going to the dogs".

impmann · August 2016

BigDipper hit the nail on the head.

Its a service. It has a cost. Those costs spiral, not completely because of the infrastructure or "incompetance" but because the budges have been *CUT* year on year for years, meaning it always looks like its 'under-performing".

Like Mr Fab, I'm not stupid enough to believe that the NHS doesn't need some kind of reform, rework and modernisation. However, we need to accept that if we want to have a free service for all going into the future, this will *COST MONEY* and it will never pay for itself. Modernising will cost money but will save money in the long run - and will improve services.

Perhaps removing the layers of management and admin would be preferable to closing hospitals and cutting the essential services. Perhaps questioning how contracts are awarded, and costed, would be a better place to start. Perhaps modernising and building new hospitals that cost less to run, have better efficiency etc would be perferable. But these take time, and don't provide immediate "gains" that politicians like.

But we have to stop believing that the NHS has to cost *less* to run. That is a political fantasy, and all parties in recent years have been guilty of this.

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Whoever voted Tory at the last election...

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