Paul3446

You get your house in order and your act together, not your act in order!

I love mixed metaphors!

The Zohan

Agreed, just chucking money at a problem isnot the answer, nor is employing legions of managers and layers of management. sticking plaster aproach and spin,spin labour again.

the 11 years and still whinging on about the last gov't is getting a little boring. One term to assest the situation and get your ducks in a row then another to really make a visible positive difference would have just about been acceptable.

Bleating on and blaming others is for loosers and if the shoe fits....

Martin2005

Paul

You say spin but who is spinning here? Most of the points you make are unquantifiable Daily Mailesque headlines.

Are all the new hospitals, and new wings on old hospitals, just a figment of my imagination or are they real?

Do we or do we not have record numbers of Doctors & Nurses, or did I just dream that?

The NHS cannot possibly be as bad as it was 11 years ago, it's just not possible.

Richiehash

Ok firstly I'm not here to castigate the government(the squatter in no 10 was more of a reference to having an unelected PM)-I'm not paticularly partial to any political party because i recognise the need to change my ways/opinions as time progresses, however I am strongly opposed to being seen to do something and making lots of noise whilst achieving sod all.

Secondly unless youve worked within the nhs at front line and managerial levels then you would not believe how badly it is run in most cases, with managers who have no clue about how to do the job of the staff below them telling them how it should be done(there are obviously a few exeptions to this rule)

Feel free to post the employment facts if you want-please make sure that the number weighting for 'part time' staff is taken into account though-ie total hours worked.Although the only easy to find figures are the number of new nurses employed not the total no of nurses(no body seems to list how many are leaving the profession,being promoted or on long term sick)

As you say its your job to work with big money for big organisations do you honestly believe the way the nhs is spending their(our) money effectivly?
I will concede the last few percentage points may cost a bit more(law of diminishing returns etc) but is if really worth that last 2 percent improvement which may take up to 20% of total spend when massive improvements could be made with much less of a spend when you get down toward front line areas which is where its needed,rather than to the top of the pyramid and filter down as is the current case.
I'll even give you an example you can google-Velindre hospital in Cardiff was offered(by a patient no less) a cancer treatment machine(of which there were none of that type in wales) but, it was turned down on budget grounds for staffing in spite of the fact that the very same hospital department(radiotherapy) had spent close to £180k on artwork that year which would have covered the running for 2 years during which time it would have become self funding.

Also as the majority of outsourced contracts/spending depend on the level of the backhander not the quality of the service offered, i cant see that situation changing soon.An example being in 1999/2000 laptops were a very popular gift from drugs reps to department heads/budget controllers. Now in 2008 hospital machine makers(siemans<sp>, varian etc are offering cars and jollies abroad as an incentive to buy thier machinery/service contracts at an inflated cost over their competition.

In short the nhs has gone from being a public service to being jobs for the boys and I cant see that changing soon without major restructuring which wont ever occur due to the way that management protect their own interests first over that of the patients.

In conclusion I think that the nhs is in real terms(ie to the patient)no better under labour than it was under the cons, in fact slightly worse due to the way it is mismanaged(is that a real word?) which,having no real political bias i find quite saddening as it could be so much better.

cheers richie

Martin2005

As for the Boris thing, I already said I think it's shabby, although I think we should all look a bit harder past the 'spin machine' of both sides.

What I think would be interesting is peoples views on the whole 'Cigar-gate' episode, if you replaced the name of Boris Johnson, with that of Ken Livingstone, I think we both know that there would be a slight difference in the tone and nature of peoples responses (to put it mildly).

The Zohan

Disagree, if it was Red Ken then then Boris s would have gone down in my estimations.

Martin2005

Whilst I disagree with you that it's not improved, because I find it frankly impossible to believe that that's possible, how could it possibly be worse than it was?
I do absolutely agree with you that the money should of been spent more effectively. This is the great failing of this government (as I've said many times on numerous threads). We need root and branch reforms of all our public services, this government (Gordon Brown in particular) has run away from taking on the big public sector unions and the other vested interests, and until this happens every extra £1 of our money that is put it will yeild way less than £1 of improvements.
I want to hear from David Cameron on this, I want to know how they are going to change the NHS for the better, they have accepted the arguement that you cannot starve the NHS of cash in an attemp to force people to find alternatives, they have pledged to keep health spending broadly the same as this government. What we all want is our tax spend wisely, hopefully he has a plan to do this.

PeteBrant

Quick question.

What are people asking for here (Martin aside)

Less money to be spent on the NHS? or What?

The Zohan

could not agree more

Martin2005

Oh come off it Paul, you know as well I do that peoples views on this would be exactly 180 degrees different.

Richiehash

I refer you to my post regarding having worked in the nhs-however its your right to express disbelief in the face of no actual experience in the same way that i can use my experiences of the nhs to create an informed opinion rather than use rhetoric.

Thats an easy one-make all non medical staff in the nhs earning more than 22k reapply for thier own jobs whilst justifying their position. Should cut around 40% of wage costs instantly.

Allow deparments to use whichever supplier they want as opposed to the ones thier managers/trust execs say they must-minimum 20% saved there.

Let the monopolies commission take a look at the way that drug companies fix prices/product availability-potentially massive savings to be made here if theyve the political ***** to take on the likes of ICI Smith K B etc

As you are the self proclaimed expert at funding spending perhaps you have some ideas of your own to share as well?

cheers richie

The Zohan

How very NL tell people what/how they think.

No, again - if it was Kenny not Boris then i would feel the same way - it is patheric and a waste of time and money creating no stories like this.

Martin2005

Hmm.....rhetoric I think there already been enough of that on this thread!

You've worked in the NHS so you'll know what it was like 12 years ago.
The NHS is a vast organisation and the biggest employer in Western Europe, therefore there are always going to be a fair mix of good and bad, it just winds me up that people only want to focus on the bad things, usually to make crasse and biased political points.

I'm not a self proclaimed expert at public sector finances, so I'll leave that one alone, as I don't know the answer, I just hope our next load of political masters do.

Martin2005

Paul - I was talking about general opinion on this site not you in particular.

PeteBrant

It's anecdotal - I know several people that work in the NHS, and find it a much much bette rplace that 15 years ago.

Presumably you have some plan to avoid the inevitable strike action by UNISON and the BMA that would follow such a move?
What do you mean "minimum 20% saved"? Wher eis the evidence of such savings?
Are you saying that Trust execs deliberately overpay for supplies?
Rich countries pay more for drugs, so that poor countries can have them cheaper.

In addition to this, How do you force the likes of ICI to sell cheaper to the UK?
"Sell to us cheaper or we won't let you sell us life saving drugs!"


Our NHS budget is now in line with the EU average in terms of percentage of GDP - WHen Lavbour came in, it was just about the lowest.


People seems to have this bizarre idea that you can improve public services by spending less on them. (which we tried in the 80's and basically brought them to thier knees)

In what other walk of life do you apply this logic?

Leslie

Nobody has said that Pete, but what we are unhappy about is the vast sums spent on top heavy and unecessary management which costs us scads in salaries and pensions and does more to impede the running of the NHS than to improve it. Good way to buy votes with our taxes of course! We do not need a target driven organisation since those in the NHS know far better how to do their jobs than the managers do. They spend their time insisting on seriously excessive paperwork in order to impress their political masters who can then quote statistics up the ying yang to prove how good eveything is going of course. What a waste of the professional's time that is, I have seen it all being done when that person could have been seeing another patient!

All that wasted cash could have been put into the NHS to provide more doctors, nurses and equipment which is where it is really needed.

Martin. Did you realise that those hospitals you mention were built under PFI which means that the taxpayer will be paying those costs back for anything up to 50 years from now? And also that in some cases they cannot afford to open wards in some of those hospitals?

Les

PeteBrant

It's a pretty desperate state of affairs. The country owes the private sector around 100 billion - But then when you spend 15 years underinvesting, then you need to catch up - It was probably the only way without raising taxes by a significant amount.

The Zohan

as an aside my most recent experience of the NHS was this,

Went to local hospital A&E as i have developed a nasty little ear nfection bad enough to have me being sick and in agony.

I work away from home during the week some 140 miles so not practicable to see my GP.

No local NHS doc would se me as i was not registered where i work and had a GP in Npton.

A&E was empty at 8am. i got logged in.

The triage nurse was quite rude and did not understand why i should waste their time. I explained the situation to which i was greeted with a tut. I was told i would be seen that morning.

I then apologised for not being as drunk or a druggie or being involved in domestic violence. I apologised for being a working male, miles away from home and with no option but to come into A&E.

I apologised for being employed and paying his wages.

At this point he seemd a bit taken aback and suggested i visit the walk-in surgery the other side of the hostpital. I asked why he couild not have suggested this in the first place, thanked him for his help and concern and left.

Well done Dewsbury General - a shining example!

Richiehash

I think you'll find that second hand stories from a few friends is anecdotal rather than personal experience from both within the nhs and as a patient.


as the only people that would want to strike would be those who's existance within the nhs could not be justified i dont see it as a problem-you did read the bit about non medical staff did you-specifically administrators?

thats exactly what i'm saying-the trust execs/ high level managers specify their preferred suppliers that must be used rather than the cheapest

nope just allow competition in the marketplace so the smaller players can undercut the big boys-they will have no choice then


Why cant people understand that the ammount of money spent is not relevant here-its how its spent


i dont and have never applied that logic. The nhs will always need more money than it has, it just genuinly saddens me how poorly the money is used but given that a decent sized chunk of scoobynet are managerial level i wouldnt expect many to agree with me in case it rocks the gravy train.

cheers richie

alcazar

iTrader: (2)

Have to agree with everything Richie says, and I've had experience of similar in a different field.

Alcazar

PeteBrant

Of course your experience is anecdotal. It is personal, specific, anecdotal. Why should I treat your second hand story (from my point of view) any differently anyone elses?

Yes, I read the bit about non-medical staff. I was assuming that you were going to transfer the work that those people do onto medical staff. Obviously it has to be done by someone.
Unless you have some other plan to do the work required?

And why are they preferred? Reliability? Quality of product? Economies of scale? Exclusvivity deals? Long term agreements?

Cheapest does not equate to best value for money.


Competition from who?

Which of the multi-national drug company conglomerates are "smaller players"?
Of course spending money more effectively is important, you are absolutely correct. But your posts have been advocating cutting here and cutting there. To what end?



Or they have a better knowledge of managerial decisions and the thought process behind those decisions, perhaps?

Of course this is a silly suggestion, but so is postulating that is someone disagress, then they must be on the NHS gravy train.

Richiehash

If you want to ignore facts go ahead-thats fine


I take it you do understand assumption is the mother of all **** ups?
If you read a little further you may have come accross the bit were i said let them reapply for thier jobs if they can justify them?


Nope because in almost all cases because of the incentives they offer to higher management levels.



Exactly my point-the 3 major companies(ICI SKB and GLAXO) have the entire market sewn up to the point where no other company could introduce and market any drugs in this country. Tragedy highlights case for new paracetamol drug - 28 July 1990 - New Scientist a classic example

Errrrr i think i said saving not cutting but,how about to get rid of unneeded expense to allow more front line medical staff/equipment/drugs for the same money


Or of course that they are a group of largely self serving individuals who are trying to get what they can out of the system before they are found out.In fairness though i was referring to the mid management gravy train runners in all areas not just in the nhs-it appears tho that you believe the nhs 'gravy train' exists also though and having not condemed it you must be in favour of it then?


cheers richie

PeteBrant

Hang on, why is mine and friends experience anecdotal, but yours isn't?

Firends that work in the NHS have to work hard and are certainly not on a "gracy train" and in thier experience the service has improved. In my own experience the service has improved from 20 years ago.

This is all personal and anecdotal.
So you are going to take existing public public sector workers and make them reapply for thier own jobs. Whos going to manage this? How much will it cost?And if you decide you can cut 40% of the wagebill (which seems to me like a figure plucked out of thin air), how are you going to pay the fairly enourmous redundacy bills? You can't just sack them. Not to mention the huge union problems you will have.
And who is going to do the work they leave behind? These people do fulfill a function otherwise they wouldn't be in a job, Hospitals are on a very tight budget, they aren't in a position to have "charity" jobs.

I think this is sounding a bit conspiracy theory to me. Sure, maybe there are one or two bad apples, but the majority of professional staff in my opinion are just that; Professional. They aren't on the take.
If there is anywhere you have to justify expediture, it's in the public sector, just look at bodies such as NICE.


So how do you propose to fix it?
Cutting and saving are a fine line. Bringing in more frontline staff is of course welcome, but not at the expense of overhead staff that do a valuable service.

I'm all for putting management consultants and advertising executives up against the wall come the revolution, but I don't think its a problem endemic in the NHS.

I'm not going to condemn something I don't beleive exists.

Richiehash

OK we'll just have to agree to disagree-but the fact remains that the nhs is in need of some serious painfull reforms and removing of useless dead wood-i dont think it can be done without the government tinkering with a few new laws etc. and some wailing and gnashing of teeth from those who cannot justify their jobs.
Much of what i have seen and read comes from a regional nhs manager who i feel is a little more qualified on the subject than you or i (this includes emails i have read and minutes from meetings i have seen).
There is also the possibility that the local nhs to your area is the perfect public body without any problems but somehow i doubt it
cheers richie

PeteBrant

I can live with that
My Ex is a rather senior member of NHS nursing staff.
Oh I doubt it too!


I think we can agree it can benefit from some reforms, its just the level of them where we differ.