NHS and politicians

[RogerS]

It's clearly a problem that the NHS is used to promote agendas, I'm constantly wary of all media outlets, Jacob probably thinks I'm a mail reader (this isn't a dig at you Jacob), in actual fact, I don't read newspapers at all as a first source of information, if a story interests me then I'll visit various web outlets to get a range of opinions on the story before I form any kind of opinion.

One thing that has come from this discussion though is that we all want the same thing, a working NHS. The biggest battle for all of us will be getting people to stop polarising around public vs private. Once the 2 factions stop fighting each other and work together then we'll all move forwards. I think that's something that has been seen in practice in the coalition, almost, something I'd like to see more of between all 3 parties, government should be inclusive, not exclusive. It may seem rose tinted but I firmly believe that working together for positive outcomes is far more productive than fighting against each other for negative results.

+1

 

[John51]

It may seem rose tinted but I firmly believe that working together for positive outcomes is far more productive than fighting against each other for negative results.

Accepting that the opposition 'might' have a point seems to be a no-no for many Brits. 'If I can prove you wrong that proves I'm right' sort of thing.

 

[Reggie]

They seem to forget that the NHS is about people, not politics, point scoring solves nothing, real solutions do. You know at the end of it all, it really doesn't matter who does the job, public or private, the positions still need to be filled, services provided, to a level of care and for a price.

 

[finneyb]

They seem to forget that the NHS is about people, not politics, point scoring solves nothing, real solutions do. You know at the end of it all, it really doesn't matter who does the job, public or private, the positions still need to be filled, services provided, to a level of care and for a price.

Agreed. To do this we need to start seeing the NHS as a universal insurance premium rather than a collection of buildings and people; it provides care when you need it be that in the public or private sector. The universal insurance premium is were the NHS wins over the likes of the US system where up to now there is an opt out and people can and do carry their own risk - that's OK until the proverbial really hits the fan eg cancer in the under 65's and they become bankrupt paying for their own treatment. ( In US over 65's are treated under Medicare, but there are still significant costs to be paid by the individual)

The universal insurance premium that we ALL pay now approximates to £2,000 pa per person (£120 billion NHS budget/ 60 million population). Of course, it's paid each and every year even if you don't need the treatment - but that's what insurance is all about - risk management.

Brian

 

[RogerS]

I was talking about this last night with a doctor friend of mine. One thing that came out is that compared to many years ago, almost without exception all hospitals now follow strict protocols...that's box-ticking to you and me..and it is here that most of the waste in the NHS occurs. Needless tests are carried out because they are demanded by the protocols and there seems to be no margin for an intelligent and common-sense approach.

However, hospitals do not have the same protocols for the same 'illness/emergency'! Enter the 'Post Code Lottery'. Compare and contrast the experience of his 84 year old mother-in-law at Peterborough Hospital...admitted with bleeding from her back passage (and according to my friend, he would immediately start thinking of the possibility of cancer) ...but was promptly discharged after minimal tests and told to go to her GP. Peterborough is under extreme financial pressure in no small part due to the relatively high immigrant population compared to Worcester where my own 85 year-old mother-in-law went and who went through a battery of tests because that was what their protocol demanded.

 

[Modernist]

Peterborough is under extreme financial pressure in no small part due to the relatively high immigrant population compared to Worcester where my own 85 year-old mother-in-law went and who went through a battery of tests because that was what their protocol demanded.

I wasn't aware the the % immigrants was a factor in NHS funding.

Re cull of NHS managers the efficiency of the system depends entirely on the effectiveness of it's management. This needs to be a tiered structure but the key word is effective ie managed with common sense and teeth where required. One problem is the constant interference of ill informed politicians who are having a similar devastating effect on education.

 

[RogerS]

Peterborough is under extreme financial pressure in no small part due to the relatively high immigrant population compared to Worcester where my own 85 year-old mother-in-law went and who went through a battery of tests because that was what their protocol demanded.

I wasn't aware the the % immigrants was a factor in NHS funding.

No one said it was. Suggest you leave your preconceptions/bias behind. Simple fact...larger demand due to the high numbers of immigrants and many not speaking English therefore more demand for translators who are not always available when required...leading to delays....leading to a more inefficient NHS.

.[/quote]

 

[Cheshirechappie]

Peterborough is under extreme financial pressure in no small part due to the relatively high immigrant population compared to Worcester where my own 85 year-old mother-in-law went and who went through a battery of tests because that was what their protocol demanded.

I wasn't aware the the % immigrants was a factor in NHS funding.

Re cull of NHS managers the efficiency of the system depends entirely on the effectiveness of it's management. This needs to be a tiered structure but the key word is effective ie managed with common sense and teeth where required. One problem is the constant interference of ill informed politicians who are having a similar devastating effect on education.

When, in a publicly owned service, things are not as good as they should be (e.g. Mid Staffs, Redditch, 13000 avoidable deaths etc.) then it damn well IS the duty of politicians to intervene. The public services are run on our behalf, and paid for by us, so our elected representatives should be acting on our behalf to ensure that inadequate service is improved. Those schools and hospitals doing a good job can be left to get on with it (except for regular inspection and monitoring to ensure that they continue to do a good job), those that are not should, on our behalf, be sorted out.

Politicians also owe us the duty of ensuring that our taxes are spent wisely. A publicly-provided service should be as good as, or better than, the equivalent service provided privately for the same cost, otherwise the taxpayer is not getting value for money. If public funds are not being used efficiently, politicians should intervene to see that they are.

Would you willingly pay a high price for a sub-standard service?

 

[Modernist]

Peterborough is under extreme financial pressure in no small part due to the relatively high immigrant population compared to Worcester where my own 85 year-old mother-in-law went and who went through a battery of tests because that was what their protocol demanded.

I wasn't aware the the % immigrants was a factor in NHS funding.

No one said it was. Suggest you leave your preconceptions/bias behind. Simple fact...larger demand due to the high numbers of immigrants and many not speaking English therefore more demand for translators who are not always available when required...leading to delays....leading to a more inefficient NHS.

.

[/quote]

Clearly you said it was Roger.

I don't see any preconceptions in my comments as I have not commented previously. If more translators are required then the management should be in a position to provide them. If the system is geared to need then it should be able to respond.

When, in a publicly owned service, things are not as good as they should be (e.g. Mid Staffs, Redditch, 13000 avoidable deaths etc.) then it damn well IS the duty of politicians to intervene. The public services are run on our behalf, and paid for by us, so our elected representatives should be acting on our behalf to ensure that inadequate service is improved. Those schools and hospitals doing a good job can be left to get on with it (except for regular inspection and monitoring to ensure that they continue to do a good job), those that are not should, on our behalf, be sorted out.

Politicians also owe us the duty of ensuring that our taxes are spent wisely. A publicly-provided service should be as good as, or better than, the equivalent service provided privately for the same cost, otherwise the taxpayer is not getting value for money. If public funds are not being used efficiently, politicians should intervene to see that they are.

Would you willingly pay a high price for a sub-standard service?

Unless of course the constant intervention of politicians was part of the cause of the problem in the first place. Management of NHS functions should be carried out by competent managers who's own performance is appraised regularly as in outside industry.

 

[Cheshirechappie]

Who is holding the managers of the Mid Staffs NHS Trust to account? Who should should deal with the inadequate performance of the 14 NHS trusts in which up to 13,000 avoidable deaths occurred? Why did the Care Quality Commission - the quango supposedly appointed to do just that - apparently suppress reports of inadequate service, and when that came to light, who should deal with the CQC?

Oh - and as an aside - who is paying for all this? What would happen if such scandals had occurred in private hospitals?

 

[Phil Pascoe]

No, N.H.S. management shouldn't provide interpreters - anyone needing one should bring their own or pay for one. It's daft things like that that eat up the money. Try going to any other country and expecting them to pay for interpreters.

 

[Jacob]

Who is holding the managers of the Mid Staffs NHS Trust to account? Who should should deal with the inadequate performance of the 14 NHS trusts in which up to 13,000 avoidable deaths occurred? Why did the Care Quality Commission - the quango supposedly appointed to do just that - apparently suppress reports of inadequate service, and when that came to light, who should deal with the CQC?

CQC is another example of politicos evading responsibility . Setting up enquiries, commissions, calling in "hit teams" etc etc are ways of appearing to be doing something but in fact shutting everybody up in the short term and passing the buck and hoping the issue will be forgotten or bogged down forever.
Similarly with trusts, free schools, academies etc etc all devious tricks.

 

[Cheshirechappie]

CQC is another example of politicos evading responsibility . Setting up enquiries, commissions, calling in "hit teams" etc etc are ways of appearing to be doing something but in fact shutting everybody up in the short term and passing the buck and hoping the issue will be forgotten or bogged down forever.
Similarly with trusts, free schools, academies etc etc all devious tricks.

I'm not sure that I understand this comment.

"CQC is another example of politicos evading responsibity." Er - how that, then?

"Setting up enquiries, commissions, calling in "hit teams" etc etc are ways of appearing to be doing something but in fact shutting everybody up in the short term and passing the buck and hoping the issue will be forgotten or bogged down forever." What should the politicos do, then?

 

[RogerS]

Note that Jacob continues to use terms that are pejorative towards the current Government. Terms such as trusts, academies etc.

Clearly forgetting that the recent report by Professor Jarman laid much of the blame at the doorstep of the last Labour Government. And I see yet another £500 million IT project instigated by Labour has hit the buffers and been abandoned.... Honestly Labour shouldn't go anywhere an major IT project!

Brian (Modernist)....there is a difference between 'funding' and 'costs'. Surely you know that? Your preconceptions could be taken to be that you imply a racist bias to my comment.

 

[Jacob]

....

"CQC is another example of politicos evading responsibity." Er - how that, then?

There you go - you can't spot the trick! That's the whole point.

"Setting up enquiries, commissions, calling in "hit teams" etc etc are ways of appearing to be doing something but in fact shutting everybody up in the short term and passing the buck and hoping the issue will be forgotten or bogged down forever." What should the politicos do, then?

Make difficult decisions themselves and get their ministries to take on some more direct responsibility for things. Lead from the front in other words. It's not just a lefty thing - Aneurin Bevan, Attlee, Churchill. Even Thatcher had *****x even though she was an out and out disaster.

 

[Cheshirechappie]

....

"CQC is another example of politicos evading responsibity." Er - how that, then?

There you go - you can't spot the trick! That's the whole point.

"Setting up enquiries, commissions, calling in "hit teams" etc etc are ways of appearing to be doing something but in fact shutting everybody up in the short term and passing the buck and hoping the issue will be forgotten or bogged down forever." What should the politicos do, then?

Make difficult decisions themselves and get their ministries to take on some more direct responsibility for things. Lead from the front in other words. It's not just a lefty thing - Aneurin Bevan, Attlee, Churchill. Even Thatcher had *****x even though she was an out and out disaster.

OK Jacob - for the benefit of us thickos who can't 'spot the trick' with regard to the CQC, would you be kind enough to explain exactly what it is?

When the politicians 'make difficult decisions thenselves', should it be on the basis of something a Special Adviser told them, something they heard in the Westminster Arms, voices in their heads, or the report of an enquiry set up to gather, record and assess the evidence of what went wrong and make reccommendations about doing things better?

 

[Modernist]

Note that Jacob continues to use terms that are pejorative towards the current Government. Terms such as trusts, academies etc.

Clearly forgetting that the recent report by Professor Jarman laid much of the blame at the doorstep of the last Labour Government. And I see yet another £500 million IT project instigated by Labour has hit the buffers and been abandoned.... Honestly Labour shouldn't go anywhere an major IT project!

Brian (Modernist)....there is a difference between 'funding' and 'costs'. Surely you know that? Your preconceptions could be taken to be that you imply a racist bias to my comment.

We agree on that then.

Re IT, the industry from day 1 has had a cynical beanfeast at the expense of the taxpayer which continues unabated whichever party is in power. I am not sure there have been any "successful" gov IT projects but plenty of the reverse. Some salesmen (old ones) are still drinking the profits of decimalization. The millennium bug proved remarkably absent on the day and the Police, NHS, MOD and Civil Service generally have had a never ending series of money squandering schemes with little or nothing to show. In my own county there has been more than one occasion when schools could not even exchange emails owing to the incompetence of the selected contractors.

 

[RogerS]

Note that Jacob continues to use terms that are pejorative towards the current Government. Terms such as trusts, academies etc.

Clearly forgetting that the recent report by Professor Jarman laid much of the blame at the doorstep of the last Labour Government. And I see yet another £500 million IT project instigated by Labour has hit the buffers and been abandoned.... Honestly Labour shouldn't go anywhere an major IT project!

Brian (Modernist)....there is a difference between 'funding' and 'costs'. Surely you know that? Your preconceptions could be taken to be that you imply a racist bias to my comment.

We agree on that then.

Re IT, the industry from day 1 has had a cynical beanfeast at the expense of the taxpayer which continues unabated whichever party is in power. I am not sure there have been any "successful" gov IT projects but plenty of the reverse. Some salesmen (old ones) are still drinking the profits of decimalization. The millennium bug proved remarkably absent on the day and the Police, NHS, MOD and Civil Service generally have had a never ending series of money squandering schemes with little or nothing to show. In my own county there has been more than one occasion when schools could not even exchange emails owing to the incompetence of the selected contractors.

Don't necessarily blame the IT contractors. Politicians and civil servants will always buy the lowest cost. At the end of the day it is they who carry the can. Also the politicians and civil servants are past masters at never defining exactly what it is that they require. Also past masters at moving the goalposts part way through. And then again just before the Go-Live date.

I can tell you of one Govt IT project that was a success. IAFS. Immigration Asylum Fingerprint System. Also Eurodac...that was an EU wide fingerprint system that went live across all countries in the EU ....on time to the day. mmmm..now I wonder who was involved project managing the Uk end ? :-"

 

[Jacob]

....

"CQC is another example of politicos evading responsibity." Er - how that, then?

There you go - you can't spot the trick! That's the whole point.

"Setting up enquiries, commissions, calling in "hit teams" etc etc are ways of appearing to be doing something but in fact shutting everybody up in the short term and passing the buck and hoping the issue will be forgotten or bogged down forever." What should the politicos do, then?

Make difficult decisions themselves and get their ministries to take on some more direct responsibility for things. Lead from the front in other words. It's not just a lefty thing - Aneurin Bevan, Attlee, Churchill. Even Thatcher had *****x even though she was an out and out disaster.

OK Jacob - for the benefit of us thickos who can't 'spot the trick' with regard to the CQC, would you be kind enough to explain exactly what it is?

Polticos get the credit for setting up a guard dog. Dog gets the blame for having no teeth. The institutions themselves get all the blame for their failings. Politicos have neatly sidestepped responsibility.
It's an old trick performed everywhere. A committee sets up a sub-committee, which may be an efficient way of dealing with an issue, but could just be a way of kicking it into touch. Or delegate responsibility to an silly person and you know nothing will be done. Set up an enquiry - costs millions, takes years, nothing happens. Everybody gets the blame except the politicos.

 

[Cheshirechappie]

That's not exactly a ringing endorsement of publicly owned services, is it, Jacob?

It is, sadly, a fairly accurate portrayal of how the vested interests entrenched in some of the public services protect their interest - their continuing pay and pensions, and those of their mates - without bothering too much about the pesky taxpayers or users of the service. It happened with education until Gove shook the system up and allowed many more schools to manage themselves, thus cutting out the entrenched cohorts of the 'education establishment' in both Whitehall and LEAs (which has the added advantage of cutting the overall cost of education - you still have the schools and teachers, but not the paperpushers and meetings wallahs). The schools now have every incentive to high standards, because people won't send their children there if standards are low. No longer do people have to send their children to a bog-standard comprehensive (to use Alistair Campbell's phrase) just because the LEA tells them to, and won't provide a better alternative.

Perhaps we might be better off with more of the NHS left to private enterprise. At least if a private company messes up, they either go bust and leave their competitors to pick up the business, or lose their contract to one of their competitors. Quite a good incentive to do things to a decent standard - provided, that is, those commissioning and monitoring the service on behalf of the public actually discharge their responsibilities honourably, and don't cover things up as the CQC apparently did. Private companies are usually better at dealing with complaints, too. If they just ignore complaints, as some NHS Trusts have tended to do, they get a bad reputation, and people will use alternative services.

All in all, choice is a good thing for people using services (and buying goods). The good providers thrive and grow, the bad shrivel and go bust.