NHS beyond a cure ?

[observer]

Is the NHS in terminal decline or is there a cure ?  Well, it certainly needs money, and lots of it. It probably needs more clinical and less managerial admin staff; and it probably requires measures to reduce demand. So why are the politicians still just talking about it ?

[Dizzy]

Probably because that's all politicians ever do Obs...ie 'talk'...

Not sure if I've got this 100% right but I was reliably informed a few weeks ago that there are plans to change how GP referals are dealt with.  At present GP's can refer patients for further tests and hospital appointments/procedures etc etc but it is to be changed so that a GP's 'referal' goes to a central outsourced company somewhere and THEY will then decide whether to actually refer the patient and if they need further assessment, treatment or whatever rather than the GP. 

 

[Evil Sid]

 

So why are the politicians still just talking about it ?

But they are doing something about it.

 

As Sir Humphrey Appleby might say " By discussing the issue we can assure the press and thereby the voters that every effort is being made to look towards achieving a suitable cost effective goal driven solution to the current situation, which can then be implemented at a later time when the current financial situation has changed, so whilst effectively we are doing nothing about it but seem to be doing something about it, we are at least getting good press" 

[asperity]

As long as I can remember the NHS has, allegedly, been on the brink of total collapse. The Tories have, also allegedly, been on the brink of privatising the NHS for near enough 50 years. not doing much of a job on that score are they?

 

[Davy51]

I don't think today's NHS is helped by having the whole broken into so many parts & all requiring an army of backroom staff, managers, directors & CEOs to run them. The cost of the excess admin should be spent on hands on nursing staff & patient care/hospital improvements.There are too many quangos thriving off what should be a very customer (patient) focussed organisation & taking up funds that should be spent on the frontline.

 

Add to this the stupid GP quotas & is easy to see why the A&E departments are overstretched & taking up time & costs that should be spent within the main body of the NHS. And while we are on the subject ,why do doctor's surgeries need so many clerical & reception staff these days ?

[Davy51]

Maybe the NHS could be turned into a disaster movie Asp with the latest   American heart throb ,male or female, playing the lead role & turning the collapsing organisation around with just seconds to go before the NHS budget self combusts.

[algy]

I believe that the government are looking at the possibility of reducing the number of over 70's requiring treatment by the process of elimination ( a different way of saying geronticide).

[observer]

Well, the first thing to decide is where to get the money to fund the NHS and care services: the obvious answer is to introduce a draconian taxation of the rich, meanwhile transferring the whole of the overseas aid budget to fund the NHS and social services, and ring fence it. Streamline the organisation by scrapping all the Trust Quangos with their paid leeches, thinning out admin in the process. Start recruiting and training indigenous clinical staff, including GPs. Reduce demand by health promotion and education, by charging time wasters and health tourists, and migrants. Open elderly care units in the community, to release acute beds in hospitals, and start treating providers like worthwhile occupations. And finally, take the politics out of it, by having an independent and clinical admin system, and ring fencing funding.

[Evil Sid]

Sorted. all you have to do now is convince the government. :lol:

[asperity]

Define "the rich" Obs. Define "draconian" Obs,

[observer]

Let's start with the 1% who control more wealth than the rest put together, then work down through the obscene payments to CEOs, footballers and pop singers etc.  Draconian = very harsh, cruel.

[asperity]

Observer IS Jeremy Corbyn, and I claim my prize :lol:

[observer]

Miles out Asp:  Jeremy, like all Labour Leaders in the past two decades, may "talk" about it, in the comfort of their Islington dinner parties - but the "doing" is a totally different thing. The PM is of course correct in saying that a strong economy with a surplus can provide the means of funding public services, but even that requires some public investment initially.  What we do have,  is the widest wealth gap in recent history, with now obscene levels of payments to CEOs, Footballers etc; so it's a no brainer to suggest that Gov taps into such wealth asap; which is unfortunately not the nature of the Tories. Nothing new in this of course, in the early 50s, the top rate of income tax was around 84%, and the tax take funded the creation of the NHS and the record provision of housing.

[asperity]

Wrong again Obs.

 

http://webarchive.nationalarchives.gov.uk/20140109143644/http://www.hmrc.gov.uk/stats/tax_structure/surtaxrates_1948to1973.pdf

 

The only time tax rates were 80% + was a few years in the late 70s, you remember when pop groups had almost all their earnings stolen. It didn't stop the country grinding to a halt then did it?

[observer]

Think you'll find Maggie reduced top rates from around 80% to 60% on the highest earners (wilki).

[asperity]

Think you'll find Maggie reduced rates from around 80% on the highest earners. Don't get your pop groups etc at all.

Which is exactly what I said, or didn't you bother looking? Maggie became PM in 1979 after Labour tried taxing the rich "until the pips squeak" (copyright James Callaghan Prime Minister (failed). Another memorable quote "crisis, what crisis" when most of our public services were on strike). My point being that you are attacking the problem from the wrong end. Instead of denigrating people who manage to make money, we should be encouraging them to make more of it, not taking what they make away from them.

 

And before we throw any more of our hard earned money into the bottomless pit of the NHS, perhaps some of this nonsense should be addressed:-

 

 

He/she is really going to reduce waiting times/increase patient survival rates/ensure our hospitals are clean, hygienic and fit for purpose (sarcasm alert). Or perhaps he/she will be an excuse for upper management to increase their own pay because they have more people to manage? And please note that this is for an assistant director, so the director is unable to do the job of managing, no doubt, a cohort of managers of equality and diversity. The public sector is, I'm afraid, just extracting the Michael. I'm willing to change my mind if there is any public sector director out there able to convince me otherwise?

[observer]

Don't disagree with the second part of your post, I refered to such waste in my criticism of excess management and quangos.  As for your nonsense about people "making more of it", the idea that such money "trickles down" to the Plebs is Reaganomic fantasy and such money won't find it's way to supporting public services anyway.  That mentality has caused the huge wealth gap we now have in society, and if continued will no doubt, based on historical precedent, result in a more violent kind of revolution than the one we are currently experiencing at the polls.

[Bazj]

Which is exactly what I said, or didn't you bother looking? Maggie became PM in 1979 after Labour tried taxing the rich "until the pips squeak" (copyright James Callaghan Prime Minister (failed). Another memorable quote "crisis, what crisis" when most of our public services were on strike). My point being that you are attacking the problem from the wrong end. Instead of denigrating people who manage to make money, we should be encouraging them to make more of it, not taking what they make away from them.

 

And before we throw any more of our hard earned money into the bottomless pit of the NHS, perhaps some of this nonsense should be addressed:-

 

 

He/she is really going to reduce waiting times/increase patient survival rates/ensure our hospitals are clean, hygienic and fit for purpose (sarcasm alert). Or perhaps he/she will be an excuse for upper management to increase their own pay because they have more people to manage? And please note that this is for an assistant director, so the director is unable to do the job of managing, no doubt, a cohort of managers of equality and diversity. The public sector is, I'm afraid, just extracting the Michael. I'm willing to change my mind if there is any public sector director out there able to convince me otherwise?

 

and imagine how much the actual director of equality and diversity earns.... plus a secretary, plus an office and probably the car to go with it, and not to mention the gold plated pension pot and the certainty that even if he tells an Irish joke at the next diversity and equality meeting, he''ll be moved sideways to an equally paid job somewhere within the NHS

[Freeborn John]

Over sixty six thousand days sick were thrown in Warrington Hospital last year. In one hospital!

A hospital spokesman smugly pointed out that this was below the NHS average, so presumably that's alright then.

This is the classic symptom of a malaise called public sector bloat, I suggest, one that the NHS suffers in spades.

[asperity]

Don't disagree with the second part of your post, I refered to such waste in my criticism of excess management and quangos.  As for your nonsense about people "making more of it", the idea that such money "trickles down" to the Plebs is Reaganomic fantasy and such money won't find it's way to supporting public services anyway.  That mentality has caused the huge wealth gap we now have in society, and if continued will no doubt, based on historical precedent, result in a more violent kind of revolution than the one we are currently experiencing at the polls.

Your, and Corbyn's, dream of stopping the top earners earning any more until those at the bottom (e.g. those who don't actually"earn" anything) have caught up is pure fantasy. The top 10% pay most of the tax received anyway, and logic dictates that if you cap those earnings you will cap the tax receipts as well. It's the politics of envy writ large.

[observer]

Oh not the old cap doffing, knee bending peasant's chant about envy, think that went out with Downton Abbey ! Let's simplify it right down for you: get a hundred people and give them all a hundred pounds each; within a period of time, that money will gravitate to a smaller and smaller number and will be used for their self indulgent opulence. But the theory that buying expensive housing, cars etc, will somehow keep the rest in work and the means to exist at a civilised level, is a fiction put about by the rich themselves, in order to preserve inequality and thus their priviledge. One person cannot spend at the rate required to sustain the rest, unless of course they are some kind of glorified philanphropist; so the money gets locked away in order to make even more money. If however the money is regularly redistributed through taxation, it funds the spending power of the majority and thus demand for goods and services, which creates jobs and the whole economic merry go round keeps turning. This pragmatic approach has never been more urgent, as technology displaces large swathes of the workforce. Now you can support the idea of an every man for himself society, where the rich retreat behind security walls, and the rest exist outside; until finally deciding to scale those walls; or you can operate a system that recognises the need for a cohesive society and our responsibilities to each other. Such an approach is essential to the provision of health, education, housing and infrastructure provision that allow us to term ourselves civilised.

[asperity]

You just can't see the wood for the trees can you Obs. Like I said in a previous post the top rate of income tax in the late 70s (before Maggie) was in the mid 80% and the country was wracked by strikes. Remember Callaghan? Remeber the winter of discontent? The high tax rates didn't have the money flowing in then, what makes you think it would work this time round? When Maggie came in and dropped the top rates of tax, then the money came in and the economy recovered. I'm not doffing my cap or bending my knee to anybody, but the truth is you make the tax rates draconian, the people liable won't be seen for dust (with their riches). Good riddance you may say, conveniently forgetting that it's the top earners are the ones paying the bulk of ther tax. Envy Obs, not a nice character trait.

[observer]

Far from envy Asp, I'm quite satisfied personally; merely a pragmatic appraisal of the overall situation.  Yes, I would say "good riddance", to the footballers (many who are foreign), the pop singers, etc;  simply window dressing when measured against the need for a Doctor or Surgeon etc.  but perhaps some asset stripping before they leave, then move on to tax the source of their obscene payments. As for the inability of Gov to come up with tax rules, that accountants can drive a coach and horses through, and HMRC are totally afraid of pursuing - that's one for Gov, but it would help, if the "experts" who advise Gov in formulating tax policy, weren't then allowed to move into the private sector, advising the wealthy how to dodge it.

[asperity]

I don't know what's more annoying - listening to a cracked record or banging my head against a brick wall!

[observer]

Leave the wall alone, it's distorting your perspective !