Do you want to discuss boring politics? (22 Viewers)

[fernandopartridge]

The NHS is more than adequately funded as it is.
It suffers from piss poor management and over demand.
I have a family member involved in the NHS (as a lot of people do) and the stories coming out are truelly shocking.

I reluctantly feel its near its end, and will ultimately move to a personal health insurance model. That will obviously mean a two tier system similar to America.
Not ideal, not what I'd want to see, but unfortunately its becoming inevitable.

Can you share some of the shocking stories of inefficiency?

 

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[fatso]

Can you share some of the shocking stories of inefficiency?

Oh I think your more than capable of finding them on line.

 

[CCFCSteve]

I'd be interested to know from some of his more right wing critics on here what he could do. Certainly things I can think of which would turn my opinion on him.

- Front up to public about what’s needed to improve public services - then increase income tax and remove of triple lock. Promise to reverse income tax increase by end of Parliament/early next if the circumstances allow
- Refuse any above inflation pay rises in public sector unless there’s productivity improvements or significant staff shortages in those areas
- Provide and deliver proper growth plans - infrastructure spending, social housing, encourage increased investment etc
- Try to address the forecasted ballooning welfare bill - clamp down on abuse/overuse of things like motorbility, lower level mental health claims
- Review civil services numbers - if possible reduce overall numbers to nearer 2019 levels and clear out under performers
- Review how electricity costs are calculated ie find a fairer alternative to marginal pricing (electricity wholesale costs being set at last and most expensive unit generated) which would better reflect renewable energy input to demonstrate to the public that net zero policies will benefit them
- Lead attempts to amend ECHR and/or Refugee convention to bring up to date and ensure we make our own decisions regarding deportations etc

Some might not like attempts to improve productivity/delivery in public sector but you won’t get the publics buy in on tax rises if you don’t at least try. Also a mix of both is likely to be seen as a positive by markets and may in turn reduce borrowing costs….freeing up more cash. Any savings made should be ploughed back into public sector spending/capital expenditure (social housing, infrastructure, transport etc) with a greater focus on social care. If possible promise to reverse last years increase in emp’er NIC funds allowing

 

[Brighton Sky Blue]

- Front up to public about what’s needed to improve public services - then increase income tax and remove of triple lock. Promise to reverse income tax increase by end of Parliament/early next if the circumstances allow
- Refuse any above inflation pay rises in public sector unless there’s productivity improvements or significant staff shortages in those areas
- Provide and deliver proper growth plans - infrastructure spending, social housing, encourage increased investment etc
- Try to address the forecasted ballooning welfare bill - clamp down on abuse/overuse of things like motorbility, lower level mental health claims
- Review civil services numbers - if possible reduce overall numbers to nearer 2019 levels and clear out under performers
- Review how electricity costs are calculated ie find a fairer alternative to marginal pricing (electricity wholesale costs being set at last and most expensive unit generated) which would better reflect renewable energy input to demonstrate to the public that net zero policies will benefit them
- Lead attempts to amend ECHR and/or Refugee convention to bring up to date and ensure we make our own decisions regarding deportations etc

Some might not like attempts to improve productivity/delivery in public sector but you won’t get the publics buy in on tax rises if you don’t at least try. Also a mix of both is likely to be seen as a positive by markets and may in turn reduce borrowing costs….freeing up more cash. Any savings made should be ploughed back into public sector spending/capital expenditure (social housing, infrastructure, transport etc) with a greater focus on social care. If possible promise to reverse last years increase in emp’er NIC funds allowing

How is a nurse or a teacher or a civil servant meant to become more productive? How is it even measured? Both genuine questions by the way, not trying to be funny.

 

[CCFCSteve]

Can you share some of the shocking stories of inefficiency?

I can. Terminally ill patient (although happens with most) being seen/treated by different doctors and nurses daily, some read notes, some don’t. Limited consistency. Stems from poor rota management which has also led to a lot of nurses moving to agency. Both cost nhs significantly in terms of productivity and cost

 

[CCFCSteve]

How is a nurse or a teacher or a civil servant meant to become more productive? How is it even measured? Both genuine questions by the way, not trying to be funny.

It’s done by outputs v inputs (costs of delivery). Very hard for teachers. Civil servants and people in health care need to be taken on department basis not on an individual basis.

I’ve seen firsthand huge inefficiencies in the nhs. Mentioned a glaring one above. Even how notes are maintained on their patient system could be easily improved ie you keep an executive summary of latest situation (4-5 bullet points max) at top of notes to save missing key points and new staff reading through everything

 

[Brighton Sky Blue]

It’s done by outputs v inputs (costs of delivery). Very hard for teachers. Civil servants and people in health care need to be taken on department basis not on an individual basis.

I’ve seen firsthand huge inefficiencies in the nhs. Mentioned a glaring one above. Even how notes are maintained on their patient system could be easily improved ie you keep an executive summary of latest situation (4-5 bullet points max) at top of notes to save missing key points and new staff reading through everything

Our recent NHS experience I think has been kind of typical of public services in general. Lots of well intentioned and hardworking staff, but a luck of the draw on competency. Mrs BSB’s Caesarean for example was done brilliantly, but we’ve had midwives who couldn’t even tell which way up baby was in the womb.

 

[SkyBlueDom26]

Doesn’t need to change a thing, everything is going great. The people that kept telling us he was a political genius have gone quiet

The Green Party, the group who want 0 checks on people coming in and no limit, want to get rid of our nato membership and nuclear weapons. Whoever votes for them is an absolute disgrace, it would be the end of our country

 

[chiefdave]

How is a nurse or a teacher or a civil servant meant to become more productive? How is it even measured? Both genuine questions by the way, not trying to be funny.

The noise around public sector productivity is just nonsense, plain and simple. Its being used as a stick to beat down workers asking for a pay rise when even the people who produce the figures will happily tell you its a meaningless stat and there's no effective way of measuring public sector productivity or comparing it to the private sector.

 

[Brighton Sky Blue]

The noise around public sector productivity is just nonsense, plain and simple. Its being used as a stick to beat down workers asking for a pay rise when even the people who produce the figures will happily tell you its a meaningless stat and there's no effective way of measuring public sector productivity or comparing it to the private sector.

These suggestions about the civil service I find a bit odd too. Just think everyone knows they can’t respond to criticism and it’s convenient to blame them for ministerial incompetence.

 

[CCFCSteve]

The noise around public sector productivity is just nonsense, plain and simple. Its being used as a stick to beat down workers asking for a pay rise when even the people who produce the figures will happily tell you its a meaningless stat and there's no effective way of measuring public sector productivity or comparing it to the private sector.

You’ve talked about inefficiencies (which would lead to reduced productivity) numerous times on here yourself Dave. If people don’t think there can be improvements in how public services are delivered then we’ve got no chance

 

[chiefdave]

I can. Terminally ill patient (although happens with most) being seen/treated by different doctors and nurses daily, some read notes, some don’t. Limited consistency. Stems from poor rota management which has also led to a lot of nurses moving to agency. Both cost nhs significantly in terms of productivity and cost

You've answered your own question there, and your answer is very much in line with my experience personally and what I have encountered with my Dad.

A huge over-reliance on transient agency staff and nobody taking overall charge of an individuals health. Starts at GP level. My surgery has 10+ doctors at any one time. If you can make it past the receptionist and get an appointment the chances of you seeing the same person twice are minute (there's only one doctor who has been there since I registered which was just before covid).

Then you get referred to a department at the hospital more than likely run by the likes of BUPA, Virgin Health or one of the other companies happy to take money out of the system for routine stuff. They're only concerned with a binary answer. Had this with my Dad, he would be sent to a department that dealt in a specific thing, they would only be interested in if he had that specific thing or not and if he didn't back out the door.

If you can finally work through the system to get to see someone who is in a position to help you the service is generally excellent, the process to get there is an absolute disaster.

 

[CCFCSteve]

These suggestions about the civil service I find a bit odd too. Just think everyone knows they can’t respond to criticism and it’s convenient to blame them for ministerial incompetence.

My only comment on civil service was talking about reducing numbers to nearer 2019 levels. The home office has been discussed numerous times by a number of governments yet nothings changed.

 

[chiefdave]

You’ve talked about inefficiencies (which would lead to reduced productivity) numerous times on here yourself Dave. If people don’t think there can be improvements in how public services are delivered then we’ve got no chance

There's a huge difference between looking at individual services and how they can be improved and taking a finger in the air figure and using that to determine if people should get even an inflationary pay rise.

Besides, many people bang on about improving efficiency while happily ignoring the evidence that things like flexible working and working from home have large productivity benefits. Seems like people say they want improvements but only on their terms.

 

[CCFCSteve]

You've answered your own question there, and your answer is very much in line with my experience personally and what I have encountered with my Dad.

A huge over-reliance on transient agency staff and nobody taking overall charge of an individuals health. Starts at GP level. My surgery has 10+ doctors at any one time. If you can make it past the receptionist and get an appointment the chances of you seeing the same person twice are minute (there's only one doctor who has been there since I registered which was just before covid).

Then you get referred to a department at the hospital more than likely run by the likes of BUPA, Virgin Health or one of the other companies happy to take money out of the system for routine stuff. They're only concerned with a binary answer. Had this with my Dad, he would be sent to a department that dealt in a specific thing, they would only be interested in if he had that specific thing or not and if he didn't back out the door.

If you can finally work through the system to get to see someone who is in a position to help you the service is generally excellent, the process to get there is an absolute disaster.

That all negatively impacts productivity which was my original point

 

[CCFCSteve]

There's a huge difference between looking at individual services and how they can be improved and taking a finger in the air figure and using that to determine if people should get even an inflationary pay rise.

Besides, many people bang on about improving efficiency while happily ignoring the evidence that things like flexible working and working from home have large productivity benefits. Seems like people say they want improvements but only on their terms.

I said above inflation pay rises

 

[chiefdave]

That all negatively impacts productivity which was my original point

How will withholding pay rises from front line staff, and therefore encouraging them to leave the NHS in greater numbers, improve such issues?

 

[chiefdave]

Interesting that Reform are off the chart in the polls but are not only failing to make significant gains when it comes time to vote, they're also losing where they are the incumbent.

Super Thursday saw predictions as high as Reform gaining10 seats but they ended up with 1 and now they've lost another seat.

Given that the general feeling is that council elections are more likely to see people prepared to change their vote than a general election potentially not a great sign.

 

[rob9872]

 

[CCFCSteve]

How will withholding pay rises from front line staff, and therefore encouraging them to leave the NHS in greater numbers, improve such issues?

Above inflation (again). As I said in the original post, you try to justify above inflation pay rises to a public who will be asked to pay more in tax, if public services aren’t improving.

 

[Grendel]

There's a huge difference between looking at individual services and how they can be improved and taking a finger in the air figure and using that to determine if people should get even an inflationary pay rise.

Besides, many people bang on about improving efficiency while happily ignoring the evidence that things like flexible working and working from home have large productivity benefits. Seems like people say they want improvements but only on their terms.

I don’t think if you went to get your appendix removed and the surgeon was opting for a WFH day you’d be experiencing a surge in productivity.

can’t work out how manufacturing can achieve it either.

I assume you were massively increasing productivity yesterday when you said you weren’t getting any work done as you were watching women’s cricket.

 

[SBT]

Interesting that Reform are off the chart in the polls but are not only failing to make significant gains when it comes time to vote, they're also losing where they are the incumbent.

Super Thursday saw predictions as high as Reform gaining10 seats but they ended up with 1 and now they've lost another seat.

Given that the general feeling is that council elections are more likely to see people prepared to change their vote than a general election potentially not a great sign.

They’re calling it Davey-mania

 

[chiefdave]

Above inflation (again). As I said in the original post, you try to justify above inflation pay rises to a public who will be asked to pay more in tax, if public services aren’t improving.

That doesn't answer the question. If you push more people out of the profession how is the service going to improve.

What are you expecting a front line worker to do that will resolve the issues you've highlighted?

Sure we'd all love a stunningly efficient NHS but I'm not sure how pushing front line staff to work elsewhere is going to achieve that.

 

[CCFCSteve]

That doesn't answer the question. If you push more people out of the profession how is the service going to improve.

What are you expecting a front line worker to do that will resolve the issues you've highlighted?

Sure we'd all love a stunningly efficient NHS but I'm not sure how pushing front line staff to work elsewhere is going to achieve that.

I did say unless there are significant staff shortages. Don’t believe all the BMA BS though. They’re letting down there members by focussing on pay restoration when we’re losing loads of doctors who don’t have training posts to go to. Focus on that !

Doctors ‘have no clear career path’ amid rise in competition for training posts

The data sends a ‘deeply worrying message to the next generation of doctors’, the Royal College of Physicians said.

www.independent.co.uk

I’ve said before I know rosters are a major issue not just salaries. This reenforces it

NHS England » Staff leaving the NHS among lowest in over a decade

NHS England » Staff leaving the NHS among lowest in over a decade

www.england.nhs.uk

But nothing can be done to improve productivity in the NHS .

 

[duffer]

I havnt swallowed anything, its just the obvious path forwards.
You stick your head it the sand you ludite and continue to live in denial, the realists amongst us will look to, and prepare for the future.

It's "luddite", and it's got nothing to do with the NHS.

The "realists" ought to do some research before claiming their opinions as fact. Proportionally, the NHS has a lower proportion per capita cost than many of our European equivalents.

Compared to the batshit US, well best not to go there I'd guess, but anyone thinking we need to introduce US style healthcare practices is off their tits, frankly.

As with many things clung to by the right, and repeatedly and incorrectly claimed as "fact" , it's not too hard to find the truth (if you actually want to of course).

https://www.health.org.uk/features-and-opinion/features/how-much-does-the-uk-spend-on-health-care-compared-to-europe