I'm so glad privatisation has seen the end of strikes in the postal service
The strikes are going to be the end of the postal service. No longer being publicly owned, Royal Mail has no right to exist. It needs to earn it.
The real problem is that electronic communications have eclipsed the postal service.
Yes, and this is ongoing. More and more of our suppliers in our house now send their bills by internet, are paid by direct debit and have opted out of paper copies. The Royal Mail has a unique distribution system with unmatched knowledge of its customer base in its staff. They need to find a use for that before it is too late.
The parcel side of things is roaring ahead. The internet age and all that.
The online purchasing of postage is good, I would make some improvements, but overall is very useful.
The collection service - where they collect parcels from you at the doorstep - is surprisingly little known. But is, again excellent.
Letters will die - to a small remaint on the side of a large parcel operation.
I get quite annoyed when I get a letter from my bank or the like - even though it's, supposedly, an online-only bank. I'm assume there's a regulation somewhere that says they need to provide printed copies of certain things once in a while. Last one I got was about 30 pages of A4 neatly folded into a big envelope in order to detail every months charges for something had been £0.00 going back about 8 years.
Handy to have that on file...
Can't be a legal requirement - I get f*ck-all from my bank (Halifax).
This probably means I need to weigh up my annoyance at the odd letter, and my annoyance at dealing with their website to find if there's a tickbox I need to change. Joy...
Two things about the voter ID requirements coming in this year: 1 - they advantage older voters over younger voters; this is deliberate 2 - there will be a great deal of confusion this May with people who aren't aware they need ID, and end up not being able to vote.
(1) is pretty obviously going to benefit the Tories; that's why they're doing it after all. The impact of (2) will reduce over time - once it happens this May people will realise and get prepared.
So this May might have a built in bias to the Cons, that will then become less pronounced over time. Added to the impact of mortgage rises, cost of living increases, and all the other issues discussed in detail on here over the past few months, might there be some advantage to the Cons to go this May, or as early as possible, to take advantage.
This isn't a prediction - more an idle speculation, based on the idea of Tory cynicism.
The thing is, it disproportionately disadvantages the lower socio-economic parts of society and minority groups as they are less likely to have a valid form of ID.
This is a long term issue for Labour but once it's in it would be very hard to remove completely. They'd have to change the rules to allow more forms of valid ID. For example you will be able to use a 60+ Oyster card but not a young persons one even though they are the same things.
Oh I agree - but I'm focusing on how the impact might influence decision making about when a GE might be, not how to modify the impact. What I'm thinking about the latter is that initially, there'll potentially be one really chaotic election where it has a big impact; and at the moment that will be the locals in May 2023. In the short term aftermath, some people will act by making sure they have ID or get a postal vote, and the opposition parties will try and promote that. So the impact will less after that first election. In the long term, a Labour or coalition government might not remove the ID requirement, as you say, but they would be in a position to add those other IDs - student ID, youth railcards, etc. - to lessen the impact.
Old fogey question. What's the ID young people use to deal with the Challenge 25 policy for alcohol sales? Is the same ID valid for voter ID?
I suspect my Dad is never going to vote again (96) but he doesn't have any of those ids and doesn't know he needs one. He is a Tory (member or ex-member due to age) and a leaver. I can't imagine the Tories will try and take him down to the polling station, but they will be disappointed if they do.
You could arrange for him to have a postal vote.
As I said I don't think he has any plans to vote again anyway. I'm also not incentivised to help as we have never voted the same and I have very different views (ie I'm not a hang em and flog em and send em back to where they came from person) I'm sure there will be others in the same boat who will have no idea they need id and will either not have it at all or can't be arsed to go home to collect it and return to the polling station. I see this going very badly indeed.
Ah, I see.
Let's hope Sunak doesn't go for broke and call a GE to coincide with this year's May locals then.
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
See the incident where a friend did OR on a medical unit.
The response to his thesis (on how to improve efficiency) was an attempt to destroy him, academically, which was snookered by his professor. Who essentially told those involved that he would make them famous.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
I'm so glad privatisation has seen the end of strikes in the postal service
The strikes are going to be the end of the postal service. No longer being publicly owned, Royal Mail has no right to exist. It needs to earn it.
The real problem is that electronic communications have eclipsed the postal service.
Yes, and this is ongoing. More and more of our suppliers in our house now send their bills by internet, are paid by direct debit and have opted out of paper copies. The Royal Mail has a unique distribution system with unmatched knowledge of its customer base in its staff. They need to find a use for that before it is too late.
The parcel side of things is roaring ahead. The internet age and all that.
The online purchasing of postage is good, I would make some improvements, but overall is very useful.
The collection service - where they collect parcels from you at the doorstep - is surprisingly little known. But is, again excellent.
Letters will die - to a small remaint on the side of a large parcel operation.
I get quite annoyed when I get a letter from my bank or the like - even though it's, supposedly, an online-only bank. I'm assume there's a regulation somewhere that says they need to provide printed copies of certain things once in a while. Last one I got was about 30 pages of A4 neatly folded into a big envelope in order to detail every months charges for something had been £0.00 going back about 8 years.
Handy to have that on file...
Can't be a legal requirement - I get f*ck-all from my bank (Halifax).
This probably means I need to weigh up my annoyance at the odd letter, and my annoyance at dealing with their website to find if there's a tickbox I need to change. Joy...
I opted out (firstdirect) opted back in because I needed a recent paper BS to prove identity, got forcibly opted out again last year, but I think I still get paper tax certs and securities statements.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
I'm so glad privatisation has seen the end of strikes in the postal service
The strikes are going to be the end of the postal service. No longer being publicly owned, Royal Mail has no right to exist. It needs to earn it.
The real problem is that electronic communications have eclipsed the postal service.
Yes, and this is ongoing. More and more of our suppliers in our house now send their bills by internet, are paid by direct debit and have opted out of paper copies. The Royal Mail has a unique distribution system with unmatched knowledge of its customer base in its staff. They need to find a use for that before it is too late.
The parcel side of things is roaring ahead. The internet age and all that.
The online purchasing of postage is good, I would make some improvements, but overall is very useful.
The collection service - where they collect parcels from you at the doorstep - is surprisingly little known. But is, again excellent.
Letters will die - to a small remaint on the side of a large parcel operation.
I get quite annoyed when I get a letter from my bank or the like - even though it's, supposedly, an online-only bank. I'm assume there's a regulation somewhere that says they need to provide printed copies of certain things once in a while. Last one I got was about 30 pages of A4 neatly folded into a big envelope in order to detail every months charges for something had been £0.00 going back about 8 years.
Handy to have that on file...
Can't be a legal requirement - I get f*ck-all from my bank (Halifax).
This probably means I need to weigh up my annoyance at the odd letter, and my annoyance at dealing with their website to find if there's a tickbox I need to change. Joy...
What you have to watch out for with the Halifax's online is they dupe you into going paperless even if you don't want to. We've got used to it now and it's better for the environment of course (and cheaper for the bank!) but initially we must have inadvertantly opted for it by clicking a 'Continue' button which turned out to mean 'continue to switch to paperless' rather than 'continue with your current arrangement'.
If only Remain had been as sneaky - we could have been voting for 'Leave (the current arrangement in place)' ;-)
Politico.com - Oops! The Worst Political Predictions of 2022 The red wave never arrived, nor did the Russian victory over Ukraine. And that’s just the start of an incredible year in bad prognostication.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
without sufficient staff (doctors, nurses, porters, cleaners etc) you're changing the deckchairs on the titanic.
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
BTW, I don't know if it's been covered, but 100 years ago today the 120-odd small railway companies were grouped into the Big Four - the LMS, Southern, LNER and GWR. They existed for 25 years before they were nationalised into BR.
On both occasions, because they did not want t pay their war debts...
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
without sufficient staff (doctors, nurses, porters, cleaners etc) you're changing the deckchairs on the titanic.
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
I agree wrt social care; but I'd also strongly argue that the GP system is also utterly borken - and that this failure puts immense pressure on other NHS services, including A&E.
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
To be fair, both May and Johnson tried to fix social care.
Unfortunately, their solutions involved taxes going up, which meant their solutions were kyboshed.
And as long as "have something for nothing" is a winning slogan, Britain isn't going to get much better.
My fear is that the moment of payback- where we have to pay something for nothing- has arrived.
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
without sufficient staff (doctors, nurses, porters, cleaners etc) you're changing the deckchairs on the titanic.
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
I agree wrt social care; but I'd also strongly argue that the GP system is also utterly borken - and that this failure puts immense pressure on other NHS services, including A&E.
Social care can be fixed very quickly by giving it (and councils) money. There is no short term fix for GP services.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
without sufficient staff (doctors, nurses, porters, cleaners etc) you're changing the deckchairs on the titanic.
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
I agree wrt social care; but I'd also strongly argue that the GP system is also utterly borken - and that this failure puts immense pressure on other NHS services, including A&E.
I'd agree with that. I've not been to the GP since the first lockdown (when no-one was using their GPs) and I went from phone call to operation (in a private hospital) to remove a lump within 4 weeks. I suspect it may take that long to get the initial appointment if I'd tried it now.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Politico.com - Oops! The Worst Political Predictions of 2022 The red wave never arrived, nor did the Russian victory over Ukraine. And that’s just the start of an incredible year in bad prognostication.
1. Sunak to call a snap election in April and win five year mandate amid rumours Labour plans to put VAT on chips. 2. Biden to resign in favour of President Harris, who selects AOC as VP; while GOP crown DJT as their POTUS candidate with Ivanka as VP. 3. Putin challenges Zelenskyy to decide the war by an arm-wrestle, and unexpectedly wins when Zelenskyy falls out of the window. Old eastern-bloc countries immediately leave the EU and join the Russian-led EUski. 4. Arsenal win the Premiership and Man U are relagated having suffered 22 straight defeats in 2023.
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
without sufficient staff (doctors, nurses, porters, cleaners etc) you're changing the deckchairs on the titanic.
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
I agree wrt social care; but I'd also strongly argue that the GP system is also utterly borken - and that this failure puts immense pressure on other NHS services, including A&E.
I'd agree with that. I've not been to the GP since the first lockdown (when no-one was using their GPs) and I went from phone call to operation (in a private hospital) to remove a lump within 4 weeks. I suspect it may take that long to get the initial appointment if I'd tried it now.
GP services are a postcode lottery, and have been for decades - as long as I've known. You can get brilliant ones, or ones like my current surgery, which is frankly failing its patients. I have lots of funny stories about it.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
During and after the banking crisis I was contracting at Citi Group.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
New York Times ($) - The ‘Red Wave’ Washout: How Skewed Polls Fed a False Election Narrative The errant surveys spooked some candidates into spending more money than necessary, and diverted help from others who otherwise had a fighting chance of winning.
Senator Patty Murray, a Democrat, had consistently won re-election by healthy margins in her three decades representing Washington State. This year seemed no different: By midsummer, polls showed her cruising to victory over a Republican newcomer, Tiffany Smiley, by as much as 20 percentage points.
So when a survey in late September by the Republican-leaning TRAFALGAR Group showed Ms. Murray clinging to a lead of just two points, it seemed like an aberration. But in October, two more Republican-leaning polls put Ms. Murray barely ahead, and a third said the race was a dead heat.
As the red and blue trend lines of the closely watched RealClearPolitics average for the contest drew closer together, news organizations reported that Ms. Murray was suddenly in a fight for her political survival. Warning lights flashed in Democratic war rooms. If Ms. Murray was in trouble, no Democrat was safe.
Ms. Murray’s own polling showed her with a comfortable lead, and a nonprofit regional news site, using an established local pollster, had her up by 13. Unwilling to take chances, however, she went on the defensive, scuttling her practice of lavishing some of her war chest — she amassed $20 million — on more vulnerable Democratic candidates elsewhere. Instead, she reaped financial help from the party’s national Senate committee and supportive super PACs — resources that would, as a result, be unavailable to other Democrats.
SSI - Story makes a pretty compelling case. Must admit that yours truly was concerned about Patty Murray's re-election, because of some resemblances between her situation, and that of Sen. Warren Magnuson in 1980, the election that transformed him in a twinkling from a Capitol Hill power broker into a political has-been.
Duh! Should have realized, any "polling" by Trafalgar Group & etc., was likely as legit as a 3-dollar bill.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
During and after the banking crisis I was contracting at Citi Group.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
In my experience, reducing layers of management never seems to involve taking out those layers near the top for some strange reason.
However, I agree that there needs to be significant changes to the NHS's structure: there are loads of different systems that would remain free at the point of use. I don't have the knowledge or wisdom to say which would be 'best'.
structure is not the problem it's funding that's the problem. Ageing hospitals and insufficient pay to attract/keep staff. most of the structural stuff would be doing the same thing more efficiently, which is worthwhile looking at, but it won't resolve the issues of lack of facilities/staff.
The only thing structurally which is broken is social care which no-one has been brave enough to try and fix.
I disagree: structure is a significant issue. It's essentially the same structure as when it was formed, over seventy years ago. There has been some evolution, but nothing like the way the structure of society - and what society demands - along with medical technology, has advanced.
A company I knew invented a new type of medical diagnostics device. The barriers to get something like it into hospitals was massively high and, if the rumours are true, somewhat corrupt ("pay me money and we'll talk.")
Society and technology has changed. The NHS has not kept up, sadly.
(And I'm not saying the NHS requires more money. Just that it's possible that the NHS will suck up extra funding and not deliver improvements for patients.)
without sufficient staff (doctors, nurses, porters, cleaners etc) you're changing the deckchairs on the titanic.
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
I agree wrt social care; but I'd also strongly argue that the GP system is also utterly borken - and that this failure puts immense pressure on other NHS services, including A&E.
I'd agree with that. I've not been to the GP since the first lockdown (when no-one was using their GPs) and I went from phone call to operation (in a private hospital) to remove a lump within 4 weeks. I suspect it may take that long to get the initial appointment if I'd tried it now.
My local GP is running just fine. Apart from the stupid “call at exactly 8am” thing. Appointments in person are fine.
This was the one where the main GP realised the incentives in the planned vaccination program and got the builders in over Christmas to maximise COVID safe vaccination through put.
At the start of the pandemic, she interpreted the rules on declaring someone as vulnerable as meaning she could do it, and trawled all the patients files (along with her staff) to identify the vulnerable and register them as such.
Later, when the admin staff had little to do, she got them to deliver medication to those sheltering at home.
Another neighbouring GP has been missing in action since COVID started.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
I had assumed the reason why all these managers and contracts were so popular with the Tories was because their spiv patrons benefit from syphoning all that cash away from actual healthcare. The system makes quite a lot of people and service companies very well off.
I'm left to wonder when was the last occasion a UK GE occurred within a month or two of an American Presidential election?
1964 I think. We voted on October 15th and the Americans on November 3rd. The Government changed in the UK as Wilson's Labour won a narrow majority but Lyndon Johnson remained US President crushing Barry Goldwater 61 to 38.5.
I'll offer 1832 as an example of two elections being held very close together - the UK election was held on 8 December 1832 - 8 January 1833 and saw Earl Grey's Whigs demolish Wellington's Tories. The US election held on November 2nd - December 5th 1832 saw Andrew Jackson win re-election against Henry Clay.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
I had assumed the reason why all these managers and contracts were so popular with the Tories was because their spiv patrons benefit from syphoning all that cash away from actual healthcare. The system makes quite a lot of people and service companies very well off.
Difference between current Tory version of crony government, and that of Mayor Daley (the Elder) in Chicago, was that Daley insisted that HIS cronies actually do the jobs, not just send in their bills.
New York Times ($) - The ‘Red Wave’ Washout: How Skewed Polls Fed a False Election Narrative The errant surveys spooked some candidates into spending more money than necessary, and diverted help from others who otherwise had a fighting chance of winning.
Senator Patty Murray, a Democrat, had consistently won re-election by healthy margins in her three decades representing Washington State. This year seemed no different: By midsummer, polls showed her cruising to victory over a Republican newcomer, Tiffany Smiley, by as much as 20 percentage points.
So when a survey in late September by the Republican-leaning TRAFALGAR Group showed Ms. Murray clinging to a lead of just two points, it seemed like an aberration. But in October, two more Republican-leaning polls put Ms. Murray barely ahead, and a third said the race was a dead heat.
As the red and blue trend lines of the closely watched RealClearPolitics average for the contest drew closer together, news organizations reported that Ms. Murray was suddenly in a fight for her political survival. Warning lights flashed in Democratic war rooms. If Ms. Murray was in trouble, no Democrat was safe.
Ms. Murray’s own polling showed her with a comfortable lead, and a nonprofit regional news site, using an established local pollster, had her up by 13. Unwilling to take chances, however, she went on the defensive, scuttling her practice of lavishing some of her war chest — she amassed $20 million — on more vulnerable Democratic candidates elsewhere. Instead, she reaped financial help from the party’s national Senate committee and supportive super PACs — resources that would, as a result, be unavailable to other Democrats.
SSI - Story makes a pretty compelling case. Must admit that yours truly was concerned about Patty Murray's re-election, because of some resemblances between her situation, and that of Sen. Warren Magnuson in 1980, the election that transformed him in a twinkling from a Capitol Hill power broker into a political has-been.
Duh! Should have realized, any "polling" by Trafalgar Group & etc., was likely as legit as a 3-dollar bill.
Can’t remember if you were around then, SSI, but we had a huge debate about Trafalgar on here at the time of the 2020 election. With that in mind I did think, looking at the polls, that the narrative of a Red Wave was massively overstated. But as a liberal observer in a far away land I didn’t back my instinct over the professional prognosticators on the ground over there. More fool me.
I'm so glad privatisation has seen the end of strikes in the postal service
The strikes are going to be the end of the postal service. No longer being publicly owned, Royal Mail has no right to exist. It needs to earn it.
It still is required by law to provide the universal service which should be state subsidised in my view.
Otherwise as mentioned it will just be another parcel delivery service as letters further decline. Even Amazon use Royal Mail for the final mile, especially in rural areas
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
some of point 4 is about capacity in cities but if you're in the country travel times can make it really hard to get to a hospital.
as an aside, I'm surprised that the Tories have kept private health insurance as a benefit in kind (and thus taxable) it seems like the kind of policy which would be their way of easing the situation. not that it'd make a difference for too many people but that's not stopped them in the past
I'm left to wonder when was the last occasion a UK GE occurred within a month or two of an American Presidential election?
1964 I think. We voted on October 15th and the Americans on November 3rd. The Government changed in the UK as Wilson's Labour won a narrow majority but Lyndon Johnson remained US President crushing Barry Goldwater 61 to 38.5.
I'll offer 1832 as an example of two elections being held very close together - the UK election was held on 8 December 1832 - 8 January 1833 and saw Earl Grey's Whigs demolish Wellington's Tories. The US election held on November 2nd - December 5th 1832 saw Andrew Jackson win re-election against Henry Clay.
Wellington just wasn’t the electorate’s cup of tea anymore.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
Certainly, any attempt to flatten the pyramid in the NHS will be countered with a campaign against “Breaking up the NHS”
Remember when an administrator at Great Ornand Street was caught sending an email boasting that she had dealt with an attempt to slip administration - by sending redundancy warnings to all the nurses working in children’s oncology….
The high end admins in the NHS are a major part of the new Upper 10,000 - they have very good access to the media.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
I am not sure I agree, and happy New Year Richard. I suspect one of the key issues with the NHS is it is a victim of its own success. It is keeping people alive for longer. And the longer an NHS client lives the more expensive they become. Someone has to sit down with a pencil and paper and work out the cost against the benefits of extending life with diminishing quality of life. Basically we are talking rationing and the moral dilemmas that brings.
Alternatively a nominal charging model which again links into rationing. Otherwise, and this is where, I suspect, the current iteration of the Conservative Party would like to go, sell the whole shebang to Cedars Sinai Healthcare and let them sort it out.
...because that's worked so well with other big public services.
I wasn't suggesting selling everything to a wealthy buyer was my ideal resolution, but you can see that building in failure tees the NHS up nicely for some sort of private enterprise solution. I suspect Sunak would be more than comfortable with a market model for healthcare in the UK. I am not sure it is quite s*** enough yet to bring the punters along, but it's getting there.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
During and after the banking crisis I was contracting at Citi Group.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
In my experience, reducing layers of management never seems to involve taking out those layers near the top for some strange reason.
In related news, water is wet and the Pope is Catholic.
A suggestion - the late pope, when canonised, becomes the patron saint of Anti-Tank missile users?
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
The only way you could break up the NHS regionally is by devolving fully it to regional government which doesn't exist everywhere in England.
BTW, I don't know if it's been covered, but 100 years ago today the 120-odd small railway companies were grouped into the Big Four - the LMS, Southern, LNER and GWR. They existed for 25 years before they were nationalised into BR.
On both occasions, because they did not want t pay their war debts...
I had a personal moment of silence just before midnight last night thinking of the G&SWR, which society I am a member of, and the L&SWR, that my Uncle George worked for.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
I had assumed the reason why all these managers and contracts were so popular with the Tories was because their spiv patrons benefit from syphoning all that cash away from actual healthcare. The system makes quite a lot of people and service companies very well off.
Of course there's a lot of money to make. I am not sure that's the primary reason though. I think its cultural. It's just what happens to all untouchable bureaucratic organisations. They grow fat, inefficient, corrupt, and totally focused on building their own empires. Nature's equivalent is the tumour.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
BTW, I don't know if it's been covered, but 100 years ago today the 120-odd small railway companies were grouped into the Big Four - the LMS, Southern, LNER and GWR. They existed for 25 years before they were nationalised into BR.
On both occasions, because they did not want t pay their war debts...
I had a personal moment of silence just before midnight last night thinking of the G&SWR, which society I am a member of, and the L&SWR, that my Uncle George worked for.
I am very fond of the old Midland Railway, but the 'obscure' one I love is the North Staffordshire Railway.
In recent years, the US Post Office has been making physical changes to make it easier for them to deliver packages, securely. Post Office boxes are larger than they were, and often come in groups that include a large parcel box.
(In the last year, I have had one parcel dleivered to the parcel box. A key was left in my regular mail box, which allowed me to open the larger box and retrieve the parcel.)
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
Certainly, any attempt to flatten the pyramid in the NHS will be countered with a campaign against “Breaking up the NHS”
Remember when an administrator at Great Ornand Street was caught sending an email boasting that she had dealt with an attempt to slip administration - by sending redundancy warnings to all the nurses working in children’s oncology….
The high end admins in the NHS are a major part of the new Upper 10,000 - they have very good access to the media.
That's typical of top down services though - if you ask the BBC to save some money they will axe Eastenders and Songs of Praise. Cuts to frontline services that people care about make it less likely that attempts to cut budgets will succeed, and if they do, it will be at a great political cost and won't be attempted again in a hurry.
If the UK and the US elections are held during the same year, they may influence each other, just to complicate matters more for bettors. For example, if Trump were to win the Republican nomination before the UK election, that might, to some small extent, damage the Conservative chances. But, were Nikki Haley to win the nomination, that might help the Conservatives.
Just to be clear, in both cases, I am saying "might", not "would". I want to call attention to possible interactions not, as yet, discuss possible scenarios.
(For the record: Haley is one of the possible Republican candidates I consider qualified to be president, unlike Trump, DeSantis, and Noem.)
New York Times ($) - The ‘Red Wave’ Washout: How Skewed Polls Fed a False Election Narrative The errant surveys spooked some candidates into spending more money than necessary, and diverted help from others who otherwise had a fighting chance of winning.
Senator Patty Murray, a Democrat, had consistently won re-election by healthy margins in her three decades representing Washington State. This year seemed no different: By midsummer, polls showed her cruising to victory over a Republican newcomer, Tiffany Smiley, by as much as 20 percentage points.
So when a survey in late September by the Republican-leaning TRAFALGAR Group showed Ms. Murray clinging to a lead of just two points, it seemed like an aberration. But in October, two more Republican-leaning polls put Ms. Murray barely ahead, and a third said the race was a dead heat.
As the red and blue trend lines of the closely watched RealClearPolitics average for the contest drew closer together, news organizations reported that Ms. Murray was suddenly in a fight for her political survival. Warning lights flashed in Democratic war rooms. If Ms. Murray was in trouble, no Democrat was safe.
Ms. Murray’s own polling showed her with a comfortable lead, and a nonprofit regional news site, using an established local pollster, had her up by 13. Unwilling to take chances, however, she went on the defensive, scuttling her practice of lavishing some of her war chest — she amassed $20 million — on more vulnerable Democratic candidates elsewhere. Instead, she reaped financial help from the party’s national Senate committee and supportive super PACs — resources that would, as a result, be unavailable to other Democrats.
SSI - Story makes a pretty compelling case. Must admit that yours truly was concerned about Patty Murray's re-election, because of some resemblances between her situation, and that of Sen. Warren Magnuson in 1980, the election that transformed him in a twinkling from a Capitol Hill power broker into a political has-been.
Duh! Should have realized, any "polling" by Trafalgar Group & etc., was likely as legit as a 3-dollar bill.
Can’t remember if you were around then, SSI, but we had a huge debate about Trafalgar on here at the time of the 2020 election. With that in mind I did think, looking at the polls, that the narrative of a Red Wave was massively overstated. But as a liberal observer in a far away land I didn’t back my instinct over the professional prognosticators on the ground over there. More fool me.
Was around for that, and even participated in the Trashing of Trafalgar. So more fool me than you!
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
If the UK and the US elections are held during the same year, they may influence each other, just to complicate matters more for bettors. For example, if Trump were to win the Republican nomination before the UK election, that might, to some small extent, damage the Conservative chances. But, were Nikki Haley to win the nomination, that might help the Conservatives.
Just to be clear, in both cases, I am saying "might", not "would". I want to call attention to possible interactions not, as yet, discuss possible scenarios.
(For the record: Haley is one of the possible Republican candidates I consider qualified to be president, unlike Trump, DeSantis, and Noem.)
Haley has about as much chance of being GOP nominee as Hunt has of being the next Tory leader.
Whoever the GOP nominee or President is will not make the slightest difference to the next UK election result either, we are a different country.
The only British politician close to Trump is Farage anyway, who is neither Tory nor Labour
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
The serious political debauchery of the NHS as religion nonsense is all tory - AV ref, lies on a bus, clap for carers.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
I don't agree. The clinical side has generally been fair to good for as long as I've known it, and it's only now that real horror stories like Northern Monkey's have become common (of course any system has the occasional disaster). The problem was the immense waiting time both for A&E and for non-urgent operations - typically two years. We did (by diverting spending and raising NI by 1p) get the A&E time down to 4 hours (still too long IMO) and the non-urgent ops down to 18 Months (good enough IMO). They are now back to "who knows?" and "2 years" respectively.
As we embark upon a season of something less than full bipartisanship in Our (if not your) Nation's Capital, take a gander at this picture, taken of a group of young men playing cards at a US Army hospital shortly after WW2/
Two of whom would soon embark upon political careers in their home states, that would see them both elected to multiple terms in the US Senate and to top leadership in Congress.
Each representing a different political party, and from very different but equally American states. They were frequent opponents, occasional allies, and lifelong friends.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
I was going to say you've got me. Then I read this.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
The serious political debauchery of the NHS as religion nonsense is all tory - AV ref, lies on a bus, clap for carers.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
To blame for the horrendous state of the NHS, not the suicide. If your explanation for the perilous collapse in service delivery in recent years is "Labour" then you are bonkers.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
Regulation drives behaviour. The Johnson government had a few decent ideas on this front, but then dilute / abandon execution with pressure from their friends. People need to drink less alcohol, eat less sat fats, salt & sugar, and exercise more. Its not remotely about promoting diet or what to eat. Just education about what they are doing.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
2. Yes, I sort of agree, though I am somewhat suspicious of creating another big 'national' anything. In the short term, way, way more capacity needs to be created for recuperation/nursing homes, for those whose NHS treatment has ended but who aren't well enough to be sent home. The focus of these should be excellent food, getting strength back to live independently etc. This could be paid for by axing a lot of NHS administration as per 3., which I also agree with. 4. If the NHS were user-driven, hospitals would appear where there was a 'market' for them, like supermarkets. Some big 'superhospitals', some small local ones. Provision is best allocated this way. Even if the NHS remains free ultimately, it is vital that a form of financial exchange and customer choice rules - that each user has a theoretical 'pot' of money that follows them, and hospitals must attract customers like any other organisation. That's the only way things will really improve.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
If adding minerals to bread is adulterating bread, why is adding minerals to soil not adulterating the soil?
How much pressure would be taken off the NHS by ceasing to put calcium in bread? Presumably it would increase the incidence of calcium deficiency problems like osteoporosis, so it must be doing a serious amount of damage elsewhere to make discontinuing it net positive.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
Regulation drives behaviour. The Johnson government had a few decent ideas on this front, but then dilute / abandon execution with pressure from their friends. People need to drink less alcohol, eat less sat fats, salt & sugar, and exercise more. Its not remotely about promoting diet or what to eat. Just education about what they are doing.
As I said, saturated fats have already dropped massively from poorer peoples' diets. This hasn't resulted in a fall in the conditions associated (largely falsely) with saturated fat consumption. Coconut oil is a saturated fat - do you think we should all consume less coconut oil? This is what I mean by dietary advice or regulation being more harmful than good when it's based on false premises.
I also don't really agree on salt, though white table salt is nasty stuff - 'less salt' is an oversimplification. All mammals need salt, hence you have to give horses and cows their salt lick.
Processed sugar and alcohol I do agree on, but I don't think minimum alcohol pricing has really worked in Scotland (I don't know the latest stats), nor do I think Government information campaigns particularly work.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
2. Yes, I sort of agree, though I am somewhat suspicious of creating another big 'national' anything. In the short term, way, way more capacity needs to be created for recuperation/nursing homes, for those whose NHS treatment has ended but who aren't well enough to be sent home. The focus of these should be excellent food, getting strength back to live independently etc. This could be paid for by axing a lot of NHS administration as per 3., which I also agree with. 4. If the NHS were user-driven, hospitals would appear where there was a 'market' for them, like supermarkets. Some big 'superhospitals', some small local ones. Provision is best allocated this way. Even if the NHS remains free ultimately, it is vital that a form of financial exchange and customer choice rules - that each user has a theoretical 'pot' of money that follows them, and hospitals must attract customers like any other organisation. That's the only way things will really improve.
I disagree with marketising it - so much of the problem is pointless competition. But the big hospital / small hospital model does work. My dad went into hospital in November after a series of falls. Goes into the community hospital in Banff. When his condition worsened they transferred him to Aberdeen.
Teesside needs something similar. So much aggro down there about having a Big Hospital in each town. Both Hartlepool and Stockton have crumbling old facilities. Plan was to build a new hospital to serve both. Uproar. In reality they should have Pools Stockton AND Boro together - better to consolidate services and specialisms than retain the old crumbling hospitals as they have done.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
I agree with all of those - though on the last I do think it is reasonable for all towns of a decent size to have their own proper A&E facilities. There are too many population centres now where A&E is too far away to be effective even if there is a proper ambulance service running - which often there is not.
But even with all the things you mention, we still have a model for funding and delivery of medical services which is ultimately unfit for purpose. We need far more use of insurance by those who can afford it - including compulsory medical insurance provided by businesses over a certain size as part of remuneration packages. We also need to break the gatekeeper role of GPs and allow people to directly access services for specific medical conditions. This is the model in much of Europe and it works far more effectively. There are many other things we ned to do but none of them will happen if we persist with the lie that our health system is 'the best in the world'.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
I don't agree. The clinical side has generally been fair to good for as long as I've known it, and it's only now that real horror stories like Northern Monkey's have become common (of course any system has the occasional disaster). The problem was the immense waiting time both for A&E and for non-urgent operations - typically two years. We did (by diverting spending and raising NI by 1p) get the A&E time down to 4 hours (still too long IMO) and the non-urgent ops down to 18 Months (good enough IMO). They are now back to "who knows?" and "2 years" respectively.
The horror stories have always been there Nick. You just haven't been listening to them.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
If adding minerals to bread is adulterating bread, why is adding minerals to soil not adulterating the soil?
How much pressure would be taken off the NHS by ceasing to put calcium in bread? Presumably it would increase the incidence of calcium deficiency problems like osteoporosis, so it must be doing a serious amount of damage elsewhere to make discontinuing it net positive.
For several reasons. 1. Chewing on chalk isn't a particularly good/easy way to absorb calcium. If it was anything like as easy to absorb calcium like that, we wouldn't have developed other ways to do it over thousands of years. Dairy is of course a far better source. 2. Calcium alone doesn't strengthen bones; it gives them a powdery bulk, much like chalk itself, but to give them tensile strength you meed magnesium, and vitamins D and K are also very important in the process. So just shoving food full of chalk grossly oversimplifies a complex nutritional process. Obviously the calcium in dairy or other natural foods is balanced out with its other biochemical accompaniments naturally - or should be. 3. Excess calcium flowing around the blood isn't necessarily a good thing - deposits that clog up arteries are actually largely made from calcium.
But even with all the things you mention, we still have a model for funding and delivery of medical services which is ultimately unfit for purpose. We need far more use of insurance by those who can afford it - including compulsory medical insurance provided by businesses over a certain size as part of remuneration packages. We also need to break the gatekeeper role of GPs and allow people to directly access services for specific medical conditions. This is the model in much of Europe and it works far more effectively. There are many other things we ned to do but none of them will happen if we persist with the lie that our health system is 'the best in the world'.
1) make it easier for small companies to provide health insurance from payroll 2) change health insurance so that it is tax exempt when paid via payroll (it's currently BIK so taxed)
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Great post Rochdale.
I agree. Great to see someone put their balls on the line and offer a positive solution.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
If adding minerals to bread is adulterating bread, why is adding minerals to soil not adulterating the soil?
How much pressure would be taken off the NHS by ceasing to put calcium in bread? Presumably it would increase the incidence of calcium deficiency problems like osteoporosis, so it must be doing a serious amount of damage elsewhere to make discontinuing it net positive.
For several reasons. 1. Chewing on chalk isn't a particularly good/easy way to absorb calcium. If it was anything like as easy to absorb calcium like that, we wouldn't have developed other ways to do it over thousands of years. Dairy is of course a far better source. 2. Calcium alone doesn't strengthen bones; it gives them a powdery bulk, much like chalk itself, but to give them tensile strength you meed magnesium, and vitamins D and K are also very important in the process. So just shoving food full of chalk grossly oversimplifies a complex nutritional process. Obviously the calcium in dairy or other natural foods is balanced out with its other biochemical accompaniments naturally - or should be. 3. Excess calcium flowing around the blood isn't necessarily a good thing - deposits that clog up arteries are actually largely made from calcium.
When my son had anaemia, one of the things we were told by the specialist was that he should not drink milk (he drank a lot of it) with his meals. The claim was that calcium prevented the uptake of iron. We followed the advise as part of the treatment and his anaemia eventually disappeared though how much that particular aspect was responsible I am not sure.
A football match between Greenock Morton FC, the closest professional club to Faslane where the Royal Navy’s Trident submarines are based, and Nottingham Forest, would be the Deterrence-Trent Derby.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
2. Yes, I sort of agree, though I am somewhat suspicious of creating another big 'national' anything. In the short term, way, way more capacity needs to be created for recuperation/nursing homes, for those whose NHS treatment has ended but who aren't well enough to be sent home. The focus of these should be excellent food, getting strength back to live independently etc. This could be paid for by axing a lot of NHS administration as per 3., which I also agree with. 4. If the NHS were user-driven, hospitals would appear where there was a 'market' for them, like supermarkets. Some big 'superhospitals', some small local ones. Provision is best allocated this way. Even if the NHS remains free ultimately, it is vital that a form of financial exchange and customer choice rules - that each user has a theoretical 'pot' of money that follows them, and hospitals must attract customers like any other organisation. That's the only way things will really improve.
I disagree with marketising it - so much of the problem is pointless competition. But the big hospital / small hospital model does work. My dad went into hospital in November after a series of falls. Goes into the community hospital in Banff. When his condition worsened they transferred him to Aberdeen.
Teesside needs something similar. So much aggro down there about having a Big Hospital in each town. Both Hartlepool and Stockton have crumbling old facilities. Plan was to build a new hospital to serve both. Uproar. In reality they should have Pools Stockton AND Boro together - better to consolidate services and specialisms than retain the old crumbling hospitals as they have done.
I felt that you probably wouldn't go along with the market idea, but you work for the supermarket sector right? Your industry deals with all the challenges it gets, and manages to provide massive consumer choice, and exceptional value (some of the cheapest and best supermarket food in the world). Competition does that. The power of the consumer to go elsewhere for their weekly shop does that. Consumers of the NHS do pay for the service, but because it's indirect, there's no incentive to make sure the old biddie is eating or taking her pills, or to hurry to clean up the old git who has just pissed himself. Restaurants live or die by TripAdvisor - where is HospitalAdvisor?
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
My friend is a doctor in the German healthcare system. He is complaining about stresses on the system due to Covid etc, but I think what we have in the UK goes beyond that to outright collapse. I think the basic issue is that there is no resilience in the UK system. Recently the NHS has been just about coping; now it no longer can. Other systems have a bit more resilience.
I don't have any insistence on the NHS as a preferred delivery model - other countries have at least as good insurance based systems - but I would be extremely wary of changing the model as the solution to current problems. That's likely to make things even worse in the short to medium term. The root causes are in the funding and policy decisions, I think.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
During and after the banking crisis I was contracting at Citi Group.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
In my experience, reducing layers of management never seems to involve taking out those layers near the top for some strange reason.
In related news, water is wet and the Pope is Catholic.
A suggestion - the late pope, when canonised, becomes the patron saint of Anti-Tank missile users?
Is canonisation just expected now? It's getting very early Roman Emperor-esque.
In fairness they do share a title with many of them.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
Very interesting thoughts. Here's where I diverge:
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
If adding minerals to bread is adulterating bread, why is adding minerals to soil not adulterating the soil?
How much pressure would be taken off the NHS by ceasing to put calcium in bread? Presumably it would increase the incidence of calcium deficiency problems like osteoporosis, so it must be doing a serious amount of damage elsewhere to make discontinuing it net positive.
For several reasons. 1. Chewing on chalk isn't a particularly good/easy way to absorb calcium. If it was anything like as easy to absorb calcium like that, we wouldn't have developed other ways to do it over thousands of years. Dairy is of course a far better source. 2. Calcium alone doesn't strengthen bones; it gives them a powdery bulk, much like chalk itself, but to give them tensile strength you meed magnesium, and vitamins D and K are also very important in the process. So just shoving food full of chalk grossly oversimplifies a complex nutritional process. Obviously the calcium in dairy or other natural foods is balanced out with its other biochemical accompaniments naturally - or should be. 3. Excess calcium flowing around the blood isn't necessarily a good thing - deposits that clog up arteries are actually largely made from calcium.
When my son had anaemia, one of the things we were told by the specialist was that he should not drink milk (he drank a lot of it) with his meals. The claim was that calcium prevented the uptake of iron. We followed the advise as part of the treatment and his anaemia eventually disappeared though how much that particular aspect was responsible I am not sure.
Minerals and vitamins affect each other vastly. That's why a well formulated multivitamin will not just have '100% RDA' of everything in it, because they cancel each other out, or need to be present more for another one to be absorbed, etc. etc.
A football match between Greenock Morton FC, the closest professional club to Faslane where the Royal Navy’s Trident submarines are based, and Nottingham Forest, would be the Deterrence-Trent Derby.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
2. Yes, I sort of agree, though I am somewhat suspicious of creating another big 'national' anything. In the short term, way, way more capacity needs to be created for recuperation/nursing homes, for those whose NHS treatment has ended but who aren't well enough to be sent home. The focus of these should be excellent food, getting strength back to live independently etc. This could be paid for by axing a lot of NHS administration as per 3., which I also agree with. 4. If the NHS were user-driven, hospitals would appear where there was a 'market' for them, like supermarkets. Some big 'superhospitals', some small local ones. Provision is best allocated this way. Even if the NHS remains free ultimately, it is vital that a form of financial exchange and customer choice rules - that each user has a theoretical 'pot' of money that follows them, and hospitals must attract customers like any other organisation. That's the only way things will really improve.
I disagree with marketising it - so much of the problem is pointless competition. But the big hospital / small hospital model does work. My dad went into hospital in November after a series of falls. Goes into the community hospital in Banff. When his condition worsened they transferred him to Aberdeen.
Teesside needs something similar. So much aggro down there about having a Big Hospital in each town. Both Hartlepool and Stockton have crumbling old facilities. Plan was to build a new hospital to serve both. Uproar. In reality they should have Pools Stockton AND Boro together - better to consolidate services and specialisms than retain the old crumbling hospitals as they have done.
I felt that you probably wouldn't go along with the market idea, but you work for the supermarket sector right? Your industry deals with all the challenges it gets, and manages to provide massive consumer choice, and exceptional value (some of the cheapest and best supermarket food in the world). Competition does that. The power of the consumer to go elsewhere for their weekly shop does that. Consumers of the NHS do pay for the service, but because it's indirect, there's no incentive to make sure the old biddie is eating or taking her pills, or to hurry to clean up the old git who has just pissed himself. Restaurants live or die by TripAdvisor - where is HospitalAdvisor?
I'm against competition in the NHS because we simply can't afford it. Competition by definition means having surplus capacity. I can't choose Hospital B over Hospital A if B is full. We can't afford to provide the basics in terms of capacity, so how do we move to having a surplus?
Weeeeeeel, we could use the private sector. There is a lack of capacity in the NHS and medical beds which can be rented as required. It was the New Labour solution to the previous Tory NHS crisis - pay the private sector to reduce the waiting lists. And we could do more of that - but how many Private Hospital staff are shared with the NHS. Again, we only make that work by having more specialist doctors, and we only get those by investing in training.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The Tories.
Under New Labour satisfaction was the highest ever, waiting lists were at their lowest ever, the 4 week target was hit over 95% of the time. Cancer was guaranteed. People didn't die on hospital beds.
Labour fixed the NHS. The Tories have broken it.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
Nah.
You can bury your head in the sand but it is obviously true and sadly it will only get worse no matter how much money we throw at it.
It is broken, increasingly and comprehensively so. But there is a fix - one that involves the NHS evolving from the mess it is in. Political imagination and bravery by the bucketload also needed: On the menu: 1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively 2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it 3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster 4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
2. Yes, I sort of agree, though I am somewhat suspicious of creating another big 'national' anything. In the short term, way, way more capacity needs to be created for recuperation/nursing homes, for those whose NHS treatment has ended but who aren't well enough to be sent home. The focus of these should be excellent food, getting strength back to live independently etc. This could be paid for by axing a lot of NHS administration as per 3., which I also agree with. 4. If the NHS were user-driven, hospitals would appear where there was a 'market' for them, like supermarkets. Some big 'superhospitals', some small local ones. Provision is best allocated this way. Even if the NHS remains free ultimately, it is vital that a form of financial exchange and customer choice rules - that each user has a theoretical 'pot' of money that follows them, and hospitals must attract customers like any other organisation. That's the only way things will really improve.
I disagree with marketising it - so much of the problem is pointless competition. But the big hospital / small hospital model does work. My dad went into hospital in November after a series of falls. Goes into the community hospital in Banff. When his condition worsened they transferred him to Aberdeen.
Teesside needs something similar. So much aggro down there about having a Big Hospital in each town. Both Hartlepool and Stockton have crumbling old facilities. Plan was to build a new hospital to serve both. Uproar. In reality they should have Pools Stockton AND Boro together - better to consolidate services and specialisms than retain the old crumbling hospitals as they have done.
I felt that you probably wouldn't go along with the market idea, but you work for the supermarket sector right? Your industry deals with all the challenges it gets, and manages to provide massive consumer choice, and exceptional value (some of the cheapest and best supermarket food in the world). Competition does that. The power of the consumer to go elsewhere for their weekly shop does that. Consumers of the NHS do pay for the service, but because it's indirect, there's no incentive to make sure the old biddie is eating or taking her pills, or to hurry to clean up the old git who has just pissed himself. Restaurants live or die by TripAdvisor - where is HospitalAdvisor?
I'm against competition in the NHS because we simply can't afford it. Competition by definition means having surplus capacity. I can't choose Hospital B over Hospital A if B is full. We can't afford to provide the basics in terms of capacity, so how do we move to having a surplus?
Weeeeeeel, we could use the private sector. There is a lack of capacity in the NHS and medical beds which can be rented as required. It was the New Labour solution to the previous Tory NHS crisis - pay the private sector to reduce the waiting lists. And we could do more of that - but how many Private Hospital staff are shared with the NHS. Again, we only make that work by having more specialist doctors, and we only get those by investing in training.
Private hospitals would I suppose be able to offer health services to NHS patients and be reimbursed for so doing.
I only believe in privatisation of 'demand' being a virtue. I am not really interested subcontracting - privatisation of 'supply'. That's not an improvement, and can be the opposite. Channel 4 privatisation, I see no point in, because the consumer is already empowered in that set up.
Which demonstrates how the lying shits have already lost the public. "We have an independent pay review body and its unfair for the nurses to ask for more" is already not supported - because its guff. Doubly so now that the man hiding behind the independent pay review body is ordering them what pay to review.
And still some people support the government and think they are in the right and the nurses in the wrong,.
On Friday I realised I had a load of post for an old lady on my route. I usually see her a couple of times a week at least. She's usually complaining about the late delivery; not because she's getting her post late, but because they're making me work so late
I'd noticed that I hadn't seen her just before or after Christmas, and her mailbox was getting too full to get much more mail into. There were lights on, so I rang her doorbell. The dog barked a lot and I waited. Then I rang again and knocked. The dog barked more and I waited
I then stuffed her mail into her mailbox. The Gardeners' World got in with two cuts to my left index finger
I went over to the Co-Op a few hundred yards down the road and asked if they'd seen her lately because I was a bit worried. I talked to a few people until I chatted to someone whose sister lived a couple of doors down who said she'd let me know
Yesterday, I was just about to deliver her post when she tapped me on the shoulder and wanted to give me a hug because I'd shown concern
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
To blame for the horrendous state of the NHS, not the suicide. If your explanation for the perilous collapse in service delivery in recent years is "Labour" then you are bonkers.
New Labour effectively silenced the voice of patients by abolishing the Community Health Councils.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
I don't agree. The clinical side has generally been fair to good for as long as I've known it, and it's only now that real horror stories like Northern Monkey's have become common (of course any system has the occasional disaster). The problem was the immense waiting time both for A&E and for non-urgent operations - typically two years. We did (by diverting spending and raising NI by 1p) get the A&E time down to 4 hours (still too long IMO) and the non-urgent ops down to 18 Months (good enough IMO). They are now back to "who knows?" and "2 years" respectively.
The A&E time was 4 hours to be treated and discharged or admitted, not to be seen. The Labour target was 18 weeks (not months) from referral to definitive treatment such as surgery. Plenty wrong with that target culture, but both targets were being met above 90% in 2010.
The deterioration in meeting the targets preceeded covid, though that has accelerated the decline:
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
During and after the banking crisis I was contracting at Citi Group.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
In my experience, reducing layers of management never seems to involve taking out those layers near the top for some strange reason.
In related news, water is wet and the Pope is Catholic.
A suggestion - the late pope, when canonised, becomes the patron saint of Anti-Tank missile users?
Is canonisation just expected now? It's getting very early Roman Emperor-esque.
In fairness they do share a title with many of them.
I'm so glad privatisation has seen the end of strikes in the postal service
The strikes are going to be the end of the postal service. No longer being publicly owned, Royal Mail has no right to exist. It needs to earn it.
The real problem is that electronic communications have eclipsed the postal service.
Yes, and this is ongoing. More and more of our suppliers in our house now send their bills by internet, are paid by direct debit and have opted out of paper copies. The Royal Mail has a unique distribution system with unmatched knowledge of its customer base in its staff. They need to find a use for that before it is too late.
The parcel side of things is roaring ahead. The internet age and all that.
The online purchasing of postage is good, I would make some improvements, but overall is very useful.
The collection service - where they collect parcels from you at the doorstep - is surprisingly little known. But is, again excellent.
Letters will die - to a small remaint on the side of a large parcel operation.
I get quite annoyed when I get a letter from my bank or the like - even though it's, supposedly, an online-only bank. I'm assume there's a regulation somewhere that says they need to provide printed copies of certain things once in a while. Last one I got was about 30 pages of A4 neatly folded into a big envelope in order to detail every months charges for something had been £0.00 going back about 8 years.
Handy to have that on file...
Can't be a legal requirement - I get f*ck-all from my bank (Halifax).
This probably means I need to weigh up my annoyance at the odd letter, and my annoyance at dealing with their website to find if there's a tickbox I need to change. Joy...
What you have to watch out for with the Halifax's online is they dupe you into going paperless even if you don't want to. We've got used to it now and it's better for the environment of course (and cheaper for the bank!) but initially we must have inadvertantly opted for it by clicking a 'Continue' button which turned out to mean 'continue to switch to paperless' rather than 'continue with your current arrangement'.
If only Remain had been as sneaky - we could have been voting for 'Leave (the current arrangement in place)' ;-)
The cynical application of nudge theory.
There really should be a law against that. It’s not on.
Which demonstrates how the lying shits have already lost the public. "We have an independent pay review body and its unfair for the nurses to ask for more" is already not supported - because its guff. Doubly so now that the man hiding behind the independent pay review body is ordering them what pay to review.
And still some people support the government and think they are in the right and the nurses in the wrong,.
I don't really know why the Government is involved in nurses' pay. The Government has provided the overall budget, it should surely be for individual trusts to make decisions on remuneration. They have certainly done this in the case of their Chief Execs. Let them make the tough decisions and explain to nurses. It seems they get all the advantages of being arms length and yet all the decisions that come with a potential backlash still have to be taken by Ministers.
What the hell has happened to the NHS? Why is it on its knees?
Someone I know, for reasons I won’t go into, seriously tried to commit suicide yesterday. They took a load of paracetamol and took themselves off somewhere secluded to die. The police helicopter had to find them using the thermal imaging camera.
When they got to hospital they were waiting an hour - an hour - to be triaged, whilst vomiting up blood.
If someone in this position has to wait an hour to be traiged, to have to wait to be given the drugs they need to counteract the paracetamol while vomiting blood, the system is well and truly broken.
Who is going to take responsibility for this and fix it? The NHS is falling apart. It was fine in 2010.
The clinical side of it is falling apart. The administrative side with its Trusts and Chief Execs paid 3 times more than the Prime Minister is in rude health.
Given the amount of administrative stuff that lands on the front end staff, I wouldn’t say that the admin side is in “rude health”
I would say fucked up is more like it.
Lots of administrators create lots of administration.
Only if the administration is allowed to become and end in of itself.
To me, the example of perfect management is when the front line people think
1) everything is working perfectly 2) what does management do?
In case I was being too oblique, of course I agree 100%. The system of organisation in the NHS, with arms length trusts, is a disaster. Why do we have a massive DoH, telling a massive NHS England what to do, who in turn tell massive hospital trusts what to do, who in turn tell clinical staff what to do? Just how do all these pen-pushers help? Any organisation that was paid by its users, not via central grant, would aggressively streamline away the vast majority of them and be no worse for it.
During and after the banking crisis I was contracting at Citi Group.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
In my experience, reducing layers of management never seems to involve taking out those layers near the top for some strange reason.
In related news, water is wet and the Pope is Catholic.
A suggestion - the late pope, when canonised, becomes the patron saint of Anti-Tank missile users?
Is canonisation just expected now? It's getting very early Roman Emperor-esque.
In fairness they do share a title with many of them.
The tender unto Caesar thing is amusing…
When you realise that Caesar was the High Priest of Rome. And the Pope inherited the title.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
To blame for the horrendous state of the NHS, not the suicide. If your explanation for the perilous collapse in service delivery in recent years is "Labour" then you are bonkers.
It's not (and you made good suggestions earlier) - it's that a lot of the reason why health reform is difficult in this country is because the NHS has been made into a political football. Labour is to blame for that - any attempts by a Conservative government to look at any change in the NHS is met with a chorus of "evil Tories trying to destroy the NHS". So we never get any meaningful reform because one party is too scared to do anything while the other is in hoc to its public sector union supporters.
Labour didn't fix it. They just papered over the cracks and deferred the bill to future taxpayers. Under both Labour and the Tories we have had a third rate service that ranks worse than almost every other first world country for actually doing its fundamental job of keeping people alive and making them better. The NHS is a failed institution and has been for decades.
I don't agree. The clinical side has generally been fair to good for as long as I've known it, and it's only now that real horror stories like Northern Monkey's have become common (of course any system has the occasional disaster). The problem was the immense waiting time both for A&E and for non-urgent operations - typically two years. We did (by diverting spending and raising NI by 1p) get the A&E time down to 4 hours (still too long IMO) and the non-urgent ops down to 18 Months (good enough IMO). They are now back to "who knows?" and "2 years" respectively.
The A&E time was 4 hours to be treated and discharged or admitted, not to be seen. The Labour target was 18 weeks (not months) from referral to definitive treatment such as surgery. Plenty wrong with that target culture, but both targets were being met above 90% in 2010.
The deterioration in meeting the targets preceeded covid, though that has accelerated the decline:
So you disagree with those posters that this afternoon are blaming the 23 years of Labour mismanagement and cultural appropriation of the NHS for it's current chaos, whilst the Conservatives have got it broadly right over the last 47 years?
If the plan is for c. 2% pay rises across the public sector in 2023-4, then God help us all. There won't just be strikes, but entire sectors will grind to a stop for lack of staff.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
To blame for the horrendous state of the NHS, not the suicide. If your explanation for the perilous collapse in service delivery in recent years is "Labour" then you are bonkers.
It's not (and you made good suggestions earlier) - it's that a lot of the reason why health reform is difficult in this country is because the NHS has been made into a political football. Labour is to blame for that - any attempts by a Conservative government to look at any change in the NHS is met with a chorus of "evil Tories trying to destroy the NHS". So we never get any meaningful reform because one party is too scared to do anything while the other is in hoc to its public sector union supporters.
This is nothing to do with any of that. This - very simply - is about the government choosing not to pay nurses enough money. That is a political choice, but its a Tory one not a Labour one. Quote a turnaround though in 2 years from people being told to go out clapping for our NHS heroes to people being told the nurses are greedy and if they rely on a foodbank at their own hospital its their own fault.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
To blame for the horrendous state of the NHS, not the suicide. If your explanation for the perilous collapse in service delivery in recent years is "Labour" then you are bonkers.
It's not (and you made good suggestions earlier) - it's that a lot of the reason why health reform is difficult in this country is because the NHS has been made into a political football. Labour is to blame for that - any attempts by a Conservative government to look at any change in the NHS is met with a chorus of "evil Tories trying to destroy the NHS". So we never get any meaningful reform because one party is too scared to do anything while the other is in hoc to its public sector union supporters.
This is nothing to do with any of that. This - very simply - is about the government choosing not to pay nurses enough money. That is a political choice, but its a Tory one not a Labour one. Quote a turnaround though in 2 years from people being told to go out clapping for our NHS heroes to people being told the nurses are greedy and if they rely on a foodbank at their own hospital its their own fault.
That is comfortably above the average wage in the country. I frankly find it hard to believe that someone who has such a salary is dependent on food banks although no doubt they will take free food if it is offered.
I am not saying that this is a fortune or anything. But it is not poverty wages.
The idea that you can manage something as complex as a healthcare system with only centralized management at a national level is ridiculous. If you look at privatized systems from Germany to the US, they have regional management. Managing a huge work force at various skill levels, masses of specialized real estate, continuous capital expenditure with rapid technological improvement is genuine work. The bloat in the NHS is at the hospital and national level, not in the Trusts.
All very true and rational. However, with the NHS, rationality plays little in the decision making process. It's a religion and to advocate radical change - or, Heaven forbid, design a service that puts patients first - will get you burnt at the metaphorical cross.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
So we are back to blaming Aneurin Bevan.
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
Labour was the one who talked about "our" NHS as though it was some sort of political property as well as "you can't trust the Tories" mantra. They also have been the ones that have pinned the myth of the 1948 NHS as the Gold Standard that can't be changed. That has stymied any meaningful attempts at reform.
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
To blame for the horrendous state of the NHS, not the suicide. If your explanation for the perilous collapse in service delivery in recent years is "Labour" then you are bonkers.
It's not (and you made good suggestions earlier) - it's that a lot of the reason why health reform is difficult in this country is because the NHS has been made into a political football. Labour is to blame for that - any attempts by a Conservative government to look at any change in the NHS is met with a chorus of "evil Tories trying to destroy the NHS". So we never get any meaningful reform because one party is too scared to do anything while the other is in hoc to its public sector union supporters.
This is nothing to do with any of that. This - very simply - is about the government choosing not to pay nurses enough money. That is a political choice, but its a Tory one not a Labour one. Quote a turnaround though in 2 years from people being told to go out clapping for our NHS heroes to people being told the nurses are greedy and if they rely on a foodbank at their own hospital its their own fault.
That is comfortably above the average wage in the country. I frankly find it hard to believe that someone who has such a salary is dependent on food banks although no doubt they will take free food if it is offered.
I am not saying that this is a fortune or anything. But it is not poverty wages.
But it’s a career rather than a job, and hence the average alone is insufficient data.
Comments
Let's hope Sunak doesn't go for broke and call a GE to coincide with this year's May locals then.
The response to his thesis (on how to improve efficiency) was an attempt to destroy him, academically, which was snookered by his professor. Who essentially told those involved that he would make them famous.
If only Remain had been as sneaky - we could have been voting for 'Leave (the current arrangement in place)' ;-)
The red wave never arrived, nor did the Russian victory over Ukraine. And that’s just the start of an incredible year in bad prognostication.
https://www.politico.com/news/magazine/2022/12/31/the-worst-political-predictions-of-2022-00074872
To me, the example of perfect management is when the front line people think
1) everything is working perfectly
2) what does management do?
without fundamental reform of the social care system you can't resolve the rest of the problems. I have family that do and have worked in the social care system and it's more broken than the NHS. without fixing it you'll not properly resolve the NHS issues.
On both occasions, because they did not want t pay their war debts...
Unfortunately, their solutions involved taxes going up, which meant their solutions were kyboshed.
And as long as "have something for nothing" is a winning slogan, Britain isn't going to get much better.
My fear is that the moment of payback- where we have to pay something for nothing- has arrived.
Best to adopt inverse-wishcasting (fearcasting?):
1. Sunak to call a snap election in April and win five year mandate amid rumours Labour plans to put VAT on chips.
2. Biden to resign in favour of President Harris, who selects AOC as VP; while GOP crown DJT as their POTUS candidate with Ivanka as VP.
3. Putin challenges Zelenskyy to decide the war by an arm-wrestle, and unexpectedly wins when Zelenskyy falls out of the window. Old eastern-bloc countries immediately leave the EU and join the Russian-led EUski.
4. Arsenal win the Premiership and Man U are relagated having suffered 22 straight defeats in 2023.
After Charlie Prince was told to fuck off, new management realised that there were people whose entire job was attending meetings and compiling PowerPoints from the PowerPoints at said meetings.
In one case, there were two levels above this (of the same) before you hit to real decision makers. There were two levels below before you got to people doing banking.
We joked that each day you could hear the crash as the tower got shorter as a whole floor was knocked out of the building…..
https://www.theguardian.com/world/2023/jan/01/extinction-rebellion-announces-move-away-from-disruptive-tactics
Will upset Dura, I guess.
The errant surveys spooked some candidates into spending more money than necessary, and diverted help from others who otherwise had a fighting chance of winning.
Senator Patty Murray, a Democrat, had consistently won re-election by healthy margins in her three decades representing Washington State. This year seemed no different: By midsummer, polls showed her cruising to victory over a Republican newcomer, Tiffany Smiley, by as much as 20 percentage points.
So when a survey in late September by the Republican-leaning TRAFALGAR Group showed Ms. Murray clinging to a lead of just two points, it seemed like an aberration. But in October, two more Republican-leaning polls put Ms. Murray barely ahead, and a third said the race was a dead heat.
As the red and blue trend lines of the closely watched RealClearPolitics average for the contest drew closer together, news organizations reported that Ms. Murray was suddenly in a fight for her political survival. Warning lights flashed in Democratic war rooms. If Ms. Murray was in trouble, no Democrat was safe.
Ms. Murray’s own polling showed her with a comfortable lead, and a nonprofit regional news site, using an established local pollster, had her up by 13. Unwilling to take chances, however, she went on the defensive, scuttling her practice of lavishing some of her war chest — she amassed $20 million — on more vulnerable Democratic candidates elsewhere. Instead, she reaped financial help from the party’s national Senate committee and supportive super PACs — resources that would, as a result, be unavailable to other Democrats.
https://www.nytimes.com/2022/12/31/us/politics/polling-election-2022-red-wave.html
SSI - Story makes a pretty compelling case. Must admit that yours truly was concerned about Patty Murray's re-election, because of some resemblances between her situation, and that of Sen. Warren Magnuson in 1980, the election that transformed him in a twinkling from a Capitol Hill power broker into a political has-been.
Duh! Should have realized, any "polling" by Trafalgar Group & etc., was likely as legit as a 3-dollar bill.
On the menu:
1. Invest heavily into preventative maintenance. Sure Start, Healthy living, mental health. National Something Service. Will cost a bomb but will deliver more long term as we get healthier and smarter people able to work more productively
2. Create a National Care Service, which removes all the support for adult and elderly social care from the NHS. Treatment of unpaid carers another scandal, treatment of the elderly increasingly a mess, fix it
3. The NHS - cut down by the spinning out of the other parts - refocuses on treatment. Cut all the vulture management levels and competition bullshit, invest in early diagnosis and treatment, get people out of pain and back to productive work faster
4. Consolidate services into clusters. End the stupidity of each town's MP demanding its own full service hospital. Big specialist hospitals give better specialist care for a lower cost. If people have to travel further to visit how is that any different from how us country bumpkins have it already? And it's 2023 - use technology to visit. So don't let SpivCo install tech at bedside then charge a fucking quid per minute to use it.
This was the one where the main GP realised the incentives in the planned vaccination program and got the builders in over Christmas to maximise COVID safe vaccination through put.
At the start of the pandemic, she interpreted the rules on declaring someone as vulnerable as meaning she could do it, and trawled all the patients files (along with her staff) to identify the vulnerable and register them as such.
Later, when the admin staff had little to do, she got them to deliver medication to those sheltering at home.
Another neighbouring GP has been missing in action since COVID started.
The ultimate blame for this lies with Labour - it ramped up the NHS myth for its own political purposes for decade after decade. Political gain over patients lives.
https://georgeforny.com/
SSI - You can still sign up for George Santos emails! And to DONATE!!
I throw fish on the floor.
You do not hit the angry parrot.rr
I'm left to wonder when was the last occasion a UK GE occurred within a month or two of an American Presidential election?
1964 I think. We voted on October 15th and the Americans on November 3rd. The Government changed in the UK as Wilson's Labour won a narrow majority but Lyndon Johnson remained US President crushing Barry Goldwater 61 to 38.5.
I'll offer 1832 as an example of two elections being held very close together - the UK election was held on 8 December 1832 - 8 January 1833 and saw Earl Grey's Whigs demolish Wellington's Tories. The US election held on November 2nd - December 5th 1832 saw Andrew Jackson win re-election against Henry Clay.
Otherwise as mentioned it will just be another parcel delivery service as letters further decline. Even Amazon use Royal Mail for the final mile, especially in rural areas
as an aside, I'm surprised that the Tories have kept private health insurance as a benefit in kind (and thus taxable) it seems like the kind of policy which would be their way of easing the situation. not that it'd make a difference for too many people but that's not stopped them in the past
I throw fish on the floor.
He waddles and slurs,
A sight to abhor.
He tells tales of lies and deceit,
And his words are always slurred.
He speaks of riches and wealth,
But his actions show they're deferred.
I try to ignore his drunken babble,
But it's hard to ignore his squawk.
He tells me to buy more gin,
But I know that I must walk.
I'll sober him up one day,
But until then I'll endure.
This drunk and deceitful parrot,
My feathered friend, so impure.
I’ll get my coat.
Remember when an administrator at Great Ornand Street was caught sending an email boasting that she had dealt with an attempt to slip administration - by sending redundancy warnings to all the nurses working in children’s oncology….
The high end admins in the NHS are a major part of the new Upper 10,000 - they have very good access to the media.
A suggestion - the late pope, when canonised, becomes the patron saint of Anti-Tank missile users?
There are one or two Tories on here who are so unashamedly myopic that they can pin the blame for everything and anything on all comers bar the Conservatives.
"Political gain over patients lives" now there's a thought. I'll bat that one back and suggest fast track PPE contracts for friends and family is an easier finger point.
(In the last year, I have had one parcel dleivered to the parcel box. A key was left in my regular mail box, which allowed me to open the larger box and retrieve the parcel.)
https://www.bbc.co.uk/news/world-europe-64076981
"Czechoslovakia was divvied up quietly by the federal state's two prime ministers, with no referendum."
Just to be clear, in both cases, I am saying "might", not "would". I want to call attention to possible interactions not, as yet, discuss possible scenarios.
(For the record: Haley is one of the possible Republican candidates I consider qualified to be president, unlike Trump, DeSantis, and Noem.)
And if you want an example of how it gets used by Labour as a political weapon, look no further than today's thread. We have a heartbreaking story of somebody trying to commit suicide and what do we get from certain sections of the left as to who is to blame for it? That's right "The Tories".
Whoever the GOP nominee or President is will not make the slightest difference to the next UK election result either, we are a different country.
The only British politician close to Trump is Farage anyway, who is neither Tory nor Labour
1. Of course healthier people who don't need NHS treatment is ideal. But realistically, the NHS has even less clue how to get people healthy than how to make them better when they get ill. Dietary advice is famously fashion-led, and what we would be likely to get is a lot of promotion of vegetarian and vegan lifestyles that wouldn't make anyone healthier. As an example, poorer people in the UK have radically cut their saturated fat intake in recent years, but health has not improved. The things that would really improve general health are big changes to food staples. Exchanging heat treatment of milk for pressure treatment. Moving away from margarine. Improvements to the mineralisation of soil so that produce is more nutritious. The end of adulteration of bread with chalk. The dietary advice that would help is stuff like kids getting at least one egg a day. Realistically, I don't see this happening. So I agree with the principle but probably not the practise.
Two of whom would soon embark upon political careers in their home states, that would see them both elected to multiple terms in the US Senate and to top leadership in Congress.
Each representing a different political party, and from very different but equally American states. They were frequent opponents, occasional allies, and lifelong friends.
https://en.wikipedia.org/wiki/File:Bob_Dole_and_Daniel_Inouye_at_Percy_Jones_Army_Hospital.jpg
4. If the NHS were user-driven, hospitals would appear where there was a 'market' for them, like supermarkets. Some big 'superhospitals', some small local ones. Provision is best allocated this way. Even if the NHS remains free ultimately, it is vital that a form of financial exchange and customer choice rules - that each user has a theoretical 'pot' of money that follows them, and hospitals must attract customers like any other organisation. That's the only way things will really improve.
How much pressure would be taken off the NHS by ceasing to put calcium in bread? Presumably it would increase the incidence of calcium deficiency problems like osteoporosis, so it must be doing a serious amount of damage elsewhere to make discontinuing it net positive.
I also don't really agree on salt, though white table salt is nasty stuff - 'less salt' is an oversimplification. All mammals need salt, hence you have to give horses and cows their salt lick.
Processed sugar and alcohol I do agree on, but I don't think minimum alcohol pricing has really worked in Scotland (I don't know the latest stats), nor do I think Government information campaigns particularly work.
Teesside needs something similar. So much aggro down there about having a Big Hospital in each town. Both Hartlepool and Stockton have crumbling old facilities. Plan was to build a new hospital to serve both. Uproar. In reality they should have Pools Stockton AND Boro together - better to consolidate services and specialisms than retain the old crumbling hospitals as they have done.
But even with all the things you mention, we still have a model for funding and delivery of medical services which is ultimately unfit for purpose. We need far more use of insurance by those who can afford it - including compulsory medical insurance provided by businesses over a certain size as part of remuneration packages. We also need to break the gatekeeper role of GPs and allow people to directly access services for specific medical conditions. This is the model in much of Europe and it works far more effectively. There are many other things we ned to do but none of them will happen if we persist with the lie that our health system is 'the best in the world'.
1. Chewing on chalk isn't a particularly good/easy way to absorb calcium. If it was anything like as easy to absorb calcium like that, we wouldn't have developed other ways to do it over thousands of years. Dairy is of course a far better source.
2. Calcium alone doesn't strengthen bones; it gives them a powdery bulk, much like chalk itself, but to give them tensile strength you meed magnesium, and vitamins D and K are also very important in the process. So just shoving food full of chalk grossly oversimplifies a complex nutritional process. Obviously the calcium in dairy or other natural foods is balanced out with its other biochemical accompaniments naturally - or should be.
3. Excess calcium flowing around the blood isn't necessarily a good thing - deposits that clog up arteries are actually largely made from calcium.
Not because of a strike backlog - we did have lots old Christmas cards to deliver, but hardly any parcels
What we had on the 28th was hundreds of travel brochures
In this particular area we also had loads of Marlborough College summer school brochures
I had over a hundred of them, each over half an inch thick
I also climbed over a hundred flights of stairs that day
I had a thirteen hour shift
2) change health insurance so that it is tax exempt when paid via payroll (it's currently BIK so taxed)
https://twitter.com/thhamilton/status/1609610006722232320
I don't have any insistence on the NHS as a preferred delivery model - other countries have at least as good insurance based systems - but I would be extremely wary of changing the model as the solution to current problems. That's likely to make things even worse in the short to medium term. The root causes are in the funding and policy decisions, I think.
In fairness they do share a title with many of them.
Weeeeeeel, we could use the private sector. There is a lack of capacity in the NHS and medical beds which can be rented as required. It was the New Labour solution to the previous Tory NHS crisis - pay the private sector to reduce the waiting lists. And we could do more of that - but how many Private Hospital staff are shared with the NHS. Again, we only make that work by having more specialist doctors, and we only get those by investing in training.
I only believe in privatisation of 'demand' being a virtue. I am not really interested subcontracting - privatisation of 'supply'. That's not an improvement, and can be the opposite. Channel 4 privatisation, I see no point in, because the consumer is already empowered in that set up.
Government plans to order "independent" pay body to cap rises in the NHS at 2% for 2023-4.
https://www.theguardian.com/society/2023/jan/01/nhs-unions-2-pay-rise-next-year-could-mean-more-strikes
And still some people support the government and think they are in the right and the nurses in the wrong,.
On Friday I realised I had a load of post for an old lady on my route. I usually see her a couple of times a week at least. She's usually complaining about the late delivery; not because she's getting her post late, but because they're making me work so late
I'd noticed that I hadn't seen her just before or after Christmas, and her mailbox was getting too full to get much more mail into. There were lights on, so I rang her doorbell. The dog barked a lot and I waited. Then I rang again and knocked. The dog barked more and I waited
I then stuffed her mail into her mailbox. The Gardeners' World got in with two cuts to my left index finger
I went over to the Co-Op a few hundred yards down the road and asked if they'd seen her lately because I was a bit worried. I talked to a few people until I chatted to someone whose sister lived a couple of doors down who said she'd let me know
Yesterday, I was just about to deliver her post when she tapped me on the shoulder and wanted to give me a hug because I'd shown concern
I hope they don't get rid of us
The deterioration in meeting the targets preceeded covid, though that has accelerated the decline:
Sigh.
There really should be a law against that. It’s not on.
When you realise that Caesar was the High Priest of Rome. And the Pope inherited the title.
There won't just be strikes, but entire sectors will grind to a stop for lack of staff.
That is comfortably above the average wage in the country. I frankly find it hard to believe that someone who has such a salary is dependent on food banks although no doubt they will take free food if it is offered.
I am not saying that this is a fortune or anything. But it is not poverty wages.