The BBC reporting has, typically, been cautious, but I do get the impression their live text people have been talking up things shifting, including yesterday talking up a guy saying McCarthy couldn't count on his vote (he could so far today) and how McCarthy was further away than ever from getting the gig.
It's obviously an uninviting offer for McCarthy, but as he stares down an eighth vote that he is all but certain to lose, he may soon reconsider his options.
The likes of the Mail and the Sun are going to spend time and treasure trying to find out who the woman who turned Harry into a man is. Anyone who has a snippet of info can name their price. Fortunes will be made and reputations tarnished. Harry has probably saved the very papers he hates!
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Well that just might be the utterly awful innuendo of the passage.
It all sounds made up by people who don't know how English life works, like, say, Meg and the ghostwriter. 97.5% of women at that level of society love horses very much so you don't have to specify, arse is not spelled like that, English pubs are not California bars - if it is dark enough to shag outside it's winter, and they are not a credible venue for this episode. It's house party stuff.
Reminds me of the tale of a Tory MP being caught having al fresco sex with a guardsman in Green Park when Churchill was PM.
Churchill is told about it and says, "You mean last night? It's the middle of winter - coldest night of the year wasn't it?"
His aide confirms it was indeed last night and the weather was as described.
"Makes you proud to be British" says the PM.
I seem to recall a story about a couple being arrested for outdoor sex in mid winter during Covid lockdown - if so, it shows our generation is still matching the past.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
I am sure Max will be along very soon to correct his earlier mistake.
That's 2019, what does 2022 look like?
Healthcare spending is distorted from 20 onwards, so 19 is likely our best metric until we get 23 or even 24 figures.
But the government isn't cutting spending, it's increasing it from COVID levels.
Sure, to paper over the cracks of past underspend and mis-management. How much is being spent on agency staff because we don't pay enough to permanent staff or can't get the numbers due to lack of training places? How much spent managing old, inefficient buildings because we haven't invested in modern facilities?
Yes lack of investment drives higher running costs. My city has 3 hospitals, each with acute services, so each needing on call teams across a variety of specialities. For about 30 years there have been plans to rebuild and consolidate on two sites. There have been a number of proposals, all reaching the design stage and then falling at the funding stage, so gets abandoned.
A couple of years later new proposals are raised, though increasingly hard to get clinician engagement, as bitter experience is that these too will be abandoned. The current SMT has a more evolutionary approach, refurbishing obsolete estate, and gradually shifting departments. We plod on on a building site, hampered by unsuitable buildings. There will still be 3 hospitals here when I retire.
In part because politicians, local and national, would step in "to save our hospital"
Incidentally, what is your opinion of the sprawling mess that some hospital sites are? I've walked miles in some to get to from the entrance to the ward.
Wouldn't hi-rise with a pile of big lifts be better?
That has been a problem, and still is. One of our hospitals opened in 1905 as the North Evington Poor Law Infirmary, now known as the Leicester General Hospital. There are political problems closing it (it used to be Keith Vaz's constituency!) but the bigger problems closing it are practical, in that none of the proposed replacement schemes on the other sites ever replaces like with better, or even like with like. We need more beds and operating theatres and clinics, not fewer, but they are always shaved off to meet the budget.
The core of LGH is the Victorian hospital, with a central spine, and wards radiating. This was done in line with infection control in pre-antibiotic times. In addition there are a higgledy piggly additions dating from the 1950s (full of asbestos...) through to some pre-fab operating theatres put up 10 years ago. It is a sprawling mess, and expensive to maintain and staff. Popular with staff and patients though as possible to park, an advantage of a sprawling site.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Well that just might be the utterly awful innuendo of the passage.
It all sounds made up by people who don't know how English life works, like, say, Meg and the ghostwriter. 97.5% of women at that level of society love horses very much so you don't have to specify, arse is not spelled like that, English pubs are not California bars - if it is dark enough to shag outside it's winter, and they are not a credible venue for this episode. It's house party stuff.
Reminds me of the tale of a Tory MP being caught having al fresco sex with a guardsman in Green Park when Churchill was PM.
Churchill is told about it and says, "You mean last night? It's the middle of winter - coldest night of the year wasn't it?"
His aide confirms it was indeed last night and the weather was as described.
"Makes you proud to be British" says the PM.
I seem to recall a story about a couple being arrested for outdoor sex in mid winter during Covid lockdown - if so, it shows our generation is still matching the past.
I mean, it doesn’t always have to involve removing all clothes does it.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Harry strikes me as the sort of person who, if he can't get exactly what he wants when he wants it, will try and destroy and bring down everyone else around him.
I am not sure he used to be like this.
Are you sure you are not confusing Harry with Boris Johnson?
The BBC reporting has, typically, been cautious, but I do get the impression their live text people have been talking up things shifting, including yesterday talking up a guy saying McCarthy couldn't count on his vote (he could so far today) and how McCarthy was further away than ever from getting the gig.
It's obviously an uninviting offer for McCarthy, but as he stares down an eighth vote that he is all but certain to lose, he may soon reconsider his options.
American politicians are much more confidently tenacious than ours. Even in the depths of the meaningful Brexit votes the likes of Steve Baker and Johnson were at least publicly agonising, and people shifted positions under pressure constantly.
Harry strikes me as the sort of person who, if he can't get exactly what he wants when he wants it, will try and destroy and bring down everyone else around him.
I am not sure he used to be like this.
Reckon if we were still in medieval times this is the sort of scenario that would have resulted in an attempt to usurp the throne. On the basis that Harry would probably have made the more fun guy to go hunting with, he'd have had the support of a fair number of the great nobles too.
You could probably get Philippa Gregory to re-write the whole thing as set in the late medieval period and it would be a whole lot of fun. Not so much as a reality documentary though.
Is the media strategy to tell all the stories in a rush now, so that they'll be nothing left for the media to pry about for the rest of his life? Not sure it works like that.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
The likes of the Mail and the Sun are going to spend time and treasure trying to find out who the woman who turned Harry into a man is. Anyone who has a snippet of info can name their price. Fortunes will be made and reputations tarnished. Harry has probably saved the very papers he hates!
They will put their finest Things which never happened teams on to it.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
The same is true of the BBC and every other provider of public services that uses this model. The incentive gies the wrong way, and I have been saying this here for many years.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
The BBC reporting has, typically, been cautious, but I do get the impression their live text people have been talking up things shifting, including yesterday talking up a guy saying McCarthy couldn't count on his vote (he could so far today) and how McCarthy was further away than ever from getting the gig.
It's obviously an uninviting offer for McCarthy, but as he stares down an eighth vote that he is all but certain to lose, he may soon reconsider his options.
American politicians are much more confidently tenacious than ours. Even in the depths of the meaningful Brexit votes the likes of Steve Baker and Johnson were at least publicly agonising, and people shifted positions under pressure constantly.
And more cutthroat and aggressive in the media, but a lot better behaved in the chamber
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
I have not been paying much attention to the Harry and Meghan saga, but I just saw he has revealed that he and William both asked Charles not to marry Camilla. I reckon that is by far the worst revelation he has made (that I am aware of anyway). It crosses a line. That kind of stuff really should be kept private.
The great (or terrible) thing about this saga is you don't have to pay attention, as the juicy stuff will get reported widely enough to pick up anyway.
I'd be interested in the context of that remark, as I'm not sure why he would include that sort of detail, as while there are plenty of people who do not like Camilla, it doesn't seem to add to his own heroic/martyr narrative to spill the beans about telling his dad not to marry the love of his life, even if it would be understandable for someone to not be a fan of the mistress of their dad.
All rather bad for the institution of course. Either Wills is, rather surprisingly for someone so boring, the kind of bastard who would physically assault his own brother, or Harry is someone who would lie about such a thing - either way, definitely a sign of decades of acrimony to come.
The photo that keeps on giving.
Either from a sense of self preservation or a deep love of the intstitution, I do get the impression Wills is turning into a staunch defender of the old old Firm.
I think people may have underestimated when he was younger just how much it would be drilled into him, as the future heir, what was expected of him, and how much that will have stuck with him. As a result he's much more willing to accept the 'rules'.
Also, Wills has a purpose- it's going to take a while, but eventually he will be King. Harry's last residue of original purpose vanished with the birth of baby George.
We haven't worked out what to do with spare heirs once they become redundant. Accepting that Harry isn't doing this right, he's hardly doing worse than his uncle Andrew.
They've got about ten years to work out what to do with Charlotte and Louis then, if they're going to avoid having another generation fucked up by the institution.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
Or look at the quality of Social Care, which is largely driven by competing providers. Not noted for its high standards or absence of scandals.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
He's polishing his geezer credentials. He's shagged older birds behind the pub, killed 25 taliban and told his old man not to marry his knock off. Then gets beat up by his older brother. Sounds like an Eastenders episode.
He missed out the bit where he beat Chuck Norris in an arm wrestle.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
"A Metropolitan Police officer has admitted using duct tape to restrain a woman.
Appearing via video-link at Kingston Crown Court from HMP Wandsworth, PC Sam Grigg pleaded guilty to charges of false imprisonment and assault occasioning actual bodily harm.
The 36-year-old used duct tape to restrain Natasha Rabinowitz in a house in Twickenham, southwest London, on 2 December last year."
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
The same is true of the BBC and every other provider of public services that uses this model. The incentive gies the wrong way, and I have been saying this here for many years.
The BBC is one of the worlds biggest and most trusted global media brands. You just don’t like the fact it’s not right wing enough.
I have not been paying much attention to the Harry and Meghan saga, but I just saw he has revealed that he and William both asked Charles not to marry Camilla. I reckon that is by far the worst revelation he has made (that I am aware of anyway). It crosses a line. That kind of stuff really should be kept private.
The great (or terrible) thing about this saga is you don't have to pay attention, as the juicy stuff will get reported widely enough to pick up anyway.
I'd be interested in the context of that remark, as I'm not sure why he would include that sort of detail, as while there are plenty of people who do not like Camilla, it doesn't seem to add to his own heroic/martyr narrative to spill the beans about telling his dad not to marry the love of his life, even if it would be understandable for someone to not be a fan of the mistress of their dad.
All rather bad for the institution of course. Either Wills is, rather surprisingly for someone so boring, the kind of bastard who would physically assault his own brother, or Harry is someone who would lie about such a thing - either way, definitely a sign of decades of acrimony to come.
The photo that keeps on giving.
Either from a sense of self preservation or a deep love of the intstitution, I do get the impression Wills is turning into a staunch defender of the old old Firm.
I think people may have underestimated when he was younger just how much it would be drilled into him, as the future heir, what was expected of him, and how much that will have stuck with him. As a result he's much more willing to accept the 'rules'.
Also, Wills has a purpose- it's going to take a while, but eventually he will be King. Harry's last residue of original purpose vanished with the birth of baby George.
We haven't worked out what to do with spare heirs once they become redundant. Accepting that Harry isn't doing this right, he's hardly doing worse than his uncle Andrew.
They've got about ten years to work out what to do with Charlotte and Louis then, if they're going to avoid having another generation fucked up by the institution.
They could train to be opthalmologists in London, that's what the Syrian monarchy (sorry, Republic) did with their spare.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
If real, then respect for being frank I guess, though feels like that level of detail might take away from the core message (I'm guessing that to be that the media are awful, and William a tool).
Internet sleuths can probably start making educated guesses about the pub and year, and start hunting for witnesses.
Yes, what a great idea. Let's start guessing about which woman Prince Harry had sex with in a field. What a shame for voyeurs that he didn't film the whole episode and post it on YouTube.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
Or look at the quality of Social Care, which is largely driven by competing providers. Not noted for its high standards or absence of scandals.
Well exactly. Yes there are downsides to monopolistic public monoliths, but there are also downsides to the opposite.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
Public satisfaction with the NHS was 70% in 2010, its highest ever. The graph is visible here:
I have not been paying much attention to the Harry and Meghan saga, but I just saw he has revealed that he and William both asked Charles not to marry Camilla. I reckon that is by far the worst revelation he has made (that I am aware of anyway). It crosses a line. That kind of stuff really should be kept private.
The great (or terrible) thing about this saga is you don't have to pay attention, as the juicy stuff will get reported widely enough to pick up anyway.
I'd be interested in the context of that remark, as I'm not sure why he would include that sort of detail, as while there are plenty of people who do not like Camilla, it doesn't seem to add to his own heroic/martyr narrative to spill the beans about telling his dad not to marry the love of his life, even if it would be understandable for someone to not be a fan of the mistress of their dad.
All rather bad for the institution of course. Either Wills is, rather surprisingly for someone so boring, the kind of bastard who would physically assault his own brother, or Harry is someone who would lie about such a thing - either way, definitely a sign of decades of acrimony to come.
The photo that keeps on giving.
Either from a sense of self preservation or a deep love of the intstitution, I do get the impression Wills is turning into a staunch defender of the old old Firm.
I think people may have underestimated when he was younger just how much it would be drilled into him, as the future heir, what was expected of him, and how much that will have stuck with him. As a result he's much more willing to accept the 'rules'.
Also, Wills has a purpose- it's going to take a while, but eventually he will be King. Harry's last residue of original purpose vanished with the birth of baby George.
We haven't worked out what to do with spare heirs once they become redundant. Accepting that Harry isn't doing this right, he's hardly doing worse than his uncle Andrew.
They've got about ten years to work out what to do with Charlotte and Louis then, if they're going to avoid having another generation fucked up by the institution.
They could train to be opthalmologists in London, that's what the Syrian monarchy (sorry, Republic) did with their spare.
Well, Labour is talking about training more healthcare professionals, and I'm sure it would be a great boost if they could get the Royal Family to be part of the enterprise.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It’s not simple. Thirteen years of people getting older, fatter, sicker. Not enough investment - measures allowed to creep up such as waiting times etc. and then covid, which would have challenged the 2010 NHS, and now trying to catch up.
But the big one? Social care is fecked, so the hospitals have 12,000, yes 12,000 medically well people on their wards right now.
I see on our local news that at least one hospital is putting patients like this into a hotel. Great. Roll this out nationally and the ambulance issues will disappear.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Harry strikes me as the sort of person who, if he can't get exactly what he wants when he wants it, will try and destroy and bring down everyone else around him.
I am not sure he used to be like this.
Reckon if we were still in medieval times this is the sort of scenario that would have resulted in an attempt to usurp the throne. On the basis that Harry would probably have made the more fun guy to go hunting with, he'd have had the support of a fair number of the great nobles too.
You could probably get Philippa Gregory to re-write the whole thing as set in the late medieval period and it would be a whole lot of fun. Not so much as a reality documentary though.
Is the media strategy to tell all the stories in a rush now, so that they'll be nothing left for the media to pry about for the rest of his life? Not sure it works like that.
He reminds me of George Plantagenet, Duke of Clarence.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
Or look at the quality of Social Care, which is largely driven by competing providers. Not noted for its high standards or absence of scandals.
I frequently notice that my privately run bus simply doesn't show up at all to take me to work.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
If real, then respect for being frank I guess, though feels like that level of detail might take away from the core message (I'm guessing that to be that the media are awful, and William a tool).
Internet sleuths can probably start making educated guesses about the pub and year, and start hunting for witnesses.
Yes, what a great idea. Let's start guessing about which woman Prince Harry had sex with in a field. What a shame for voyeurs that he didn't film the whole episode and post it on YouTube.
I guarantee that is the exact sentence being said in several newspaper offices right now.
The week of the Two Speeches it would seem - Sunak vs Starmer in Wars of the Pledges. I've not heard either speech or read them in much detail. I suspect both were long on platitudes and generalities and short on solutions and specifics.
I'll be honest - I'm of the generation that was young when the NHS was in its prime. Going to the local clinic in the village hall to see my little brother get his jabs is one of my earliest memories. It all seemed so friendly and kind and above all local. I presume it went about the same time as the park keeper and the grass tennis court.
It's increasingly difficult to defend THAT NHS - free at the point of delivery remains a hugely laudable aim and a world in which people are denied medical treatment by their financial situation has no attraction. We come back to the cost of everything and the value of nothing.
It is the unquantified and unquantifiable value of things which is more important than their cost. The NHS has for much of its time provided that value but an ageing population, scattered families and the end of inter-generational houses has had consequences. Who takes care of you if you are old, fall and cannot manage? Your family, if you have one, can't take you as their house is too small and you end up either in care or dependent on the vagaries of domiciliary care.
It is this post-hospital care which is the start of the resolution to this - a clear and robust process for when someone leaves hospital and returns either home or to care or to their family (how about some proper recognition for carers?) so that beds are freed and those in genuine need of hospital care aren't left on trolleys or in ambulances.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Well that just might be the utterly awful innuendo of the passage.
It all sounds made up by people who don't know how English life works, like, say, Meg and the ghostwriter. 97.5% of women at that level of society love horses very much so you don't have to specify, arse is not spelled like that, English pubs are not California bars - if it is dark enough to shag outside it's winter, and they are not a credible venue for this episode. It's house party stuff.
Reminds me of the tale of a Tory MP being caught having al fresco sex with a guardsman in Green Park when Churchill was PM.
Churchill is told about it and says, "You mean last night? It's the middle of winter - coldest night of the year wasn't it?"
His aide confirms it was indeed last night and the weather was as described.
"Makes you proud to be British" says the PM.
I seem to recall a story about a couple being arrested for outdoor sex in mid winter during Covid lockdown - if so, it shows our generation is still matching the past.
Early on in the pandemic, Phil Hammond (the doctor rather than the former Chancellor) suggested positions that maximised the distance between respiratory systems.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
Public satisfaction with the NHS was 70% in 2010, its highest ever. The graph is visible here:
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
No, it is simple demographics that explain why extra funding is needed to stand still. Look at these 4 maps of the population over 65 across the decades:
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
Demand has increased because of an ageing population, and a rising population, and the increase in funding hasn't been enough to keep up. But this demographic data has been in the public domain and competent governance and management would have planned for the increased demand. And, of course, a rising population means a higher tax take, so there's more money to spend.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
No, it is simple demographics that explain why extra funding is needed to stand still. Look at these 4 maps of the population over 65 across the decades:
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
The Dems really should switch en masse to McCarthy*, just for giggles.
(*Or for whoever they agree is the most moderate GOP rep.)
Why? As soon as this ends, Republicans can at least do some setting of the agenda, launch investigations into Biden etc. And they'll do it regardless of which of them is speaker.
There is no real incentive for them to do anything to end this at all. It isn't their responsibility as they aren't the majority, so there is no pressure to do anything - they can just sit back, vote Jeffries as often as they are asked to, and enjoy the show.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
Demand has increased because of an ageing population, and a rising population, and the increase in funding hasn't been enough to keep up. But this demographic data has been in the public domain and competent governance and management would have planned for the increased demand. And, of course, a rising population means a higher tax take, so there's more money to spend.
The demographic transition from a young and growing population with lots of healthy working age people to a much older population, with many more unhealthy retired people, was always going to result in large changes in how we allocated national income. The idea that we might be able to get through the transition and spend the same percentage of national income on health services - regardless of how those health services were organised - is complete denial.
We have to find a way to make this work, because it's the way the entire global population, and therefore the global economy, is heading. More of the labour of working age population will have to be allocated to the care of the elderly. It's just a simple result of the numbers. Or else we have a major change in our moral framework and start culling people once they've had their three-score-and-ten.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Nothing wrong with taking a break, Max. Many of us do from time to time, but if you do, please come back.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
Theory X and Y, innit.
There are people, systems and managers who work best with a clear, even stark, set of incentives- positive and negative.
There are people, systems and managers who work best by sweeping all the incentives off the table- in effect saying "my default is to trust you to do the best you can, how can your manager enable this?"
It's not particularly about right and wrong, but the two systems barely understand each other.
However, the traditional vocational model we have for public services in the UK leans towards system Y. If you want to go system X, you can, and maybe you should. Just expect a lot of your existing staff to leave and your new staff to be awfully expensive to motivate.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
Demand has increased because of an ageing population, and a rising population, and the increase in funding hasn't been enough to keep up. But this demographic data has been in the public domain and competent governance and management would have planned for the increased demand. And, of course, a rising population means a higher tax take, so there's more money to spend.
The demographic transition from a young and growing population with lots of healthy working age people to a much older population, with many more unhealthy retired people, was always going to result in large changes in how we allocated national income. The idea that we might be able to get through the transition and spend the same percentage of national income on health services - regardless of how those health services were organised - is complete denial.
We have to find a way to make this work, because it's the way the entire global population, and therefore the global economy, is heading. More of the labour of working age population will have to be allocated to the care of the elderly. It's just a simple result of the numbers. Or else we have a major change in our moral framework and start culling people once they've had their three-score-and-ten.
Let's spend more. I don't want to be culled in a few years time if it's all the same to you, thanks.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
Demand has increased because of an ageing population, and a rising population, and the increase in funding hasn't been enough to keep up. But this demographic data has been in the public domain and competent governance and management would have planned for the increased demand. And, of course, a rising population means a higher tax take, so there's more money to spend.
The demographic transition from a young and growing population with lots of healthy working age people to a much older population, with many more unhealthy retired people, was always going to result in large changes in how we allocated national income. The idea that we might be able to get through the transition and spend the same percentage of national income on health services - regardless of how those health services were organised - is complete denial.
We have to find a way to make this work, because it's the way the entire global population, and therefore the global economy, is heading. More of the labour of working age population will have to be allocated to the care of the elderly. It's just a simple result of the numbers. Or else we have a major change in our moral framework and start culling people once they've had their three-score-and-ten.
Let's spend more. I don't want to be culled in a few years time if it's all the same to you, thanks.
If one really wanted to be provocative, one could point to the pragmatic attitude to euthanasia of the Swiss as the secret of their healthcare success. I don't think it is that (numbers are too small), but we know that a lot of health spending goes on the last year of life.
The Dems really should switch en masse to McCarthy*, just for giggles.
(*Or for whoever they agree is the most moderate GOP rep.)
Why? As soon as this ends, Republicans can at least do some setting of the agenda, launch investigations into Biden etc. And they'll do it regardless of which of them is speaker.
There is no real incentive for them to do anything to end this at all. It isn't their responsibility as they aren't the majority, so there is no pressure to do anything - they can just sit back, vote Jeffries as often as they are asked to, and enjoy the show.
Biden's approval rating has been improving slowly for a while. This nonsense is doing him no harm at all.
(For those who do not follow these things, the improvement is from dire to merely bad.)
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
Demand has increased because of an ageing population, and a rising population, and the increase in funding hasn't been enough to keep up. But this demographic data has been in the public domain and competent governance and management would have planned for the increased demand. And, of course, a rising population means a higher tax take, so there's more money to spend.
The demographic transition from a young and growing population with lots of healthy working age people to a much older population, with many more unhealthy retired people, was always going to result in large changes in how we allocated national income. The idea that we might be able to get through the transition and spend the same percentage of national income on health services - regardless of how those health services were organised - is complete denial.
We have to find a way to make this work, because it's the way the entire global population, and therefore the global economy, is heading. More of the labour of working age population will have to be allocated to the care of the elderly. It's just a simple result of the numbers. Or else we have a major change in our moral framework and start culling people once they've had their three-score-and-ten.
Let's spend more. I don't want to be culled in a few years time if it's all the same to you, thanks.
A lot easier to do if the economy doesn't have a massive trade deficit, of course.
< No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
First, it isn't - second, there have been plenty of spells when the "Righties" have been in a majority and those on the Left have been in a minority When the main centre-right party is trailing by 20 points it's no real surprise more anti-Government voices but yes, of course, there needs to be challenge and scrutiny of what Labour is proposing as there should be of the Government.
To go back to @MaxPB's point, I don't think anyone is suggesting a US type model in its entirety. In a sense, we have the private medical sector for those who can afford it but we cannot get to a point where people eschew urgent medical treatment because of the cost - they may do so now because they can't afford the time off work but that's a different thing.
I suspect there are elements from a number of different systems of health provision we could borrow. Taking the best of what's out there and utilising it here seems the obvious way forward but we do need to slaughter a sacred cow or two along the way and that's the most difficult part of the debate.
I can't help but notice that, after 13 years of Conservative government, the emerging consensus on here is that the NHS is beyond repair. People seemed reasonably happy with it, despite the grumbles, back in 2010. What on earth has happened, I wonder?
It genuinely is a puzzle. Because as I understanf it the last ten years have seen real terms increases in funding and recruitment. Has the model just finally become unworkable?
No, it is simple demographics that explain why extra funding is needed to stand still. Look at these 4 maps of the population over 65 across the decades:
Boomers f*cked the country? (Or their parents did).
Shift in the expected period 2016-26 is particularly dramatic.
Yes, as per this population pyramid of expected population changes between 2016 and 2041. The population growth in the population is the elderly, and a few teenagers. The working age population is unchanged.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
As a 'Leftie' it doesn't feel that way to me: You, Max, LuckyGuy, AndyJS, Fishing, HYUFD, Leon, WilliamGlen etc. bang the drum for the Right alongside quite a few others.
Given the sticky wicket you're currently batting on I think you hold your own.
In part because politicians, local and national, would step in "to save our hospital"
Incidentally, what is your opinion of the sprawling mess that some hospital sites are? I've walked miles in some to get to from the entrance to the ward.
Wouldn't hi-rise with a pile of big lifts be better?
One hospital I went to with a relative you were directed to walk all the way through the hospital following signs, which was quite a way, and then out the back door to another building entirely in order to get a scan.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
The Dems really should switch en masse to McCarthy*, just for giggles.
(*Or for whoever they agree is the most moderate GOP rep.)
Why? As soon as this ends, Republicans can at least do some setting of the agenda, launch investigations into Biden etc. And they'll do it regardless of which of them is speaker.
There is no real incentive for them to do anything to end this at all. It isn't their responsibility as they aren't the majority, so there is no pressure to do anything - they can just sit back, vote Jeffries as often as they are asked to, and enjoy the show.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
Defending an unpopular Government isn't easy - defending a popular one is much easier.
Apparently (according to various newspaper sites) Harry is bragging (that's what it is, no matter how he says it) about how many Taliban he's killed in Afghanistan . The lad just doesn't know when to shut up.
Never mind that, read this
Prince Harry describes losing his virginity as 'a humiliating episode' In his autobiography, Prince Harry has spoken about how he lost his virginity with an "older lady" who "loved horses very much".
He described the moment as "a humiliating episode" and says it took place "in a field".
The excerpt read: "I mounted her quickly, after which she spanked my ass and held me back… one of my mistakes was letting it happen in a field, just behind a busy pub.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
and to think some people unfairly say that the right have no shame!
In part because politicians, local and national, would step in "to save our hospital"
Incidentally, what is your opinion of the sprawling mess that some hospital sites are? I've walked miles in some to get to from the entrance to the ward.
Wouldn't hi-rise with a pile of big lifts be better?
One hospital I went to with a relative you were directed to walk all the way through the hospital following signs, which was quite a way, and then out the back door to another building entirely in order to get a scan.
I've been into Salisbury hospital today for a scan. It's a WW2 barracks-style hospital added to many times over the years. It's an absolute rabbit-warren - miles of corridors and covered ways connecting the various buildings. Must be really depressing to work in day-in, day-out.
Brilliant staff though - patient, kind, caring and good-humoured.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
How do you know they haven't changed their minds or died? No Tory can support either the current government or any reasonably foreseeable version of a Tory opposition. Meanwhile the leftiest lefty BJO is passionately anti labour. These are strange times.
There are a number of ex-centre right posters who now appear to be centre-left posters. Scott and Sunil spring instantly to mind. Don't think they've moved much. But the situation certainly has. Plus. Our resident Lib Dems don't seem overly anxious to see another Tory-led government. Nor particularly spooked by a Labour one. MoonRabbit possibly the exception.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
How do you know they haven't changed their minds or died? No Tory can support either the current government or any reasonably foreseeable version of a Tory opposition. Meanwhile the leftiest lefty BJO is passionately anti labour. These are strange times.
I've got 40 who've posted or liked something in the last 4 months but done nothing else.
One or two have died, yes. A few more have been perma banned. A very small number three or four have switched to Labour.
In part because politicians, local and national, would step in "to save our hospital"
Incidentally, what is your opinion of the sprawling mess that some hospital sites are? I've walked miles in some to get to from the entrance to the ward.
Wouldn't hi-rise with a pile of big lifts be better?
One hospital I went to with a relative you were directed to walk all the way through the hospital following signs, which was quite a way, and then out the back door to another building entirely in order to get a scan.
I've been into Salisbury hospital today for a scan. It's a WW2 barracks-style hospital added to many times over the years. It's an absolute rabbit-warren - miles of corridors and covered ways connecting the various buildings. Must be really depressing to work in day-in, day-out.
Brilliant staff though - patient, kind, caring and good-humoured.
Built in part for war casualties by the Yanks, hence covered ways big enough to drive Jeep down!
There are a number of ex-centre right posters who now appear to be centre-left posters. Scott and Sunil spring instantly to mind. Don't think they've moved much. But the situation certainly has. Plus. Our resident Lib Dems don't seem overly anxious to see another Tory-led government. Nor particularly spooked by a Labour one. MoonRabbit possibly the exception.
I count myself amongst that number. Ex-Tory member, council candidate etc. I'll likely be dead before the Tories can atone for what they have become, in my eyes.
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
How do you know they haven't changed their minds or died? No Tory can support either the current government or any reasonably foreseeable version of a Tory opposition. Meanwhile the leftiest lefty BJO is passionately anti labour. These are strange times.
I've got 40 who've posted or liked something in the last 4 months but done nothing else.
One or two have died, yes. A few more have been perma banned. A very small number three or four have switched to Labour.
The rest lurking.
I reckon you’ll find the same in May and in 2024 when seeking volunteers to go knocking on voters’ doors….
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
So that’s what SeanT, Byronic, Lady G and others of that ilk have been doing.
There are a number of ex-centre right posters who now appear to be centre-left posters. Scott and Sunil spring instantly to mind. Don't think they've moved much. But the situation certainly has. Plus. Our resident Lib Dems don't seem overly anxious to see another Tory-led government. Nor particularly spooked by a Labour one. MoonRabbit possibly the exception.
If they were genuinely leftwing they would have voted for Corbyn. Anyone can be a glory hunter
In part because politicians, local and national, would step in "to save our hospital"
Incidentally, what is your opinion of the sprawling mess that some hospital sites are? I've walked miles in some to get to from the entrance to the ward.
Wouldn't hi-rise with a pile of big lifts be better?
One hospital I went to with a relative you were directed to walk all the way through the hospital following signs, which was quite a way, and then out the back door to another building entirely in order to get a scan.
I've been into Salisbury hospital today for a scan. It's a WW2 barracks-style hospital added to many times over the years. It's an absolute rabbit-warren - miles of corridors and covered ways connecting the various buildings. Must be really depressing to work in day-in, day-out.
Brilliant staff though - patient, kind, caring and good-humoured.
Built in part for war casualties by the Yanks, hence covered ways big enough to drive Jeep down!
I used the satnav on my phone to get back out - about half the distance I went on the way in, following the signs!
Curiously there's a (relatively) new hospital on the site but it all the old buildings seems to have been kept on and are still in use.
There are a number of ex-centre right posters who now appear to be centre-left posters. Scott and Sunil spring instantly to mind. Don't think they've moved much. But the situation certainly has. Plus. Our resident Lib Dems don't seem overly anxious to see another Tory-led government. Nor particularly spooked by a Labour one. MoonRabbit possibly the exception.
Scott is driven mad by Brexit and that (and only that) explains everything he does.
Sunil is just bonkers.
I can think of two regular Tories who switched to Lib Dem and maybe three to Labour on top.
Harry strikes me as the sort of person who, if he can't get exactly what he wants when he wants it, will try and destroy and bring down everyone else around him.
I am not sure he used to be like this.
Reckon if we were still in medieval times this is the sort of scenario that would have resulted in an attempt to usurp the throne. On the basis that Harry would probably have made the more fun guy to go hunting with, he'd have had the support of a fair number of the great nobles too.
You could probably get Philippa Gregory to re-write the whole thing as set in the late medieval period and it would be a whole lot of fun. Not so much as a reality documentary though.
Is the media strategy to tell all the stories in a rush now, so that they'll be nothing left for the media to pry about for the rest of his life? Not sure it works like that.
Has he covered his years at Eton yet? Bound to be something there to look forward to.....
Keir needs to reform the NHS into a Swiss system. Today he has given himself the room to do that.
Lol, as if. The Swiss healthcare system is fully privatised and insurance based with subsidies offered by the state to low wage workers and unemployed people. Otherwise there is nothing like the NHS in Switzerland, all healthcare providers are privately owned and run for profit and insurers are owned and run privately for profit. There is no scenario where any party will ever propose to switch the UK to Swiss style healthcare, it would mean dismantling the NHS completely, privatising all hospitals and trusts, mandating insurance. It's a non-starter.
That's ultimately what we need Max. NHS is not fit for purpose.
This is true, but significant reform is politically completely impossible, because the vested interests will always accuse you of wanting to Americanise the NHS.
Somebody is going to have to say to Britain:
"The unpalatable truth is that NHS needs fundamental reform. It is broken.
The current political consensus by stasis simply condemns patients to an ever worse system of outcomes. We are witnessing this winter after winter.
All other healthcare systems around the world need to be considered, to discover what they do better than us. We must be able to find elements that will work for us in our system. We need a task force as we had for Covid jabs. The finest minds - think the unthinkable to give us a hugely improved system."
Labour will scream. The healthcare unions will scream. The trusts will scream. But fuck them. They gave got us where we are, whilst refusing to take any responsibility. If somebody can do better, they should be allowed to.
And the worst part of it is that we spend a fucking shit load of money on the NHS, comparable to other nations which have better health outcomes...
Do we ? As a % of GDP, what's the Swiss spend per capita in healthcare; or Germany or France ? From what I can quickly find, it's a bit more than we spend.
For 2019, UK is at 9.9% of GDP, France 11.1%, Switzerland 11.3% and Germany 11.7%.
Yes, it's easy to find those figures, but more difficult to tell whether they are comparing like with like. But it's hard to deny that Switzerland's per capita spending is a lot more than ours.
%GDP is the best comparitor we have. Sure if both Switzerland and the UK spent 11.3% of GDP the nominal Swiss spend per capita would be much higher than the UK's but their Labour costs are correspondingly higher too.
Ignoring the distorting (and temporary) effects of Covid, spending 11%-12% of GDP on health is going to help deliver better outcomes than spending the 10% GDP that the UK historically has.
It's not temporary though, the spending increases on healthcare over COVID haven't been cut back and there is no plan to cut them back. We are spending substantially the same as everywhere else in Europe and not getting anything like those healthcare outcomes.
Anyway, surely you'd prefer an insurance based system, rich people pay more money for better insurance which feeds into capital investment and effective subsidisation of the healthcare by them.
I'd personally have no objection to a universal system of compulsory insurance; I could not support a system that meant you get better cancer treatment, say, by paying higher premiums.
That's why the swiss system works well, broadly everyone gets pretty good healthcare. My wife's insurance package required her to get a GP referral for any specialist treatment so it was a bit cheaper but the GP would always give the referral and the best possible course of action. Some insurance packages which are more expensive allow direct booking for specialists without the GP referral but it's maybe two days extra to get the GP referral and then it's the same specialists in the same hospitals as the person paying much more money.
The point is how efficiently you allocate risk.
Rationing with a monolithic provider certainly can keep procurement costs down but it will carry its own bureaucracy and because it's carrying all the risk for everyone and has to take a one size fits all approach it doesn't really allow people to make their own decisions about where to invest on their own healthcare, or change behaviours, so it doesn't transform outcomes.
The vast majority of European systems have compulsory insurance and pretty much equality of outcomes so I don’t think you’re going to get anyone going down the US route, not least because it’s hideously expensive.
NHS outcomes were reasonable as recently as 2010. We were still a bit behind European peers on cancer survival rates among other things, but it was a value for money health service with high rates of satisfaction.
I don’t see how the funding mechanism is the biggest issue here. The gap with social care is an obvious problem, the dynamic between GPs and hospital care clearly needs fixing and the whole system needs more staff and beds. I don’t see how moving to an insurance based set up changes that, not to mention the doubtless vast cost of change.
Because underperforming hospitals, units and GPs will actually face the prospect of having to close and everyone losing their jobs. The NHS has simply got no recourse to force underperforming healthcare providers to improve. The same failed managers make the same excuses about funding over and over again and patients are on the losing end with worsening healthcare outcomes.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
See the privatised railways, Royal Mail and our water companies for recent newsworthy examples of people being paying customers of previously state run services.
No, that's ridiculous because there's no regional monopolies in healthcare. Patients are free to take their business elsewhere if they receive poor service at a private GP. I can't get a different train to Cardiff in June for our 15 year graduation anniversary reunion, it's GWR or nothing.
You’re seriously suggesting the full fat US model, with its attendant cost?
Great if you can afford it, pretty shit if you’re uninsured.
No? Where have I suggested that? And how do you get to that point from what I posted?
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
Please don't.
The site is dominated by Lefties at the moment and they need challenging.
Tis true, CR, but then you and I have been here long enough to have witnessed the changing composition of the Site. You surely remember when 'the Tory herd' was a thing. Dammit, we've even had infestations of LibDems from time to time.
Swingback doesn't just apply to voting trends. It's built into the Site too.
Oh, absolutely, Peter.
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
How do you know they haven't changed their minds or died? No Tory can support either the current government or any reasonably foreseeable version of a Tory opposition. Meanwhile the leftiest lefty BJO is passionately anti labour. These are strange times.
I've got 40 who've posted or liked something in the last 4 months but done nothing else.
One or two have died, yes. A few more have been perma banned. A very small number three or four have switched to Labour.
The rest lurking.
Four months gets us back to before the Trussterfuck, which rather changed the mood.
Partly, it's not easy to defend a government that makes such an utter Horlicks of things in such a short time. And the remedial measures aren't easy to defend, either. But also... if things were so bad as to justify the gamble that most people accepted Trussonomics was, what does that say about the management of the country 2010-22?
I might not be the right person to say this- I bailed on the blue team (I hope, temporarily) quite a while back; what the party did to TMthePM was the last straw. But this sort of thing happens to political parties all the time. The wise parties work out quickly what needs to be binned while staying true to themselves.
An alleged fugitive fighting extradition to the US is seeking to be freed on bail from a Scottish jail because fellow prisoners are taunting him by singing John Denver’s hit Leaving on a Jet Plane.
Nicholas Rossi, 35, faces extradition to the US over charges of serious sexual assault in Utah, after he was arrested in an intensive care ward in Glasgow following his admission with Covid.
Claiming to be a man called Arthur Knight, Rossi has denied he is an international fugitive wanted by Interpol who has used 16 aliases to evade capture.
Authorities in the state of Rhode Island have sought his arrest for failing to register as a sex offender; he also faces fraud charges in Ohio.
Comments
It's obviously an uninviting offer for McCarthy, but as he stares down an eighth vote that he is all but certain to lose, he may soon reconsider his options.
The core of LGH is the Victorian hospital, with a central spine, and wards radiating. This was done in line with infection control in pre-antibiotic times. In addition there are a higgledy piggly additions dating from the 1950s (full of asbestos...) through to some pre-fab operating theatres put up 10 years ago. It is a sprawling mess, and expensive to maintain and staff. Popular with staff and patients though as possible to park, an advantage of a sprawling site.
You could probably get Philippa Gregory to re-write the whole thing as set in the late medieval period and it would be a whole lot of fun. Not so much as a reality documentary though.
Is the media strategy to tell all the stories in a rush now, so that they'll be nothing left for the media to pry about for the rest of his life? Not sure it works like that.
When people become paying customers of something they will expect a minimum service and GPs making excuses to not see patients or hospitals refusing to discharge people because paperwork isn't correctly signed as happened to someone's parent on PB just doesn't happen because insurance companies withdraw their services and find other providers. The NHS being a monopoly provider of healthcare is why those poor behaviours listed are allowed to continue, patients simply don't have the choice to go elsewhere.
She was always into the Royals, had portraits of them on the walls.
Appearing via video-link at Kingston Crown Court from HMP Wandsworth, PC Sam Grigg pleaded guilty to charges of false imprisonment and assault occasioning actual bodily harm.
The 36-year-old used duct tape to restrain Natasha Rabinowitz in a house in Twickenham, southwest London, on 2 December last year."
https://news.sky.com/story/metropolitan-police-officer-admits-restraining-woman-with-duct-tape-in-a-house-while-off-duty-12780593
https://public.flourish.studio/visualisation/7984847/
Meanwhile Chelsea have agreed a fee with Shack Tar for Mud Rich. Take that tight wad Arsenal #funniestthingever
and then covid, which would have challenged the 2010 NHS, and now trying to catch up.
But the big one? Social care is fecked, so the hospitals have 12,000, yes 12,000 medically well people on their wards right now.
I see on our local news that at least one hospital is putting patients like this into a hotel. Great. Roll this out nationally and the ambulance issues will disappear.
Great if you can afford it, pretty shit if you’re uninsured.
(*Or for whoever they agree is the most moderate GOP rep.)
The week of the Two Speeches it would seem - Sunak vs Starmer in Wars of the Pledges. I've not heard either speech or read them in much detail. I suspect both were long on platitudes and generalities and short on solutions and specifics.
I'll be honest - I'm of the generation that was young when the NHS was in its prime. Going to the local clinic in the village hall to see my little brother get his jabs is one of my earliest memories. It all seemed so friendly and kind and above all local. I presume it went about the same time as the park keeper and the grass tennis court.
It's increasingly difficult to defend THAT NHS - free at the point of delivery remains a hugely laudable aim and a world in which people are denied medical treatment by their financial situation has no attraction. We come back to the cost of everything and the value of nothing.
It is the unquantified and unquantifiable value of things which is more important than their cost. The NHS has for much of its time provided that value but an ageing population, scattered families and the end of inter-generational houses has had consequences. Who takes care of you if you are old, fall and cannot manage? Your family, if you have one, can't take you as their house is too small and you end up either in care or dependent on the vagaries of domiciliary care.
It is this post-hospital care which is the start of the resolution to this - a clear and robust process for when someone leaves hospital and returns either home or to care or to their family (how about some proper recognition for carers?) so that beds are freed and those in genuine need of hospital care aren't left on trolleys or in ambulances.
This is the fucking problem with discussing NHS reform with religious types, any kind of reform is screamed down as "OMG you want the US healthcare system and for poor people to die you Tory scum".
Honestly, I'm done with this shit. I think I'm going to take a break from PB for a while.
https://twitter.com/feedthedrummer/status/1605654450818863104?t=HzXzfb1MvjIER9wgTzIBjg&s=19
If he "mounted" her then, presumably, he did so from behind.
Why would she then turn around afterwards and spank his "ass" - difficult to do during- and then hold him back.
Hold him back from what? Trying a second time?
Shift in the expected period 2016-26 is particularly dramatic.
The site is dominated by Lefties at the moment and they need challenging.
A knee-trembler in the pub car park appeals to all classes.
There is no real incentive for them to do anything to end this at all. It isn't their responsibility as they aren't the majority, so there is no pressure to do anything - they can just sit back, vote Jeffries as often as they are asked to, and enjoy the show.
We have to find a way to make this work, because it's the way the entire global population, and therefore the global economy, is heading. More of the labour of working age population will have to be allocated to the care of the elderly. It's just a simple result of the numbers. Or else we have a major change in our moral framework and start culling people once they've had their three-score-and-ten.
There are people, systems and managers who work best with a clear, even stark, set of incentives- positive and negative.
There are people, systems and managers who work best by sweeping all the incentives off the table- in effect saying "my default is to trust you to do the best you can, how can your manager enable this?"
It's not particularly about right and wrong, but the two systems barely understand each other.
However, the traditional vocational model we have for public services in the UK leans towards system Y. If you want to go system X, you can, and maybe you should. Just expect a lot of your existing staff to leave and your new staff to be awfully expensive to motivate.
I don't want to be culled in a few years time if it's all the same to you, thanks.
Swingback doesn't just apply to voting trends. It's built into the Site too.
(For those who do not follow these things, the improvement is from dire to merely bad.)
To go back to @MaxPB's point, I don't think anyone is suggesting a US type model in its entirety. In a sense, we have the private medical sector for those who can afford it but we cannot get to a point where people eschew urgent medical treatment because of the cost - they may do so now because they can't afford the time off work but that's a different thing.
I suspect there are elements from a number of different systems of health provision we could borrow. Taking the best of what's out there and utilising it here seems the obvious way forward but we do need to slaughter a sacred cow or two along the way and that's the most difficult part of the debate.
Given the sticky wicket you're currently batting on I think you hold your own.
I hope Max stays though!
What we have now is the inverse of what we had here in 2008-2010 with 'the Tory herd'.
I even did an analysis the other day with over forty regulars (ex regular) centre-right posters almost all of whom have now gone back to lurking.
Brilliant staff though - patient, kind, caring and good-humoured.
What was Einstein's definition of madness again?
Don't think they've moved much.
But the situation certainly has.
Plus. Our resident Lib Dems don't seem overly anxious to see another Tory-led government. Nor particularly spooked by a Labour one.
MoonRabbit possibly the exception.
#HenryForKing
One or two have died, yes. A few more have been perma banned. A very small number three or four have switched to Labour.
The rest lurking.
Curiously there's a (relatively) new hospital on the site but it all the old buildings seems to have been kept on and are still in use.
I think she’s written out her speech on her phone
and made the mistake many councillors make of opening by saying they will be brief, and then going on…
Sunil is just bonkers.
I can think of two regular Tories who switched to Lib Dem and maybe three to Labour on top.
Partly, it's not easy to defend a government that makes such an utter Horlicks of things in such a short time. And the remedial measures aren't easy to defend, either. But also... if things were so bad as to justify the gamble that most people accepted Trussonomics was, what does that say about the management of the country 2010-22?
I might not be the right person to say this- I bailed on the blue team (I hope, temporarily) quite a while back; what the party did to TMthePM was the last straw. But this sort of thing happens to political parties all the time. The wise parties work out quickly what needs to be binned while staying true to themselves.
An alleged fugitive fighting extradition to the US is seeking to be freed on bail from a Scottish jail because fellow prisoners are taunting him by singing John Denver’s hit Leaving on a Jet Plane.
Nicholas Rossi, 35, faces extradition to the US over charges of serious sexual assault in Utah, after he was arrested in an intensive care ward in Glasgow following his admission with Covid.
Claiming to be a man called Arthur Knight, Rossi has denied he is an international fugitive wanted by Interpol who has used 16 aliases to evade capture.
Authorities in the state of Rhode Island have sought his arrest for failing to register as a sex offender; he also faces fraud charges in Ohio.
https://www.theguardian.com/uk-news/2023/jan/05/prisoner-fighting-extradition-bullied-by-cellmates-singing-leaving-on-a-jet-plane